In 2007, a Danish national policy to future-proof emergency department (ED) performance was launched. The policy included several recommendations for the management and organisation of care that ...essentially introduced greater ED autonomy. In this study, we evaluate the effects of increased ED autonomy on readmission, mortality and episode costs for two large patient groups.
A non-randomised stepped wedge study-design where all EDs gradually implemented the policy at different steps during the study period (2008-2016). The timing and extent of policy implementation was determined from a retrospective cross-sectional survey of all 21 Danish EDs. This was linked to all episodes of hip fracture (n = 79,697) and erysipelas (n = 39,900) identified in the Nation Patient Registry and with episode-level outcomes. Mixed effect models were specified for the outcomes of 30-day readmission, 30-day mortality and episode costs, and adjusted for relevant ED- and episode-level heterogeneity.
Increased ED autonomy was associated with more readmissions (p<0.05) and higher episode costs (p<0.001) in hip fracture episodes. In erysipelas episodes, no general associations were found. When restricted to night-time admissions, increased ED autonomy was associated with poorer outcomes for erysipelas episodes and increased episode costs for both patient groups.
The intended policy effects were not found for these two patient groups; in fact, reorganisation appeared to have harmed hip fracture patients and increased episode costs. Uncertainty remains regarding the longer-term consequences.
The Belt and Road Initiative (BRI) is a central policy of the Chinese government. The initiative is directly associated with President Xi Jinping, who first put forward the BRI in Kazakhstan and ...Indonesia in 2013, initially as One Belt One Road. Different from repetitive literature that concludes the BRI as China's global strategy, this article makes a contribution to argue that the BRI is China's domestic and non-strategic policy.
To justify this argument, this article analyses how the BRI has been embedded into aspects of Chinese domestic policy by revealing its nexuses with Chinese domestic economy, politics and ideology. To deepen the understanding of the BRI's connection with the Chinese economy, this article explores the link between the BRI and China's supply-side structural reform. Meanwhile, this research demystifies the BRI as a global strategy and the difference between joining and rejecting the BRI to prove the BRI's non-strategic essence. In the end, this article discusses the BRI's far-reaching geopolitical influence.
Context
Women, transgender men, and gender non‐binary individuals facing unwanted pregnancy use online resources for abortion information. We sought to determine the informational and emotional needs ...that those seeking abortion information on Reddit expressed immediately following the Dobbs v. Jackson Women's Health Organization (Dobbs) decision in the United States. Furthermore, we aimed to understand how the Reddit community addressed these needs.
Methods
We collected posts on Reddit in the subreddit r/abortion that expressed informational or emotional needs related to the Dobbs decision created between June 24, 2022 and July 24, 2022. We identified posts using keywords including “roe,” “rvw,” and “trigger law” and then manually reviewed them to ensure relevance. We analyzed posts and their comments using qualitative descriptive analysis.
Results
One hundred and ten posts met inclusion criteria. Original posters expressed needs for legal and medical information. Posters also expressed need for logistical support, including help accessing medication abortion, traveling out of state, and financing abortion care, and emotional support in general and resulting from fear of parental disapproval and shame relating to abortion stigma. Although responders to these comments addressed these needs by offering general support, accurate information, and reliable resources, intersecting and emotional needs sometimes went unaddressed.
Conclusion
The Dobbs decision caused confusion and panic among abortion seekers requesting guidance on r/abortion, resulting in informational and emotional needs. While the r/abortion community actively addressed needs, inherent limitations of an online forum prevented some original posters from receiving the multifaceted support they needed.
The logistics industry is a derivative industry of manufacturing services extraposition. A variety of strategies to develop the manufacturing industry are important programs of action for China's ...manufacturing strategic power, and it is of great significance to promote the high-quality development of the logistics industry. This paper takes strong manufacturing provinces with the development of the logistics industry as the research object and applies network DEA measuring the production efficiency and service efficiency of the logistics industry from 2004 to 2017. This paper adopts the "Made in China 2025" strategy as a natural experiment and uses double difference to study the impact of manufacturing policies on the high-quality development of the logistics industry. The empirical results show that compared with the Reference group, the impact of the "Made in China 2025" strategy led to a significant increase in the production efficiency and service efficiency of the experimental group. The group-based test based on innovation type shows that independent innovation has a significant positive effect on the high-quality development of the logistics industry, which shows that from the perspective of technological innovation, independent innovation is the main path of the "Made in China 2025" strategy to promote the high-quality development of the logistics industry. This paper not only identifies the causal relationship between the "Made in China 2025" strategy and the high-quality development of the logistics industry but also helps clarify the mechanism of how manufacturing policies improve the high-quality development of the logistics industry, which has important implications for further promoting the combined development between manufacturing and logistics.
A leader's culpability for involving his state in a conflict affects both his war termination calculus and his domestic audience's willingness to punish him if he loses. I define a culpable leader as ...any leader who either presides over the beginning of a war, or comes to power midwar and shares a political connection with a culpable predecessor. Using a data set created specifically for this study, I find that culpable leaders are more likely than nonculpable ones to achieve favorable war outcomes. I also find that domestic audiences will be willing to punish culpable leaders who lose, yet spare nonculpable leaders who do the same. Taken together, my findings underscore the need to appreciate more fully the role individual leaders play in bringing their states to war.
Sommaire
Au gouvernement du Canada, les rapports d'évaluation de programmes contiennent des recommandations qui visent l'amélioration de leurs modalités et de leur mise en œuvre. L'élaboration de ...recommandations peut constituer une étape laborieuse de la démarche évaluative et mobiliser plusieurs parties prenantes. Cependant, peu d'études ont été réalisées afin de déterminer comment ces recommandations sont élaborées et si elles sont ensuite mises en œuvre par les responsables des programmes. Cet article présente les résultats d'un sondage mené auprès des directions d'évaluations fédérales afin de mieux cerner les enjeux relatifs à l'élaboration et à la mise en œuvre des recommendations. Les résultats témoignent d'un niveau élevé d'implication des parties prenantes à la démarche évaluative et à l'élaboration des recommandations, ce qui soutient une utilisation accrue des évaluations. Les résultats de l'étude confirment ceux d'études antérieures et démontrent que les recommandations sont principalement axées sur l'amélioration de l'efficacité et de l'efficience des programmes plutôt que sur la prise de décision plus stratégique.
In Canada's government, program evaluation reports include recommendations aimed at improving their procedures and implementation. The development of recommendations can be a tedious step in the evaluation process and involve several stakeholders. Nevertheless, little research has been done in order to define how these recommendations are developed and if they are implemented afterwards by program managers. This article introduces the findings from a survey taken by federal evaluation directors, in order to better grasp the issues related to the development and implementation of recommendations. The findings demonstrate a high level of support from stakeholders towards the evaluation process and development of recommendations, which supports an increased use of evaluations. This study's findings corroborate those of previous studies and show that recommendations are mainly focused on improving the effectiveness and efficiency of programs, rather than on the more strategic decision making.
Mankind is facing one of the greatest events in contemporary history. The prevalence of corona disease has dramatic economic, political and social consequences and is changing the individual and ...collective culture and behavior of human beings. The research question is that “How the coronavirus pandemic will impact on the domestic politics and international relations?” The authors believe that in the post-Corona period, we will see the rise of nationalism and the Strengthening the state role in governing the community and the transformation of public health into a matter of national security. In the foreign field, Governments will withdraw from the globalization process to save the lives of their citizens by restricting the free movement of people and goods and by tightening immigration policies and protecting borders. The research findings indicate that has changed the nature of threats in the 21st century and inequality in economic and social structures and a lack of health care can challenge the internal security of governments. Also, corona reminds us that global politics must be reformed, contrary to the principles of neoliberalism and minimal government.
The dominant perspective on federalism and American public opinion suggests that Americans simply do not consider federalism when making policy evaluations. Recently, however, several scholars have ...argued that even if Americans do not make legalistic or theoretical references to federalism, they often think intuitively about intergovernmental politics. This study presents the results of a three-part survey experiment designed to assess how readily individuals come to think about federalism when evaluating public policy. In general, individuals do not consider the intergovernmental implications of policy, even when asked to explicitly compare two levels of government. Overwhelmingly, individual preference for government activity obscures concerns for federalism in eight of nine substantive policy domains. Yet, this indeterminacy does not mean that public opinion is irrelevant for studies of American federalism. Rather, it is a highly malleable instrument that political elites can use to leverage public support for policies.
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