Recovery Program Research Articles

A cost-effectiveness analysis of a housing and recovery program for people with severe and persistent mental illnesses and precarious housing

ABSTRACT The Doorway program supports people with Serious and Persistent Mental Illnesses (SPMIs) receiving care within Victoria’s public mental health system and who are precariously housed. This paper reports on its cost-effectiveness. The study design was difference-in-differences involving a Treatment-As-Usual comparison group (TAU) using deidentified client records. The primary outcome measure was the proportion of days of secure housing per participant during the study and pre-study periods. Similarly, health service usage was also extracted from participants’ records. The cost of public mental health service usage was then estimated, including using governmental published data. The program’s Incremental Cost Effectiveness Ratio (ICER) and Cost-effectiveness Acceptability Curve were estimated using the bootstrap method. An ICER threshold of Australian $50,000 per additional person housed (hereafter A$) at 100% was set to determine cost-effectiveness and the probability of cost effectiveness at A$50,000. Mean total costs (secure housing and mental health service usage) were greater for the Doorway group compared to the TAU group (A$22,987). Mean percentage of days securely housed was also greater for the Doorway group (by 45.4%). The ICER value was A$50,613, the probability of this being 83.1%. The Doorway intervention was both more costly and more effective. Its cost-effectiveness approximated the pre-specified ICER threshold.

Quantifying the mortality impact of Il Piano Marshall

Abstract The Marshall Plan is often hailed as history’s most successful structural adjustment program. However, its direct impacts and its impact on public health outcomes, particularly mortality rates, remain uncertain. Using data for Italian provinces, I find that each additional million dollars in the Italian European Recovery Program was related to a decrease of one to two deaths per 1,000 people or a decline in the Italian crude death rate by 3–7 percent. The effect is driven by the grants in food and drugs (rather than reconstruction grants). This finding is robust to a range of specifications using models in levels and differences, region dummies, placebo tests, a difference-in-differences framework, coarsened exact matching, and a border-municipal research design. The largest mortality reductions came from drops in communicable and infectious diseases.

Efforts of Kokoon Hotel Banyuwangi to Retain Potential Employees

The hospitality sector is one of the impacted industries, as it is closely connected to the tourism sector by providing lodging for tourists. However, there have been some favourable effects, such as the establishment of Kokoon Hotel Banyuwangi in reaction to the pandemic scenario. Increase in staff turnover is correlated with the appearance of opportunities that have resulted from the tourism recovery programme that the Indonesian government has implemented as a response to the Covid-19 outbreak, as was stated before. The research aims to investigate the employees' perception of the workplace climate at Kokoon Hotel Banyuwangi and determine the extent to which the work environment impacts their intention to continue working at the hotel. The qualitative method offers an opportunity for an in-depth exploration of Kokoon Hotel Banyuwangi's Efforts in Retaining Employees. This research found that skill development, career advancement, pay, work culture, benefits, and outstanding relationships affect employee satisfaction at Kokoon Hotel Banyuwangi. To retain staff, Kokoon Hotel Banyuwangi offers cross-training programmes, fair promotion processes, and a comfortable work culture for employee development. Kokoon Hotel Banyuwangi employees depart for financial, professional, and outside experience reasons. Kokoon Hotel Banyuwangi has to strengthen work culture, interactions with supervisors, coworkers, and subordinates, and employee skill development.

The EUropean PErioperative MEdical Networking (EUPEMEN) project and recommendations for perioperative care in colorectal surgery: a quality improvement study.

Despite consensus supporting enhanced recovery programs, their full implementation in such a context is difficult due to conventional practices within various groups of professionals. The goal of the EUropean PErioperative MEdical Networking (EUPEMEN) project was to bring together the expertise and experience of national clinical professionals who have previously helped deliver major change programs in their countries and to use them to spread enhanced recovery after surgery protocols (ERAS) in Europe. The specific aim of this study is to present and discuss the key points of the proposed recommendations for colorectal surgery. Five partners from university hospitals in four European countries developed the project as partners. Following a non-systematic review of the literature, the European consensus panel generated a list of recommendations for perioperative care in colorectal surgery. A list of recommendations was formulated and distributed to collaborators at each center to allow modifications or additional statements. These recommendations were then discussed in three consecutive meetings to share uniform ERAS protocols to be disseminated. The working group developed (1) the EUPEMEN online platform to offer, free of charge, evidence-based standardized perioperative care protocols, learning activities, and assistance to health professionals interested in enhancing the recovery of their patients; (2) the preparation of the EUPEMEN Multimodal Rehabilitation manuals; (3) the training of the trainers to teach future teachers; and (4) the dissemination of the results in five multiplier events, one for each partner, to promote and disseminate the protocols. The EUPEMEN project allowed the sharing of the expertise of many professionals from four different European countries with the objective of training the new generations in the dissemination of ERAS protocols in daily clinical practice through a new learning system. This project was proposed as an additional training tool for all the enhanced recovery program teams.

COVID Recovery Laparoscopic Simulation Program for Gynecological Registrars—Trainee Perceptions of Regional Model

Study ObjectiveThe acquisition of gynecological operating skills can be challenging for trainees given the conflicting demands of clinical work. Alternative models of surgical skill training such as laparoscopic simulation is, therefore, required. This study demonstrates the development of a regional gynecological surgery laparoscopic simulation program and trainee perceptions of such an approach. DesignAn intervention-based cohort study. SettingA regional model based in West Midlands training region. Patients/ParticipantsResponses from 64 trainees in the training region who participated in this regional program were included. InterventionsA 3-stream curriculum was developed to deliver key training outcomes as required by the Royal College of Obstetricians and Gynaecologists (RCOG) core curriculum as a component of a COVID Recovery Program. Courses were held in 7 teaching hospitals. Courses consisted of both theory and practical teaching. MeasurementsA structured feedback tool was used to collect trainee perceptions of the program. Trainee satisfaction was measured on the Likert scale of 1 to 3. A qualitative thematic analysis was conducted with rank-order analysis of coded free-text responses. Main ResultsOverall, the majority of trainees 92% (n = 58/64) were very satisfied with the course. Rank-order analysis demonstrated hands-on-practice to be the key perceived benefit of laparoscopic simulation among basic and intermediate trainees, while feedback on procedural skills was felt most useful among advanced trainees. ConclusionA regional approach to laparoscopic simulation training is both achievable and acceptable. Trainee perceptions of usefulness are altered by seniority and experience. This should be accounted for in the development of laparoscopic simulation programs.

The impact of social networks of historically underrepresented group operators (HUGOs) business recovery

While Historically Underrepresented Group Operators (HUGOs) businesses typically depend on social networks for disaster recovery, this aspect remains inadequately researched. This research investigates whether leveraging particular social networks (bonding, bridging, and linking) to obtain financial and informational access influences small business perceptions of recovery. Data was collected through a survey of 200 businesses in Salt Lake City, UT affected by the COVID-19 pandemic and analyzed using logistic regression. The findings indicate that: (1) small businesses that utilized bonding, bridging, or linking networking experienced negative recovery; however (2) HUGOs that utilized linking networks were more likely to experience a positive recovery than non-HUGOs. The research underscores the importance of diversifying social networking channels for successful HUGO business recovery and points to the need for economic recovery programs that build this networking capacity.

Enhanced recovery program in ambulatory pediatric urology: A quality improvement initiative

Enhanced Recovery After Surgery (ERAS) was established in 2001 for adult patients undergoing complex procedures. ERAS in adult ambulatory surgery later followed with similar positive outcomes. For the pediatric population, ERAS implementation has shown promising results in complex surgeries such as bladder reconstruction. Its application in pediatric ambulatory surgery has only recently been reported. We hereby report a Quality Improvement initiative in implementing an Enhanced Recovery Protocol (ERP) for pediatric urology in an ambulatory surgery center. A project was launched to evaluate and implement enhanced recovery elements into an institutional Enhanced Recovery Protocol (ERP). These included reliance on peripheral nerve blocks for all inguinal and genital cases and reduction of opioids intraoperatively and postoperatively. Improvements were placed into a project plan broken into one preparation phase to collect baseline data and three implementation phases to enhance existing and implement new elements. The implementation phase went through iterative Plan-Do-Study-Act (PDSA) cycles for all sub-projects. Team countermeasures were based on available evidence. A consensus process was used to resolve disagreement. Monthly meetings were held to share real-time data, gather new feedback, and modify plans as needed. The primary outcome measures selected were percent intraoperative opioid use, percent opioid prescribing, mean PACU length of stay, and average number of opioid doses prescribed. Secondary outcome measures were mean maximum pain score in PACU, PACU rescue rate for PONV, and patient/family satisfaction scores. Post-implementation data for 18 months was included for evaluation. Statistical process control methodology was used. The total number of participants was 3306: 561 (baseline), 220 (Phase 1) 356 (Phase 2) and 527 (Phase 3), 1642 (post-implementation). Intraoperative opioid use was eliminated in >99% of cases. Post-operative opioid prescribing was reduced from 30% to 15% of patients. The number of opioid doses was also reduced from an average of 7.6 to 6.1 doses. There was no change for the mean maximum pain score in the recovery room despite elimination of opioids. Patient/family satisfaction scores were high and sustained throughout the period of study (9.8/10). Balancing measures such as return to the operating room within 30 days and return to the emergency department within 7 days were unchanged. This QI project demonstrated the feasibility of a pediatric enhanced recovery protocol in a urology ambulatory surgery setting. With implementation of this protocol, intraoperative opioid use was virtually eliminated, and opioid prescribing was reduced without affecting pain scores or post-operative complications.

Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000-2020 NC State Inpatient Database.

Opioid use disorder (OUD) is characterized as a chronic condition that was first outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and now the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. It encompasses frequent opioid usage, cravings, the development of tolerance, withdrawal symptoms upon discontinuation, unsuccessful attempts to quit or reduce use, and recurrent use even when faced with negative consequences. Both national- and state-level data show that overdose deaths associated with prescription opioids are increasing at an alarming rate. The increasing overdose deaths from illicitly manufactured fentanyl and other synthetic opioids compound this epidemic's burden. The present study sought to determine the prevalence and potential factors associated with OUD in North Carolina. Using the State Inpatient Database, a retrospective cross-sectional study was conducted to identify OUD-related discharges between 2000 and 2020. Descriptive statistics and rates of OUD per 1000 discharges were calculated. Simple and multivariable logistic regression models were used to identify factors associated with increased odds of having an opioid use disorder diagnosis at discharge. The deviance-Pearson goodness of fit statistic was also used. Variables were identified using International Classification of Diseases, Ninth Revision, Clinical Modification, and International Classification of Diseases, Tenth Revision, Clinical Modification, codes in the discharge records. Of 19,370,483 hospitalizations that occurred between 2000 and 2020 in North Carolina, 483,250 were associated with OUD, a prevalence rate of 24.9 cases per 1000 discharges. The highest OUD rates were seen among adults who self-paid for their hospitalization, those with Medicaid, and those with other types of payors such as Workers' Compensation and the Indian Health Service; individuals between 25 and 54 years old; tobacco and alcohol users; Native American patients; patients located in urban areas; patients with lower household income; White patients; and female patients. OUD also was associated with increased odds of having one or more comorbid psychiatric disorders when controlling for other factors. Although preventive measures are crucial, including policies that discourage prescribing opioids for noncancer pain and those that target the manufacturing and distribution of synthetic opioids, providing integrated care for patients with OUD and co-occurring psychiatric and/or physical disorders is equally important. These findings suggest the need for a system-wide public health response focused on the expansion of primary prevention and treatment efforts, including crisis services, harm reduction services, and recovery programs.

Demographic and conservation genomic assessment of the threatened marbled teal (Marmaronetta angustirostris).

Genetic assessment of species that have experienced dramatic population declines provides critical information that is instrumental for the design of conservation recovery programs. Here, we use different sources of molecular data (mtDNA and ddRAD-seq) to evaluate the genetic status of wild and captive populations of marbled teal (Marmaronetta angustirostris), a duck species classified as critically endangered in Spain and near threatened at a global scale. First, we determined the evolutionary and demographic trajectories of the wild population from Spain and the currently much larger population from Iraq, which is also the documented source of European zoo stocks. Second, we evaluated the suitability of the different captive populations for ongoing restocking programs in Spain and assessed their potential impact on the genetic composition of wild populations. Populations from Spain and Iraq were assigned to distinct genetic clusters, albeit with an overall low level of genetic differentiation, in line with their recent divergence (<8000 years ago) and lack of phylogeographic structure in the species. Demogenomic inferences revealed that the two populations have experienced parallel demographic trajectories, with a marked bottleneck during the last glacial period followed by a sudden demographic expansion and stability since the onset of the Holocene. The wild population from Spain presented high levels of inbreeding, but we found no evidence of recent genetic bottlenecks compatible with the human-driven decline of the species during the past century. The captive populations from the two Spanish centers involved in restocking programs showed genetic introgression from European zoos; however, we found limited evidence of introgression from the zoo genetic stock into the wild population from Spain, suggesting captive-bred birds have limited breeding success in the wild. Our study illustrates how ex situ conservation programs should consider the genetic distinctiveness of populations when establishing breeding stocks and highlights the importance of genetically assessing captive populations prior to reinforcement actions.

Abstract 2139: Galectin-3 Plays A Critical Intracellular Role In Macrophages By Promoting The Repair, Removal, And Replacement Of Damaged Lysosomes And Protecting Against Atherosclerosis

Galectin-3 (Gal3) is a β-galactoside-binding lectin predominantly known as a secreted inflammatory biomarker in cardiovascular disease, with significantly elevated circulating levels in patients with atherosclerosis and myocardial infarction. However, the molecular mechanisms of Galectin-3 action and whether its intracellular role contributes to atherogenesis remain unclear. Using several databases of bulk and single cell RNAseq, we first show that Gal3 transcripts are upregulated during plaque progression with particular abundance in the myeloid/macrophage lineage and foamy macrophages. Furthermore, Gal3 transcripts correlate significantly with increases in a network of lysosomal genes, suggesting a possible link between macrophage Gal3 and lysosomal function. Indeed, instigation of lysosome membrane damage in primary macrophages via cholesterol crystals and LLOMe triggers robust recruitment of Gal3 to lysosomes by sensing exposed carbohydrate moieties of proteins including Lamp1. Gal3 recruitment initiates a two-pronged lysosomal recovery program composed of either lysosomal repair involving the ESCRT complex or lysosomal removal and replacement involving autophagy/lysophagy and TFEB-mediated lysosomal biogenesis. Gal3-KO macrophages corroborate these findings displaying blunted ESCRT recruitment, diminished autophagy and TFEB activation, and resultant accumulation of damaged lysosomes. Gal3-deficiency also results in enhanced apoptosis and inflammasome/IL-1β activation upon triggering of lysosomal stress in macrophages. These findings are recapitulated in vivo, where Gal3-null bone marrow transplanted in atherogenic LDLR-null mice yields increased lesion size as well as altered plaque composition with macrophage accumulation, apoptosis, and necrotic core formation, characteristic features of the advanced plaque. Taken together, our data implicate unique and previously unrecognized protective function for intracellular Galectin-3 in macrophages and atherosclerosis which are distinct from its traditional role as an inflammatory biomarker in cardiovascular disease.

Transforming into a Learning Health System: A Quality Improvement Initiative.

The Institute of Medicine introduced the Learning Healthcare System concept in 2006. The system emphasizes quality, safety, and value to improve patient outcomes. The Bellevue Clinic and Surgical Center is an ambulatory surgical center that embraces continuous quality improvement to provide exceptional patient-centered care to the pediatric surgical population. We used statistical process control charts to study the hospital's electronic health record data. Over the past 7 years, we have focused on the following areas: efficiency (surgical block time use), effectiveness (providing adequate analgesia after transitioning to an opioid-sparing protocol), efficacy (creating a pediatric enhanced recovery program), equity (evaluating for racial disparities in surgical readmission rates), and finally, environmental safety (tracking and reducing our facility's greenhouse gas emissions from inhaled anesthetics). We have seen improvement in urology surgery efficiency, resulting in a 37% increase in monthly surgical volume, continued adaptation to our opioid-sparing protocol to further reduce postanesthesia care unit opioid administration for tonsillectomy and adenoidectomy cases, successful implementation of an enhanced recovery program, continued work to ensure equitable healthcare for our patients, and more than 85% reduction in our facility's greenhouse gas emissions from inhaled anesthetics. The Bellevue Clinic and Surgical Center facility is a living example of a learning health system, which has evolved over the years through continued patient-centered QI work. Our areas of emphasis, including efficiency, effectiveness, efficacy, equity, and environmental safety, will continue to impact the community we serve positively.

ANALYSIS OF CAUSES AND POSTOPERATIVE RECOVERY OF ANTERIOR CRUCIATE LIGAMENT INJURY CAUSED BY AEROBICS IN KNEE JOINTS

Background: During the process of aerobic exercise, there are a lot of jumping and split movements, which can easily cause anterior cruciate ligament (ACL) injury in the knee joint. After undergoing ACL reconstruction (ACLR) surgery, postoperative recovery is crucial. Currently, many methods have been applied, but research on water exercise is still limited. Purpose: This paper aims to understand the role of water exercise in the recovery of athletic ability after ACLR and provide guidance for athletes’ postoperative rehabilitation. Methods: Forty athletes with ACL injuries caused by aerobics practice or competition and undergoing surgery were randomly assigned to either group A or group B. The former received six weeks of a conventional postoperative recovery program, and the latter received six weeks of a water exercise postoperative recovery program. Knee joint range of motion (ROM), swelling value, visual analog scale (VAS) score, knee joint function score, and passive angle reproduction (PAR) were measured before and after the experiment. Results: After six weeks of recovery, the knee ROM was [Formula: see text], the swelling value was [Formula: see text][Formula: see text]cm, the VAS score was [Formula: see text], the Lysholm score was [Formula: see text], and the International Knee Documentation Committee (IKDC) score was [Formula: see text] in group B, which were significantly lower than those before recovery and those in group A ([Formula: see text]). After recovery, the PAR of the affected side was still different from that of the healthy side in the two groups ([Formula: see text]), but the PAR of group B was better than that of group A ([Formula: see text]). Conclusion: Compared to the conventional program, the water exercise-based postoperative recovery program demonstrates better performance in improving knee joint ROM, functionality, and proprioception, and can be used for practical post-ACLR rehabilitation.

Assessment of the Success of Digital Signature and Stamp Implementation in the National Economic Rescue (PEN) Application System at Credit Insurance Companies in Indonesia

Utilization technology in sector industry non-bank finance in Indonesia is increasingly widespread, including in the guarantee credit of state-owned companies. The company uses System Application Guarantee for transaction guarantee credit with produce Certificate Guarantee as proof of approval. The request can be active in the context of the COVID-19 pandemic and the Indonesian government's efforts to implement the company's National Economic Recovery (PEN) program guarantee. Implementation feature sign hand and digital stamp on the System Application PEN underwriting allows provision of document Guarantee Certificate in the form of legal and supportive softcopy restrictions contact physique during a pandemic. Study This aim is to measure the successful implementation features of the success models by Delone and McLean and analyze the connection between variables in research. The benefits cover assessment, evaluation, and strategy-based results evaluation using feature sign hand and digital stamp. Delone and McLean's original model was modified to eliminate variable intention to use. The research was conducted by analyzing the results of questionnaires from 108 officials' user systems throughout Indonesia. Process of data analysis using the method of Partial Least Square with device SMARTPLS software. Research results prove that quality systems will influence the satisfaction of future users who will be influential to benefit clean from the feature sign hand and digital stamp on the System Application PEN Guarante.

Analysis of Quality of Life Among Covid-19 Survivors in Medan

The Covid-19 pandemic is a global challenge with significant impacts in various countries, including Indonesia. This study investigates the quality of life of Covid-19 survivors in the Medan Sunggal Sub-district, considering age, gender, education, employment status, and disease duration. Descriptive research was conducted from March to June 2023, involving 146 respondents aged 16-55 who had survived for one year. The snowball sampling method was applied, and data were collected using the SF-36 questionnaire. Results showed that early adulthood and female age groups tended to have better quality of life. Higher education was also positively correlated with quality of life. The implications of these findings support the development of specific recovery and support programs for Covid-19 survivors, especially those experiencing prolonged symptoms. With a better understanding of the factors that influence the quality of life of Covid-19 survivors, recommendations include developing rehabilitation and support programs tailored to individual characteristics. These efforts are expected to support optimal recovery and contribution to the response to the pandemic in Medan Sunggal Sub-district.

It's not about the money: New evidence on U.S. reconstruction aid in Italy, 1947–68

AbstractThis paper studies the economic impact of foreign aid on Italian firms. In particular, I study the different effects of three main forms of aid: Export–Import Bank loans, Marshall Plan European Recovery Program (ERP) ‘dollars’ loans and the Marshall Plan ERP ‘lire’ loans. In all programmes, the United States sent technologically advanced machinery to allow for a modernization of the technology of Italian firms, but the conditions of such loans differed. This paper tests how crucial such different features have been for the effectiveness of firm reconstruction aid. By creating a new dataset on recipient firms and linking it to a large comprehensive firm‐level dataset (Imita.db), I compare the effects on the performance of firms. I find that the Export–Import Bank loan raised the long‐run profitability of firms, but that firms which received more flexible forms of Marshall Plan aid (‘ERP‐lire’) raised their performance much more than Export–Import Bank recipients. Recipients who only received funds provided with long delays (‘ERP‐dollars’) did not benefit from them. This evidence suggests that rather than receiving foreign aid per se, the most crucial features of reconstruction aid in Italy have been obtaining the requested goods on time and adjusting requests to receive the most needed productive goods.

Impact of enhanced recovery program implementation on postoperative outcomes after liver surgery: a monocentric retrospective study.

It is still unclear whether enhanced recovery programs (ERPs) reduce postoperative morbidity after liver surgery. This study investigated the effect on liver surgery outcomes of labeling as a reference center for ERP. Perioperative data from 75 consecutive patients who underwent hepatectomy in our institution after implementation and labeling of our ERP were retrospectively compared to 75 patients managed before ERP. Length of hospital stay, postoperative complications, and adherence to protocol were examined. Patient demographics, comorbidities, and intraoperative data were similar in the two groups. Our ERP resulted in shorter length of stay (3 days [1-6] vs. 4 days [2-7.5], p = 0.03) and fewer postoperative complications (24% vs. 45.3%, p = 0.0067). This reduction in postoperative morbidity can be attributed exclusively to a lower rate of minor complications (Clavien-dindo grade < IIIa), and in particular to a lower rate of postoperative ileus, after labeling. (5.3% vs. 25.3%, p = 0.0019). Other medical and surgical complications were not significantly reduced. Adherence to protocol improved after labeling (17 [16-18] vs. 14 [13-16] items, p < 0.001). The application of a labeled enhanced recovery program for liver surgery was associated with a significant shortening of hospital stay and a halving of postoperative morbidity, mainly ileus.

Enhanced recovery program in neurosurgery (current trends)

Enhanced recovery program in neurosurgery (current trends)

Racial Disparity in Length of Stay Following Implementation of a Bariatric Enhanced Recovery Program

IntroductionEnhanced Recovery Programs (ERPs) mitigate racial disparities in postoperative length of stay (LOS) for colorectal populations. It is unclear, however, if these effects exist in the bariatric surgery population. Therefore, this study aimed to evaluate the racial disparities in LOS before and after implementation of bariatric surgery ERP. MethodsA retrospective cohort study was performed using data from a single institution. Patients undergoing minimally invasive sleeve gastrectomy or Roux-en-Y gastric bypass from 2017 to 2019 (pre-ERP) or 2020-2022 (ERP) were included. Chi-square, Kruskal–Wallis, and analysis of variance were used to compare groups, and estimated LOS (eLOS) was assessed via multivariable regression. ResultsSeven hundred sixty four patients were identified, including 363 pre-ERPs and 401 ERPs. Pre-ERP and ERP cohorts were similar in age (median 44.3 years versus 43.8 years, P = 0.80), race (53.4% Black versus 56.4% Black, P = 0.42), and preoperative body mass index (median 48.3 versus 49.4, P = 0.14). Overall median LOS following bariatric surgery decreased from 2 days pre-ERP to 1 day following ERP (P < 0.001). Average LOS for Black and White patients decreased by 0.5 and 0.48 days, respectively. However, overall eLOS remained greater for Black patients compared with White patients despite ERP implementation (eLOS 0.21 days, P = 0.01). ConclusionsImplementation of a bariatric surgery ERP was associated with decreased LOS for both Black and White patients. However, Black patients did have slightly longer LOS than White patients in both pre-ERP and ERP eras. More work is needed to understand the driving mechanism(s) of these disparities to eliminate them.

Beyond ‘responsibility vs. responsiveness’: reconfigurations of EU economic governance in response to crises

ABSTRACT The Covid-19 pandemic led to an important reconfiguration of economic governance in the European Union towards deeper economic integration. This fits uneasily with predictions of an inevitable political ‘lock-in’ stemming from a responsibility–responsiveness dilemma, or an inexorably constraining politicisation. Investigating the evolution in discourses on and policies of economic governance in the EU, the papers in this collection approach the relationship between prevailing notions of responsible and responsive government as socially constructed and critically contingent upon politicisation processes. The special issue explores the reconfiguration of economic governance in the EU through multi-level analysis of politicisation, ranging from citizens’ attitudes to conflicts over central banking mandates, using a variety of methodological toolkits. As the collection shows, the shift towards investment, fiscal sharing, and green transition in the new recovery programme followed the emergence of a form of ‘responsive responsibility’ dating back to the aftermath of the euro crisis and which has led to the incorporation of responsiveness imperatives in prevailing notions of ‘responsible government’.

Focus Strategy of Business Products Through Competitive Performance

Based on year-on-year growth, Indonesia's economic growth in the first quarter of 2020 was largest in the information and communication sector, namely 0.53% through the use of the digital economy which plays an important role in supporting the economy through the downstreaming of information technology. The important role of Micro, Small and Medium Enterprises (MSMEs) as contributors to Gross Domestic Product in the recovery of the Indonesian economy, the government is committed to continuing to support MSMEs so that they can survive, develop and grow amidst the crisis. pandemic challenges and transformation through the National Economic Recovery Program (NoF 2021). Jayapura Province recorded significant progress in terms of the growth of cooperatives and SMEs in supporting government programs with 944 business units spread across 20 districts and cities (Papua.go.id) followed by an increase in regional income and alleviating poverty in the region. Quantitative methodology with a sample size of 110 SMEs using 5 Likert scales. The analysis tool uses SEM PLS. The results of this research show that there is a significant positive influence between growth strategy, focus strategy, technology selection on competitive performance.