BACKGROUND: The 2010 Child Dental Care Reform of the National Health Insurance Law marked a turning point in the Israeli oral healthcare system by establishing Universal Health Coverage of dental care for children. Initially, the reform included children up to age 8 and gradually expanded to age 18 in 2019. The basket of services includes preventive and restorative treatments provided by the four Health Maintenance Organizations (HMO). The aim of this study was to examine the uptake of child dental services during the first decade of the reform.
METHODS: A retrospective analysis was conducted to determine the treatment uptake, type and amount of the services delivered based on annual service utilization reports submitted by the HMOs to the Ministry of Health in the years 2011-2022.
RESULTS: The number of insured children increased from 1,546,857 in 2011 to 3,178,238 in 2022. The uptake of dental services gradually increased during the study period with a slight decrease in 2020. The percentage of children who used the services gradually increased from 8 to 33%, with the incremental inclusion of additional age groups. From 2012 onwards the most common treatments provided were preventive, however the single most common treatment was dental restoration. In 2022 35% of the population of Israel was under the age of 18. Out of these, about a third received dental treatment via the HMOs. This is a significant achievement, since before the reform all treatments were paid out-of-pocket. After a short period of increasing uptake, a stable service utilization pattern was evident that can indicate better public awareness and service acceptance.
CONCLUSIONS: Although this is a reasonable uptake, additional efforts are required to increase the number of children receiving dental care within the public insurance. Such an effort can be part of a multi-disciplinary approach, in which pediatricians and public health nurses can play a vital role in dental caries prevention, enhancement of awareness and service utilization.

Saudi Arabia guarantees citizens the right to receive medical care and treatment during emergencies or sickness and aging. However, with the consistent increase in expenditure and inability to provide access, the transformation was an unavoidable action. Therefore, this paper aims to address the potential and risks behind the National Transformation Program (NTP) in Saudi Arabia through the lens of the Value Transformation Framework. Multiple research databases (PubMed, Web of Science, UpToDate, Google Scholar, and Summon) were searched between 2016 and 2024. Relevant articles were selected by scanning the title and abstract, yielding 34 references after the screening, exclusion, and inclusion criteria were met. Citation software was used to identify additional sources as analysis proceeded, in accordance with the hermeneutic approach in mapping and classification. The most cited concerns were the sustainability and workforce of the healthcare system. In terms of care delivery, the literature was extensive. In contrast, insufficient studies have been conducted on infrastructure and people. Furthermore, limited information is available on how to assess the transformation, which remains an unaddressed research question. NTP could meet several hurdles. However, through the measurement, assessment phases, and development tracking, success could be achieved.

In response to China\'s incentive for \"connotative development\" in doctoral education, universities are actively fostering creative and innovative PhD candidates with enhanced research productivity and superior educational quality. A Chinese university, aligning with this objective, has initiated significant reforms in its doctoral admission methods, introducing a new type of student and altering the proportion of existing ones. Recognizing the complexity and uncertainty inherent in the doctoral admission process, this theory-based study employs a Theory of Change framework to systematically evaluate the immediate, intermediate, and long-term outcomes of this university\'s interventions. It assesses the transformative impact of these changes by integrating secondary data with qualitative insights, including focus group discussions with twelve students and semi-structured interviews with three supervisors. The study reveals that while this university has made substantial progress in achieving short-term goals, these reforms have not uniformly benefited all student categories, presenting distinct challenges and opportunities for stakeholders. Consequently, it advocates for diversifying the student composition and emphasizes inclusive pedagogical strategies to facilitate high-quality doctoral education. Importantly, this research extends beyond this university, promoting a balanced mix of student profiles and a holistic approach to shaping effective policies and practices within doctoral admission, essential for navigating global competition.

Until 1994, men were not recognized legally as victims of rape in England and Wales. This article explores the history of male survivors of rape there, establishing the uneven patchwork of support services available to them prior to 1994. It argues that a growing psychiatric literature which studied male survivors of sexual violence was a major factor in convincing lawmakers to include men as potential victims of rape in updated sexual offence legislation. Other medical professionals played key roles in bringing male survivors to police attention, but psychiatric research was most influential in changing the policy agenda in this arena.

This study investigates the potential economies of scope in the Norwegian public hospital sector after a major structural and organizational reform. Economies of scope refers to potential cost savings occurring from the scope of production rather than the scale. We use a data driven approach to distinguish between relatively specialized and differentiated hospitals. Using registry data spanning the period 2013-2019, we use non-parametric data envelopment analysis with bootstrapping procedures to investigate the potential presence of economies of scope. This is done separately for three different dimensions of which hospital production can be either specialized or differentiated. The findings suggest that economies of scope are present in the Norwegian hospital sector, meaning that there are cost savings related to the optimal differentiation of the activity. It is difficult to conclude on how these findings relate to the reform.

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This paper explores the cascading influence of revolutionary moments on democracy and inequality, not at home, but across borders. We use data on revolutions and other social upheavals over the past 120 years and examine their cross-national impact on a range of variables in neighboring countries. Engaging with debates on whether substantial democracy and equality increases require extraordinary circumstances, our research investigates whether revolutionary activities induce consequential spillovers, such as policy concessions from elites in neighboring contexts. In exploring spillover effects, the paper examines how significant events in one nation influence social life in adjacent ones. It encompasses an analysis of 171 countries over two centuries, connecting data on revolution with democracy and equality metrics, and hypothesizing that elite fear of revolutionary contagion may necessitate democracy and equality concessions to mitigate potential uprisings. Findings suggest neighboring revolutions positively impact domestic democracy and equality levels. We observe significant increases in an index of democracy and two indices of economic egalitarianism, although one of the egalitarianism measures is robust to all model specifications. Additionally, we find that isolated \"protest-led ousters\" can moderately increase suffrage and one of our indices of egalitarianism, while coups do not seem to impact democracy or inequality variables. By examining various upheaval types and outcomes across time and space, the study illuminates the causal relationship between global mobilizations and local changes, providing insights into how global events inform domestic outcomes.

BACKGROUND: Despite longstanding efforts and calls for reform, Canada\'s incremental approach to healthcare changes has left the country lagging behind other OECD nations. Reform to the Canadian healthcare system is essential to develop a higher performing system. This study sought to gain a deeper understanding of the views of Canadian stakeholders on structural and process deficiencies and strategies to improve the Canadian healthcare system substantially and meaningfully.
METHODS: We conducted individual, ~ 45-minute, semi-structured virtual interviews from May 2022 to August 2022. Using existing contacts and snowball sampling, we targeted one man and one woman from five regions in Canada across four stakeholder groups: (1) public citizens; (2) healthcare leaders; (3) academics; and (4) political decision makers. Interviews centered on participants\' perceptions of the state of the current healthcare system, including areas where major improvements are required, and strategies to achieve suggested enhancements; Donabedian\'s Model (i.e., structure, process, outcomes) was the guiding conceptual framework. Interviews were audio-recorded, transcribed verbatim, and de-identified, and inductive thematic analysis was performed independently and in duplicate according to published methods.
RESULTS: The data from 31 interviews with 13 (41.9%) public citizens, 10 (32.3%) healthcare leaders, 4 (12.9%) academics, and 4 (12.9%) political decision makers resulted in three themes related to the structure of the healthcare system (1. system reactivity; 2. linkage with the Canadian identity; and 3. political and funding structures), three themes related to healthcare processes (1. staffing shortages; 2. inefficient care; and 3. inconsistent care), and three strategies to improve short- and long-term population health outcomes (1. delineating roles and revising incentives; 2. enhanced health literacy; 3. interdisciplinary and patient-centred care).
CONCLUSIONS: Canadians in our sample identified important structural and process limitations to the Canadian healthcare system. Meaningful reforms are needed and will require addressing the link between the Canadian identity and our healthcare system to facilitate effective development and implementation of strategies to improve population health outcomes.

This article introduces a special, 20th anniversary issue of the Journal of Educational Change. The special issue edictoras have organized significant international contributions to theory-building into three areas. These concern diverse modalities of educators\' professionalism, debates around \"getting to scale\" with successful innovations, and conflicting views of social justice in schools and societies. Each of these areas comprises an independent vector of disagreement and debate, with differing meaning and interpretations based upon the cultures and histories of the given systems under review. The article asks what kinds of new research, and what kinds of affiliated theories in these topic areas, can best help to move the field of educational change forward in the coming years.

BACKGROUND: The objective of this article is to explain the political factors determining the relatively weak performance of the Polish health care (HC) sector. This can be treated as a critical case for several reasons. First, the Poles are among the most unsatisfied patients in the European Union, with one of the lowest life expectancy levels. Second, Poland spends one of the lowest shares of gross domestic product on HC-related expenditures among OECD countries. Third, the country is facing medical personnel shortages.
METHODS: The analysis is based on the mixed-methods approach. The authors rely on quantitative data outsourced from a survey, which is supplemented by the semistructured, in-depth interviews with selected key HC stakeholders representing patients\' advocacy groups, medical personnel organizations, and high-level decision-makers.
RESULTS: The Polish HC system remains weak due to the postcommunist legacy in terms of organization, a short-term approach by politicians, and weak decision-making processes.
CONCLUSIONS: The HC policy inertia in Poland is determined by a group of interrelated political factors that effectively block the development of any positive reform.