Institutional Hurdles Research Articles

Funny Money Circulation and Fabric Exports From China to Dubai Through Indian Trading Networks

Chiefly drawing on my ethnographic fieldwork in the district of Keqiao in Zhejiang Province since 2009, I argue that irregular financial transactions—conceptualized as “funny money” in this article—play a significant role in the sustenance of otherwise tenuous business relations between Indian traders and Chinese suppliers in the China–Dubai fabric trade. Much of the fabric exported from Keqiao to Dubai relies on intertwined formal and informal transactions operated by Indian trading networks. These labyrinthine transnational funny money transactions aim to circumvent institutional hurdles and overcome deficiencies in operating capital, yet inherent to this system is a cycle of payment lags that cause tense relations between payers and payees. Funny money transactions facilitate eventual payment in most cases most of the time and maintain enough trust to keep the trade network alive. Furthermore, the interlocking circuits of funny money also prevent the overaccumulation of wealth and power by any particular stakeholder involved in the international trade and defy or at least circumvent the formal political authority of state and financial institutions that seek to curtail such practices. These transactions thereby create a larger space for business survival among the grassroots players, especially Indian traders who may not have enough capital available when they initiate a deal with a Chinese supplier.

E-Therapy Critical Success Factors: The Immediate Impact of COVID-19

:The overall impact of COVID-19 removed the traditional barriers to e-therapy, creating a seismic shift in attitudes and incentives that allowed therapists to apply virtual meeting technologies in service to their patients’ mental health needs. A post-COVID-19 Delphi study, using the same study design conducted in 2011, found that Internet communication technologies used by patients and therapists, the implementation of secure applications and procedures, and the removal of legal obstacles allowed e-therapy to become an effective treatment option and opened doors to treat more patients. Therapists utilized information technology to enhance patient interactions in remote settings, allowing for more empathy and improved service quality than reported in past studies. A comparison of the findings between the studies conducted in 2020 and 2011 indicates a decline of information system management oversight and suggests that organizational leadership was in tune with common issues facing therapists delivering services under trying circumstances. E-therapy works, but a return to pre-COVID-19 legal restrictions, institutional hurdles, organizational impediments, and technological costs may limit future opportunities to implement and use mobile technologies to provide better treatment for patients.

How non-value added work affects the productivity of healthcare professionals

This paper analyses how non-value added work significantly reduces the productivity of healthcare staff and the service capacity of healthcare systems worldwide. It first describes how the ageing population, manpower shortage and wastefulness in hospitals continuously increase the demand-supply gap. The paper explores the application of lean thinking practised by manufacturing industries in improving healthcare staff productivity to complement the conventional supply, demand and technology solutions. It illustrates the principles and best practices in spotting and stopping the seven lean wastes or ‘muda’, particularly in hospitals. The paper identifies several industry and institutional hurdles in improving productivity. It concludes with recommendations for policymakers, regulators and payers to enjoin healthcare institutions to adopt lean practices in order to improve their capacity, cost performance and patient care quality.

Distributed Ledger Technology Affordances for Financing Sustainable Development

Distributed Ledger Technology (DLT) has been heralded as one of the most significant innovations since the internet. This article explores the applicability of DLT to the issue of financing the UN Sustainable Development Goals (SDGs) by approaching the question of what opportunities DLT presents for aligning investments with SDGs-related outcomes within the financial sector through the concept of affordances. Our qualitative research inquiry combining an exhaustive analysis of practitioner literature and interviews with 15 leading sustainable and responsible investment (SRI) practitioners and 14 actors involved in DLT ventures in Sub-Saharan Africa shows that despite discourse around blockchain technology that focuses on generic perceptions of affordances relating to data transparency, actualization of these affordances within the sustainable finance field is contingent upon a number of socio-cognitive and institutional hurdles. As a result, while discourse around blockchain presents a galvanizing vision for innovation within the financial sector, its direct benefits for mobilizing additional contributions towards the SDGs by private sector investors remain ambiguous.

Barriers to climate change adaptation in indigenous communities: A case study on the mohawk community of Kanesatake, Canada

The switch from climate change mitigation to the adaptation to its impacts or effects initially appears to be a promising strategy. Academics and practitioners, however, confront limits and barriers to the adaptation both in theory and practice. Despite the extensive efforts in understanding limits and barriers, little is still known about political and institutional barriers, more specifically political challenges in Indigenous communities that typically nullify the effect of adaptation strategies. This study investigates the experience of the Mohawk community of Kanesatake, a First Nations community in Canada, during and after the 2017 and the 2019 floods in Quebec. Results reveal the links between the proximate set of barriers and historical, political pressures in Indigenous communities. Findings explain that unhealed wounds in relationships among nations generate political and institutional hurdles, which eventually orchestrate the co-occurrence of multiple barriers: the lack of land ownership rights, insurance, and social institutions such as police force and firefighters, to name a few. Findings have implications both for theory and practice. In theory, the findings reveal the fact that barriers are not mutually exclusive; in fact, they are often interdependent. In practice, findings support the fact that policies fail if they disregard underlying interdependencies.

Design Pedagogy: The New Architectural Studio and Its Consequences

This article argues that the typical architectural studio is both outmoded and irresponsible. It is outmoded because it typically is organized around a nineteenth-century model of design virtuosity, and it is irresponsible because it ignores pressing and current spatial justice problems. It also takes to task the aura of the academic setting in which the formally motivated studio reigns supreme. In lieu of this model of architectural education, the article argues for an education that empowers graduates to tackle the major problems that society currently faces: housing, climate, income inequality/unemployment and health. To do this, it acknowledges but suggests overthrowing the many institutional hurdles keeping architectural education attached to the status quo.

Design of a student-led organizational partnership to host an annual statewide Science Olympiad K-12 outreach tournament.

Since fall 2015, the University of Virginia's (UVA) Engineering Student Council (ESC) has partnered with the nonprofit Virginia Science Olympiad (VASO) organization to host a Science Olympiad (SciOly) state tournament in Charlottesville, Virginia, each spring. This annual tournament brings over 2,000 middle and high school students, teachers, and parents to the UVA campus, and teams of 15-17 people from roughly 90 schools across Virginia participate in 46 different events (23 middle school, Division B; 23 high school, Division C) relating to the science, technology, engineering, and mathematics (STEM) fields throughout the day-long competition. The national SciOly organization sets the events and rules to comply with national education standards, and the VASO board coordinates the teams and tournaments within the state. By collaborating with VASO, UVA ESC was able to plan a large-scale SciOly tournament at UVA in approximately 10 mo with the support of the UVA School of Engineering and Applied Science. Since this event was planned and executed solely by undergraduates in cooperation with the nonprofit organization, there were institutional hurdles that were overcome through the months of planning. The Virginia SciOly state tournament has continued to be held at UVA with the support and cooperation of the UVA ESC and VASO, and bringing this tournament to UVA has allowed for increased excitement for participating K-12 students and a mitigated burden to the VASO organizers in planning the state competition. This paper aims to provide a resource for other universities to support STEM activities in K-12 outreach organizations, like SciOly, in the future.

Policy instruments and barriers to rural tourism development – a case study of cluster in the Liptov touristic region in Slovakia

Tourism industry, in general, and rural tourism specifically is often promoted as a go-to solution to the various problems that rural regions and communities are currently facing. In Slovakia, several policies have been formulated and implemented in order to harness this potential in reality. The main aim of this contribution is to (via an in-depth case study of a tourism cluster in Liptov region in Slovakia) find out the current state of the policy instruments being implemented to promote the development of rural tourism as well as barriers that hinder the effectiveness of said instruments. By means of questionnaire survey and interviews with relevant stakeholders (accommodation providers, representatives of local self-government and support organizations at the local and regional level) we identified both financial and institutional hurdles, but also a difference in opinions of different actors concerned.

Walk tall: The story of Rex Bionics

Executive SummaryWalk tall: The story of REX Bionics is about the key decisions faced by the founders Richard Little and Robert (Robbie) Irving to commercialise a ‘walking skeleton’ for people who are wheelchair-bound for extended periods. The changing role of the founders in a technology-based business and the interplay between the founders’ vision and the reality of growing technology-based businesses is the focus. The history of REX Bionics lies in the founders’ first-hand experiences with people diagnosed with multiple sclerosis. Over 15 years the company evolved from a ‘workshop idea’ in a garage to public listing on the London AIM Stock Exchange. Facing multiple institutional hurdles, rapidly moving technology and high start-up costs, REX Bionics successfully commercialised the walking robotic exoskeleton inspirited by the ‘Power Load’ in the movie Aliens. Little and Irving faced some tough choices about which commercialisation pathways to pursue in the light of diverse perspectives from the board of directors, an advisory board, various investors to their personal mission.

Health care reform in Belgium: contracting for co-creating integrated care as change management strategy

Introduction: The Belgian Health Care Reform: “Integrated Care for a better health” was approved by all competent ministers in 20151. This Plan is based on the principles of Triple Aim2, together with equity and job satisfaction for the care providers. The core strategy of the plan is to drive change in a ‘mixed or guided bottom-up approach’, with large-scale locoregional change piloting projects implemented on and by the field, and government as facilitator. Over the past year, field actors of pilot regions worked together to elaborate an actionplan with local collaborations and initiatives in order to achieve integrated care. Different stakeholders from health care as well as social care are involved including patients and citizens. In the course of the co-creation process between the wide variety of field actors and government several difficulties surfaced, both from the projects and policy perspective. Description of policy context and objective: Belgium has an accessible health care with a national, compulsory health insurance (covering 99% of the population). Fee for Service, fragmented services and lack of coordination and communication make the system inefficient and unsustainable for dealing with multimorbidity. A legislative basis is created to allow pilot regions to test new organizational structures (integration management), work across silo’s and operate in a system of shared savings. Predicted expenditure, for the determined target population is guaranteed as revenue: by increasing efficiency, gains can be reassigned by the project. Target Population: The Plan targets the whole Belgian population with a focus on people with a chronic disease. 14 projects (2.584.824 inhabitants) are selected for implementation as from 1.1.2018. Highlights: Facilitators/barriers for implementation: - Anchoring visionary leadership in governance supported by stakeholder leadership on a national level - A national strategy for ICT system and data management is a priority and prerequisite for projects to be operational (national eHealth plan), and needs specific investment. Needs are identified in co-creation. - Close interaction between authorities and pilots - Dealing with institutional and legal hurdles between regional and federal authorities and the wide range of fractionated competencies in health and social care. - The projects are multi-stakeholder consortia with a mix (of conflicting) interests of partners. The uncertainty of achieving the triple aim makes projects hesitant to take risk for pre-financing innovative actions. Uncertainty on the impact on revenue challenges the confidence so hardly needed in the shift towards integrated care. - Need of social entrepreneurship with a population management scope conflicts with traditional social profit service delivery. Comments on transferability and conclusion: From a healthcare policy perspective, each country system is faced with the same complex process of changing the existing structures and cultures. The Belgian approach combines stimulation of bottom up ideas and entrepreneurship with guidance from the policymakers by setting out the framework for innovation, creating a safe environment for setting down sustainable system change. This takes time: uniting different stakeholders around the same vision, the will to embrace the complexity and to take the plunge.

The Role of Intermediaries in Supporting Local Low-Carbon Energy Initiatives

Recent scholarly attention shows that grassroots civil society low-carbon energy initiatives increasingly become part of the subnational climate change governance landscape. Despite their potency in view of consumer-owned distributed generation and enhanced citizen influence in the organization of the energy infrastructure, local low-carbon energy initiatives (LLCEIs) struggle to become viable alternatives to the centralized, private oriented energy system. To further LLCEI development, support needs to build their capacities; alleviate institutional hurdles and barriers stemming from the fossil fuel-based energy regime; and open up the system for the uptake, acceptance or breakthrough of LLCEIs. Evidence suggests that so-called “intermediaries” form a part of the solution in addressing these issues. Despite previous attempts at analyzing intermediary roles and activities vis-à-vis the development of community energy, the reality of the various roles and strategies intermediaries can employ and the support LLCEIs require to further develop have not yet been synthesized in a comprehensive analytical framework. This article aims to fill this gap by developing such a framework. We reflect on the analytical framework by evaluating the intermediary support structure in a specific case: the Province of Fryslân. From the analysis, we conclude that the Frisian case provided modest support to the claim that intermediary support is effective in addressing the needs of LLCEIs as the strategies and roles observed represent a complete and coherent support structure.

Barriers to pro-environmental behaviours at Bournemouth University

This study investigates the main barriers to pro-environmental behaviours at Bournemouth University (BU). The University is committed to help achieving the UN Sustainable Development Goals and over the years has implemented several activities to improve its sustainability performance covering aspects such as energy and carbon management, recycling, travelling, sustainable and ethical food, ethical purchasing and investment, education for sustainable development, and student and staff engagement in sustainability via the Green Impact scheme run by the National Union of Students (NUS). While most of the activities have been successful, participation to the Green Impact scheme, particularly of staff, has been slow. This research project investigates the main barriers at the university to more participation and engagement in environmental initiatives like the Green Impact. It compares cross-faculty behavioural habits and also investigates what the main barriers are to staff engaging further. The research takes a two-step approach, employing both quantitative and qualitative methods. The first part of the research includes a questionnaire and the second a semi-structured interview with staff at the University of Sheffield who is championing the Green Impact scheme. Surprisingly, results demonstrated that there was no significant difference in behaviours between faculties where staff participated to the Green Impact scheme and faculties where staff did not. Results also showed that the main barriers to pro-environmental behaviours were time, funding, and institutional hurdles, in line with other similar recent research in the field. The semi-structured interview with staff at the University of Sheffield helped in defining possible solutions for BU to increase Green Impact participation and ultimately staff engagement in achieving the Sustainable Development Goals.

Overcome Entrenched Institutional Hurdles to Smart Water Systems

It's vital for the water and wastewater industry to welcome the next generation of water professionals by updating its regulatory framework, certification process, and workforce expectations. Such changes will help bolster the industry's adoption of data analytics and smart technology processes to advance infrastructure renewal.

Signalling, governance, and goals: Reorienting the United States Power Africa initiative

Power Africa, the United States’ effort to boost electrification on the continent launched in 2013, has made an impressive start. Progress toward generation and connections goals are on track. The initiative has catalyzed significant private sector investment, built a diverse portfolio, and embraced a range of technologies including natural gas. Nevertheless, Power Africa faces political and institutional hurdles that threaten its continued success and perhaps its very survival.

Constitutional Dynamics in the European Union: Success, Failure, and Stability of Institutional Treaty Revisions

ABSTRACTDespite high institutional hurdles for constitutional change, one observes surprisingly many EU treaty revisions. This article takes up the questions of what determines whether a treaty provision is successfully changed and why provisions are renegotiated at subsequent Intergovernmental Conferences. The article presents an institutionalist theory explaining success and renegotiation and tests the theory using all core institutional provisions by means of Qualitative Comparative Analysis. The causal analysis shows that low conflict potential of an issue is sufficient for successfully changing the treaties. Furthermore, high conflict potential of an issue and its fundamental change are sufficient for it to be renegotiated.

From ‘Intersex’ to ‘DSD’: a case of epistemic injustice

The 2005 International Consensus Conference on Intersex resulted in a substantive revision of the lexicon and guidelines for treating intersex conditions. The speed with which the new treatment protocol has been adopted by healthcare practitioners and providers is considered unprecedented. However, a number of intersex people and advocacy groups have complained that the recommended revisions are inadequately informed by the testimony of intersex people. In this paper, I argue that such complaints are valid and that, despite the conference conveners stated intention, the revisions perpetuate the epistemic injustice long endured by intersex people. By analyzing the Consensus Conference and its results as a failed attempt to redress the epistemic marginalization of intersex patients and advocacy groups, I am able to identify lingering institutional hurdles to cultivating the virtue of epistemic justice in biomedical practice.

Ecosystem services find their federal footing: A history of the 2008 Farm Bill and 2012 Forest Planning Rule

This paper provides a history of two important federal initiatives that call for ecosystem services analysis to support government decision-making: the Conservation Title of the 2008 Farm Bill and the 2012 US Forest Service9s Forest Planning Rule. The history shows that an ecosystem services-based approach to resource management not only cleared the significant political, legal, and institutional hurdles associated with national legislation and regulatory reform, but also contributed directly to the reforms9 success. However, the history also suggests that it may be difficult to more broadly replicate ecosystem services statutory and regulatory mandates across federal environmental programs.

The Evaluation Index System of Innovation-Driven Capability of Chinese Manufacturing Industry Based on Factor Analysis

In China’s new normal, a strategy named “Made in China 2025” was proposed to speed up the manufacturing’s transformation and upgrading. The hardship of China’s manufacturing industry transformation and upgrading are the limit capability of independent innovation, the complexity and variability for competitive environment and the existence of institutional hurdles. At present, China is facing the powers of the industry from manufacturing to major, The paper will use factor analysis method to construct the evaluation index system of innovation-driven ability of Chinese manufacturing industry, and established evaluation model of innovation-driven ability of Chinese manufacturing industry. Based on the analysis of the model, the paper will propose the innovation driving strategy to speed up manufacturing transformation and upgrading.

Evaluation Theory and Practice: Comparing Program Evaluation and Evaluation in Planning

This article reviews the major approaches of program evaluation and evaluation in planning. The challenges to evaluating plans and planning are discussed, including the reliance on ex ante evaluations, a lack of outcome evaluation methodologies, the attribution gap, and institutional hurdles. Areas requiring further research are also highlighted, including the need to develop appropriate evaluation methodologies; creating stronger linkages between program evaluation and evaluation in planning; examining the institutional and political contexts guiding the use (and misuse) of evaluation in practice; and the importance of training and educating planners on evaluation.

A political economy analysis of human resources for health (HRH) in Africa.

BackgroundDespite a global recognition from all stakeholders of the gravity and urgency of health worker shortage in Africa, little progress has been achieved to improve health worker coverage in many of the African human resources for health (HRH) crisis countries. The problem consists in how policy is made, how leaders are accountable, how the World Health Organization (WHO) and foreign donors encourage (or distort) health policy, and how development objectives are prioritized in these countries.MethodsThis paper uses political economy analysis, which stems from a recognition that the solution to the shortage of health workers across Africa involves more than a technical response. A number of institutional arrangements dampen investments in HRH, including a mismatch between officials’ tenure in office and program results, the vertical nature of health programming, the modalities of Overseas Development Assistance (ODA) in health, the structures of the global health community, and the weak capacity in HRH units within Ministries of Health. A major change in policymaking would only occur with a disruption to the political or institutional order.Results/conclusionsThe case study of Ethiopia, who has increased its health workforce dramatically over the last 20 years, disrupted previous institutional arrangements through the power of ideas—HRH as a key intermediate development objective. The framing of HRH created the rationale for the political commitment to HRH investment. Ethiopia demonstrates that political will coupled with strong state capacity and adequate resource mobilization can overcome the institutional hurdles above. Donors will follow the lead of a country with long-term political commitment to HRH, as they did in Ethiopia.