Suchergebnisse

Government programmes have always relied on the enrolment of intermediate actors, both public and private, in the regulatory process. An increasing recognition that the form of implementation is as important as the passing of new legislation means that these actors are increasingly the focus, rather than just the means to an end, of regulatory programmes. This is particularly the case in international maritime environmental regulation. In this paper I examine how the enrolment of private actors takes place, both discursively and through the use of incentives and sanctions. I focus in particular on the use of liability and compulsory insurance and examine the conditions necessary for an environmental insurance market to function. I then take one set of private actors—Protection and Indemnity (P&I) Clubs which insure shipowners' third party liabilities—and look how international government institutions create (dis)incentives and discourses that encourage the P&I Clubs to act in favour of regulatory goals. The contingent nature of regulation means there is an increasing feedback in which P&I Clubs are allowed to contribute to the framing of specific government programmes in the name of practical implementation, but this must be balanced against the risk of allowing private interests to determine ultimate policy objectives.  2000 Elsevier Science Ltd. All rights reserved

Over forty years ago, an Ontario Provincial Committee headed by Emmett Hall and Lloyd Dennis released Living and Learning (1968), a bold and provocative progressive reform prescription for the perceived ills afflicting the Ontario public school system. One of the most strident critics of the Hall-Dennis Report was Dr. James Daly, a little known McMaster University English history professor, who responded with a stinging critique in the form of a political pamphlet-sized book entitled Education or Molasses: A Critical Look at the Hall-Dennis Report (1969). While Daly's little book echoed the essential message of Hilda Neatby's So Little for the Mind (1953), it never attracted the same popular acclaim. Many Ontario educators from regular classroom teachers to academics sympathized with Daly, but few rallied to his defence in the ensuing public debate. This article explores Dr. Daly's personal crusade and assesses why it fizzled in the public arena, yet actually helped to turn the tide in the 1980s backlash against the Hall-Dennis brand of 'romantic progressive' reform.

Objective: Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. Design and Methods: Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. Results: We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional examples where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. Conclusions: We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.