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The academic literature showed an increasing interest in studying the link between national identity and anti-immigrant sentiment. This work is based on ten countries from the International Social Survey Program (ISSP) dataset for two different waves: 2003 and 2013. The paper aims to analyse the influence of the three facets of national identity (nationalism, political patriotism, and cultural patriotism) and other socioeconomic traits on attitudes towards immigrants (ATI). Untried methods in social science based on the fuzzy-hybrid analysis (FHA) and the fuzzy clustering are used first to analyse citizens according to their levels of openness towards immigrants, nationalism, cultural patriotism, and political patriotism. Then, the ordered probit model is applied to thoroughly examine the intricate relationships connecting the three facets of national identity and individual sociodemographic characteristics with ATI. The results show that the national identity and cultural patriotism constructs negatively influence ATI, while political patriotism positively influences ATI. In addition, country, political orientation, age, religion, economic situation, gender, place of birth, principal status, and education are crucial factors that explain ATI.

Qingyue Meng and colleagues assess what China’s health system reform has achieved and what needs to be done over the next decade

Background Healthcare systems around the world have been responding to the demand for better integrated models of service delivery. However, there is a need for further clarity regarding the effects of these new models of integration, and exploration regarding whether models introduced in other care systems may achieve similar outcomes in a UK national health service context. Methods The study aimed to carry out a systematic review of the effects of integration or co-ordination between healthcare services, or between health and social care on service delivery outcomes including effectiveness, efficiency and quality of care. Electronic databases including MEDLINE; Embase; PsycINFO; CINAHL; Science and Social Science Citation Indices; and the Cochrane Library were searched for relevant literature published between 2006 to March 2017. Online sources were searched for UK grey literature, and citation searching, and manual reference list screening were also carried out. Quantitative primary studies and systematic reviews, reporting actual or perceived effects on service delivery following the introduction of models of integration or co-ordination, in healthcare or health and social care settings in developed countries were eligible for inclusion. Strength of evidence for each outcome reported was analysed and synthesised using a four point comparative rating system of stronger, weaker, inconsistent or limited evidence. Results One hundred sixty seven studies were eligible for inclusion. Analysis indicated evidence of perceived improved quality of care, evidence of increased patient satisfaction, and evidence of improved access to care. Evidence was rated as either inconsistent or limited regarding all other outcomes reported, including system-wide impacts on primary care, secondary care, and health care costs. There were limited differences between outcomes reported by UK and international studies, and overall the literature had a limited consideration of effects on service users. Conclusions Models of integrated care may enhance patient satisfaction, increase perceived quality of care, and enable access to services, although the evidence for other outcomes including service costs remains unclear. Indications of improved access may have important implications for services struggling to cope with increasing demand. Trial registration Prospero registration number: 42016037725 .

In recent years, the world has witnessed a backlash against globalization and a rise in populist and nationalist movements around the world. However, there appears to be little empirical research concerning how these movements, and especially nationalist sentiment, actually influence trade. Therefore, we explore how and when nationalist sentiment within a country influences trade. Our results indicate that the effect of nationalist sentiment on imports is mediated by lower participation in free trade agreements (FTAs) but not via tariffs. Furthermore, we are unable to confirm support for a direct effect of nationalist sentiment on imports, as predicted by the consumer ethnocentricity literature. However, we do find a strong and negative impact of nationalist sentiment on exports. It would appear that nationalist sentiments tend to blunt the desire to export. Psychic distance between the countries appears to magnify the effects of nationalist sentiment on tariffs and FTAs, but not the direct effects on trade. Finally, we also find that custom union membership, such as the EU, negates the effect of nationalist sentiment on tariffs but this cannot be confirmed for FTAs. Overall, our model enriches our understanding of how nationalist sentiment in society affects trade and offers guidance to policymakers.

National identity studies diverge on several issues, such as the number of factors and their respective items’ adscription. Multi-Group Confirmatory Factor Analysis (MGCFA) is the standard method applied to cross-national datasets. Differences between groups can be the result of measurement artefacts. We argue that these problems can be better addressed by an alternative approach that builds a synthetic indicator named Relative National Identity Synthetic Indicator (RNISI), based on a Fuzzy Hybrid Analysis (FHA). The study aims to shed some light on the study of the latent variable national identity by comparing two methodologies: the classic method most often used (MGCFA) and the Fuzzy-Hybrid Approach, which, to our knowledge, has not been previously applied. This empirical study was based on a dataset from across ten countries using two waves (2003 and 2013) of the International Social Survey Programme (ISSP). The FHA results were compared with those obtained by two MGCFA models in which national identity was built as a second-order construct that depends on the ethnic, ancestry and civic first-order latent variables. The comparison lets us conclude that FHA can be considered a valid tool to measure the national identity by groups, and to provide additional information in form of elasticity figures. These figures can be employed to analyse the indicator’s sensitivity by group and for each of the items included in the national identity construct.

In new democracies, what is the role of nationalism in terms of democratic behavior such as voter turnout? Previous studies have found that, in Western democracies, constructive national pride increases voter turnout, while blind national pride decreases it. However, little scholarly attention has been paid to new democracies. Given different political contexts, we argue that blind national pride can boost turnout in some new democracies that have lingering authoritarian legacies. Using the case of South Korea, we offer a theory about the relationship between blind national pride and voter turnout. We show that, in contrast to the West, blind national pride is positively associated with turnout in South Korea, and that the relationship appears more robust among both older cohorts, who experienced authoritarianism directly in the recent past, and those with conservative ideologies.

There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. However, this model has rarely been mainstreamed and sustained in real-world settings. The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model. A multilevel, mixed-method study of Skype video consultations (micro level) was embedded in an organizational case study (meso level), taking account of national context and wider influences (macro level). The study followed the introduction of video outpatient consultations in three clinical services (diabetes, diabetes antenatal, and cancer surgery) in a National Health Service trust (covering three hospitals) in London, United Kingdom. Data sources included 36 national-level stakeholders (exploratory and semistructured interviews), longitudinal organizational ethnography (300 hours of observations; 24 staff interviews), 30 videotaped remote consultations, 17 audiotaped face-to-face consultations, and national and local documents. Qualitative data, analyzed using sociotechnical change theories, addressed staff and patient experience and organizational and system drivers. Quantitative data, analyzed via descriptive statistics, included uptake of video consultations by staff and patients and microcategorization of different kinds of talk (using the Roter interaction analysis system). When clinical, technical, and practical preconditions were met, video consultations appeared safe and were popular with some patients and staff. Compared with face-to-face consultations for similar conditions, video consultations were very slightly shorter, patients did slightly more talking, and both parties sometimes needed to make explicit things that typically remained implicit in a traditional encounter. Video consultations appeared to work better when the clinician and patient already knew and trusted each other. Some clinicians used Skype adaptively to respond to patient requests for ad hoc encounters in a way that appeared to strengthen supported self-management. The reality of establishing video outpatient services in a busy and financially stretched acute hospital setting proved more complex and time-consuming than originally anticipated. By the end of this study, between 2% and 22% of consultations were being undertaken remotely by participating clinicians. In the remainder, clinicians chose not to participate, or video consultations were considered impractical, technically unachievable, or clinically inadvisable. Technical challenges were typically minor but potentially prohibitive. Video outpatient consultations appear safe, effective, and convenient for patients in situations where participating clinicians judge them clinically appropriate, but such situations are a fraction of the overall clinic workload. As with other technological innovations, some clinicians will adopt readily, whereas others will need incentives and support. There are complex challenges to embedding video consultation services within routine practice in organizations that are hesitant to change, especially in times of austerity.

This study examined whether iron deficiency (ID) in infancy contributes to problem behaviors in adolescence through its influence on poor regulatory abilities in childhood. Chilean infants (N = 1,116) were studied when there was no national program for iron fortification (1991-1996), resulting in high rates of ID (28%) and iron-deficiency anemia (IDA, 17%). Infants (54% male) were studied at childhood (Mage = 10 years) and adolescence (Mage = 14 years). IDA in infancy was related to excessive alcohol use and risky sexual behavior in adolescence through its effect on poor emotion regulation in childhood. Attentional control deficits at age 10 were also related to both infant IDA and heightened risk taking in adolescence. Findings elucidate how poor childhood regulatory abilities associated with infant IDA compromise adjustment in adolescence.

Global and national initiatives focused on health systems strengthening, universal health coverage, health security, and resilience suffer when these terms are not well understood or believed to be different ways of saying the same thing. Conceptual clarity is essential for a systematic approach to policy-making. Confusion and inefficiency arise when health system strengthening is defined as an objective and also when universal health coverage, health security or resilience are described as separate programmes to be implemented. So here is a simple guide: health system strengthening is what they do; universal health coverage, health security and resilience are what they want.