National Transition Research Articles

Health care transition from pediatric to adult care: an evidence-based guideline

For consistent quality of treatment of young people with chronic health care needs, a structured health care transition (HCT) from pediatric medicine to adult medical care is essential. Currently, most countries have no guidelines on HCT based on systematic evidence research. To close this gap, guidance to support HCT was developed in Germany. Twenty-two experts in the management of adolescents and young adults with different chronic conditions and three patient representatives were invited to take part in the guideline group. Based on a systematic literature search recommendations for HCT were drafted. Where evidence was lacking, recommendations were developed using collective expert consensus. The consensus process was independently moderated using a Delphi approach. The final draft was reviewed and endorsed by all major German medical societies. The clinical recommendations provide guidance for all chronic somatic diseases. After assessment of HCT readiness, an individualized plan for HCT should be drawn up. Key elements here are a responsible coordinator, age-adapted patient education, involvement of caregivers, web-based interventions, joint visits, and a structured summary for the receiving physician. The aim is the gradual transfer of responsibility for disease management to the young person themselves. Conclusion: As only a few randomized controlled studies on HCT are available, evidence-based statements are possible for some but not all areas of HCT. However, this guideline may help to develop globally accepted standards. These standards should be established and implemented. The aim should be a reimbursement by individual national health systems to allow appropriate support for young people.What is Known:• Health care transition from pediatric to adult care is primarily organized in local settings, partly based on disease-specific guidelines.•There have been no national guidelines in Germany until now.What is New:• Here we present the general evidence-based guidelines of the German Association of Scientific Medical Societies for health care transition.• These might serve as a blueprint for further national or international health care transition guidelines.

Policy uncertainty in Japan

We develop new economic policy uncertainty (EPU) indices for Japan from January 1987 onwards, building on Baker et al. (2016). Each index reflects the frequency of newspaper articles that contain certain terms pertaining to the economy, policy matters, and uncertainty. Our overall EPU index co-varies positively with implied volatilities for Japanese equities, exchange rates, and interest rates and with a survey-based measure of political uncertainty. It rises around contested national elections and major leadership transitions in Japan, during the Asian financial crisis and in reaction to the Lehman Brothers failure, U.S. debt downgrade in 2011, Brexit referendum, the deferral of a consumption tax hike, and the onset of the COVID-19 pandemic. Our uncertainty indices for fiscal, monetary, trade, and exchange rate policy co-vary positively but also display distinct dynamics. For example, our trade policy uncertainty (TPU) index rocketed upwards when the U.S. withdrew from the Trans-Pacific Partnership. VAR models imply that upward EPU innovations foreshadow deteriorations in Japan's macroeconomic performance, as reflected by impulse response functions for investment, employment, and output. Our study adds to evidence that credible policy plans and strong policy frameworks can favorably influence macroeconomic performance by reducing policy uncertainty.

The role of the FEC company technological development indicators on the way towards sustainable energy

The aim of the study is to substantiate the necessity of changing the approaches to selection of the list of FEC company technological development indicators for working out the corporate strategic planning documents, including implementation and realisation of corporate social responsibility (CSR) policies in the framework of national economy transition to sustainable energy. Activities in the field of energy saving and energy efficiency ensuring sustainable development with the focus on economic, social and environmental issues are considered as the basic direction ensuring achievement of planned CSR indicators. The methods consist in the systematic approach to assessing the technological development considering the new energy paradigm, disaggregation of existing indicators of complex international and Russian CSR ratings, as well as systematisation of performance indicators. The results are presented in the form of a system of technological development indicators assessing and rating the energy companies based on analysis of the CSR strategies' implementation.

Developing cross-cutting digital competencies of students in the additional professional education ecosystem of the university

One of the urgent tasks within the framework of the implementation of the Federal Project «Workforce for the Digital Economy», which is part of the national digital economy transition programme, is the development of professional competencies of workers in various sectors in the field of cross-cutting digital technologies. Today's competencies are developed taking into account the requirements of society, the state and the labour market for a person in a digital society. In training personnel for the modern labour market, the emphasis is placed on the development of cross-cutting digital competences. The components of cross-cutting digital competences and formation conditions should meet the requirements of digital economy, society, state and labour market for human competences as a person and professional not only for specialists and students of higher education for IT sphere, but also for specialists and students of higher education institutions in non-core IT areas of training and employment. The article presents the results of the research on development of cross-cutting digital competences of students of non-profile IT-specialties in higher education while mastering additional professional programmes in the ecosystem of additional professional education in a university. The author defines a new concept in professional pedagogy – «cross-cutting digital competencies», presents and characterizes its components - basic, personal and practice-oriented. In order to develop these interdisciplinary digital competences, a pedagogical model is elaborated and implemented, including a goal, objectives, pedagogical principles, factors, stages, organizational and pedagogical conditions, results, criteria and evaluation system. The publication states the results of pedagogic model implementation in the system of additional professional education and proves its effectiveness.

Methodology for rural and small-city U.S. transit agency peer grouping

Peer comparison is a valuable management tool for identifying a transit provider’s areas of relative strength, areas with room for improvement, and high-performing peers to learn from. While the U.S. Rural National Transit Database (NTD) provides performance data about rural and small city transit providers, methods and tools have been lacking for these providers to apply NTD data to identify appropriate peers. This paper describes the development of a rural transit peer-grouping method as a counterpart to a method previously developed and implemented for urban providers, and compares this method to previous transit peer-grouping approaches. In contrast to most previous efforts, which have produced fixed and often large peer groups, this method dynamically and transparently identifies appropriate peers for individual rural and small city transit providers. The method has been implemented in freely available web-based software.

Corporative environmental management system (EMS) in the natural capital rational use and national transition to sustainable economy (the case of Thailand)

Currently, environmental management standards’ incorporation in many countries is a national socio-economic progress priority, is considered as a factor ensuring not only the national welfare growth, but also a guarantee of high standards of the quality of life. Based on the results of a survey of 612 representatives of large and medium-sized businesses in the Kingdom of Thailand, this paper highlights the main delusions that limit the prospects for country's business community accelerated modernization, as well as motives that have the potential of their own application in the strategy of the widespread implementation of EMS in business practice; the main principles and tools of the national strategy for stimulating the greening of the Thai companies activities in the interrelation of the dominants of business efficiency growth and ensuring the strategic security of the state and society are also given.

РИЗИКО-ОРІЄНТОВАНИЙ ПІДХІД У ПРОЄКТУВАННІ РОЗГОРТАННЯ НОВОЇ КОМП’ЮТЕРИЗОВАНОЇ ТРАНЗИТНОЇ СИСТЕМИ (NCTS) В МИТНОМУ ПРОСТОРІ УКРАЇНИ

The deployment of the New Computerized Transit System (NCTS) in the customs field of Ukraine is considered in the paper. There is emphasized on a significance of implementation of the Convention on Common Transit Procedure in our state to develop national transit potential and to counteract to customs fraud attempts effective during the movement of goods through the Customs Border of Ukraine. The application risk-oriented approach to forming the Management Risk Plan for implementing NCTS in Ukraine is researched. Structural components of the Plan are considered: «Risk Area», «Stage of risk», «Description of risk», «Consequences of risk», «Risk effect», «Risk probability», «Risk controllability», «Risk management measures» and «Risk management measures taken». The content of risks and their consequences, effect, and probability of risk appearance are studied. It is established, officials of the State Customs Service suggested constructive and active preventive measures for each risk. It is noted, the war in Ukraine effected significantly on the implementation of NCTS. That is why, it was necessary to react and to make decisions immediately, working-out new scenarios of probable and, at the same time, hard forecasted development of events. It is supposed to identify appropriate more probable risks (for example, risks related to the increasing number of cyber attacks on sites of the State Authorities, and continuous war actions on the East and the South of Ukraine, etc.), and to develop appropriative preventive measures. It is determined, that risk management is a key component in the structure of modern managemental technologies of Executive Authority Bodies, including the State Service of Ukraine. The use of the risk-oriented approach in the preparation of the important state project on implementation of NCTS in Ukraine allowed to develop a comprehensive point of view on risks, and has provided both its identification and evaluation of its effect, and ranging, and scenarios of reaction, provided previously. These scenarios are measures defined clearly, that have been supporting gradually the best process of conscious choice and making grounded decisions in the way of a deep understanding of the nature of risks and their effect.

Inter-Provincial Power Transmission and Its Embodied Carbon Flow in China: Uneven Green Energy Transition Road to East and West

Inter-provincial power transmission in China solved the problem of electricity production and consumption spatial mismatch, which also facilitated Chinese green energy transition and sustainable development. Aiming to understand the spatial patterns and main driving factors, this paper accounted the aggregate carbon intensity per electricity produced by each province, built the inter-provincial Out–Destination matrixes of carbon emission embodied in power transmission among 27 provincial areas of 2006 and 2019, and quantitatively analyzed the change in spatial patterns of carbon flow and carbon intensity difference between power inward and outward provinces. We found that the inter-provincial power transmission has led to the reduction in the national average carbon intensity per electricity produced from 0.855 kg/kWh in 2006 to 0.628 kg/kWh in 2019 and the green energy transition of all provinces. The spatial morphology characteristics of carbon flow show the ‘three corridors of West-East Power Transmission (WEPT)’ pattern, in which power is transmitted from some main thermal power-dominated provinces in central and north-west China to the eastern coastal provinces. Further, it resulted in the carbon leakage from electricity consumption of the coastal provinces and carbon overload of the hinterland provinces. Despite natural resource endowment, the location of the provinces in the national power grid, the national low-carbon energy transition strategy, as well as advances in long-distance ultra-high-voltage power transmission technologies were the main factors to the formation and evolution of Chinese electricity green transition.

Competition, coordination, or institutional change? A multi-perspective analysis of historical electricity transitions in Mexico

The electricity sector is a complex dynamic system that has experienced continuous changes since its beginning. The aim of this article is to explore the evolution of historical electricity transitions in Mexico from 1879 to 2012 under the interactive governance approach. Governability provides an analytical framework for investigating the role of actors, technologies, and policies in national energy transitions. By integrating a multi-perspective analytical framework, we applied concepts from energy transitions and policy mixes for sustainability transitions to qualitatively describe social, economic, and technological changes and their relative role in historical transitions. The case study revealed that governability of national energy transitions may vary considerably from one episode to another depending on how governance systems have handled national societal needs and international cooperation agreements. Additionally, different drivers have been identified in shaping electricity transitions in Mexico. First, governance decisions have depended on specific (policy) paradigms that relevant actors have adopted. Second, the article highlights the key role that available (indigenous) energy resources have played in directing the path and pace of electricity production technologies. Third, increasing environmental and climate change concerns have improved the way electricity is produced and used. The analysis conducted suggests that energy transitions governability may be improved by fostering communication and cooperation among actors and institutions to define policy mixes in line with societal needs.

Transition stories: Voices of school leavers with intellectual disabilities

Accessible summary This paper focuses on the transition stories of young people with intellectual disabilities. People with intellectual disabilities have the lowest participation rates in further education training and employment. A model of supported transition places the young person at the centre of the process. Young people with intellectual disabilities have the same dreams and aspirations for their lives as everybody else. This paper found that the model of supported transition aligns with proposed national polices in the Republic of Ireland. AbstractBackgroundThe principal destinations for school leavers with intellectual disabilities from special schools in Ireland are further education (FE) through providers such as the National Learning Network or training and employment (TE) within adult day services and rehabilitation centres. In 2015, a number of inherent barriers to participation in FE/TE for young people with intellectual disabilities were identified. These were found to be linked to attitudes, stigma and low expectations of their capabilities. This resulted in the development of a supported transition model WALK PEER (Providing Equal Employment Routes).MethodsThis study explored the experiences of school leavers with intellectual disabilities who were engaging with the WALK PEER model. Data were collected from a purposive sample of 31 students with intellectual disabilities from two special schools: Group 1 (Pre‐transition) students in the penultimate year of formal education, Group 2 (Transitioning) students in the final year of formal education and Group 3 (Post‐transition) had left school two years previously.FindingsEngaging in the supported transition programme provided young people with access to information, options, confidence and some of the hard and soft skills required for successful transition into education and employment contexts.ConclusionsThe findings demonstrate a strong correlation between support programmes, transition planning and positive transitions, which is critical if young people with intellectual disabilities are to realise their goals. The research proposes a new model of “Supported Transition” that has clear implications for the development of a national transition policy as directed by the Comprehensive Employment Strategy.

Effectiveness of a 1-Hour Event on Medical Students' Perceptions of Plastic and Reconstructive Surgery.

While the broad diversity of procedures is a hallmark of plastic surgery that attracts many young trainees, the extensive breadth of the specialty can lead to dramatic misunderstandings about the scope of practice of plastic surgeons by both the public and medical professionals alike.1 As the field of plastic surgery is amid a national transition toward integrated residency programs, it is important now more than ever to expose medical students to plastic surgery early in their education. Medical schools have the unique and critical task of educating future physicians on the scope of surgical subspecialties. However, plastic surgery inclusion in medical education curricula is minimal to absent at most medical schools.2,3 We therefore recruited 31 medical students to participate in a 1-hour lecture and complete prelecture and postlecture questionnaires to determine their understanding of a career in plastic surgery and plastic surgery procedures. We found that a 1-hour educational course is effective in improving medical students’ knowledge of plastic surgery procedures. Before the intervention, students associated plastic surgery most highly with cosmetic procedures and reconstructive procedures of the breast. After the intervention, there was a statistically significant increase in students correctly identifying that “bread and butter” procedures, such as free flaps, carpal tunnel releases, orbital floor fractures, and hand tendon lacerations, are frequently treated by plastic surgeons (p < 0.05) (Fig. 1). There was also a 15.2 percent increase in participants who considered plastic surgery to be a “lifesaving” field of medicine (p < 0.05). In examining perceptions of a plastic surgery career, there was a 12.1 percent increase after the lecture in choosing lifestyle as an appealing aspect of the specialty (p < 0.05), while there were no significant changes in any of the negative perceptions studied (competitiveness, lack of relatable role models, demanding training, and so on) (Fig. 2). Despite these findings, there was no associated increase in interest in pursuing plastic surgery as a career after the event.Fig. 1.: Change in correctly identifying procedures and pathologies as related to plastic surgery.Fig. 2.: Change in perceptions of plastic surgery as career.Prior studies have attempted to quantify baseline plastic surgery medical student knowledge and provide education about the specialty via emailed surveys and 1-day courses that included presentations and surgical skills practice.4,5 Some of this work, although important, took place in the United Kingdom, where medical and surgical training is structured differently than in the United States.5 This 1-day format is likely not feasible to be incorporated into the already-dense U.S. medical school curriculum. Our study demonstrates the importance of establishing surgical subspecialty education early in medical school, especially given the trend toward integrated training programs. The lecture event provided adequate education about the procedures involved in plastic surgery, which will be valuable for all future physicians with regard to making appropriate referrals and consultations. However, a 1-hour event may fall short in recruiting medical students to plastic surgery careers. In our anecdotal experience, many plastic surgery departments or divisions host little more than an annual medical student interest group lecture in an effort to attract students to our field. To achieve this goal will likely require surgical subspecialties to be more inventive and creative in how they engage students and introduce them to their fields. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

The Barriers and Enablers of Primary Healthcare Service Transition From Government to Community Control in Yarrabah: A Grounded Theory Study.

Introduction: Consistent with the aspirations of First Nations Australians for community control of healthcare services, 123/196 (63%) of Australia's First Nations-specific primary health care services are community-controlled. Yet despite policy commitment over 30 years, the transition of government-run First Nations' primary healthcare services to First Nations community control has been slow. This paper identifies the barriers and enablers to transitioning the delivery of primary healthcare services from Queensland Health to Gurriny Yealamucka community-controlled health service in Yarrabah.Methods: Grounded theory methods were used to select 14 Gurriny and Queensland Health (QH) personnel involved in the transition for interview and to analyse these interview transcripts and 88 Gurriny organisational documents.Results: Barriers and enablers to transition were identified at three levels: those internal factors within Gurriny, external factors directly related to the government handover, and broader structural and policy factors outside the control of either Gurriny or QH. Barriers at the Gurriny organisational level were an internal lack of experience and capacity, and varying levels of community confidence; enablers were leadership stability and capacity, community mandate, relationships with partner organisations, and ability to provide service continuity. Barriers in Gurriny's relationship with QH were a lack of certainty, transparency and prioritisation of the transition process; systemic racism; difficulties obtaining and maintaining the necessary workforce; limited resources including insufficient, unstable and inappropriate funding support; and problems with information sharing; enablers were performance frameworks to keep transition progress on track. Barriers in broad policy environment were an unsupportive Queensland government policy environment; government bureaucracy; and delays, conflicts and divisions; enablers were high-level government support and commitment.Conclusions: The evaluation of Yarrabah's transition process suggests that future such transitions will require planning and commitment to a long-term, multi-faceted and complex process, encompassing the required level of authorisation and resourcing. This case example of a transition from government to community control of PHC highlighted the ongoing power issues that are faced every day by community-controlled organisations that co-exist with mainstream health systems within a colonial power structure.

Teachers’ Transition Attitudes for Students With Disabilities in Two Regions of Botswana

Postsecondary transition planning and programing is a fundamental process that allows students with disabilities (SWDs) to engage in adult roles such as higher education, employment, and independent living successfully. Despite the importance of the role of teachers regarding the effective implementation of transition practices and principles, teachers’ transition attitudes in Botswana are not clearly understood. Therefore, the purpose of this study was to explore teachers’ attitudes concerning the effective implementation of transition practices and principles to SWDs in Botswana secondary and vocational schools. The study further examined the differences between teachers on their attitudes toward delivery of transition services for SWDs based on demographic variables of gender, age, education qualification, teaching experience, school type, current position in school, and school region. A quantitative research approach entailing the use of a paper survey to collect data was adopted in this study. A total of 1,186 teachers participated in this study and mean scores were calculated to determine teachers’ transition attitudes. Moreover, t tests and one-way ANOVA tests were conducted to determine teachers’ attitude differences based on demographic variables. The findings of this study showed that generally teachers had somewhat positive attitudes toward transition practices and principles for SWDs. Furthermore, significant differences were noted on teachers’ attitudes based on all demographic variables except gender. The results indicate the importance of positive transition attitudes as well as the need to develop a national transition framework to guide and improve the transition process in Botswana.

From Constitutional Transitions to the Great National Transition: A Constant and Obstinate Italian Narrative

Abstract The essay aims to illustrate the ways in which Italian literature deals with transitions (constitutional or political). After having clarified the methodological approach, the author identifies and describes in the national literature some historical phases, analysing the trends emerging from the reading of famous novels. In conclusion, some observations are drawn, in which it is highlighted that in the national literature there is a profound awareness of the importance of informal institutional transformations and of the central role of social, moral and economic factors.

Learning to live with COVID-19 in Australia: time for a new approach.

The emergence of the Delta variant of SARS-CoV-2 has made Australia's 'COVID-zero' strategy unviable. As signalled by the Australian Government's National plan to transition Australia's national COVID-19 response, we need to plan a pathway forward for life beyond lockdown. However, this plan must be guided by long overdue discussions on our tolerance for serious illness, and hospital and intensive care unit capacity. The modelling that informs the national transition plan remains relevant, even with increases in case numbers, but one crucial thing that does change if cases continue to escalate is the effectiveness of test, trace and isolate models. As we move into suppression mode with higher rates of the population fully vaccinated, we will no longer need to find every case. This is among the many shifts in approach that will shape our transition by early 2022 to living with - and controlling - the disease.

Explaining the density of post-communist interest group populations\u2014resources, constituencies, and regime change

The article tests the energy–stability–area (ESA) model of interest group population density on a sample of different 2018 Czech, Hungarian, Polish and Slovenian energy, higher education and health care interest organisation populations. The unique context of recent simultaneous political, economic and in the cases of Czechia and Slovenia, national transitions present a hard test for population ecology theory. Besides the area (constituency size) and energy (resources, issue certainty) terms, the article brings the stability term back into the center of analysis. The stability term, that is, the effect of a profound change or shock to the polity is operationalised as Communist-era population densities. As all three policy domains are heavily state controlled and tightly regulated, the effect of neocorporatist interest intermediation is also tested. The article finds strong support for the energy and neocorporatism hypotheses and provides evidence for the effect of communist-era organisational population density on post-transition densities: The size of 2018 organisational populations is found to be dependent on pre-transition densities. The relationship is, however, not linear but curvilinear. Nevertheless, the analysis indicates that the effect of pre-transition population size is moderated by other environmental level factors.

Improving Coordination During Care Transition between Ambulatory and Inpatient Care Facilities: Evaluating the Utilization and Scope of Ehr Facilitated Longitudinal Plan of Care

Gaps in generation and timely transfer of relevant information during care transitions remain a greatchallenge to care coordination. Electronic Health Record (EHR) based information transfer tools are notefficiently used by most providers. The objective of this project was to understand the current process of caretransition between ambulatory and inpatient care setting and to explore the utilization and scope of an EHRbased Longitudinal Plan of Care in improving coordination during care transition. The Longitudinal Planof Care when compared with transition of care practices recommended by Transitions of Care ConsensusConference and National Transitions of Care Coalition work group showed that it lacked some informationpertinent to care coordination. The survey performed indicated that most commonly used Electronic HealthRecord tool for care transition were notes and chart reviews (97.4%, 93.4%). Only 12% of the participantsexpressed high satisfaction with the currently used tool. Among the participants who used the LongitudinalPlan of Care, only 8.8% reported it as a sufficient tool for information transfer. Majority (93.5%) wereunaware that such a tool existed and had never explored its functionality. Improving the functionality ofLongitudinal Plan of Care and training health care providers can greatly facilitate information transferduring care transition.

Neighborhood Economic Change in an Era of Metropolitan Divergence

This study foregrounds the metropolitan area as a key driver of contemporary neighborhood economic change. The recent “Great Divergence” in metros’ economic, social, and political conditions suggests metros increasingly stratify neighborhood trajectories. Yet, many studies only consider neighborhood-level predictors of change or implicate metro-level factors more applicable to the twentieth century (e.g., manufacturing exposure) than the twenty-first. To clarify the metro's contemporary role, this study synthesizes multiple literatures, deriving novel hypotheses that link metropolitan skill agglomeration and income segregation to neighborhood economic change, and then tests them using multilevel models and data drawn from multiple sources, including the census, Opportunity Insights, and National Transit Database. Analyses, based on all neighborhoods within 325 metros between 2000 and the mid-2010s, suggest over 10% of the variance in neighborhood median income change resides between, rather than within, metros. As predicted, metro skill agglomeration dynamics appear to boost neighborhoods’ median incomes, and metro income segregation depresses them. Results remain intact after accounting for state fixed effects and controls for five plausible alternative explanations of metro effects. Overall, the study provides a theoretical and empirical foundation for future neighborhood change research highlighting the metro in general, and two higher order spatial processes—income segregation and skill agglomeration—in particular.

Humanising the Energy Transition: Towards a National Policy on Energy Poverty in the Netherlands

Energy poverty is emerging as a national agenda in the Netherlands. Local authority leadership and action on this agenda, and European Union reporting requirements around the energy transition have aligned to create an opportunity to establish a national agenda on this issue. Early action on energy poverty by local authorities stemmed from their recognition of the value of addressing environmental, health, social welfare and poverty goals through measures to address the problem. In contrast, the experiences of vulnerable energy consumers have limited recognition in national policy. Meanwhile EU requirements for climate reporting include a specification for measuring and monitoring energy poverty. This growing momentum has resulted in an emerging interest in energy poverty as a means to achieve a just transition at a national level, as reflected in the Dutch National Climate and Energy Plan. In this paper, we profile the case of the Netherlands, and outline the opportunity we see for the development of an energy poverty agenda in national energy transition policy, as part of a multi-level energy governance effort. We report on a national stakeholder workshop that we led, linking the lived experience of energy poverty in the Netherlands with policy solutions. Following the clear call for a national policy in this workshop, we also outline a strategy for engagement with energy poverty in the Netherlands, published recently in a white paper on this topic.

How Do We Manage a Just Transition? A Comparative Review of National and Regional Just Transition Initiatives

The concept of a ‘just transition’ encompasses political and policy imperatives to minimize the harmful impacts of industrial and economic transitions on workers, communities, and society more generally, and to maximize their potential benefits. This imperative has gained heightened importance as governments commit to reducing greenhouse gas emissions. A wide range of policies, strategies and initiatives have been adopted by national and regional governments to facilitate and help manage a just transition. It is a concept that is increasingly being put into practice. This scoping study identifies and compares strategies, policies, and practices that are presently being implemented in order to manage a just transition across 25 countries and 74 regions alongside European Union-level policies. This work develops a typology of policy instruments to manage just transitions and identifies implementation gaps and leading practices.