Strategic Revision Research Articles

The aftermath of ballot box success and failure: evidence from land preservation referendums

AbstractState and local governments put hundreds of referendums on the ballot each year. Often, they pass but sometimes they fail. What happens after a successful or failed attempt at the ballot box? Do advocates go back to voters with another request? And if they do, do they tend to succeed? We employ a regression discontinuity empirical framework to causally estimate referendum dynamics in the arena of land conservation. Our results suggest municipalities where a referendum just barely fails hold about 0.5 more referendums and pass about 0.28 more referendums than municipalities that just barely pass, meaning initial defeat is often reversed. We also investigate whether strategic changes are made in election approaches for those that try again. We find no evidence of systematic patterns in strategic revisions for municipalities that fail their first referendum. However, when revisions are made, our evidence suggests that voters appear to respond positively.

Bibliometrics, the "Clinical Diagnostics" of Research Impact Comment on "'We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research': A Research Impact Evaluation at a Regional Australian Hospital and Health Service".

Following the Townsville Hospital and Health Service (THHS) strategic revision as a "research-based" institution, Brown et al have investigated the impact of THHS research, and its key drivers, based on 15 stakeholder interviews and two quantitative indicators. This commentary argues that the quantitative analyses and findings would have benefitted from applying evaluative bibliometrics, hopefully, conducted by experienced bibliometricians. We present the potential of bibliometrics for assessing the scholarly impact of research, as well as a few examples of its application to the case of THHS, for informing research policies and strategies.

Critical review of School Health & Nutrition Program for achieving Advance Preventive Healthcare for Children in Punjab

The School Health and Nutrition (SHN) program was launched in year 2007-08 in different districts of Punjab, Pakistan. As the core of this program, School Health and Nutrition Supervisors (SHNS) were hired as the main agents to implement the program’s objectives. These SHNS were appointed at Basic Health Units (BHUs) and tasked with the objectives to screen the children in public schools, identify sick children, ensure their medical treatment, referrals, and follow-ups along with conducting health education sessions in their respective schools and communities. The current paper attempted to assess the performance of this program and suggested succinct measures to reform it in order to achieve its desired objectives. It included the analysis of the reasons and bottlenecks due to which the highlighted anticipated outcomes of this program could not be fully realized. After analyzing the qualitative and quantitative shortcomings in the design and implementation of this program, the current article recommends workable solutions based on strategic revisions in both the clinical as well as the procedural part of the program.
 Keywords: adolescent health, preventive healthcare system, rural health, rural nutrition program, school children

NATO AND EU STRATEGIC REVISION. CONTEXTUAL FACTORS BEFORE AND AFTER THE RUSSIAN – UKRAINIAN WAR

The present paper approaches the significant contextual aspects in which 2022 NATO and EU strategic revision process is taking place. The study premises that Russian unjustified military aggression on Ukraine and the subsequent security challenges for the European security environment are only the most recent, visible, and implicitly, attention catching ones, and that the background of the current strategic revision of both NATO and the EU is wider and marked by the succession of internal and external crises in the last decade. However, despite the need to approach all these challenges, Russian invasion of Ukraine has a key role in these organizations’ strategic revision, as it can be considered a wake-up call, an undeniable proof that both NATO and EU have to adapt their role in the regional and international security context. Through this rather descriptive approach, this paper is meant to bring to attention the complexity of the current international and regional context, shaping NATO and EU strategic revision. Also, we will argue that one of the main challenges that are to come after this revision will consist in dealing with NATO-EU relation in the best possible manner. In order to do so, the argumentation will be built departing from the general regional context, taking in consideration both internal and external trends, continuing with the origins and signification of NATO and EUstrategic revision. This will be the basis on which we intend to reveal some of the challenges of NATO-EU relation and how this relation was impacted by the unjustified Russian military aggression on Ukraine. The argumentation capitalizes recent events with relevance for NATO and EU approach to security and is built on inputs from the level of population perception on NATO and EU, as well as from national foreign politics and trends specific to the organizations themselves. Given that this paper was written before NATO actually published its 2022 Strategic Concept, the author will mostly capitalize on EU’s official documents and, implicitly, on EU’s perspective. The study concludes that despite the highly conflict-prone context, there is also a favourable ground not only for the EU to progress in its military dimension, but also for doing this in full coordination with NATO, avoiding duplications.

Acting Local, Thinking Global in Post-War British Anarchism

ABSTRACT Internationalism has always been a major strand of anarchist political thought where it works on several levels. It has described their commitment to dynamic cosmopolitanism but also dictated revolutionary strategy and structured their social alternatives. In the post-war years, however, many anarchist thinkers, confronting the implications of the atomic bomb for state power and global governance, acknowledged the need for strategic revision. Retreating from the idea of revolution as a series of national armed uprisings, they shifted, instead, towards endorsing an ‘act local, think global’ approach to policy. But what did it mean to think global? This article focuses on British post-war anarchists and explores their spectrum of approaches to this strategy shift. While it recognises a common move towards more permeable notions of the local-global dynamic, it also argues for a richer differentiation among their responses than is usually acknowledged.

Strengthening Response Toward Promoting Mental Health in India: A Narrative Review.

Mental health is an essential component of human development. It deals with human ideas and emotions, and it helps to lead a good life by paving the way for healthy minds. The absence of a healthy mind is a substantial hindrance to personal, societal, and national economic, political, and social functioning. For a long time in India, mental illness has been shrouded in stigma, ignorance, and superstition. The National Mental Health Program (NMHP) has undergone major strategic revisions throughout its existence, from instituting a district as the entity for program planning and implementation under the District Mental Health Program (DMHP) to integrating it with the National Rural Health Mission to productively scale up the program. Many researchers reviewed the program, which was also evaluated by governing and non-governmental institutions. Financial and human capital restrictions, a lack of public involvement, inefficient training, poor non-governmental organization/private cooperation, and a deficit of solid monitoring and evaluation system have all hampered the program's impact. A thorough study of the literature on India's unique mental health initiatives was conducted using particular Medical Subject Heading (MeSH) terms, including "community mental health program,""mental health project,""innovative in mental health programs," and "India,"and Boolean operators "AND/OR." The MeSH keywords used were as follows: mental health projectOR ("mental health project" [Mesh] OR "innovative in mental health programs" [Mesh]) AND community mental health program AND("community mental health program" [Mesh]), India OR ("India" [Mesh]). A preliminary search was conducted in Google Scholar and the PubMed database. A total of 55 indexed papers were found, of which 24 articles were duplicates, hence they were removedand the research eventually contained 31 investigations. Over time, it has become clear that a strong focus on community mental health is critical, and that the DMHPand NMHP, in terms of coverage and utilization of their service components, need to be strengthened. As with many other public health programs, public awareness and information, education, and communication programs must be the most important components for change to occur at the community level.Many tactics and innovations also help to democratize mental health care by allowing the integration of mental health programs into primary care, which is more equitable in the long run and leads to "good mental health for everyone."

ECONOMIC NATIONALISM AND PHILOSOPHY OF WAR

The article is devoted to analysis of cause-and-effect connections between such socially meaningful phenomena as economic nationalism and war strategies. The relevance of the issue precisely in the context of such correlations discovers at the level of regionally significant wars and it could be important for modern countries in possible global confrontation or redistribution of geo-economic influence spheres as well. That is why in the article proposed strategic revision of the economic policy for credit-dependent countries – especially in conditions of permanent military threat – in course to creation more effective economic models with elements of protectionism, implementation of national production sector and development of forceful military-industrial systems. This approach will allow to improve defense capacity of countries, provide reliable rear protection and increase industrial activity, which is extremely important for balanced economic systems as it has been demonstrated by experience of developed countries.

A spaced-repetition approach to enhance medical student learning and engagement in medical pharmacology

BackgroundPharmacology is a cornerstone of medical education as it underlies safe prescribing practices. However, medical students have reported unease regarding their perceived proficiency in medical pharmacology. Despite the significant impetus to improve student outcomes, there is little analysis available of the techniques used by medical students to learn, retain and apply medical pharmacology knowledge.MethodsA mixed-methods, student-focused approach was conducted to design and evaluate specific resources developed to address gaps in pharmacology education. This methodology comprised an anonymised scoping survey, followed by semi-structured focus group interviews. We then developed a flashcard resource as an intervention to support long-term revision for academic and clinical success. This resource was released to a cohort of 100 graduate entry preclinical medical students who were invited at the end of year to evaluate the intervention via a subsequent anonymous survey.ResultsThe scoping survey received 103 complete responses. Surveys and focus group interviews revealed that only 50% of students engage in ongoing revision. Amongst our cohort, we identified that the evidence-based technique of spaced-repetition was particularly well regarded. Hence, we developed and evaluated a bespoke resource utilising Anki™, an open-source, spaced-repetition flashcard program. A total of 1208 flashcards spanning 156 distinct classes of drugs with supplementary summary tables, diagrams and explanatory video and summary guides were created. Designed as a strategic revision tool to reinforce learning, evaluation showed students greatly appreciated the “comprehensive” and “well formatted” Anki™ resource that supported existing teaching modalities, with a global rating of 3.8 out of 5.ConclusionsStrategic and personalised resources for medical pharmacology education that assist with in-semester revision and long-term retention are highly valued amongst students for examination preparation and preparedness for practice. Collectively, these results reflect a novel approach to identifying and addressing weaknesses in existing learning resources in a manner that is inclusive of, and acceptable to, medical students.

Sub-national tailoring of malaria interventions in Mainland Tanzania: simulation of the impact of strata-specific intervention combinations using modelling

BackgroundTo accelerate progress against malaria in high burden countries, a strategic reorientation of resources at the sub-national level is needed. This paper describes how mathematical modelling was used in mainland Tanzania to support the strategic revision that followed the mid-term review of the 2015–2020 national malaria strategic plan (NMSP) and the epidemiological risk stratification at the council level in 2018.MethodsIntervention mixes, selected by the National Malaria Control Programme, were simulated for each malaria risk strata per council. Intervention mixes included combinations of insecticide-treated bed nets (ITN), indoor residual spraying, larval source management, and intermittent preventive therapies for school children (IPTsc). Effective case management was either based on estimates from the malaria indicator survey in 2016 or set to a hypothetical target of 85%. A previously calibrated mathematical model in OpenMalaria was used to compare intervention impact predictions for prevalence and incidence between 2016 and 2020, or 2022.ResultsFor each malaria risk stratum four to ten intervention mixes were explored. In the low-risk and urban strata, the scenario without a ITN mass campaign in 2019, predicted high increase in prevalence by 2020 and 2022, while in the very-low strata the target prevalence of less than 1% was maintained at low pre-intervention transmission intensity and high case management. In the moderate and high strata, IPTsc in addition to existing vector control was predicted to reduce the incidence by an additional 15% and prevalence by 22%. In the high-risk strata, all interventions together reached a maximum reduction of 76%, with around 70% of that reduction attributable to high case management and ITNs. Overall, the simulated revised NMSP was predicted to achieve a slightly lower prevalence in 2020 compared to the 2015–2020 NMSP (5.3% vs 6.3%).ConclusionModelling supported the choice of intervention per malaria risk strata by providing impact comparisons of various alternative intervention mixes to address specific questions relevant to the country. The use of a council-calibrated model, that reproduces local malaria trends, represents a useful tool for compiling available evidence into a single analytical platform, that complement other evidence, to aid national programmes with decision-making processes.

National Mental Health Programme-Optimism and Caution: A Narrative Review.

India was one of the major World Health Organization (WHO) member countries to launch its National Mental Health Programme (NMHP) in 1982 in accordance with WHO's recommendations to deliver mental health services to the people under the framework of general health care system in the community. NMHP underwent major strategic revisions over its course, starting from setting a district as the unit for program planning and implementation under the District Mental Health Program (DMHP) to incorporating it with the National Rural Health Mission (NRHM) for effectively scaling up the program. The program also underwent evaluations by government bodies and independent agencies and was reviewed by many researchers. The program has been partly successful in terms of enhancing its reach to community, improving service delivery, and getting increased budgetary allocation, but at the same time, its impact was limited by financial and human resource constraints, lack of community participation, ineffective training, poor NGO/private partnership, and lack of a robust monitoring and evaluation (M and E) system. The latest National Mental Health Policy and the incorporation of its objectives have given a new impetus to the ongoing NMHP, however, its implementation needs to be monitored and the impact is yet to be evaluated. We attempted to review the available literature pertaining to NMHP and DMHP to highlight the determinants of its outcome, with special emphasis on on-going programs and to provide some important future directions.

A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale.

To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed.

Challenges in management of tuberculosis under programmatic conditions: Perceptions of health care providers from four states of India

Background: Among the global estimation of 10.4 million new cases of Tuberculosis (TB) in 2015, 27% of cases are contributed by India. Revised national TB control program (RNTCP) started in 1993, and now heading towards for universal access. Despite its achievements, the program faces number of implementation challenges. This qualitative study explored ‘what is healthcare providers take on it?’. Material & Methods: A total of 28 in-depth interviews were conducted in Uttarakhand, Chhattisgarh, Delhi and Maharashtra from October 2014 to January 2015, under the thematic areas of finance, human resource, and communications. Participants included senior level policy makers like principal secretaries of health, National Health Mission Directors, Director Health Services, state TB officers and district TB officers, medical officers, community volunteers and TB consultants from international agencies. Analytic induction method was used for data analysis. Results: Participants identified many barriers in the overall management and implementation of RNTCP. Convergence of RNTCP needs to be more effective. Inadequate Human resources, issues in public private partnership, insufficient budget allocation and interrupted fund flow, inefficient Information Education and Communication strategy are a few. Conclusion: This study could gather the perspectives of senior health officials, implementers and other stakeholders on challenges in implementation of TB control programme in four states. Challenges perceived by them are vital in strategic revisions of RNTCP.

Conceptualizing translation revision competence: A pilot study on the acquisition of the knowledge about revision and strategic subcompetences

Translation revision (TR) is an important step in the translation workflow. However, translation revision competence (TRC) remains an ill-defined concept. This article addresses that gap by operationalizing TR and by presenting a theoretical TRC model. Subsequently, the article analyses and interprets the results of an empirical pilot study designed to test the presence of two TR subcompetences hypothesized by the TRC model, in an experimental group and a control group of 21 MA language students. The experimental group was given TR training whereas the control group was not. The two subcompetences that were tested using a pretest—posttest experimental design were declarative-procedural knowledge about TR and the procedural strategic revision subcompetence. Both groups of participants replied to questionnaires and performed controlled revision tasks, which were subjected to quantitative statistical analyses. This article provides a detailed analysis of the results and the causes of the limited progress. In addition, it discusses the lessons learnt for both TR training and further research.

Purposefully poetic

ABSTRACTArts education has no firm place in Hawaii's public school system. Even the Board of Education plan and the State Department of Education's plans differ in how they refer to and make recommendations about the place or purpose of arts education. This article reviews examples of competing policy to suggest how arts-integrated style teaching could both bridge the gap and extend strategic goals. The article provides examples of how drama-integrated style teaching has positive social and academic benefits for English language learners that specifically build their self-efficacy, helping such students to become better learners. Using these examples, the article suggests potential strategic plan revisions.

O-Alkylated heavy atom carbohydrate probes for protein X-ray crystallography: Studies towards the synthesis of methyl 2-O-methyl-L-selenofucopyranoside.

Selenoglycosides are used as reactive glycosyl donors in the syntheses of oligosaccharides. In addition, such heavy atom analogs of natural glycosides are useful tools for structure determination of their lectin receptors using X-ray crystallography. Some lectins, e.g., members of the tectonin family, only bind to carbohydrate epitopes with O-alkylated ring hydroxy groups. In this context, we report the first synthesis of an O-methylated selenoglycoside, specifically methyl 2-O-methyl-L-selenofucopyranoside, a ligand of the lectin tectonin-2 from the mushroom Laccaria bicolor. The synthetic route required a strategic revision and further optimization due to the intrinsic lability of alkyl selenoglycosides, in particular for the labile fucose. Here, we describe a successful synthetic access to methyl 2-O-methyl-L-selenofucopyranoside in 9 linear steps and 26% overall yield starting from allyl L-fucopyranoside.

District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results.

Privileges and Immunities of the World Health Organization

This paper presents a brief overview of the World Health Organization’s experience with privileges and immunities, focusing on the sources of its privileges and immunities and the challenges encountered in asserting them and securing their respect. This overview will demonstrate how complex and sometimes elusive the legal protection afforded to the WHO can be. Although the rationale for the WHO’s privileges and immunities is constitutionally founded on the notion of functional necessity,1 the scope and limits of its functions can be blurred or shifting. While the WHO has not faced the dramatic challenges to or denials of its privileges and immunities that other organizations have encountered, the trend of progressive erosion of legal protection in the name of accountability, democratic control by national courts, the protection of human rights and shifting perceptions of the ‘added value’ of international organizations may eventually require a conscious and strategic revision by the international community of the model of international cooperation represented by international organizations.

Collaborative development of enterprise policy

Purpose – The aim of this paper is to integrate an augmented version of the Thompson et al. model of enterprise policy, delivery, practice and research with services marketing models including SERVQUAL and strategic conversations; and demonstrate a practical application of the analysed through the application of N-Vivo qualitative data classification software to create more satisfying enterprise policy recommendations that better reflect the voices of SMEs and other stakeholders. Design/methodology/approach – A five-stage iterative process model to integrate stakeholder input into enterprise policy recommendations is developed through integrating services marketing theory and the Thompson et al. model into a field study of community conversations hosted by the Tasmanian Department of Economic Development, Tourism and the Arts, Regional Development Australia's Tasmanian committee, and local governments. Findings – The five-stage iterative model leverages strategic conversations, analysis (through N-Vivo), comments and revisions, recommendation co-creation, and policy assessment using SERQUAL to craft more satisfying policy recommendations. Research limitations/implications – The first limitation was the time and costs associated with conducting the community consultation workshops and analysing the data. The second limitation was the inability to craft policy quickly in response to a changing environment due to the time taken to collect and transcribe the data, undertake the analysis, and develop and report policy recommendations. The third limitation was the complexity of coordinating three levels of government, which took time and effort because each level had different interests and time frames and were at times distracted by other priorities. Originality/value – This paper contributes to better enterprise policy by providing a process model developed using both theory and a field study to illustrate how policy makers can co-develop policy that is more satisfying to policy stakeholders.

Strategic revisions in the writing of Year 7 students in the UK

This article discusses revisions to personal narrative writing made by Year 7 students (aged 11–12) in a UK secondary school. The concept of strategic revision was used as a basis for analysing drafts and revised texts in order to investigate strategies and techniques deployed by students in the process of revision and how these related to expectations student writers had of their readers.These analyses suggest that, given a reasonably supportive instructional environment, some Year 7 students can revise their own written texts strategically, and that in doing so they may recruit, and perhaps acquire, a range of writing skills and associated procedural knowledge. They also suggest that in the process of revising their texts, some student writers may have altered their expectations of their readers' understanding, ability to interpret and willingness to empathise.Implications for researching writing processes and for the writing curriculum are suggested, including the use of students' revisions to tap into the complex sets of procedural knowledge which seem to underlie aspects of writing and writing development.

Producing Pain

Starting in 1993, the Ultimate Fighting Championship broadcast ‘no-holds-barred’ fights, pitting athletes trained in a variety of combat sports against each other. While critics were scandalized by the permissiveness of these contests, aficionados were stunned by the effectiveness of relatively non-violent fighting techniques. The matches revealed how resilient a trained fighter’s body might become. Fighters had to adapt to several waves of changes in fighting strategies and to strategic revisions of match regulations intended to make them more obviously violent. Seemingly minor changes in the tools available to contestants - ‘mundane technology’ such as the structure of the fighting space, standardized clothing and lightweight gloves - shifted radically how contestants’ bodies could be used. In addition, fighters modified their own bodies to make them better suited for the activity, for example, altering perceptions of pain. Ironically, the mass-mediated presentation of deregulated fighting revealed that, instead of being humanity’s natural state, it was technically demanding, dependent upon substantial enculturation of athletes’ bodies, and far from instinctual.