Why Have Policies Often Remained Symbolic? Understanding the Reasons for Decoupling between Policy and Practice

Why have policies that are unquestioningly accepted as appropriate remained symbolic? To answer the research question, I suggest two possible reasons for decoupling between policy and practice: the characteristics of normative pressure as “the weak enforcement mechanism of law” through the implementation stage and jurisdictions’ capacity to infuse the stories of success based on others’ use to their own day‐to‐day realities. In this article, I seek to reintroduce a seminal contribution of the early institutionalists by challenging the assumption that dimensions of adoption and implementation are synonymous or positively correlated. Empirical findings contribute to provide scholars and practitioners with a larger picture of policy diffusion and support the arguments by Nicholson‐Crotty and Carley that policy learning takes place based on policymakers’ assessment of both “policy actions” and “outcomes” in previously adopting jurisdictions.     

International diffusion of regulatory governance: EU actorness in public procurement

This paper attempts to go beyond actor‐centered explanations of the European Union's (EU) presence in regulatory politics by examining the role of the EU in the diffusion of regulatory norms and practices. We explore the international diffusion of public procurement policy, to which multiple organizations and especially the EU and the World Trade Organization have made an active contribution. Using the “opportunity‐presence‐capability” scheme, we argue that the EU is actively co‐shaping the global agenda on public procurement, mainly as a result of the “opportunity” and “presence” dimensions of its global actorness and its role in the horizontal diffusion of public procurement regulations between international organizations. For “EU as a global actor” literature to offer valuable explanations, an in‐depth analysis of its relationship with other international organizations, such as the World Trade Organization, reveals significant interactions and the co‐shaping of policy agendas.     

Active resistance to democratic diffusion

Recent research on the international diffusion of democracy has focused on demonstrating how diffusion can change regime outcomes. Although there is still debate within the field of democratization over how important democratic diffusion is relative to domestic factors, autocratic leaders believe that democratic diffusion can be a threat to their rule. It is clear that some countries, such as North Korea, prevent diffusion by severely restricting interactions with foreigners and forbidding access to external sources of information. The more intriguing question is how the states that have economic, diplomatic, and social linkages with democratic states prevent democratic diffusion. In other words, what methods do globally-engaged, autocratic governments use to limit exposure to and reduce receptivity to democratic diffusion?In addition to using coercion and economic patronage, autocratic states utilize two non-material mechanisms to prevent democratic diffusion: 1) restricting exposure to democratic ideas and 2) developing alternative narratives about democracy to reduce local receptivity to democratic diffusion. Sophisticated autocratic leaders can limit receptivity to democratic diffusion if they convince citizens that those ideas are “foreign,” will cause “chaos,” or if they believe they already have their own form of democracy. I explore these methods of establishing firewalls to prevent diffusion by examining the cases of China and Kazakhstan, two countries where a high level of economic linkage coincides with a successful continuation of autocratic rule, despite the global spread of democratic norms. China has developed extensive methods to restrict access to foreign ideas about democracy while Kazakhstan has mainly focused on developing an alternative narrative about democracy. This article contributes to the literature on authoritarian persistence and democratic diffusion by investigating the internal methods autocratic leaders adopt to ensure that democratic diffusion does not threaten their rule.     

Policy Diffusion and Performance-based Budgeting

This article applied the policy diffusion model as a theoretical framework for interpreting the international spread of performance-based budgeting, based upon 33 OECD case studies of countries that have implemented this reform. The data show that the historical development of performance-based budgeting was fairly consistent with the diffusion model. In particular, the adoption of performance budgeting took off during 1985–1995 and then accelerated over the following 15 years, and the primary innovators were a group of four English-speaking countries with comparatively laissez-faire economies (the United States, Canada, Australia, and New Zealand). The case studies indicated that performance-based budgeting was generally part of a broader program of governmental reform, that executive agencies were more important than parliaments in managing it, that it became quite important in budget- and policy-making, and that implementing it faced a significant number of challenges.     

手法联合盐酸氨基葡萄糖治疗膝骨关节炎临床观察

目的 基于红外热成像技术评价手法治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效,探讨手法作用机制,形成手法治疗KOA规范化诊疗评估方案。方法 通过简单随机方法将40例KOA患者分为对照组和治疗组,每组20例（治疗组和对照组分别被剔除1例和2例）。治疗组采用手法治疗联合盐酸氨基葡萄糖胶囊口服,对照组采用自我按摩联合盐酸氨基葡萄糖胶囊口服。治疗2周后,以膝关节区域温度、督脉温度、视觉模拟量表（visual analogue scale, VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（the Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC）、连续5次坐立时间、15 m直线连续行走时间为指标,评价两组疗效。结果 两组治疗后VAS评分均显著降低（P＜0.05）;治疗组治疗前后VAS评分差值显著大于对照组（P＜0.05）。两组治疗后WOMAC的疼痛、僵硬、生活功能评分和总分显著降低（P＜0.05）;其中治疗组治疗前后WOMAC总分和僵硬评分差值显著大于对照组（P＜0.05）。两组治疗后连续5次坐立时间、15 m直线连续行走时间均显著降低（P＜0.05);治疗组治疗后连续5次坐立时间、15 m直线连续行走时间降低值显著大于对照组（P＜0.05）。两组治疗后膝关节区域温度显著降低（P＜0.05）,督脉区域温度显著升高(P＜0.05);治疗组治疗后膝关节区域温度降低值和督脉区域温度升高值显著大于对照组（P＜0.05)。两组基于WOMAC总分的临床疗效比较,差异有统计学意义（P＜0.05）,治疗组临床疗效明显优于对照组。结论 中医手法治疗可减轻KOA患者膝关节疼痛、僵硬症状,改善日常生活功能,疗效优于自我按摩。     

针刺对睡眠剥夺受试者面部红外热成像的影响

目的 观察针刺对睡眠剥夺受试者面部新陈代谢热的影响。方法 将64例健康青年受试者随机分为4组：正常睡眠组（A组）、睡眠剥夺组（B组）、睡眠剥夺与小醒脑开窍针法配合申脉、照海穴针刺治疗组（C组）和睡眠剥夺与非经非穴针刺治疗组（D组）。A组保持正常睡眠状态,对B、C、D组同时进行24 h睡眠剥夺,次日应用红外热成像技术检测4组受试者面部热值,及观察C、D组针刺治疗后面部热值的变化。结果 红外热成像图显示,A组面部呈温热状态,B、C、D组面部呈高热状态。A组热值显著低于B组、C组和D组（P<0.05）。B、C、D 3组热值多重比较,差异均无统计学意义（P>0.05）。C、D组针刺治疗后面部热值均较治疗前显著下降（P<0.05）,但C组治疗后面部热值降低值显著大于D组（P<0.05）。结论 睡眠剥夺可导致面部热值升高,小醒脑开窍针法配合申脉、照海穴针刺能够降低睡眠剥夺者面部较高热值,且疗效优于非经非穴针法。     

基于数据挖掘实现成人喉软骨和舌骨CT图像重组的年龄推断

目的 运用数据挖掘技术探索喉软骨和舌骨CT图像重组用于成人年龄推断的可行性.方法 收集413例颈部薄层CT图像,样本年龄范围18～<80岁,将样本随机分为测试集和训练集.参照TURK等的分级方法,对所有样本进行全方位综合阅片分级,将甲状软骨骨化过程分为6级,环状软骨骨化过程分为5级,舌骨大角和舌骨体的骨性结合分为3级....     

技术市场竞争与美国的技术安全化选择

技术市场竞争正成为大国技术竞争中最复杂、最重要和最突出的表现形式。作为霸权国,美国有着以不对称权力优势干预技术市场、重塑技术产业链的政治惯性,市场竞争与权力优势是美国技术安全化的动力追求与能力支撑。美国将技术与安全议题相联结,不仅能够挣脱现有规则与制度的束缚、阻断竞争国既有的技术扩散趋势,还可以动员和捆绑其他国家共同行动,达到最大化控制他国市场选择、保有和扩张国家市场份额的目的。因此,无论是美日半导体技术之争,还是在中美5G技术之争中,当处于崛起状态的竞争国使美国倍感技术市场竞争压力时,美国都以技术安全化手段,在国家和全球的技术市场选择中不断渗透意识形态与安全逻辑,动态持续对目标国进行安全化的塑造与打击。作为当下美国技术安全化主要的目标国,中国需要以更灵活的技术策略应对美国的技术安全化陷阱,从市场拓展、自主创新、企业管理和话语权提升等多方面对美国可能采取的安全化市场打击与压缩的行为作出应对。     

针刺阳陵泉对不同病程缺血性脑卒中偏瘫患者脑效应机制研究

目的 基于功能磁共振成像技术探究针刺阳陵泉对不同病程缺血性脑卒中偏瘫患者的脑效应机制。方法 筛选纳入损伤以单侧基底节区和（或）放射冠为主的40例缺血性脑卒中偏瘫患者分为长病程组24例、短病程组16例。对所有受试者进行1次fMRI扫描,扫描期间给予针刺患侧阳陵泉干预,持续1 Hz的频率平补平泻捻针1分钟,留针8分钟出针。选取双侧半球的辅助运动区（SMA）、背侧运动前区（PMd）、腹侧运动前区（PMv）、初级运动区（M1）共计8个种子点,计算并对比静息态及针刺态下每对种子点之间的功能连接强度的变化及与FMA的相关性。结果 静息态时,长病程组PMv-R与SMA-L之间功能连接度强于短病程组（P＜0.05）;针刺态时,长病程组中SMA-L与PMv-L之间功能连接弱于静息态时（P＜0.05）,短病程组中SMA-L与SMA-R、PMv-R之间、SMA-R与PMd-R之间、PMv-R与PMv-L之间功能连接强于静息态（P＜0.05）;针刺态时,长病程组和短病程组间各对种子点对在针刺态下和全组各对种子点在静息态与针刺态下之间功能连接强度差异均无统计学意义(P＞0.05);长病程组中,针刺态时下肢FMA评分与健侧PMd-L—M1-L之间功能连接强度呈负相关（r=-0.411, P＜0.05）;短病程组中,静息态时下肢FMA评分与PMd-L—M1-L、PMv-R—M1-R之间功能连接强度呈负相关（r=-0.588及r=-0.542,P＜0.05）;在全组中,静息态时下肢FMA评分与PMv-R—M1-R之间功能连接强度呈负相关（r=-0.432, P＜0.05）;上下肢FMA总分与PMv-R—M1-R之间功能连接强度呈负相关（r=-0.319, P＜0.05）。结论 不同病程脑卒中偏瘫患者在接受针刺患侧阳陵泉后在脑结构重组及脑功能重塑的过程中有着差异性的表现,激活的脑区也存在差别,病程时间越长的患者,其大脑病灶侧PMv与健侧SMA之间存在更强的功能连接。针刺阳陵泉时,脑区功能连接在双侧SMA、PMd、PMv、M1之间有特定的效应靶点,可能是改善患者运动功能障碍和神经缺损程度的作用机制之一。     

基 于 功 能 性 磁 共 振 成 像 技 术 探 讨 针 刺 太 冲 穴 脑 激 活 区 的 性 别 差 异

目的 采用功能性磁共振成像(functional magnetic resonance image, fMRI)技术观察针刺太冲穴所激活脑区的性别差异,以阐明针刺效应性别差异的机制。方法 女性组选取25例青年女性志愿者,男性组选取30例青年男性志愿者,针刺志愿者左侧太冲穴并收集fMRI数据。结果 女性组针刺太冲穴激活的脑区有左侧小脑下部、右侧缘上回、左侧中央后回。男性组针刺太冲穴激活的脑区有右侧缘上回、左侧中央盖沟、右侧中央旁小叶。与女性组比较,男性组更广泛地激活了右侧缘上回、右侧中央沟盖。结论 针刺受试者太冲穴激活脑区并不完全对称,针刺效应在大脑具有偏侧性,针刺太冲穴时大脑活动反应存在性别差异。