Structural Adjustment Research Articles

How gender shapes practice choices among family medicine residents and early career family physicians: a Canadian qualitative study.

The practice choices of family medicine residents and early career family physicians shape access to primary care. A growing proportion of family physicians are women. This study examined how gender operates in shaping family physician practice choices and subsequent practice patterns. Qualitative interview data were analyzed. Family medicine residents and early-career family physicians from three Canadian provinces (Nova Scotia, Ontario, and British Columbia) participated in interviews. Qualitative interview data was collected as part of a larger mixed methods study. Eighty-eight interviews were transcribed verbatim and coded into several node reports including one on gender. Reflexive thematic analysis was conducted to identify themes related to how gender impacts physician practice choices. Many participants described multiple intersecting pathways through which it was apparent that gender shaped their career and practice choices. Others did not identify the impact of gender in this regard. Parenthood and caregiving were commonly discussed, as were clinical interests specific to women's health, however, gendered expectations of patients and colleagues were also seen to shape choices. In this way, gender shaped choices directly, but also indirectly in response to gendered experiences and expectations. Findings support the need for structural reforms including: increased availability of collaborative team based models, flexible work schedules, closure of gendered wage gaps, and integration of gender awareness training through academic and healthcare institutions. Consideration of how primary care policies differentially impact across clinician gender is key to future planning to support a changing workforce that meets patient needs.

Leadership, Gender, and School Culture: Navigating Power and Resistance in Education

This paper investigates the ongoing gender inequalities within education systems, influenced by globalization and entrenched power dynamics that often limit gender inclusivity. Global initiatives aimed at gender equality frequently adopt a universalist approach, yet this can mask intersectional disparities and reinforce hegemonic masculinity, especially through the spread of Western masculine ideals. Within educational institutions, heteronormative and cisnormative school cultures frequently marginalize non-heterosexual identities, creating challenging environments for Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) students. Although anti-discrimination policies exist, many teachers lack adequate training to address gender and sexuality issues, leading to adverse academic and social outcomes for marginalized students. The study reveals that traditional educational leadership often reinforces conventional gender norms, while transformational leadership grounded in social justice is essential to fostering inclusivity and addressing intersecting inequalities. The findings underscore the need for structural reforms to establish supportive and equitable school settings that acknowledge and celebrate diverse gender identities

Legacies from early-season hot drought: how growth cessation alters tree water dynamics and modifies stress responses in Scots pine.

Tree responses to drought are well studied, but the interacting effects of drought timing on growth, water use, and stress legacy are less understood. We investigated how a widespread conifer, Scots pine, responded to hot droughts early or late in the growing season, or to both. We measured sap flux, stem growth, needle elongation, and leaf water potential (Ψleaf) to assess the impacts of stress timing on drought resilience in Scots pine saplings. The early summer hot drought had peak temperatures of 36.5 °C, while the late summer hot drought peaked at 38.2 °C. Soil water content during both periods declined to ca. 50% of control values. The early-season hot drought caused growth cessation already at Ψleaf - 1.1 MPa, visible as an almost 30 days earlier end to needle elongation, resulting in needles 2.7 cm shorter, on average. This reduction in leaf area decreased productivity, resulting in a reduction of 50% in seasonal transpiration. However, the reduced water use of early-stressed saplings appeared to enhance resistance to a late-season drought, as reflected in a smaller decline in Ψleaf and lower tree water deficit compared to saplings that did not experience early-season stress. In summary, we observed persistant drought legacy effects from early-season hot-drought stress, as evident in a 35% reduction of leaf area, which impacted tree water use, stress resistance, and productivity. These structural adjustments of leaf development and reduced bud mass from early-season stress could be critical in evergreen conifers, whose long-lived foliage influences future water use and growth potential.

Classification and spatial characteristics of different development stages in China: Evidence from the contribution rate of production factors.

This paper aims to reveal the changing characteristics of the contribution rates of different production factors in China since the reform and opening up from two dimensions: stage and space. The study used national data from 1978 to 2021 and provincial data from 2000 to 2020, combined with methods such as C-D production function and spatial econometrics for analysis. Research has found that: (1) In terms of stage characteristics, during the structural adjustment stage (1978-1998), economic growth mainly relies on capital and labor input, and the contribution rate of land factors gradually decreases. During the high-speed development stage (1998-2012), the contribution rate of technological factors gradually increased, while the contribution rate of land factors remained relatively stable. In the stage of high-quality development (2012 present), the contribution rate of technological factors continued to rise and become the dominant factor, while the contribution rate of land factors has decreased to a lower level. (2) Regarding spatial characteristics, the spatial econometric model reveals significant spatial agglomeration characteristics of capital and labor, and land factors positively affect local and neighboring economic growth. From 2000 to 2020, the contribution rate of capital factors in various provinces showed a difference of "low in the east and high in the west," which decreased year by year. The contribution rates of labor and land factors have declined to low levels in all provinces; The contribution rate of technological elements has significantly increased, with a higher contribution rate in the southeast region; High-quality development progress in each province can be identified based on the contribution rates of different production factors. The research findings help to understand the impact of varying production factors on economic development at a temporal and spatial scale and provide a scientific basis for achieving a high-quality development pattern of rational allocation of factors and regional coordinated development.

Shifting from Burden Sharing to Task Sharing: Advancing Community-Initiated Care in MHPSS for Refugee Resettlement

The complexities of refugee resettlement in the U.S. require comprehensive mental health and psychosocial support (MHPSS) strategies, yet significant gaps persist due to resettlement policies prioritizing short-term self-sufficiency over long-term mental health and well-being. This study explores the shift from traditional “burden sharing” to “task sharing” models that emphasize community-initiated care (CIC). Using a two-phase qualitative method, 27 refugee leaders and bilingual service providers from 14 refugee communities, including Afghan, Bhutanese, Burmese, Congolese, Somali, and Sudanese communities, across four states participated in focus groups or key informant interviews. Thematic analysis revealed that peer support models play a critical role as bridges between cultures, service sectors, and formal and informal networks. However, peer support remains insufficient without structural reform, as refugees face barriers such as lack of professional development and power imbalances with professionals while managing their own life challenges. This study emphasizes formalizing CIC models that empower refugees to lead the sharing process in collaborative care. Intersectoral collaboration and supportive policy frameworks are necessary to sustain peer support and build long-term leadership capacity. The findings highlight the need for a system-level shift to ensure equitable responsibility for care, fostering sustainable, community-driven MHPSS solutions in refugee resettlement.

Reforming Long‐Term Care Provision and Work in Post‐Pandemic Times: Scope and Drivers of Policy Change in the Spanish Decentralised System

ABSTRACTThe COVID‐19 pandemic unveiled and magnified structural challenges of long‐term care (LTC) provision and work across Europe, bringing the need for reforms on the quality‐of‐care provision and work to the fore in several countries. Focusing on the case of Spain, this paper analyses to what extent the window of opportunity opened by the pandemic resulted in structural LTC reform, focusing on the scope and drivers of policy change/continuity. Relying on a multidimensional framework to analyse policy change, we performed qualitative policy analysis to assess our expectations on the mechanisms facilitating/hindering policy change in the country, where a reform process on LTC provision and work took place between July 2021 and June 2022. Our findings reveal that the pandemic fostered a radical policy change; yet, its scope was constrained by the opening of veto points, partisan incongruence, and financial limitations. The reform led to the introduction of a new care model and a new configuration of service provision. However, results were mixed, with some areas only seeing incremental adjustments due to resistance from vested interests and institutional veto players operating along the country's multi‐level governance of LTC. Our findings contribute to understanding welfare policy change beyond the ‘expansion–retrenchment’ debate, delving into the complexities of pursuing crisis‐induced reforms on LTC provision and work in decentralised welfare systems.

Delocalized Nonbonding Orbitals of Thioxanthone in Polycyclic Aromatic Hydrocarbons for Reduced Energy Gap and Narrowband Emission.

Chalcogen-containing carbonyls, specifically thioxanthone (TX), hold great potential in organic light-emitting diodes (OLEDs). While the development of narrowband OLEDs with chalcogen-containing carbonyls remains challenging due to difficulties in achieving both high device efficiency and narrow emission spectra. Herein, via a strategic incorporation of the TX moiety, two orange-red narrowband emitters, 2TXBN and BNTXBN, are designed and synthesized for the first time. Both 2TXBN and BNTXBN exhibit bright orange-red emissions with peaks at 582 and 585 nm, respectively, along with narrow full widths at half maximum of 30 and 32 nm. Notably, 2TXBN demonstrates delocalization of the nonbonding orbital within the TX segment, which raises the first triplet energy level and reduces the singlet-triplet energy gap. This electronic structural adjustment effectively shortens the delayed fluorescence lifetime, leading to enhanced device performance. Accordingly, OLED employing 2TXBN as the emitter achieves remarkable performance, with a maximum external quantum efficiency of 31.0%, a current efficiency of 69.0 cd A-1, and a power efficiency of 76.0 lm W-1, highlighting the efficacy of the nonbonding orbital delocalization strategy in achieving bathochromic-shifted narrowband OLED materials.

Structural Adjustment Programs (SAPS) and Social, Economic and Political Stability of the Least Developed Countries Since 1980s

Structural Adjustment Programs (SAPS) and Social, Economic and Political Stability of the Least Developed Countries Since 1980s

University trauma surgery and orthopedics: where is the journey going to?

In the field of tension between generalists and specialists, in modern university trauma and orthopedic surgery the question arises as to which expertise has the greatest importance for the future of clinical care. University medicine consists of three large pillars: Research, teaching and treatment of patients. Each of these pillars is faced with the challenge of increasing specialization; however, generalists are extremely important for the future of university trauma surgery and orthopedics. Generalists promote interdisciplinary collaboration through their broad training and are versatile in acute care situations. Specialists are characterized by in-depth specialist knowledge and technological expertise in specific areas of surgery. This article analyses the changing requirements in trauma surgical and orthopedic care in the context of innovation, technologization, digitalization and increasing specialization. It also examines how structural reforms, such as the Hospital Structure Act and the new licensing regulations, are influencing the role of generalists and specialists in university training and clinical practice. The article provides adifferentiated view of which specialist skills will be necessary in hospitals in the coming years and discusses whether abalance between generalism and specialization is the solution for high-quality patient-centered care.

Alkali metal ion-doped GaN for ultrafast electrochemical capacitor: Doping mechanism, structural adjustment, and structure–performance relationship

Alkali metal ion-doped GaN for ultrafast electrochemical capacitor: Doping mechanism, structural adjustment, and structure–performance relationship

CEO characteristics and capital structure dynamics: Evidence from a transitional economy

We investigate the relationship between CEO characteristics and the speed of adjustment (SOA) of capital structure for listed firms in Vietnam over the period 2000–2023. Our findings demonstrate that CEO gender, age, and education increase the SOA, but CEO tenure decreases the SOA. State ownership and firm size are closely associated with adjustment costs of capital structure. Our findings reveal that in State-Owned Enterprises (SOEs), long-tenured CEOs have a positive effect on the SOA, while the impact of CEO qualifications on the SOA is negative. The role of CEO characteristics is more pronounced during the COVID-19 pandemic.

High-sensitivity and stability electrochemical sensors for chlorogenic acid detection based on optimally engineered nanomaterials.

Developing cost-effective and efficient analytical methods is essential for detecting chlorogenic acid (CGA), as excessive consumption of CGA, despite its significant antioxidant, anticancer, and anti-inflammatory properties, can cause serious health problems. The remarkable progress and adjustable features of nanomaterials have significantly improved the analytical capabilities of electrochemical sensors for CGA. This review examines the use of optimally engineered nanomaterials in CGA electrochemical sensors, emphasizing the design and modification strategies of various nanomaterials. It starts with an introduction to the basic principles of electrochemical sensors, detailing their components and the analytical methods employed. Subsequently, the review explores how structural and compositional adjustments in electrocatalysts from different nanomaterial categories enhance CGA detection performance. In conclusion, it discusses the challenges and opportunities linked to designing nanomaterials for modified electrodes in CGA sensors. This review seeks to enhance the understanding of the connection between nanomaterial structures and the performance of CGA electrochemical sensors, offering new perspectives for the future design of highly efficient CGA electrochemical sensors.

How does structural reform affect cost and demand in railway systems

How does structural reform affect cost and demand in railway systems

An optimization method for terahertz metamaterial absorber based on MOPSO

Metamaterials can freely control terahertz waves to obtain the desired electromagnetic characteristics by designing the geometry and direction of the unit structure, which is widely used in sensing, communication and stealth technology in radar. The traditional design of terahertz metamaterial absorber usually requires continuous structural adjustment and a large number of simulations to meet the expected requirements. The process is heavily dependent on the experience of researchers, and the physical modeling and simulation solution process is time-consuming and inefficient, which has greatly hindered the development of metamaterial absorbers. Therefore, deep learning has been used to predict the structural parameters or spectra of metamaterial absorbers due to its powerful learning ability. However, when designing a new structure, a large number of training samples need to be reprepared, which is time-consuming and not universal. Particle swarm optimization can quickly converge to the optimal solution through the sharing and cooperation of individual information in the group, without prior preparation. Therefore, this paper proposed a fast design method of terahertz metamaterial absorber based on multi-objective particle swarm optimization algorithm. Taking a new center symmetric absorber structure composed of four L as an example, the structure parameters are optimized to achieve fast automatic design of metamaterial absorber. The multi-objective particle swarm optimization takes the absorptivity and quality factor as independent targets to design the structure parameters of the absorber, realizes the dual-objective optimization of the absorber, and overcomes the shortcoming of the multi-objective conflict that PSO cannot solve. The optimally-designed absorber achieves perfect absorption at 1.613THz with a quality factor of up to 319.72 and a sensing sensitivity of 264.5GHz/RIU when used for refractive index sensing. In addition, the causes of absorption peaks are analyzed in detail using impedance matching, surface current, and electric field distribution. By studying the polarization characteristics of the absorber, it is found that it is not sensitive to polarization, which is more stable in practical application. In summary, the multi-objective particle swarm optimization algorithm can realize the design according to the demand, reduce the experience requirement of researchers in the design of metamaterial absorber, improve the design efficiency and performance, and have great application potential in the design of terahertz functional devices.

Electronic structure adjustment of 3D transition bimetallic phosphate/reduced graphene oxide as a hybrid electrocatalyst for the HER

NiCoP@rGO/NF is beneficial for not only improving separation-transfer-photo-induced charge, but also lowering the ΔGH value on active sites, greatly enhancing electrochemical and photocatalytic HER efficiency.

High workload and under-appreciation lead to burnout and low job satisfaction among radiographers

IntroductionBurnout and low job satisfaction in healthcare can impact patient safety and staff retention. This study aims to gain information on the factors influencing burnout and job satisfaction among radiographers in the UK, Ireland and internationally. This can inform strategies for improving the workforce supply and demand imbalance. MethodsAn online questionnaire was developed, which included demographic questions and two validated instruments, the Maslach Burnout Inventory (MBI) and the Job Satisfaction Survey (JSS). The questionnaire was distributed to diagnostic radiographers through the EFRS Research Hub at the European Congress of Radiology, Vienna, in early March 2023. It was disseminated online through Twitter, Facebook, and email over six weeks. Results245 radiographers completed the questionnaire, with the majority (n = 207, 84.5 %) female. Not all respondents responded to all questions. The numbers of respondents for each section were: Pay n = 205, Promotion = 206, supervision = 212, fringe benefits = 211, CR = 212, OC = 214, Co-workers = 213, NoW = 211, Communication = 213 and overall JS = 205. The questionnaire had participants from twenty-one countries, with 66.5 % from Ireland. The mean values for emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) indicate moderate levels of burnout among responding radiographers. 44.2 % of radiographers were dissatisfied, 43.7 % were ambivalent, and 12.1 % were satisfied overall. Workload, under-appreciated work, and time pressures were ranked as the top three factors contributing to burnout. Staff numbers, workload and poor management were the top three factors reducing job satisfaction. ConclusionBurnout levels were moderate, and overall job satisfaction was very low among radiographers. Workload and under-appreciation were key factors impacting low job satisfaction and high burnout. Implications for practiceHealthcare policies that address radiographer burnout through wage structure adjustments, targeted human capital investment, and management practices aligned with staff needs are needed. Implementing these strategies is essential for improving healthcare efficiency, staff wellbeing, and patient care outcomes.

Sejarah Salahuddin Al-Ayyubi

The Ayyubid Dynasty, established by Salahuddin al-Ayyubi, played a significant role in Islamic history through complex socio-political transformations. Salahuddin faced substantial challenges in replacing the influence of the Fatimid Dynasty and Shia doctrine with Ahlusunnah Waljamaah as the official state doctrine. To achieve this goal, he implemented reforms in education, politics, and the military, including transforming Al-Azhar University into a Sunni educational center and establishing Sunni-based madrasas in Egypt. This study employs a qualitative approach with content analysis, examining books, journals, and historical documents to explore Salahuddin's leadership strategies. The findings reveal that Salahuddin successfully strengthened Ahlusunnah Waljamaah through the establishment of educational institutions, the appointment of Sunni scholars, and political and structural reforms that promoted socio-political stability. In the socio-cultural domain, he supported the formation of public institutions, such as hospitals, and encouraged cultural dialogue during the Crusades. This analysis underscores that Salahuddin's success was not limited to his military achievements but also included the socio-religious transformations that reinforced political stability and legitimacy. The study highlights the relevance of Salahuddin's strategies in building an inclusive and sustainable Islamic civilization, making his legacy a model for leadership focused on advancing civilization. These findings demonstrate the importance of synergy between religious vision and structural reforms in creating sustainable socio-political stability, offering significant contributions to contemporary Islamic leadership discourse.

Occupational diversity in Chinese cities: facts, evolution and policy implications

<div><p>Measuring the occupational diversity and trend of Chinese cities from the perspective of the distribution of urban occupational types, and discussing the impact of urban characteristics on urban occupational diversity can provide reference for guiding urban full and high-quality employment. By using the improved Herfindahl index, panel data fixed effect model and Oaxaca blinder decomposition, it is found that the occupational diversity in Chinese cities showed a trend of first decreasing and then increasing from 2002 to 2016, which was due to the adjustment of urban industrial structure and the emergence of new economy after the financial crisis; at the same time, the larger the city, the higher the administrative level and the more developed the economy, the higher the degree of occupational diversity. The conclusion of the study is helpful to intuitively understand the occupational distribution, industrial structure and division of labor in different cities, evaluate the human resource structure and economic development potential of cities, and then provide policy suggestions for different cities to formulate industrial development and human resource planning.</p></div>

AN ANALYSIS OF POVERTY ALLEVIATION EFFORTS IN RURAL INDIA IMPACT OF MICRO-FINANCE WITH SELF-HELP GROUP-BANK LINKAGE SCHEME

During the 1990s numerous structural adjustment programs have been implemented across the world for eradicating poverty. The government of India has also made innumerable efforts to address poverty, but still, the rate of poverty is still high in comparison to other developing nations. Data also suggest that the rate of savings is also accelerating but this is not distributed equally. The policies of liberalization, globalization and privatization during the 1990s resulted in the growth of the economy of the country during 1999-2000 and 2004-2005. However, it failed to eradicate poverty uniformly in the different regions of the country. To uplift the rural parts of this county, the National Bank of Agriculture and Rural Development (NABARD) implemented a self-help groups bank linkage program in 1992. This was done to boost microfinancing in rural parts of India through self-help groups.Microfinancing programs have been used by many countries across the world to facilitate the availability of banking facilities to economically weaker people. NABARD implemented this program in 13 states for penetrating financial services to the disadvantaged population. Researchers have noted that microfinancing programs have helped people affiliated with the SHGs in getting credit help. However, it has been found that many women have joined these groups to gain banking help and address gender inequality (Malhotra, 2016). Research scholars have noted that most of the people in these groups have a need for financial assistance for income generation activities, for clearing debt or for social purposes.

India as a Developed Country in 2047: Risks and Challenges

The fast-paced recovery after the sharp contraction seen during the pandemic has seen India reaching the pre-pandemic level. The international comparison shows India as the fastest-growing large economy and is expected to become the third-largest economy by 2030. Despite this, with per capita income at about $2,500, it is a low-middle-income country. From this, having seen the fast pace of growth, the Prime Minister has set an aspirational target of achieving the high-income status by the centenary year of independence, 2047, which requires a more than five-fold increase in per capita income at the current exchange rate. Equally important is the challenge of absorbing the addition to the labour force and absorbing those in the informal sectors in productive better-paying jobs. This article presents the nature of the challenge and the macroeconomic and structural reform needed to achieve them. JEL Codes: O2, O23, O53