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5. Strong state, weak system : social health insurance in rural China, 1956-2007

Author

Manuel, Ryan, Yip, Winnie, and Drysdale, Peter

Subjects
368.4
Abstract

A question of great interest to China watchers is whether or not central mandates are successfully implemented, and how. The issues surrounding this question are at the heart of the analysis in this thesis about China's attempts to institute social health insurance schemes in rural areas from 1949 to 2007. The thesis looks at central government attempts to institute social health insurance schemes between 1949 and 2007 and tries to explain the significant variation in enrolment in social health insurance across this experience. The study shows that implementation of social health insurance schemes in rural China, measured in terms of their widespread uptake, succeeded on two occasions. There also have been a number of failures and collapses of social health insurance schemes in rural China. To explain the variation, the thesis first constructs a framework of how rank and authority of decrees work in the Chinese Communist Party. This framework allows an evaluation of how implementation decrees are transmitted down from the centre to local areas (who implement policy). The thesis argues that the issuing of a central decree holding the local Party secretary to account for high enrolment is the necessary and sufficient condition for the central government to ensure high enrolment in social health insurance schemes. The issuing of a central decree is shown only to be a necessary condition, but not a sufficient condition. And the holding of the local Party secretary to account must occur through the Party governance system rather than through the health governance system. The thesis shows that the rise, fall, failure to rise, and then unexpected rise of social health insurance can be explained by the systems of coordination and control used to hold the local Party secretary responsible for ensuring high levels of enrolment in health insurance. It shows that only the local Party secretary can mobilise the local state sufficiently to meet central decree. And only certain central decrees can motivate the local Party secretary sufficiently to mobilise the local state. The thesis concludes by applying this framework to broader questions of health system reform in modern-day China. It draws tentative conclusions as to how wider health system reform can be understood through the thesis' analytical framework and suggests testing this framework in other policy contexts.

Published
2015

8. sj-docx-1-trd-10.1177_26330040221093743 – Supplemental material for Quality of life in Barth syndrome

Author

Kim, Alexander Y., Vernon, Hilary, Manuel, Ryan, Almuqbil, Mohammed, and Hornby, Brittany

Subjects
Medicine
Abstract

Supplemental material, sj-docx-1-trd-10.1177_26330040221093743 for Quality of life in Barth syndrome by Alexander Y. Kim, Hilary Vernon, Ryan Manuel, Mohammed Almuqbil and Brittany Hornby in Therapeutic Advances in Rare Disease

Published
2022
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15. Management of Hemangioblastomas

Author

Alberto Surur, Ricardo Theaux, Lucas Caussa, Silvia Zunino, Ruan Manuel Ryan, Enrique J. Herrera, Juan Viaño, Francisco José Pueyrredon, and J. C. Suárez

Subjects
In vivo magnetic resonance spectroscopy, medicine.medical_specialty, business.industry, medicine.medical_treatment, Arteriogram, Subtotal Resection, medicine.disease, Radiosurgery, medicine, Radiology, Myocardial infarction, Brainstem, business, Survival rate, Diffusion MRI
Abstract

Objective: The aim of this paper is to present our experience in the management of hemangioblastomas. Material and Method: ten patients with sporadic hemangioblastomas (6 male and 4 female; range 4-75 years) were analyzed. Central ventriculography, cerebral arteriogram, cranial CT scan and head MRI (MR spectroscopy and diffusion MRI) were performed. Location was at cerebellum in 8 patients, left occipital lobe in 1 and brain stem in 1. Nine patients were surgically treated and 1 patient underwent stereotactic radiosurgery due to tumour location in the brainstem and surgery was clinically contraindicated. Results: Only onerecurrence occurred in a 4-year-old patient who had undergone subtotal resection and had to be operated 10 years later due to tumor growth. Two patients died; one subject during the immediate post-operative period due to massive gastrointestinal bleeding and cardiac arrest and the other due to myocardial infarction 25 years after surgery. The 8 surviving patients currently present with normal neurological status and have perfectly normal lives, including the subject who underwent stereotactic radiosurgery of brainstem. The survival rate of these patients is 1-16 years.

Published
2018

16. Our Experience in Brain Oligodendroglioma Management in Adults

Author

Ricardo Theaux, Daniel Lerda, Francisco José Pueyrredon, Juan Manuel Ryan, Martín Arneodo, Juan Viaño, Gustavo Jarchum, J. C. Suárez, Silvia Zunino, Alberto Surur, and Enrique J. Herrera

Subjects
Chemotherapy, medicine.medical_specialty, Motor area, business.industry, medicine.medical_treatment, Treatment options, medicine.disease, Radiation therapy, Mean Survival Time, medicine, Immunohistochemistry, Oligodendroglioma, Radiology, business, Brain Oligodendroglioma
Abstract

Objective: to present our 19 years’ experience in the management of oligodendroglioma brain tumors in adults. Materials and Methods: From a series of 505 adult patients with brain tumors operated on from January 1991 to December 2009, 30 cases (5.9%) were histopathologically diagnosed as oligodendrogliomas. Twenty-six of them achieved a good follow-up. Results: from the 26 patients, the age ranged between 23 and 72 years. Histological diagnosis showed pure oligodendrogliomas in 17 patients and 9 cases of oligoastrocytomas. Ki-67 immunohistochemistry was performed in 23 patients: in 16 positivity was less than or equal to 5% and in 7 it was greater than 5%. Chromosomes 1p and 19q were studied in 12 patients with positive co-deletion in 2 and negative in the other 10. Twenty patients were operated on,3 received radiation therapy and chemotherapy, and 1 brachytherapy with Iodine-125 and two were not operated on (because the diagnosis was incidental, the tumor was small and was located in the motor area). Currently, 19 patients are alive (73%) and 7 died (27%). Mean survival time of the deceased patients was 7 years and 2 months and a median of 5 years and 8 months. Conclusion: it is not possible to make statistical analysis because small number of cases, although total removal seems to be the best treatment option, due to our small series of cases, we hope randomized double-blinded future studies will clear up the best choice of diagnosis and treatment.

Published
2018

20. Diversity and Functions of Benthic Macroinvertebrates in Relation to Water and Riparian Conditions in Riverine Channels of Eden and Dibibi, Quirino, Philippines.

Author

CARIG, ELIZABETH T., CARIG, JOEL G., and MANUEL, RYAN P.

Subjects
INVERTEBRATES, FRESHWATER biodiversity, BENTHIC animals, ECOSYSTEM management, OLIGOCHAETA
Abstract

Benthic macroinvertebrate diversity provides information on the quality of freshwater ecosystems. The dynamics of freshwater bodies and surrounding riparian zones in Eden and Dibibi were described using the ecology of macroinvertebrates. Various macroinvertebrate indices were used to calculate organic pollution levels. A total of 165 specimens were collected, representing five families, four orders/suborders, and three morphotypes. The two river channels have very low alpha diversities (H'Eden=1.43 and H'Dibibi=1.41). For both channels, dominance is distributed to about three taxa (1/DEden=2.90; 1/DDibibi=2.73). Hydropsychidae and Perlidae were the most abundant, indicating a plentiful supply of oxygenated water and perennial water flow. The Hilsenhoff Family Biotic Index (FBI) scale gives Hydropsychidae a TV of 4, indicating that it is somewhat tolerant to polluted water. Highly sensitive families include Perlidae TV=1; Tipulidae TV=3. Perlidae, Tipulidae, and Oligochaeta are also indicators of potential organic pollution. All physicochemical parameters are within "normal". The Ephemeroptera-Plecoptera-Trichoptera (EPT) taxa and %EPT indices produced indicate that the sampled waters are "moderate" to "very good" condition. Due to the abundance of Hydropsychidae, Hilsenhoff FBI rated the sampled waters of Eden as "Excellent"; Dibibi was slightly lower in quality. Furthermore, the indices indicate the presence of pollution-causing elements, which can be linked to human presence and land uses. The geomorphology of the two river sections' riparian and lotic zones, including those of upriver, provide resilience against anthropogenic stresses. This is supported by measurements and observations of physicochemical parameters. Management decisions must take into account the enforcement of environmental functions that deter degradation and ensure river ecosystem's stability. [ABSTRACT FROM AUTHOR]

Published
2022
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25. Twists in the Belt and Road.

Author

Manuel, Ryan

Subjects
*INTERNATIONAL trade disputes, *DECISION making, *BUREAUCRACY, *CIVIL service
Abstract

China's Belt and Road Initiative (BRI) remains a topic of great interest. But there is little knowledge about China's internal voices. Dissent remains rare, yet there has been considerable pushback on BRI policy and decision making. This is because there is an array of structural problems with the BRI's design. BRI is entirely an economic program, run by various parts of the economic bureaucracy. But it does not give bureaucrats sufficient mandate to pursue their interests within China's internal politics. So the BRI is attractive for central SOEs and dealmakers but unattractive to local leaders who are held accountable for whatever goes wrong in their respective areas. Although overt criticism is rare, failure to carry out orders is common. China's leaders have responded to critiques of the BRI, radically changing its official focus and policy. It has moved from a geoeconomic export policy to part of China's toolkit in the current US trade war. But there is no indication that the structural problems will be addressed, thus limiting the BRI's ability to achieve its goals, and as such, pushback will continue. [ABSTRACT FROM AUTHOR]

Published
2019

27. From the editors' desk.

Author

Chey, Jocelyn and Manuel, Ryan

Subjects
SOCIAL Credit System (China), COVID-19 pandemic, ECONOMIC policy
Published
2023

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