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Browse FSI scholarship on geopolitics, global health, energy, cybersecurity and more.

Featured Publications

Struggles for Political Change in the Arab World, edited by Lisa Blaydes, Amr Hamzawy, and Hesham Sallam

Struggles for Political Change in the Arab World

This volume edited by Lisa Blaydes, Amr Hamzawy, and Hesham Sallam explains how politicians, opposition movements, and external actors across the region have adapted in the ten years since the Arab Spring.
Liberalism and Its Discontents by Francis Fukuyama

Liberalism and Its Discontents

It's no secret that liberalism hasn't always lived up to its own ideals. But in this short, clear account, Francis Fukuyama offers an essential defense of a revitalized liberalism for the twenty-first century.
Everything Counts: Building a Control Regime for Nonstrategic Nuclear Warheads in Europe

Building a Control Regime for Nonstrategic Nuclear Warheads in Europe

A new report led by Rose Gottemoeller on non-strategic nuclear warhead policies in Europe, particulary in light of Russia's changing status in the global nuclear community.

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Journal Articles

Effect of Eyeglasses on Student Academic Performance: What Matters? Evidence from a Randomized Controlled Trial in China

Kang Du, Huan Wang, Yue Ma, Hongyu Guan, Scott Rozelle
International Journal of Environmental Research and Public Health, 2022 September 1, 2022

Although eyeglasses have been considered a cost-effective way to combat myopia, the empirical evidence of its impacts on improving learning outcomes is inconsistent. This paper provides empirical evidence examining the effect of providing eyeglasses on academic performance between provinces with a different economic level in western China. Overall, we find a significant impact in Intention-to-Treat analysis and a large and significant local average treatment effect of providing free eyeglasses to students in the poor province but not in the other. The difference in impact between the two provinces is not a matter of experimental design, implementation, or partial compliance. Instead, we find that the lack of impact in the wealthier provinces is mainly due to less blackboard usage in class and wealthier households. Our study found that providing free eyeglasses to disadvantaged groups boosted their academic performance more than to their counterparts.

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Commentary

Op-Ed | Challenges of Content Governance in the Metaverse

Leila Morch, Julie Owono
2022 August 31, 2022
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Reports

Content Governance in the Metaverse

Julie Owono, Leila Morch
2022 August 31, 2022

Paper from the Content Policy and Society Lab

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Policy Briefs

Policy Roundup: August 2022

Clifton B. Parker
2022 August 30, 2022

Key policy takeaways from Rose Gottemoeller on why the U.S. should avoid a nuclear arms race, Michael McFaul on how Putin may try to end the war in Ukraine, Oriana Skylar Mastro on China's intentions toward Taiwan, Francis Fukuyama on political realignment in America, Renée DiResta and Samantha Bradshaw on Russian propaganda in cyberspace, and Gil Baram on the cyber war between Israel and Iran.

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Journal Articles

Parenting Centers and Caregiver Mental Health: Evidence from a Large-Scale Randomized Controlled Trial in China

Qi Jiang, Sarah-Eve Dill, Sean Sylvia, Manpreet Singh, Xinshu She, Eric Wang, Alexis Medina, Scott Rozelle
Child Development, 2022 August 28, 2022

This study conducts an exploratory analysis of the impacts of a center-based early childhood development intervention on the mental health of caregivers, using data from a cluster-randomized controlled trial of 1664 caregivers (Mage = 36.87 years old) of 6- to 24-month-old children in 100 villages in rural China. Caregivers and children in 50 villages received individual parenting training, group activities and open play space in village parenting centers. The results show no significant overall change in caregiver-reported mental health symptoms after 1 year of intervention. Subgroup analyses reveal heterogeneous effects by caregiver socioeconomic status and identity (mother vs. grandmother). Findings suggest that early childhood development interventions without targeted mental health components may not provide sufficient support to improve caregiver mental health.

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Book Chapters

Bureaucrats, Local Elites, and Economic Development

Ling Zhu, Xueguang Zhou
2022 August 28, 2022

Chapter in the volume Economies, Institutions and Territories: Dissecting Nexuses in a Changing World.

 

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Working Papers

The Impact of Centralized Drug Procurement on Drug Prices and Utilization in China

Jing Zhang, Wenjia Wang
2022 August 26, 2022

This study investigated the impact of China’s centralized drug procurement (CDP) on drug prices, utilization, and expenditure in China. Employing the event study method, we estimated the impacts for both contract-awarded (hereafter, “approved”) drug products and unawarded (hereafter, “unapproved”) products in the same molecule-dosage forms. The results show that the CDP decreased the prices of the approved drug products by 66.7% on average. Moreover, unintendedly, the CDP also pushed the prices of the unapproved products down by 25.9%. After the inception of the CDP, the quantities sold of the approved and unapproved products rose by four times and fell by 75.4%, respectively. With these estimates, we concluded that the CDP saves 252.2 billion yuan (equivalent to 38.8 billion US dollars) annually in drug expenditure.

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Case Studies

Unheard Voice: Evaluating five years of pro-Western covert influence operations (TAKEDOWN)

Graphika, Stanford Internet Observatory
2022 August 24, 2022
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Book Chapters

What Is at Stake in the US–China Technological Relationship?

Graham Webster, Maria Adele, Carrai Jennifer Rudolph, Michael Szonyi
2022 August 23, 2022

Graham Webster has authored a chapter in the forthcoming book from Harvard University Press, The China Questions 2: Critical Insights into US-China Relations

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Commentary

Daphne Keller and ACLU File Comment to Meta Oversight Board in "UK Drill Music" Case

Daphne Keller
ACLU, 2022 August 23, 2022

The Program on Platform Regulation's Daphne Keller worked with the ACLU to file this comment to the Meta Oversight Board's "UK Drill Music" case.

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Journal Articles

Association Between Mental Health and Executive Dysfunction and the Moderating Effect of Urban-Rural Subpopulation in General Adolescents from Shangrao, China: A Population-Based Cross-Sectional Study

Qingmin Lin, Cody Abbey, Yunting Zhang, Guanghai Wang, Jinkui Lu, Sarah-Eve Dill, Qi Jiang, Manpreet Singh, Huan Wang, Scott Rozelle, Fan Jiang
BMJ Open, 2022 August 23, 2022

Objectives: To examine the association between mental health and executive dysfunction in general adolescents, and to identify whether home residence and school location would moderate that association.

Design: A population-based cross-sectional study.

Setting: A subsample of the Shanghai Children's Health, Education, and Lifestyle Evaluation-Adolescents project. 16 sampled schools in Shangrao city located in downstream Yangtze River in southeast China (December 2018).

Participants: 1895 adolescents (48.8% male) which were divided into three subpopulations: (A) adolescents who have urban hukou (ie, household registration in China) and attend urban schools (UU, n=292); (B) adolescents who have rural hukou and attend urban schools (RU, n=819) and (C) adolescents who have rural hukou and attend rural schools (RR, n=784).

Measures: The Depression Anxiety and Stress Scale-21 was used to assess adolescent mental health symptoms, and the Behaviour Rating Inventory of Executive Function (parent form) was applied to measure adolescent executive dysfunction in nature setting.

Results: Mental health symptoms were common (depression: 25.2%, anxiety: 53.0%, stress: 19.7%) in our sample, and the prevalence rates were lower among UU adolescents than those among the RR and RU, with intersubgroup differences in screen exposure time explaining most of the variance. We found the three types of symptoms were strongly associated with executive dysfunction in general adolescents. We also observed a marginal moderating effect of urban-rural subgroup on the associations: UU adolescents with depression (OR 6.74, 95% CI 3.75 to 12.12) and anxiety (OR 5.56, 95% CI 1.86 to 16.66) had a higher executive dysfunction risk when compared with RR youths with depression (OR 1.93, 95% CI 0.91 to 4.12) and anxiety (OR 1.80, 95% CI 1.39 to 2.33), respectively.

Conclusions: Rural adolescents experienced more mental health symptoms, whereas urban individuals with mental health problems had a higher executive dysfunction risk.

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Journal Articles

Assessing Taiwan’s Pay-for-Performance Program for Diabetes Care: A Cost–Benefit Net Value Approach

Karen Eggleston, Jui-fen Rachel Lu, Ying Isabel Chen, Chih-Hung Chen, Brian Chen
European Journal of Healthcare Economics, 2022 August 22, 2022
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Journal Articles

Internal Capabilities and External Resources of Academically Resilient Students in Rural China

Cody Abbey, Huan Wang, Chen Ji, Nancy Wu, Scott Rozelle, Xinshu She, Manpreet Singh
Adversity and Resilience Science, 2022 August 20, 2022

Resilience can play an important role in enabling disadvantaged students to succeed academically. However, few studies in low-resource contexts have evaluated resilience as a process (including a child’s internal capabilities and external resources, like the internal capabilities of a child’s caregiver) and as an outcome (e.g., academic achievement). In the current study, we examined the associations among students’ self-reported internal capabilities, their external resources (e.g., caregivers’ internal capabilities), and their academic resilience (operationalized as performance on a math test). The study was conducted among 1609 primary and secondary school students in rural China using the Connor–Davidson Resilience Scale (CD-RISC) to measure internal capabilities. Student CD-RISC scores were positively associated with external resources including caregiver CD-RISC scores, maternal education level, high levels of perceived social support, recreational reading, and involvement in group-based activities at school. A one-point increase in students’ CD-RISC scores was associated with a 0.01 SD increase in math score (p < 0.001), and the math scores of students whose CD-RISC scores were in the bottom quartile were 0.18 SD lower than those of their peers (p < 0.01). High levels of perceived social support and recreational reading were also associated with academic resilience in the adjusted equation. Directions for future research and policy implications are discussed.

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Journal Articles

Postnatal Mental Health, Breastfeeding Beliefs, and Breastfeeding Practices in Rural China

Qi Jiang, Evelyn Zhang, Nourya Cohen, Mika Ohtori, Sabrina Zhu, Yian Guo, Hannah Faith Johnstone, Sarah-Eve Dill, Huan Zhou, Scott Rozelle
International Breastfeeding Journal, 2022 August 20, 2022

Background: The importance of breastfeeding in low- and middle- income countries is well recognized, yet the importance of postnatal mental health on breastfeeding practices and beliefs in these settings has been understudied. This study investigates the associations between maternal mental health problems, breastfeeding beliefs and breastfeeding practices in rural China.

 

Methods: Cross-sectional data were collected in November and December 2019 from 742 mothers of infants under 6 months old in rural Sichuan Province, China. Maternal mental health (depression, anxiety, and stress symptoms) was assessed using the Depression, Anxiety, and Stress Scale (short form). Breastfeeding beliefs were assessed using the Iowa Infant Feeding Attitude Scale and Breastfeeding Self-Efficacy Scale (short form). Breastfeeding practices were assessed through a 24-h dietary recall questionnaire. Ordinary least squares regression, multiple logistic regression and heterogeneous effects analyses were used to identify associations between symptoms of mental health problems and breastfeeding outcomes.

 

Results: The average age of sample infants was 2.7 months. Among mothers, 13% showed symptoms of depression, 16% anxiety, and 9% stress. The prevalence of exclusive breastfeeding in the previous 24 h was 38.0%. Depression symptoms were significantly associated with breastfeeding attitude and breastfeeding self-efficacy. Anxiety and stress symptoms were significantly associated with breastfeeding self-efficacy. There were no significant associations between symptoms of mental health problems and exclusive breastfeeding. The heterogeneous effects analyses revealed that less educated mothers with symptoms of stress had lower odds of exclusive breastfeeding than educated mothers without symptoms of stress. Mothers of younger infants had higher odds of exclusive breastfeeding than the mother of older infants, regardless of depression, anxiety, or stress symptoms.

 

Conclusion: Symptoms of maternal mental health problems are significantly associated with breastfeeding attitude and self-efficacy; however, these symptoms are not associated with breastfeeding practices. Maternal educational level and infant age may play a role in mothers’ breastfeeding practices. To improve breastfeeding practices, interventions should employ a multi-dimensional approach that focuses on improving maternal mental well-being and considers demographic characteristics.

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Journal Articles

The Know-Do Gap in Quality of Health for Chronic Non-communicable Diseases in Rural China

Sha Meng, Qingzhi Wang, Yuju Wu, Hao Xue, Linhua Li, Ruixue Ye, Yunwei Chen, Lucy Pappas, Muizz Akhtar, Sarah-Eve Dill, Sean Sylvia, Huan Zhou, Scott Rozelle
Frontiers in Public Health, 2022 August 18, 2022

Proper management of non-communicable diseases (NCDs) is a severe challenge to China's rural health system. This study investigates what influences the poor medical treatment of NCDs (diabetes and angina) by evaluating the “know-do gap” between provider knowledge and practice. To determine whether low levels of provider knowledge low quality of patient care is the primary constraint on the quality of NCDs diagnosis and treatment in rural China. Providers from Village Clinics (VC) and Township Health Centers (THC), and Standardized Patients (SP) were selected by a multi-stage random sampling method. Clinical vignettes were administered to 306 providers from 103 VCs and 50 THCs in rural Sichuan Province. SPs presented diabetes symptoms completed 97 interactions with providers in 46 VCs and 51 THCs; SPs presented angina symptoms completed 100 interactions with providers in 50 VCs and 50 THCs. Process quality, diagnosis quality, and treatment quality were assessed against national standards for diabetes and angina. Two-tailed T-tests and tests of proportions for continuous outcomes and tests of proportions for binary dependent variables were used to compare vignette and SP results. Differences between vignette and SP data calculated the know-do gap. Regression analyses were used to examine the providers/facility characteristics and knowledge/practice associations. THC providers demonstrated significantly more knowledge in vignettes and better practices in SP visits than VC providers. However, levels of knowledge were low overall: 48.2% of THC providers and 28.2% of VC providers properly diagnosed type 2 diabetes, while 23.8% of THC providers and 14.7% of VC providers properly diagnosed angina. With SPs, 2.1% of THC providers and 6.8% of VC providers correctly diagnosed type 2 diabetes; 25.5% of THC providers and 12.8% of VC providers correctly diagnosed angina. There were significant know-do gaps in diagnosis process quality, diagnosis quality, and treatment quality for diabetes (p < 0.01), and in diagnosis process quality (p < 0.05) and treatment quality for angina (p < 0.01). Providers in rural China display low levels of knowledge when treating diabetes and angina. Despite low knowledge, evidence of the know-do gap indicates that low-quality healthcare is the primary constraint on the quality of NCD diagnosis and treatment in rural China. Our research findings provide a new perspective for the evaluation of the medical quality and a technical basis for the development of new standardized cases in the future.

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Book Chapters

Is China a Challenge to U.S. National Security?

Oriana Skylar Mastro
2022 August 18, 2022

A chapter in The China Questions 2: Critical Insights into US-China Relations, edited by Maria Adele Carrai, Jennifer Rudolph, and Michael Szonyi.

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Journal Articles

Behavioral Strengths and Difficulties and Their Associations with Academic Performance in Math among Rural Youth in China

Wenjing Yu, Cody Abbey, Yiwei Qian, Huan Wang, Scott Rozelle, Manpreet Singh
Healthcare, 2022 August 16, 2022

Behavioral strengths and difficulties among children and adolescents may be significantly associated with their academic performance; however, the evidence on this issue for rural youth in developing contexts is limited. This study explored the prevalence and correlates of mental health from three specific dimensions—internalizing problems, externalizing problems, and prosocial behavior—measured by the Strengths and Difficulties Questionnaire (SDQ), and the association of these dimensions with academic performance in math among a sample of 1500 students in rural China. Our findings indicated that students in rural China had worse behavioral difficulties and poorer prosocial skills when compared to most past studies conducted inside and outside of China. In addition, total difficulties and prosocial scores on the SDQ were significantly associated with student math test scores, as students whose externalizing, internalizing, and prosocial scores were in the abnormal range scored lower in math by 0.35 SD, 0.23 SD, and 0.33 SD, respectively. The results add to the growing body of empirical evidence related to the links between social environment, mental health, and academic performance in developing countries, highlighting the importance of students’ mental health for their academic performance, and of understanding risk factors in the social environment among rural youth in developing countries.

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Journal Articles

Labor conflict within foreign, domestic, and Chinese-owned manufacturing firms in Ethiopia

Marcel Fafchamps, James Chu
World Development, 2022 August 14, 2022

A large firm survey shows that labor conflicts in Ethiopia are more frequent in foreign-owned firms, especially those that are Chinese-owned. Foreign firms hire similarly educated and experienced workers, while offering similar salaries and benefits. We draw on case studies to explore reasons why foreign, and especially Chinese-owned firms, face exceptional levels of labor conflict. Misaligned perceptions about the role of local labor laws may be an important driver of conflict.

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Journal Articles

How Information Flows from the World to China

Yingdan Lu, Jack Schaefer, Kunwoo Park, Jungseok Joo, Jennifer Pan
The International Journal of Press/Politics, 2022 August 8, 2022

Government censorship—internet shutdowns, blockages, firewalls—impose significant barriers to the transnational flow of information despite the connective power of digital technologies. In this paper, we examine whether and how information flows across borders despite government censorship. We develop a semi-automated system that combines deep learning and human annotation to find co-occurring content across different social media platforms and languages. We use this system to detect co-occurring content between Twitter and Sina Weibo as Covid-19 spread globally, and we conduct in-depth investigations of co-occurring content to identify those that constitute an inflow of information from the global information ecosystem into China. We find that approximately one-fourth of content with relevance for China that gains widespread public attention on Twitter makes its way to Weibo. Unsurprisingly, Chinese state-controlled media and commercialized domestic media play a dominant role in facilitating these inflows of information. However, we find that Weibo users without traditional media or government affiliations are also an important mechanism for transmitting information into China. These results imply that while censorship combined with media control provide substantial leeway for the government to set the agenda, social media provides opportunities for non-institutional actors to influence the information environment. Methodologically, the system we develop offers a new approach for the quantitative analysis of cross-platform and cross-lingual communication.

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Books

The Law of Democracy, Legal Structure of the Political Process

Samuel Issacharoff, Pamela S. Karlan, Pamela S. Karlan, Nathaniel Persily, Franita Tolson
2022 August 3, 2022

This book created the field of the law of democracy, offering a systematic account of the legal construction of American democracy. This edition represents a significant revision that reflects the embattled state of democracy in the U.S. and abroad.

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Journal Articles

Game-based investigation of standardized forward contracting for long-term resource adequacy

Mark C. Thurber, Fletcher Passow, Trevor L. Davis, Frank Wolak
The Electricity Journal, 2022 August 1, 2022
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Journal Articles

China's Skill-biased Imports

Hongbin Li, Lei Li, Hong Ma
China Economic Review, 2022 August 1, 2022

China has witnessed rapid increases in the skill premium over the last few decades. In this paper, we study the short-run effect of capital goods imports on skill premium in China. The surge in capital goods imports, which embody advanced technology, can explain the rising demand for skill in China. We exploit regional variations in capital goods import exposure stemming from initial differences in import structure and instrument for the capital goods import growth using exchange rate movements. A city at the 75th percentile of the distribution of capital goods imports growth has a higher skill premium by 5 percentage points (0.38 standard deviation) over the one at the 25th percentile. To explore the underlying mechanism, we provide firm-level evidence and show that imported capital goods are skill-complementary.

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