National Reform Research Articles

Reminder design and childhood vaccination coverage

A major policy concern across public vaccination programs is non-compliance. Exploiting Danish population data and three national reforms in regression discontinuity designs, we document the effects of reminders for childhood vaccination coverage. Retrospective reminders are primarily effective for families with small children and when sent out close to the recommended vaccination age. Digital and postal reminders are equally effective. Prospective reminders increase timely vaccinations in later childhood and help reaching high coverage for new vaccines in increasingly complex vaccination programs. While reminders prompt additional preventive care for focal children, we find no spillovers to other health behaviors or relatives.

Capital generates green: Evidence from China's national innovation system policy

A national innovation system (NIS) is instrumental in enhancing a country's innovation potential, with its system effectiveness largely contingent upon the development of financial markets. The impact of financial innovation within the NIS framework has yet to be thoroughly investigated despite this connection. This study exploits a recent policy shock in China that includes financial innovation as part of national supply-side reform. A difference-in-differences analysis reveals that firms in areas with greater financial innovation have exhibited a significant increase in green innovation following this policy. Mechanism analyses show that, after the policy shock, financial innovation has increased firms' long-term loan ratio and credit loan ratio while reducing the cost of debt, thereby improving corporate maturity match and reducing their propensity to resort to short-term debt for long-term investment projects. These results provide novel insight into how NIS-integrated financial innovation enhances system effectiveness and promotes green innovation.

Exploring Compatibility Issues Between International Faculty and Their Host Environment: A Case of a Local National University in Japan

Purpose The number of international faculty members in universities is increasing worldwide, and Japan is no exception. However, despite this quantitative expansion, these faculty remain peripheral. Though recent studies have identified various challenges faced by international faculty, they have focused on international faculty's individual experiences and have lacked perspectives from the host institution. To more accurately understand the challenges facing international faculty, this study aims to uncover compatibility issues between these faculty and their host environment. Design/Approach/Methods In this study, I adopted a qualitative case study approach targeting a local national university in Japan. Seven international and six Japanese faculty members were interviewed. Findings The analysis revealed various issues underlying the problems faced by international faculty, including new challenges arising from recent national university reforms. The compatibility issues they experienced can be categorized into the following six areas: organizational goals, systems and practices for hiring and evaluating faculty, division of roles between international and Japanese faculty, organizational support for international faculty, organizational culture and atmosphere, and Japanese society's overall system and values. Originality/Value This study responds to a crucial academic need to understand the host institution's perspective on international faculty recruitment by providing new evidence of the challenges facing international faculty and their host institution in a low-resource environment in the midst of reforms.

The Role of Judicial Associations in Preventing Rule of Law Decay in Romania: Informal Communication and Strategic Use of Preliminary References

AbstractThis Article explores the manner in which, faced with the rule of law crisis generated by the 2017–2019 national legislative reforms, the Romanian judicial associations, organized as NGOs, have fulfilled their declared purpose of safeguarding judicial independence. By relying on effective communication tactics—including international networking and lobbying or informal discussions with high-level EU representatives—coupled with a strategic use of preliminary references, they have shed light on some of the most sensitive elements of the Romanian context, garnering both internal and international support in the process. In particular, by taking advantage of the CJEU’s increased willingness to engage with questions concerning the rule of law and the organization of the national judicial systems, the Romanian judicial associations have managed to design strategies capable of triggering preliminary rulings on the most heated and politically charged questions concerning the judiciary. This Article seeks to highlight the specific features and informal elements of such strategies.

Język francuski i współpraca międzynarodowa w malgaskim systemie edukacji

International cooperation can be a tool for national reform. Given the importance of education in development, international partnerships are developing to improve education systems. The author examines the importance of international cooperation in the development of education in the Indian Ocean, essentially taking the example of the French language in Madagascar. Interventions in this area can take several forms. The Agence universitaire de la Francophonie (AUF) contributes to the strengthening of the French language, which plays a major role in the Malagasy education system. These interventions improve the relationship between students and teachers as well as the conditions for transmitting knowledge.

The effect of gun buy-back law reform on homicides and suicides in Australia.

In this paper we use the synthetic control method (SCM) to estimate the causal effects of a national legislative reform accompanied by mandatory gun buy-backs in Australia on both suicide and homicide rates. Using a rich international dataset, we are able to separate not only these two death types, but also to distinguish deaths by firearm and by other means, thereby enabling us to test substitution-of-means hypotheses. Specifically, we apply the SCM to determine whether any reductions in firearm-related death rates where wholly or partly offset by increases in the use of other means (e.g., bladed weapons, poisons) to commit suicides and perpetrate homicides. Our findings show that these gun control policies substantially reduced both homicides and suicides by firearm, but also some evidence of other-means substitution.

The Gentile Reform of 1923 and Italian Higher Education

This article focuses on how Italian higher education was organized and managed in the early years of fascism. The main reasons why the fascist government of Italy initiated a national educational reform in 1923 are considered. The objective problems in education that Italian society faced during this period are analyzed. Special attention is given to the ideological goals that Giovanni Gentile, the Minister of Education, pursued with this reform. The reform led to fundamental changes in the traditional educational system of the Kingdom of Italy. Some radical innovations were also spurred in its higher education, such as the division of universities into different types (depending on state funding), the enhancement of the role of the rector in university life, the valorization of humanities education over that in technical and natural sciences, etc. The Gentile reform was received with mixed feelings by Italian society, including part of the leadership of the fascist party. The contradictions inherent in the reform ideology affected its results. The attempt to improve the quality of university education by standardizing academic requirements and introducing a system of uniform state examinations, contrary to the idealistic goals declared by G. Gentile himself, was the first step toward greater interference by the fascist regime in university activities, reflecting the general trend to the establishment of full state control over society.

What does PISA Assess in Reading Literacy? Misconceptions and Misuses

In the 21st century, international interaction in social, economic, cultural, and educational fields has increased. Consequently, international standards have become essential in national education policies, reforms, and practices. As an international assessment, PISA has started to function as a prominent tool in this regard. However, the impact of PISA differs across the participating countries, depending on how the concept, methodology, and practices are handled. One of the domains where this difference is seen is reading literacy. Although this domain expresses a broader and richer phenomenon, the content and scope of the concept are not accurately understood, and its influences vary across the participating countries. In Türkiye, reading literacy is mainly considered and discussed in the scope of Turkish language lessons. This perspective, which focuses on the Turkish language lessons, leads to misunderstanding of the issue and the inaccurate change and transformation of the curriculum and content. Attempting to succeed in this domain through test language lessons deepens the problems instead of solving them. In this article, misconceptions and misuses about reading literacy are explained based on a literature review, and it is pointed out that reading literacy should be addressed in a broader context, including the curricula of other subjects, rather than test language lessons.

Community Structure and Resilience of the City Logistics Networks in China

Logistics security, as the lifeline of the economy connecting production, distribution, and consumption, holds a pivotal position in the modern economic system, where any potential threats like natural disasters or cyber attacks could have far-reaching impacts on the overall economy. With a unique large-scale logistics data set, logistics networks between cities in China are constructed. We thus identify communities of cities that have dense logistics connections in these networks. The cities in the communities are found to exhibit strong connections in the economy, resources, and industry. The detected communities are also aligned with the urban agglomerations mentioned in the guidelines reported by the National Development and Reform Commission of China. We further extend our analysis to assess the resilience of the city logistics networks, especially focusing on the influence of community structures. Random and intentional attacks are considered in our resilience analysis. Our results reveal that the city logistics networks are robust to the random attacks and are vulnerable to the intentional attacks on the nodes with dense links between and within communities. Our results not only deepen our understanding of the community structure and resilience of the city logistics networks but also provide insights on how to improve the efficiency and safety of intercity logistics.

The impact of changes in a physician fee schedule on medical expenditures, fees, and volume of services. Evidence from a national fee schedule reform in Australia

We examine the impact of changes to a national physician fee schedule on total medical expenditures, the volume of services, and fees charged. In our context, changes to the fee schedule were designed to promote value-based health care, and so included different types of changes to subsidised medical services, including changes to fees. Using claims data from a sample of doctors linked to a physician survey, we use difference-in-difference methods with a staggered adoption design to compare medical services which were affected with those which were not. We show that medical expenditures and the volume of affected services fell, though there is uncertainty about the magnitude of the fall. For GPs, we find evidence of increases in expenditures and fees and an increase in fees for some services provided by specialists.

Feminization of Sri Lankan Doctors and Key Specialties: 2000 to 2020

The study focused on the feminization of Sri Lankan generalist doctors in all major and selected minor specialties between 2000 and 2020. The study analyzed all relevant documents by exploring Sri Lanka's male-to-female doctor and specialist ratio over 20 years. This was determined by analyzing state medical faculty records from 1990 to 2020. For better clarity, the researchers analyzed the gender ratio changes in every five-year block from 1990 to 2020. Focus groups filled PGIM's gender data fields. Five-year medical students surged from 43% to 63% between 1990 and 2020. Linear trend analysis predicts 68% of female medical students by 2025 and 72% by 2030. This study simulated generalist doctors with medical students. Until recently, men dominated medicine, surgery, obstetrics, and pediatrics. Female specialists have increased in all fields over the past 20 years. The feminization of medical doctors challenges national human resource policies and health sector reforms. They emphasize gender-sensitive health workforce planning that considers a country's economic development and healthcare system. Sri Lankan health policymakers should consider gender dynamics in national health HR planning for the next decade.

Progress and Institutional Challenges on Local Governments Performance Accountability System Reform in Indonesia

This study analyses, firstly, the achievement of local governments’ reform based on their Performance Accountability System (SAKIP) as part of the national administrative reform program in Indonesia. Secondly, this paper examines factors that have been affecting reform output. The study uses a mixed method perspective by analyzing the whole population of local governments from SAKIP data (2016–2019; quantitative) and applies the qualitative method of in-depth interviews with key informants. The study finds that, although there were improvements in the performance accountability system, the improvement processes have been slow and dominated by formalism at provincial and regency/city levels. Several determining factors affected the implementation of the local government performance accountability system, that is, the regulations’ arrangements, the norms, the cognitive culture, and management problems. Thus, this study confirms the theory of institutional change that considers cultural factors, political commitment, and organizational aspects that influence the dynamic of bureaucratic reform implementation.

Assessing national land administration reform in Mongolia: A mixed method evaluation using bank loan and historical land administration data

This study presents the findings from a rigorous performance evaluation of a land registry strengthening project in Mongolia. The paper contributes to a small but growing body of systematic evaluations on land administration interventions—and particularly on efforts to build the national capacity of state agencies through institutional strengthening initiatives. The research highlights a methodological approach that utilizes mixed method data sources to explore outcomes in a more rigorous way and through a gendered lens. We rely on a unique set of primary quantitative data sources, including extensive land administration and bank loan data. In addition to ex- ploring outcomes associated with credit access and lending, our extensive data sources enable us to delve into transaction cost, efficiency, and volume. We complement the quantitative data with comprehensive qualitative data from interviews and focus group discussions. This study finds that the project improved Mongolia’s registration process and land administration system. There are notable increases in transaction efficiency; digitization and strengthening of information systems; and improved transparency and access to land records. In contrast, there is more limited evidence about the program’s effect on facilitating improvements in the accuracy of land records, land markets, access to credit, and gender equality in land rights. While the project helped to reduce some instances of corruption, there remain broad challenges to land governance reform.

Factors that influence evidence-informed meso-level regional primary health care planning: a qualitative examination and conceptual framework

BackgroundEvidence-informed primary health care (PHC) planning in decentralised, meso-level regional organisations has received little research attention. In this paper we examine the factors that influence planning within this environment, and present a conceptual framework.MethodsWe employed mixed methods: case studies of five Australian Primary Health Networks (PHNs), involving 29 primary interviews and secondary analysis of 38 prior interviews; and analysis of planning documents from all 31 PHNs. The analysis was informed by a WHO framework of evidence-informed policy-making, and institutional theory.ResultsInfluential actors included federal and state/territory governments, Local Health Networks, Aboriginal Community Controlled Health Organisations, local councils, public hospitals, community health services, and providers of allied health, mental health and aged care services. The federal government was most influential, constraining PHNs’ planning scope, time and funding. Other external factors included: the health service landscape; local socio-demographic and geographic characteristics; (neoliberal) ideology; interests and politics; national policy settings and reforms; and system reorganisation. Internal factors included: organisational structure; culture, values and ideology; various capacity factors; planning processes; transition history; and experience. The additional regional layer of context adds to the complexity of planning.ConclusionsLike national health policy-making, meso-level PHC planning occurs in a complex environment, but with additional regional factors and influences. We have developed a conceptual framework of the meso-level PHC planning environment, which can be employed by similar regional organisations to elucidate influential factors, and develop strategies and tools to promote transparent, evidence-informed PHC planning for better health outcomes.

Dynamics of trace element enrichment in blue carbon ecosystems in relation to anthropogenic activities

Blue carbon ecosystems (BCEs), located at the land-sea interface, provide critical ecological services including the buffering of anthropogenic pollutants. Understanding the interactions between trace element (TE) loads in BCEs and socioeconomic development is imperative to informing management plans to address pollution issues. However, the identification of anthropogenic TE pollution in BCEs remains uncertain due to the complex geochemical and depositional processes and asynchronous socioeconomic development along continental coastlines. Here, priority-controlled TE (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) concentrations in the mangrove, saltmarsh and seagrass soils and plant tissues along the coastline of China were investigated while taking bare flat and upland soils as corresponding references. We demonstrate that blue carbon (BC) soils accumulated markedly higher concentrations of anthropogenic TEs than the reference soils, mainly due to the effective trapping of fine-grained particles and higher binding capacities. We identify the time course of TE changes over the last 100 years which shows increasing anthropogenic TE accumulation resulting from military activities (1930–1950) and the growth of industrial and agricultural activities (1950–1980), then reaching a maximum after national economic reform (1980–2000). Since the 2000s, decreases in TE discharges driven by socioeconomic reform and strengthened environmental regulations have led to a widespread reversal of anthropogenic TE concentrations in BC soils. Based on the current TE flux we estimate that BCEs can filter over 27.3–100 % of the TEs emitted in industrial wastewaters from Chinese coastal provinces annually. However, the uptake of these TEs by plants can be substantially reduced through various mechanisms offered by edaphic properties such as organic carbon, clay, and sulfur contents. Therefore, enhancing TE filtering while preventing TEs from entering food webs through the conservation and restoration of BCEs will greatly aid in achieving the sustainable development goal of the coastal zone under intensified anthropogenic activities.

Research on the Implementation Difficulties and Optimization Measures of Project-based Teaching in Maritime English

In recent years, project-based teaching has become the focus of national vocational education curriculum reform, and has also become an important teaching form in the curriculum reform of major maritime vocational colleges. The project-based teaching reform of maritime English has achieved significant breakthroughs and results after implementation, but there are still many problems in teaching practice. This article analyzes the implementation difficulties of project-based teaching in maritime English and proposes corresponding optimization measures to address these difficulties, providing reference for effectively deepening the reform of maritime English teaching in vocational colleges.

Market Competition and Anemia Management in the United States Following Dialysis Payment Reform.

Whether market competition influences health care provider responses to national reimbursement reforms is unknown. We examined whether changes in anemia management after the expansion of Medicare's dialysis payment bundle varied with market competition. With data from the US dialysis registry, we used a difference-in-differences (DID) design to estimate the independent associations of market competition with changes in anemia management after dialysis reimbursement reform. A total of 326,150 patients underwent in-center hemodialysis in 2009 and 2012, representing periods before and after reimbursement reform. Outcomes were erythropoiesis-stimulating agent (ESA) and intravenous iron dosage, the probability of hemoglobin <9g/dL, hospitalizations, and mortality. We also examined serum ferritin concentration, an indicator of body iron stores. We used a dichotomous market competition index, with less competitive areas defined as effectively having <2 competing dialysis providers. Compared with areas with more competition, patients in less competitive areas had slightly more pronounced declines in ESA dose (60% vs. 57%) following reimbursement reform (DID estimate: -3%; 95% CI, -5% to -1%) and less pronounced declines in intravenous iron dose (-14% vs. -19%; DID estimate: 5%; 95% CI, 1%-9%). The likelihoods of hemoglobin <9g/dL, hospitalization, and mortality did not vary with market competition. Serum ferritin concentrations in 2012 were 4% (95% CI, 3%-6%) higher in less competitive areas. After the expansion of Medicare's dialysis payment bundle, ESA use declined by more, and intravenous iron use declined by less in concentrated markets. More aggressive cost-reduction strategies may be implemented in less competitive markets.

Analysis of Democracy as a Political Tool for Authoritarian(ISM)

The research analyzes limitations of democracy in enforcing its values and institutions in countries that have authoritarian leaders. The study delves into the political landscape of Cameroon, where leadership operates in absolute authoritarianism. It investigates electoral deficiencies and manipulations, which hinders democratic process. The research reveals that despite claims of electoral reforms in undemocratic nations, opposition parties struggle against electoral frauds. The research concludes that democracy's implementation in authoritarian regimes is compromised by concentration of power and lack of genuine oppositions, leading to a hybrid political system that exhibits authoritarian tendencies flourishing with ease within democratic structures; in other words democracy helping authoritarians to attain legitimacy.

Capitalism Effects through Asian Crisis: An Analysis of South Korea's Economic Policy in the Welfare State Perspective

The Asian financial crisis with a marked fall in the value of the Thai currency (Bath), initially a currency crisis was followed by a financial crisis in non-bank financial institutions which had to be closed due to bankruptcy. The economic crisis was followed and spread to South Korea, Malaysia, Indonesia, the Philippines, Singapore and other Asian countries. International institutions reacted to help with the Asian crisis, initially The International Monetary Fund (IMF) after being asked for assistance by Asian countries provided assistance. Many analyzes have been given by financial, economic and political experts, one of which is Weiss and Hobson who analyzed that the Asian economic crisis appeared to have two faces namely; the external face is in the Deep Crisis area and the external face is in the ordinary crisis area, while the crisis occurs from the role of international actors, both state and non-state actors. The social policy approach that is applied takes welfare state steps, with welfare programs implemented by South Korea including reforms in the fields of labor, market and finance, BUMN and active social policies to provide social security for the unemployed or for those who become poor in the period of national economic reform. Weiss and Hobson concluded that state guided capitalism was one of the causes of the Asian crisis.

Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991–2016

BackgroundMembers of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews with chronic psychotic disorders, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000, and governmental recognition of the need to allocate resources for patients with co-occurring substance use disorder and mental illness in 2010.MethodsThe National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorder, hospitalized in 1991–2016 (at least once in 2010–2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of population-group (Arabs and Jews), time-period (Period1: 1991–2000, Period2: 2001–2009, Period3: 2010–2016) and sex, on average length of stay (LOS), annual number of hospitalizations and hospitalization days.ResultsThe proportion of Arab patients hospitalized with a diagnosis of chronic psychotic disorder (14.4%) was significantly lower than their proportion in the general population (21%), and their average age at first hospitalization (28.4 years) was older than that of Jewish inpatients (27.0 years). The average number of hospitalization days and LOS of Jewish patients were double that of Arab patients in Period1. Following implementation of the Rehabilitation Law, hospitalization days increased among Arab patients and decreased slightly among Jewish patients, such that by Period3 the average number of hospitalization days was similar among Jewish (41) and Arab (37) patients. The increase in hospitalization days among Arab patients was limited to men with no change noted among women. The number of hospitalization days among Arab women was about half that of Jewish women (p < 0.0001).ConclusionsThe findings reveal a narrowing of disparities in psychiatric hospitalizations between Arab and Jewish patients in Israel over time. However, among Arab women the number of hospitalization days remains considerably lower than that of Jewish women, raising concerns that Arab women may be receiving insufficient care. Further study is needed to fully understand the underpinnings of these disparities, although increasing the number of Arabic-language mental health services and providing psycho-education, will help further close the gap.