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Chapter 2 sets the theoretical framework for the book, which provides tools to operationalize the regime complex mechanisms of effectiveness. The chapter operationalizes the regime complex’s mechanisms of effectiveness as the utility modifier mechanism, social learning mechanism, and capacity-building mechanism to break down the major impacts of the regime complex on barriers to renewable energy development on the ground in EMDEs. This study advances novel theorizing on regime complex effectiveness by combining approaches from private governance and regime theory to conceptualize mechanisms of impact. The theoretical framework thus provides tools to guide the examination of the interaction between regime complexes and domestic political actors, and more specifically, shows how the regime complex impacts financial, regulatory, and technical barriers to renewable energy development as analyzed in the comparative case studies in Indonesia and the Philippines (Chapters 4–6).
The book concludes in Chapter 8 with a summary of the major theoretical and empirical findings on the clean energy regime complex’s emergence and effectiveness across Indonesia and the Philippines, and a discussion of the theory’s broader generalizability, further research opportunities, and policy implications and recommendations for fostering energy transitions in a world of complex governance.
Chapter 7 provides a comparative analysis of regime complex effectiveness across cases to better perceive the conditions for impact and how intervening variables such as energy crises or domestic political interests mediate effectiveness. Through the three mechanisms – utility modifier, social learning, capacity building – the regime complex has had a notably different impact in moving renewable energy development in Indonesia and the Philippines. This chapter examines and explains the variable outcomes in geothermal development between the Philippines and Indonesia by illuminating the key role of political will at the domestic level. Major findings of this chapter reveal that throughout the case studies, diverging domestic political interests and lack of political will to develop geothermal energy or adopt renewable energy regulations are key in explaining the variation in effectiveness of the clean energy complex across case studies.
Chapter 4 involves a focus on the legitimacy and effectiveness of proxy-style institutions for future generations. It sets out criteria for assessing the legitimacy of such institutions based on Klaus Dingwerth, Sylvia Karlsson-Vinkhuyzen, and Antto Vihma. Criteria for assessing the legitimacy of international tribunals are developed based on an extension of Bogdandy and Venzke’s work with the idea of accountability to the demos being extended to include future generations. A concept of ‘future legitimacy’ is introduced which involves assessing institutions in operation now from the perspective of future generations when climate change is predicted to be ravaging the planet. Criteria for effectiveness are elaborated involving the Paris Agreement goals, as well as an assessment of the promotion of intergenerational justice and the values of inclusiveness, solidarity and addressing vulnerability. Particular challenges in application of these criteria in the context of international law and related institutions which represent future generations are discussed.
Chapter 8 makes a preliminary assessment of the likely effectiveness of the proposed UN special envoy for future generations by examining this proposal through the lens of three frameworks. These frameworks are, firstly, the rationale or normative basis for such a proposal measured against the principles of intergenerational justice, solidarity and vulnerability set out in Chapter 3 of the book. Next, the special envoy proposal is evaluated in terms of its legitimacy and effectiveness using the criteria elaborated in Chapter 5 (inclusive representation, democratic control in the form of accountability and transparency, deliberation, source-based/input legitimacy in terms of expertise, legal legitimacy, tradition and discourse, substantial/output legitimacy in terms of effectiveness and equity). The possible functions of a special envoy are examined and recommendations are made as to what mandate the special envoy should have, applying the matrix of proxy functions elaborated earlier in this book, which involves breaking proxy representation down into its functions (representative, compliance, reform and norm entrepreneurial). Finally, an overarching framework is proposed for measuring the potential effectiveness of the special envoy which incorporates both frameworks – proxy representation functions and democratic legitimacy.
As the world moves with increasing urgency to mitigate climate change and catalyze energy transitions to net zero, understanding the governance mechanisms that will unlock barriers to energy transitions is of critical importance. This book examines how the clean energy regime complex-the fragmented, complex sphere of governance in the clean energy issue area characterized by proliferating and overlapping international institutions-can be effective in fostering energy transitions at the domestic level, particularly in emerging market and developing economies (EMDEs). Through comparative case studies of geothermal development in Indonesia and the Philippines, the chapters provide two different tales of energy transitions, demonstrating how domestic factors have hindered or facilitated progress. This book will be useful for students, researchers, and practitioners working in international relations, energy politics, political science, development studies, public policy, international law, and sociology. This title is also available as Open Access on Cambridge Core.
This paper critically assesses the effectiveness of the EU AI Act in regulating artificial intelligence in higher education (AIED), with a focus on how it interacts with existing education regulation. It examines the growing use of high-risk AI systems – such as those used in admissions, assessment, academic progression, and exam proctoring – and identifies key regulatory frictions that arise when AI regulation and education regulation pursue overlapping but potentially conflicting aims. Central to this analysis is the concept of human oversight: while the AI Act frames oversight as a safeguard for accountability and fundamental rights, education regulation emphasises the professional autonomy of teachers and their role in maintaining pedagogical integrity. Yet, the regulatory role of teachers in AI-mediated environments remains unclear. Applying Mousmouti’s effectiveness test, the paper evaluates the AI Act along four dimensions – purpose, coherence, results, and structural integration with the broader legal framework – and argues that legal effectiveness in this context requires a more precise alignment between AI and education regulation.
Chapter 8 draws on sociological literature in debating whether law – however drafted – is capable of solving the complex problem of discrimination against people who look different. It argues that, although we should not expect too much of law in tackling the complex social problem of appearance bias, strategically targeted laws can sometimes play a part in changing attitudes, norms and behaviours. While prohibitions on discrimination are important for remedial purposes, other types of legal and social reform may be better placed to create the conditions for greater inclusion of people with visible differences.
The origins and treatment-target-related mechanisms of schizophrenia remain to be fully understood. Pharmacological and non-pharmacological treatments require expansion and improvements to meet peoples’ needs and goals. Nevertheless, antipsychotics are a cornerstone when managing schizophrenia, being essential for reducing symptom severity, preventing relapse, improving long-term functional outcomes, and reducing premature mortality risk.
Methods
This narrative review synthesizes key evidence on the efficacy and risks associated with antipsychotic medications. The concept of effect sizes is introduced, allowing to compare antipsychotics across trials with different rating instruments and across different conditions.
Results
The available evidence in schizophrenia and comparison with medications used for medical conditions counters the sometimes-voiced criticism that antipsychotics “do not work.” Instead, for a substantial group of people with schizophrenia, positive psychotic symptoms and global psychopathology improve witha small-medium effect size of about 0.4 versus placebo. These results are comparable to median effect sizes across commonly used medications for somatic disorders. When patients with initial response are continued on antipsychotics, the effect size increases to 0.9 for relapse prevention, translating into a number needed to treat (NNT) of about 3 to prevent one more relapse versus no treatment. This NNT is 10–20 times higher than that for the prevention of poor outcomes in some common medical conditions.
Conclusions
Despite general efficacy and effectiveness of antipsychotics for schizophrenia, further development is needed regarding preventive interventions and medications with mechanisms other than postsynaptic dopamine receptor blockade, with broader efficacy for positive, negative, cognitive, suicidality, and/or reward dysregulation symptomatology, and the identification of illness mechanism/biomarker-targeting treatments to enhance treatment personalization.
Preserving or improving biodiversity outcomes requires a coordinated approach across policy levels and land managers. Agri-environmental collectives in the Netherlands adapt environmental policies to local conditions and coordinate the conservation efforts of their members. This paper describes the functions performed by the Dutch collectives through a meso-institutional lens and assesses whether the effectiveness of agri-environmental schemes has improved since the introduction of the collective approach. To this end, we use a case study of one of the Dutch collectives, and a mixed-methods approach including interviews and quantitative assessments of changes in the spatial coordination of the agri-environmental scheme for meadow bird conservation since the introduction of the collective scheme. The analysis shows an increase in contracted farmland area and spatial coordination of the contracted measures on these farmlands. The results highlight the potential value of the collective approach for the implementation of environmental policies for biodiversity.
The concluding chapter begins by summarizing the main findings of how politicians balance pressures arising from the economy, national politics, and supranational politics when they design and implement the economic policy of the European Union. With different emphasis, these pressures resurface across time and cut across the entire policy cycle, from the formation of preferences to the negotiations over legislative and executive measures, the timing and direction of reforms, and the patterns of compliance. The chapter then draws some tentative, yet interesting, insights about the effectiveness, fairness, and responsiveness of the policy. The record of effectiveness is mixed. Long-term trends appear reasonably reassuring, but these dynamics hide large cross-country differences, which, rather worryingly, characterize mainly the euro area. There are, however, no glaring indications of unfairness. Concerns about negative externalities have trumped the influence of raw economic power in implementation. Moreover, the policy is not insensitive to changes in public opinion and governmental positions. The chapter concludes by highlighting the usefulness of this theoretical framework.
The second part of the book investigates the implementation of the policy. As far as preventive surveillance is concerned, at its core lay the country-specific recommendations on the macroeconomic policies of the member states. These recommendations are the object of intense negotiations between the Commission and the Council. Why are they a matter of bargaining? What shapes the Council’s propensity to modify the Commission’s proposals and what affects their strengthening or weakening? This chapter employs bargaining and compliance theories to address these questions. Analyzing the recommendations issued between 1999 and 2019, it shows that the Council is rather active in modifying the Commission’s assessments and strengthens four-fifths of the recommending provisions that it decides to modify. Economic and supranational factors dominate this process. Governments balance the pressures originating from the bargaining dynamic within the Council with the need to preserve policy credibility and effectiveness in the face of noncompliance and worsening economic conditions.
In a world in which INGOs play such a large and fraught role, this book explores why they make the choices they do. In this chapter, we first review the book’s theory and its contributions. Next, we recap our empirical findings. We then consider how our theoretical framework might be extended to understand dynamics among INGOs headquartered in countries outside the United States and to explore cross-sectoral variation. We also consider growth in other populations of global governance actors – especially for-profit development firms, direct-giving campaigns, and domestic NGOs – and how these actors may be challenging INGOs’ dominance. We offer reflections on how the trends we identified in this book might influence INGOs’ effectiveness. Finally, we consider the study’s implications for public and private funders working with INGOs to affect social change.
The introduction explains the book’s argument that individuals impacted by the repercussions of interstate disputes dealt with by the Court should and can be further integrated into its procedure and considered in its legal reasoning. Through the lens of social idealism, it explains how the Court’s effectiveness and legitimacy may be compromised due to its reluctant approach towards individuals. It also clarifies the method, methodology, scope, and structure of the book.
This chapter concludes the monograph, summarizing the main reflections offered throughout and reflecting on the future of the relationship between the individual and the International Court of Justice.
In the post-World War II era, international lawyers have occupied the front seat in the study of international organisations (IOs). During the past decade, this disciplinary hierarchy has grown to feel increasingly unsatisfying. This chapter offers an anthropological take on the study of IOs building both on the past decade of anthropological work and my ethnography at the UN Human Rights Committee. IOs are frequently accused of ineffectiveness embedded in endless paper-pushing techniques. In this chapter, I engage with these criticisms and ask: can we find another perspective from which to assess effectiveness? What happens if we stop investing our analytical attention in what we think IO operations and their desired ‘impacts’ should be and instead engage in non-normative inquiries into what IOs actually do? I explore what can we learn about IOs’ visions for world improvement by focusing on the legal technicalities and material forms that define their operations. I propose that, instead of a hindrance or distraction, these forms embody ‘standards for a better world’ that are an essential component of IOs’ civilising mission.
Exposure and response prevention (ERP) is the first-line psychological treatment for obsessive compulsive disorder (OCD). Recent research shows that the Bergen 4-day Treatment (B4DT), which is a concentrated ERP program, can be very effective. However, this intensive format has not been widely implemented, and it is unclear whether positive outcomes are unique to B4DT, or whether a similar intensive ERP program (not based on B4DT) is equally effective. We examined short- and long-term outcomes of the Melbourne Intensive Treatment-OCD (MIT-O) program, an out-patient intensive ERP program for OCD involving an intensive phase of four full-day sessions conducted over two weeks, and a supportive 21-day phase involving self-directed tasks and twice-a-week check-in calls with the therapy team. Participants were 21 individuals with OCD. The severity of OCD, depression, anxiety, stress, obsessive beliefs, and emotion regulation difficulties were assessed at four time points (pre-treatment, post-treatment, 6-month, and 12-month follow-up). Results showed a large and significant decrease in OCD and obsessive beliefs at post-treatment. These improvements were maintained at 12-month follow-up. Using international consensus criteria for treatment response, almost all participants (90.5%) showed at least partial treatment response and one-third were in remission at the final assessment. These results showed that the MIT-O program was effective, but post-treatment and 12-month remission rates were somewhat less favourable than previously published results from the B4DT program. Nevertheless, the MIT-O post-treatment outcomes were comparable to other CBT programs for OCD and should be considered when other longer term treatment formats such as in-patient treatments are not feasible.
Key learning aims
(1) To evaluate the effectiveness of an intensive exposure and response prevention program in reducing obsessive compulsive disorder (OCD) symptoms.
(2) To examine the long-term maintenance of treatment gains at 6-month and 12-month follow-up assessments.
(3) To report the treatment response rate and remission outcomes achieved through the intensive format.
(4) To consider the broader implementation of intensive exposure and response prevention programs as an alternative format for OCD treatment.
People with non-communicable diseases (NCDs) have a higher prevalence of comorbid depression than the general population. While previous research has shown that behavioural activation is effective for general depression, its efficacy and safety in treating depression associated with NCDs remains unclear.
Aims
To compare the efficacy and safety of behavioural activation against comparators in reducing depression symptoms in people with NCDs.
Method
We searched six databases from inception until 30 March 2023 (updated 23 September 2024) for randomised controlled trials (RCTs) comparing behavioural activation with comparators for depression in people with NCDs. Risk of bias was assessed using the Cochrane Collaboration’s ‘risk-of-bias 2 tool’. We calculated a random-effects, inverse-variance weighting meta-analysis.
Results
Of the 21 386 initial studies, 12 RCTs (with 2144 patients) comparing behavioural activation with any comparator on treatment outcomes for depression with comorbid NCD met the inclusion criteria. Six studies rated as low risk of bias. For short-term follow-ups (up to 6 months), meta-analysis showed behavioural activation had little effect on depression symptom improvement in people with NCDs (Hedges’ g = −0.24; 95% CI, −0.62 to 0.15), compared to comparators, with high heterogeneity (I2 = 91.91%). Of the 12 included studies, three RCTs provided data on adverse events occurring during the trial.
Conclusions
Evidence from this systematic review is not sufficient to draw clear conclusions about the efficacy and safety of behavioural activation for reducing depression symptoms in people with NCDs. Future reviews need to include more high-quality, well-designed RCTs to better understand the potential benefits of behavioural activation for comorbid depression.
Public acceptability is crucial for the effectiveness of policy implementation. The carbon trading market is widely adopted by many countries and regions to achieve carbon neutrality and mitigate climate change. Our paper utilizes China's carbon trading market as a quasi-natural experiment, drawing on microdata from the China Residential Energy Consumption Survey to analyze the policy's impact on public acceptance of carbon pricing. We find that the carbon trading market significantly reduces the acceptability of carbon prices among households working in carbon-related industries in the pilot areas. This conclusion is still valid after a series of robustness checks. Regarding the mechanism of influence, the carbon trading market raises households' perceived costs, mainly reflected in the negative impact of rising product prices and increasing living costs. Finally, enhancing public perception of carbon, improving the distribution effect and decreasing the information asymmetry of the policy implementation can improve public acceptability of carbon prices.
Since the 1950s, the United Nations (UN) has designated days (e.g., World Wetland Day), years (e.g., Year of the Gorilla) and decades (e.g., Decade on Biodiversity) with a commonly stated goal to raise awareness and funding for conservation-oriented initiatives, and these Days, Years and Decades of ‘…’ (hereafter ‘DYDOs’) continue. However, the effectiveness of these initiatives to achieve their stated objectives and to contribute to positive conservation outcomes is unclear. Here we used a binary analysis change model to evaluate the effectiveness of UN conservation-oriented DYDOs observed between 1974 and 2020. We also examined four case studies to understand the different strategies employed to meet specified conservation goals. We found that DYDOs apparently contributed to positive conservation outcomes when they were tied to social media campaigns and/or when they were strategically situated in current events or global discourse. Although the outcomes of DYDOs were varied, those with longer timescales and those that engaged local communities were more likely to be successful. We suggest that DYDO organizers should identify all possible paths of action through the lens of the change model outlined in this paper to strengthen the value and effectiveness of these initiatives in the future. Using this approach could help ensure that resources are used efficiently and effectively, and that initiatives yield positive conservation outcomes that benefit people and nature.