The application of health industry policies could be discovered more quickly and comprehensively through the automated identification of policy tools, which could provide references for the formulation, implementation, and optimization of subsequent policies in each province. This study applies the Bidirectional Encoder Representation from Transformer (BERT) model to identify policy tools automatically, utilizes Focal Loss to reduce the unbalance of a dataset, and analyzes the evolution of policy tools in each province, which contains time, space, and topic. The research demonstrates that the BERT model can improve the accuracy of classification, that supply and environment policy tools are more prevalent than demand tools, and that policy instruments are organized similarly in four major economic regions. Moreover, the policy\'s attention to topics related to healthcare, medicine, and pollution has gradually shifted to other topics, and the extent of policy attention continues to be concentrated on the health service industry, with less attention paid to the manufacturing industry from the keywords of the various topics.

Building a marine ecological security shelter (MESS) has become the main strategy to adapt marine ecological threats in China. As China\'s marine policy lacks a robust framework document, it is necessary to consider whether the policy system can effectively support the construction of MESS. However, the linkage between the construction measures of MESS and related policies is not clear. Therefore, the purpose of this paper is to clarify the concept of MESS and its connection with policy, by adopting the policy content analysis method to analyze the evolution process of MESS-related policy system. The legislative shortcomings and implementation obstacles of the MESS-related policy system are then summarized and discussed. The results show that from 1981 to 2021 the MESS-related policy system has been continuously improved. However, the policy system\'s support and guarantee capacity for building MESS still needs to be improved. (1) Due to the lack of basic laws and special laws, the coordination among governance subjects and among policies lacks legislative guarantee. (2) The construction of MESS continues the inter-regional and inter-department administrative barriers in collaborative governance of marine environment. To establish an effective collaborative governance model, it is essential to improve the governance structure and mechanism. (3) The government-led governance pattern faces the problem of mechanism failure. The command and control instrument accounts for more than 82%, and the public and enterprises lack strong policy guarantees to participate in marine governance. (4) The policy system\'s adaptability to emerging threats must be improved. Marine policies rarely involve emerging threats such as climate change and new pollutants. Meanwhile, the real-time supervision and monitoring mechanism is weak. The real-time supervision is only accounting for about 10%. Generally speaking, as a complex and long-term system engineering, the construction of MESS will inevitably encounter contradictions in politics, culture, and economy. China should deepen the construction of marine ecological civilization and form a governance concept based on ecosystems. Overall, this paper helps to understand the internal connection between MESS and policy comprehensively and provides a new perspective for improving China\'s marine governance capacity.

Senegal has long sought solutions to achieve universal health coverage (UHC). However, in a context dependent on international aid, the country faces multiple external pressures to choose policy instruments. In this commentary, we propose an analysis of this influence. The empirical material comes from our involvement in analysing health reforms for 20 years and from many interviews and observations. While studies have shown that community-based health insurance (CBHI) was not an appropriate solution for UHC, some international actors have influenced their continued application. Another global partner proposed an alternative (professional and departmental CBHI), which was counteracted and delayed. These issues of powers and influences of international and national consultants, established in a neo-liberal approach to health, have lost at least a decade from UHC in Senegal. The alternative now appears to be acquired and is scaling up at the country level, witnessing a change in the current policy paradigm.

As a nature-based solution for climate change mitigation, blue carbon has been highlighted for realizing carbon neutrality in China. China\'s central and local governments have issued many policies to promote blue carbon protection and development. However, scaling up blue carbon restoration and protection is required for its substantial contribution to carbon neutrality. This study evaluates the characteristics of China\'s blue carbon policies using qualitative document analysis based on policy instrument theory. The distribution of different policy instruments among blue carbon policies and resources is analyzed. Suggestions for improving blue carbon policy supply are put forward combined with comparative experience from international organizations and other jurisdictions. The following policies should be strengthened to secure efficient blue carbon protection, restoration, and creation: blue carbon protection legislation, marine ecological compensation system, stable investment in blue carbon projects, integrated blue carbon verification system, and inclusion of blue carbon in regulated carbon markets.

Extended producer responsibility (EPR) schemes have effectively increased the plastic waste that is separately collected. However, due to the structure of the recycling industry, EPR cannot increase recycling rates up to the target levels. Additional policy instruments to increase recycling rates such as recycled content targets, green dot fees bonus for recycled content, recycling targets and taxes on non-recycled plastic packaging have been discussed on a political level in the last years. However, very little research has quantitatively studied the effectiveness of these policy interventions. Using a partial equilibrium model, this paper examines the effectiveness of the implementation of the aforementioned policy instruments to increase recycling rates and the impact on different stakeholders of the value chain: plastic producers, consumers, producer responsibility organization and recyclers. Results show that direct interventions (recycled content standards and recycling targets) have the benefit of decoupling the recycling industry from external markets such as the oil market. They can be a good starting point to increase recycling, but in the long term they may be restricting by not presenting incentives to achieve recycling levels beyond the targeted amounts and by limiting technological innovation. On the contrary, economic interventions such as a green dot fee bonus or a packaging tax create economic incentives for recycling. However, these incentives are diminished by the lower perceived quality of packaging with higher recycled content levels.

Governments in Australia and internationally are experimenting with policy instruments to facilitate the adoption of farming practices with reduced environmental impacts. The Great Barrier Reef (Australia) is one such case, where sustained efforts over 20 years have yielded insufficient progress towards targets to reduce the impacts of agriculture on water quality in downstream marine ecosystems. We present a critical review of policy instruments as implemented in Great Barrier Reef catchments. We catalogue the evolving mix of policy instruments employed in reef programs, and examine evidence of the effectiveness of agricultural extension, financial incentives, and direct regulation of farming practices. There is little robust evidence to assess instrument effectiveness, in part due to the evolving mix of the instruments employed, weak program evaluation and heterogeneity of agricultural enterprises. We identify the need to improve the understanding of instrument fit to landholders and enterprises. We recommend a modelling approach to clarify pathways to impact and guide improved policy evaluation.

Health care for the elderly is one of the key issues in the field of public health. In the context of global aging, the government\'s policy framework for elderly care affects the development of local elderly care. The priorities and instruments of the elderly care policy are important windows for understanding the local development planning system. This paper uses a quantitative text analysis method based on text mining to analyze 3,618 provincial policies in China. Considering the pilot demonstration projects for elderly care selected by the Chinese government in recent years, this paper finds that local elderly care policies have a three-phase evolution, and the priorities in each phase are solving the legacy of transition, expanding private sector participation, and realizing the well-being of the elderly. Moreover, mature regions use more environmental policy instruments, and the most effective are financial services, regulatory systems, and strategic guidance. For immature regions, it is necessary to use more core instruments on the premise of using basic instruments so that public policies can serve local development and realize the well-being of the elderly.

Following decades of international collaboration to restore the Baltic Sea, we provide an assessment of the domestic implementation of measures agreed to limit diffuse agricultural pollution and the patterns of policy instruments applied. Despite the Helsinki Convention being unusually specific in detailing what measures countries should introduce, we find many shortcomings. These are most pronounced in the larger countries (Poland, Germany and Russia), while smaller countries perform better, notably Sweden and Estonia. The patterns of policy instruments applied differ, influenced by domestic politics. The limited use of complementary policy instruments suggests that other priorities overrule full and effective implementation, with engagement mirroring the advantages that a restored Baltic Sea can bring to countries. Using the European Agricultural Fund for Rural Development to support farmers in managing nutrients, particularly advisory services and investments in modern manure management technologies, represents a significant opportunity for reducing agricultural pollution in most countries.

Because of the size of its population and economy, good environmental governance in Asia is fundamental not only for the well-being of the region\'s population but also for the health of the planet. This article introduces the challenges of governing the environment in Asia. The issue evaluates the outcomes and institutional changes in selected countries related to substantive environmental issues such as air pollution, water quality, municipal solid waste, transport, land use, and climate change. By synthesizing the main research issues, methodology and findings of the growing literature on the region, we highlight the trends in environmental governance and gaps in policy and research. Despite the efforts made, there are still remaining environmental governance challenges to be addressed by both the academics and practitioners in Asia.

OBJECTIVE: Many health systems face challenges such as rising costs and lacking quality, both of which can be addressed by improving the integration of different health care sectors and professions. The purpose of this viewpoint is to present the German health care Innovation Fund (IF) initiated by the Federal Government to support the development and diffusion of integrated health care.
METHODS: This article describes the design and rationale of the IF in detail and provides first insights into its limitations, acceptance and implementation by relevant stakeholders.
RESULTS: In its first period, the IF offered € 1.2 billion as start-up funding for model implementation and evaluation over a period of four years (2016-2019). This period was recently extended to a second round until 2024, offering € 200 million a year as from 2020. The IF is triggering the support of relevant insurers for the development of new integrated care models. In addition, strict evaluation requirements have led to a large number of health service research projects which assess structural and process improvements and thus enable evidence-based policy decisions.
CONCLUSIONS: This article is the first of its kind to present the German IF to the international readership. The IF is a political initiative through which to foster innovations and promote integrated health care.