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Abstract Background Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. Methods Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care. The marginal willingness-to-pay for five health care attributes was estimated, including public/private provision of health care, by analysing mixed logit and latent class models. Results The results indicated a significantly negative marginal willingness-to-pay for private health care, which was interpreted as representing people's previous interactions with the health care system. The latent class model further suggested preference heterogeneity across our sample. We found that Hukou type, a typical indicator of socioeconomic background, was significantly related to respondents' preference for health care utilisation. Permanent urban residents (urban Hukou) valued private health care less; in contrast rural migrants (rural Hukou) were more likely to be indifferent between public/private provision. Conclusion Urban residents in China showed a high disposition to obtain health care from the public providers of health care. Our results have implications in the context of the Chinese government attempts to expand the private health care sector in the short term. Policy makers need to consider residents' preference for health care in health policy development as the preference can only change in the long term.

Decentralization policy schemes (DPSs) in the public sector have been implemented in different ways by Slovakia and the Czech Republic. Both approaches have led to a transfer of competencies from state administration to self-government with the aim of improving the efficiency of the delivery of services. This paper presents a comparative scale efficiency analysis of the units performing services in the building order sector. The analysis is based on two unique regional datasets from two countries, Slovakia and the Czech Republic. The DPS implemented in Slovakia is based on the principle of voluntary cooperation of municipalities. In the case of the Czech building sector, the competencies have been transferred to the newly created municipalities with delegated or extended competencies. This study aims to contribute to the research on efficiency in public administration. We focused on the relationship between two types of DPSs, and units' scale efficiency. We also tried to determine whether a specific unit scale size could be identified as the most efficient. We employed a two-stage metafrontier approach based on procedures for evaluating program and managerial efficiency. The results show that different DPs have not led to statistically significant differences in performance, and it is not possible to identify the most efficient building office scale size.

Frontmatter -- AMERICAN ENCOUNTERS / GLOBAL INTERACTIONS -- CONTENTS -- Acknowledgments -- Introduction -- ONE. Dominican History, the United States in the Caribbean, and the Origins of the Good Neighbor Policy -- TWO. The Dominican Revolution of 1930 and the Policy of Nonintervention -- THREE. The Bankrupt Neighbor Policy: Depression Diplomacy and the Foreign Bondholders Protective Council -- FOUR. What Will the Neighbors Think? Dictatorship and Diplomacy in the Public Eye -- FIVE. Genocide Next Door: The Haitian Massacre of 1937 and the Sosua Jewish Refugee Settlement -- SIX. Gold Braid and Striped Pants: The Culture of Foreign Relations in the Dominican Republic -- SEVEN. Fortress America, Fortaleza Trujillo: The Hull-Trujillo Treaty and the Second World War -- EIGHT. The Good Neighbor Policy and Dictatorship -- Notes -- Bibliography -- Index

This article explores the challenges that have made the pursuit of school integration difficult in the contemporary era. Using court records and newspaper archives, we explore how a New York City school desegregation order came to be seen as "unnecessary," "unfair," and "anachronistic," claims that seem to deny the salience of race in one of the most segregated school systems in the nation. In 1974, Mark Twain Junior High School in Coney Island became the first New York City school to desegregate under federal district court order. Three decades later, Mark Twain was a highly desirable magnet school under a court-mandated desegregation plan that left students across the city competing fiercely for admissions. In 2007, an immigrant parent from India successfully sued New York City, claiming his daughter was passed over in favor of white students who scored lower on the city's selective school screening test but were admitted in the name of maintaining the 1974 court-mandated racial balance. We argue that Mark Twain's story vividly illustrates not only the importance of demographic change in school desegregation policy but also the evolution of racial discourse and the conceptions of the public good in the post–civil rights era.

The perception that better information on environment and development is the determinant of effective rational decision- and policy-making processes provide the impetus for global interest in the use of sustainable development indicators (SDIs). Accordingly, proposals for SDIs are framed either on organisational goals or on disciplinary and multidisciplinary theories -aiming to reduce uncertainties in choosing the best alternative among a set of options concerning sustainability. Despite the fact that many SDI initiatives are explicitly aimed at improving policy-making, it is not apparent that political settings and organisational realities are taken into consideration in designing the framework for sustainability assessment. Ignoring the realities of policy-making dynamics can result in poor institutionalisation of the SDI development process, and therefore reduced impact of indicators. Linkage of SDIs to policy processes must also take into account the complex role of information in policy processes. The importance of societal values, cultural contexts and behaviour of bureaucracies must be understood and used to assist the assessment of progress towards sustainability using SDIs. Essentially, objective knowledge must be tampered with pragmatism in governance. This paper highlights the case of SDI development in the state of Selangor where the notion of instrumental rationality is balanced with the 'incrementalism' of the policy process that provided the foundation for institutionalising the reporting and use of SDIs. The ideals and paradoxes of participatory decision-making, the principles of the rational model and decision-making processes within a state government are critically examined.

Este artículo se inserta analiza el complejo proceso de estructuración de las políticas sanitarias en la Argentina. Procura examinar la transformación del sistema de salud pública durante el primer gobierno peronista en Jujuy (1946-1952). En esta tarea se presta atención a la labor del máximo responsable del área sanitaria en el distrito: Emilio Navea. Son objeto de estudio sus antecedentes académicos, sus relaciones políticas, así como las iniciativas y reformas realizadas al sistema de salud local. Esta intensa actividad contribuiría de gran modo a su designación como candidato a vicegobernador, para las elecciones de 1951, en representación del peronismo jujeño. ; In this article we analyze the health policy structuring process in Argentina. Our aim is to examine the transformation of the public health system during the first Peronist government in Jujuy (1946-1952). The attention is given to the performance of Emilio Navea, head of the health area. We analyze their academic background, political relations, initiatives and reforms implemented to the local health system. The intense activity of Navea in this area contributed largely to its appointment as a lieutenant governor candidate for the 1951 elections on behalf of the political force that supported Perón in the province. ; Dossier: Nación, provincias y municipios en la centralización del sistema sanitario argentino, 1900-1955 ; Departamento de Historia

This paper explores relationships between ministers, special advisers and civil servants through the lens of a high-profile government crisis in Northern Ireland (NI). Although political–administrative relationships are a mainstay of public administration research, we still have limited understanding of how these relationships feature and function within the 'Westminster family' of governance when operating within devolved institutions or post-conflict societies, nor of their role in crisis. We use Scott's institutional pillars as an analytical framework and conduct a documentary analysis of public inquiry witness statements to explore the Renewable Heat Incentive crisis which led to the collapse of the NI legislature. Utilising a novel application of existing theory, we demonstrate that the implementation of the devolved, consociational power-sharing model incubated new governance norms, that prioritised and legitimised the agendas and actions of political actors (ministers and special advisers), over civil servants. Specifically, in understanding how relational norms – particularly distrust – feed public policy failure and institutional crisis, our findings contribute to this research area and to the broader public administration field. Government institutional crisis negatively impacts upon public service delivery and the wider health of democracy. Understanding such crises is an important first step in their amelioration. Points for practitioners Structural, systemic and day-to-day behavioural layering of distrust adversely impacts government professionals' ability to recognise, communicate and respond to risk; this can create policy problems, which can escalate, unchecked, until they have become full-blown crises. In order to proactively mitigate crises in other public policy contexts, managers and teams should build in awareness raising, reflection and management processes to individual and operational performance reviews to improve relational norms, and prevent the normalisation of distrust.

Canada's security interests and the mission of our Armed Forces – that is to defend Canada, defend North America and to promote peace and security abroad – may largely remain unchanged and timeless. The nature of the security environment, however, has not – nor will it be in the years to come. An effective and relevant Canadian Armed Forces will continue to require capable, wellequipped and operationally-ready maritime, air and land forces who are largely raised and trained within our Army, Navy and Air Force. But in order for Defence to remain relevant and effective in an era of increased instability, volatility and unpredictability, our Armed Forces need the ability and capacity to match these with an increased understanding of what is going on, and preparedness for what is to come. This is the business of our military's Joint Forces – those beyond the tactical units that the services provide. It is the joint organizations and networks within the institution that generate intelligence, provide understanding and lead the partnering, planning, force posturing and practicing so essential to the anticipation of, preparation for, and conduct of, operations – in particular in a world of unrelenting complexity. A decade after General Rick Hillier's extraordinary initiatives to transform our Armed Forces from a service-centric machine-age force to one focused on the business of operations, one that thinks and acts Canadian Forces (joint) first, we do see evidence of real progress in the approach to joint operations and improved appreciation of our military's joint functions and capabilities. Unlike the political and public calls for strong services and the modernization of their major platforms, however, this progress has been realized largely through efforts internal to the Armed Forces themselves. The initiative has been without political leadership and external policy topcover, rendering this progress and its future vulnerable and reversible. This paper describes the functions of the Joint Force; advocates for the capabilities they require to enable partnerships, enhance understanding and advance mission preparedness; and calls for unified leadership of the joint domain and over our military's joint culture. Our traditional international partners have travelled this road. They too see that clarity on joint functions, joint capability, joint domain leadership, and stewardship over joint culture are vital to their military's relevance and operational effectiveness – and to their agility and flexibility in the years to come. Their progress is the result of internal professional transformation, as well as the understanding of, and requirement by political leaders and modern defence policy to make this so. Here in Canada, the forming of new government this fall calls for a relook at Defence policy, providing new opportunity to invite that same political leadership and influence. Joint functions, joint capabilities and clear joint leadership are vital to our military's relevance to, and effectiveness in, our national defence and operations. Joint Forces and the joint domain, like strong and capable Army, Navy and Air Forces, need to be led, resourced and fully engaged before planes fly, ships sail, and troops deploy. Joint-ness requires external understanding and proponents, and, within the Forces, a clearly identifiable champion. In Canada, these range from ambiguous to absent.

Colin S. Gray distinguished himself from other scholars in the field of strategic studies with his belief that grand strategy is indispensable, complex, and inherently agential. This article identifies key themes, continuities, conceptual relationships, and potential discontinuities from his decades of grand strategic thought. Gray's statement that "all strategy is grand strategy" remains highly relevant today, emphasizing the importance of agential context in military environments—a point often neglected in strategic practice.

The relevance of the issue raised in the article is due to the fact that one of the key aspects of reforming the judicial system in Ukraine, which must meet European standards, is to ensure public order during the court hearing. In this regard, the subject matter of the article is the world-tested methods and ways of ensuring public order during the court hearing. While writing the article the authors have used the following methods: formal and legal, analytical, system analysis, system and structural. The problems that currently exist and are in the way of effective development of the national judicial system of Ukraine have been analyzed. While analyzing the most problematic and relevant issues of ensuring public order in courts the authors have emphasized on the intensification of tendencies to strengthen the security of the subjects participating in the court hearing. At the same time, it has been stated that there is the spread of the policy of many states for increasing the level of democratization of the judicial process, in particular by granting wider rights and freedoms to all its participants. Based on the successful experience of foreign countries, the authors have suggested the ways to improve the judicial process in Ukraine in the whole and not just to ensure public order during the court hearing. Special attention has been paid to the Judicial Protection Service. It has been determined that the improvement of the national legislation of Ukraine on ensuring public order during the court hearing should take into account both national traditions of judicial proceedings and European standards. At the same time, the implementation of international standards in these areas should be systematic and comprehensive. In this regard, it is necessary to form a single concept in this area. The conclusions have offered three main interrelated stages of improvement of the legislation of Ukraine in terms of ensuring public order during the court hearing.

Improving physicians' prescription practices is a primary strategy for countering the rise in resistance to antibiotics. This would prevent physicians from incorrectly prescribing antibiotics, one of the main causes of antibiotic resistance. The increasing availability of medical data and methods of machine learning provide an opportunity to generate instant diagnoses. In the present study, the example of urinary tract infections in Denmark is used to demonstrate how data-based predictions can improve clinical practice in the face of increasing antibiotic resistance. For this purpose, comprehensive administrative and medical data, in combination with machine learning methods and economic modeling, were used to develop rules for prescribing antibiotics. The total number of prescriptions could be reduced by 7.42 percent by applying the recommended policy measures without reducing the number of treated bacterial infections. This demonstrates the great potential of this method. However, in Germany this potential cannot be tapped until more information is digitized. The information that must be supplied to the IT systems in physicians' practices and hospitals is often collected and saved by decentralized institutions; linking it is key.

This study was funded by the Gillings Fellowship in Global Public Health and Autism Research (Grant Award YOG054) and the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No. 777394). ; The Soviet occupation of the Baltic States followed by joining the United Nations (UN) and European Union make these countries an interesting point of comparison in the development of autism and education policy. This study investigates how policies changed following the transition and how the right and access to education are facilitated for autistic children by performing a path dependence analysis. All Baltic States created new education policies following the transition out of the Soviet era, with their accession to the UN and their appetite to follow internationally available guidance. The right to education for all children in was adopted in all education systems. Education facilities for children with disabilities were implemented in all countries. Afterward, all countries started toward the development of more inclusive systems. Nevertheless, the majority of policies did not specify for autism, yet covered special education needs in general. A development in Latvia should be noted, where various special education needs are outlined in national policy, along with provisions and professional assistance required to address them in mainstream or special classrooms. Ultimately, education policy flourished after the transition. Their development caught up to other European Union countries and they are currently working on implementing inclusive education.

Collective identity, the emotionally powerful sense of belonging to a group, is a crucial source of popular legitimacy for nations. However efforts since the 1990s to politically support European integration by using identity mechanisms borrowed from nationalism have had very limited success. European integration may require new, post-national approaches to the relationship between culture and politics. This controversial and timely volume poses the logical question: if identity doesn't effectively connect culture with European integration politics, what does? The book brings together leading scholars from several of the disciplines that have developed concepts of culture and methods of cultural research. These expert interdisciplinary contributors apply a startling diversity of approaches to culture, linking it to facets of integration as varied as external policy, the democratic deficit, economic dynamism and the geography of integration. This book examines commonalities and connections within the European space, as well as representations of these in identity discourses. It will be useful for students and scholars of sociology, geography, anthropology, social psychology, political science and the history of European integration

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin's public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin's health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin's HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin's HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development.