Impact of Australian mandatory policies on immunisation services, parental attitudes to vaccination and vaccine uptake in a tertiary paediatric hospital

Introduction 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia nationally in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch up vaccination. We also explored the association between policy motivation, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Referrals to the Specialist Immunisation Clinic (SIC) were also reviewed. Methods Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led SIC. Vaccine-uptake was measured using the Australian Immunisation Register at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, policy motivation and VH was explored by logistic regression. Results Of 607 children included, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) of parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54,p<0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusions The 'No Jab' policies motivated attendance to a tertiary immunisation service but children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised post attendance, compared to baseline. These data will be used to inform a comprehensive evaluation of the impact of the policies, particularly the educational impact from loss of early childhood education.

Issue Salience and Pledge Fulfilment in Minority and Majority Coalitions: Evidence from the Czech Republic

The article focuses on the differences in pledge fulfilment strategies in majority and substantive minority governments. Issue ownership and dynamic agenda-setting literature are applied, expecting that government parties will focus on fulfilling the party’s most salient pledges, and also the pledges that are publicly salient for the whole electorate. Adding these expectations to the context of substantive minority governments, parties must accommodate these attempts because they face the opposition actor(s) with veto power and their own policy motivation. Compared to majority governments, the odds of adopting party-salient pledges should decrease for minority coalition parties. The effect of public-salient issues should also differ from the majority governments. This analysis is conducted on government party pledges in one minority and two majority governments in the Czech Republic (formed after 2006, 2010, and 2013 elections). The analysis shows a generally weak effect for party and public issue salience on pledge fulfilment. The decreasing effect of party issue salience for minority government parties is supported; the effect of public issue salience does, however, not differ in its decreasing direction from the majority governments. The additional model including combinations of the high and low party and public salience shows that for minority governments, public salience decreases the odds of fulfilment regardless of party issue salience. The article concludes with a contextual explanation of the minority government’s special character in the Czech case.

Does policy motivation drive party activism? A study of party activists in three Asian democracies

Studies of party activism highlight that party activists are driven by various motivations and that these affect their level of activism. However, it remains unclear whether policy-motivated activists are more engaged in party activities than those motivated by other incentives and whether the motivation–activism link varies with party characteristics. This article investigates these questions by focusing on political actors linking parties and voters in the local community. I use a party activist survey data set collected during recent national election campaigns in three Asian young democracies: Taiwan, Korea, and Mongolia. The results demonstrated the prominence of policy motivation as an impetus for activists’ intraparty commitment. I also found that the positive effect of policy motivation is especially robust in small parties, while it is muted in large parties and that party membership increases the probability of intraparty commitment, challenging the widely held belief that formal membership is pointless in Asian parties.

‘What a troubled world it still is’: The Foreign Office after Locarno, January 1927 – June 1929

Success at Locarno massively enhanced Chamberlain's authority in the management of foreign affairs to the extent that it appeared he would remain unshakeably in control for the duration of Baldwin's second administration. Yet perhaps the greatest tragedy of this period in Chamberlain's career was that his most glorious triumph should have come near the beginning of his term in office rather than as a natural culmination and fitting climax at its end. Although Chamberlain had always acknowledged that Locarno was but a beginning and ‘there are still difficulties to be faced and still a long road to travel’. critics have argued that after the plaudits and glories of Locarno Chamberlain demonstrated too little appetite for the wider issues of collective security and arms limitation. Under the spell of his personal triumph perhaps he too easily allowed a note of complacency to creep into the conduct of foreign affairs. Apparently not sure what to do next, he is thus often depicted as ‘a spent force after his efforts at Locarno … satisfied with his semi-detached relationship with Europe, qualified only by a tendency to lean towards France and to grumble over German ingratitude and demands for further revision of the Versailles treaty’. Yet, while some of this criticism may be valid, it also needs to be seen in its proper context. Certainly, as Chamberlain later described it himself, Britain came to occupy a ‘semi-detached position’ in relation to Europe after Locarno. Yet even before it, he had always contended that the security of the eastern European states was not only a problem for the future, but also one that it was not for Britain to solve. While his apparent indifference to events east of the Rhine may have been demoralising in central Europe, therefore, British reluctance to take a lead in extending the Locarno system outside the sphere of vital national interest was the almost inevitable corollary of Chamberlain's policy motivation for pursuing a Rhineland Pact in the first place. The ‘spirit of Locarno’ was not to be a model for future British action but rather a beacon to guide others in assuming the initiative elsewhere.

Policy Motivation and Party Differences in a Dynamic Spatial Model of Party Competition

We present a model of party competition that produces more realistic patterns of results than those often emphasized in the literature. Reversing Downs (1957), we assume that parties win elections in order to formulate policies, rather than formulate policies in order to win elections. Voters are modeled first as having perfect information about candidate positions, and then under conditions of uncertainty. In simulation experiments we show that policy motivation and voter uncertainty can bring about persistent and predictable party differences in sequential majority rule elections. As the degree of voter certainty decreases, parties diverge towards their optima, whereas increases in voter certainty draw parties towards cycles in which party positions vary, but predictable issue stances are maintained on the average.