Lone-Actor Terrorism. Toolkit Paper 1: Practical Guidance for Mental Health Practitioners and Social Workers

OpenAIRE

Bakker, E.; Roy, de, van Zuijdewijn J.

2016-01-01

The aim of this paper is to draw out practical implications for mental health practitioners and social workers in dealing with Lone-Actor Terrorism. It is not intended to provide a profile of lone-actor terrorists, but rather to offer guidance that may be of use to practitioners in Europe (and beyond), supporting the development of strategies to detect and deal with potential lone-actor terrorists and to understand the possible risk posed by persons of interest. This paper presents three sets...

Lone-Actor Terrorism. Toolkit Paper 1 : Practical Guidance for Mental Health Practitioners and Social Workers

NARCIS (Netherlands)

Bakker, E.; Roy, de van Zuijdewijn J.

2016-01-01

The aim of this paper is to draw out practical implications for mental health practitioners and social workers in dealing with Lone-Actor Terrorism. It is not intended to provide a profile of lone-actor terrorists, but rather to offer guidance that may be of use to practitioners in Europe (and

earGram Actors: An Interactive Audiovisual System Based on Social Behavior

Directory of Open Access Journals (Sweden)

Peter Beyls

2015-11-01

Full Text Available In multi-agent systems, local interactions among system components following relatively simple rules often result in complex overall systemic behavior. Complex behavioral and morphological patterns have been used to generate and organize audiovisual systems with artistic purposes. In this work, we propose to use the Actor model of social interactions to drive a concatenative synthesis engine called earGram in real time. The Actor model was originally developed to explore the emergence of complex visual patterns. On the other hand, earGram was originally developed to facilitate the creative exploration of concatenative sound synthesis. The integrated audiovisual system allows a human performer to interact with the system dynamics while receiving visual and auditory feedback. The interaction happens indirectly by disturbing the rules governing the social relationships amongst the actors, which results in a wide range of dynamic spatiotemporal patterns. A performer thus improvises within the behavioural scope of the system while evaluating the apparent connections between parameter values and actual complexity of the system output.

Health care delivery systems.

NARCIS (Netherlands)

Stevens, F.; Zee, J. van der

2007-01-01

A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

Denmark: Health system review

DEFF Research Database (Denmark)

Juul, Annegrete; Krasnik, Allan; Rudkjøbing, Andreas

The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

Public Health Knowledge Utilisation by Policy Actors: An Evaluation Study in Midden-Holland, the Netherlands

Science.gov (United States)

de Goede, Joyce; Steenkamer, Betty; Treurniet, Henriëtte; Putters, Kim; van Oers, Hans

2011-01-01

A comprehensive report has been prepared on the state of public health and healthcare in the Midden-Holland region of the Netherlands. This study describes the development of the report and the mechanisms behind public health knowledge utilisation by three groups of health policy actors: local authorities, public health professionals and regional…

Requirements and Solutions for Personalized Health Systems.

Science.gov (United States)

Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

2017-01-01

Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

Power structure among the actors of financial support to the poor to access health services: Social network analysis approach.

Science.gov (United States)

Etemadi, Manal; Gorji, Hasan Abolghasem; Kangarani, Hannaneh Mohammadi; Ashtarian, Kioomars

2017-12-01

The extent of universal health coverage in terms of financial protection is worrisome in Iran. There are challenges in health policies to guarantee financial accessibility to health services, especially for poor people. Various institutions offer support to ensure that the poor have financial access to health services. The aim of this study is to investigate the relationship network among the institutions active in this field. This study is a policy document analysis. It evaluates the country's legal documents in the field of financial support to the poor for healthcare after the Islamic Revolution in Iran. The researchers looked for the documents on the related websites and referred to the related organizations. The social network analysis approach was chosen for the analysis of the documents. Block-modelling and multi-dimensional scaling (MDS) was used to determine the network structures. The UCINET software was employed to analyse the data. Most the main actors of this network are chosen from the government budget. There is no legal communication and cooperation among some of the actors because of their improper position in the network. Seven blocks have been clustered by CONCOR in terms of the actor's degree of similarity. The social distance among the actors of the seven blocks is very short. Power distribution in the field of financial support to the poor has a fragmented structure; however, it is mainly run by a dominant block consisting of The Supreme Council of Welfare and Social Security, Health Insurance Organization, and the Ministry of Health and Medical Education. The financial support for the poor network involves multiple actors. This variety has created a series of confusions in terms of the type, level, and scope of responsibilities among the actors. The weak presence legislative and regulatory institutions and also non-governmental institutions are the main weak points of this network. Copyright © 2017 Elsevier Ltd. All rights reserved.

AN ANALYSIS OF THE ROLE OF ECONOMIC ACTORS IN THE WTO DISPUTE SETTLEMENT SYSTEM: LEGAL OR POLITICAL ISSUE?

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Intan Soeparna

2015-10-01

Full Text Available Economic actors are the main trade player in the World Trade Organization, although, the relation between WTO and economic actor is built by trade regulation that is negotiated among the WTO Members. Nothing in the WTO regulates economic actors to involve directly in the WTO, especially in the WTO dispute settlement system. Nevertheless, the debate amongst experts regarding the involvement of economic actors in the WTO dispute settlement system is unavoidable. This article therefore discusses the possibility of the involvement of economic actors in the WTO dispute settlement system, whether there is legal and political point of views

Governance of Health Systems Comment on “A Network Based Theory of Health Systems and Cycles of Well-Being”

OpenAIRE

Blanchet, Karl

2013-01-01

Health systems research aims to understand the governance of health systems (i.e. how health systems function and perform and how their actors interact with each other). This can be achieved by applying innovative methodologies and concepts that are going to capture the complexity and dynamics of health systems when they are affected by shocks. The capacity of health systems to adapt to shocks (i.e. the resilience of health systems) is a new area of investigation. Social network analysis is a...

Mental health in France, policies and actors: developing administrative knowledge in a segmented world.

Science.gov (United States)

Mossé, Philippe; Maury, Caroline; Daumerie, Nicolas; Roelandt, Jean-Luc

2013-01-01

The new mental health care policy, which has been set up in France, involves a change of paradigm, which has been going on since the 2000s: the emphasis is shifting from psychiatry to mental health care. This shift mainly concerns the knowledge about mental health is produced and circulates among an increasingly large number of bodies. Mainly grounded on actor interview analysis, official reports and blueprints, this study shows that the results of this process are numerous. They include the development of ambulatory care and strong moves towards decentralization. More data and knowledge are therefore to be shared in this more complex system. However, the French State, in the form of the central administration, is taking advantage of this move and is still contributing significantly to the definition and implementation of the new policy. On the other hand, the new governance dynamic is not leading to standardization of medical practices, as the mental health field remains highly heterogeneous. Copyright © 2012 John Wiley & Sons, Ltd.

Compositional schedulability analysis of real-time actor-based systems.

Science.gov (United States)

Jaghoori, Mohammad Mahdi; de Boer, Frank; Longuet, Delphine; Chothia, Tom; Sirjani, Marjan

2017-01-01

We present an extension of the actor model with real-time, including deadlines associated with messages, and explicit application-level scheduling policies, e.g.,"earliest deadline first" which can be associated with individual actors. Schedulability analysis in this setting amounts to checking whether, given a scheduling policy for each actor, every task is processed within its designated deadline. To check schedulability, we introduce a compositional automata-theoretic approach, based on maximal use of model checking combined with testing. Behavioral interfaces define what an actor expects from the environment, and the deadlines for messages given these assumptions. We use model checking to verify that actors match their behavioral interfaces. We extend timed automata refinement with the notion of deadlines and use it to define compatibility of actor environments with the behavioral interfaces. Model checking of compatibility is computationally hard, so we propose a special testing process. We show that the analyses are decidable and automate the process using the Uppaal model checker.

ACToR - Aggregated Computational Toxicology Resource

International Nuclear Information System (INIS)

Judson, Richard; Richard, Ann; Dix, David; Houck, Keith; Elloumi, Fathi; Martin, Matthew; Cathey, Tommy; Transue, Thomas R.; Spencer, Richard; Wolf, Maritja

2008-01-01

ACToR (Aggregated Computational Toxicology Resource) is a database and set of software applications that bring into one central location many types and sources of data on environmental chemicals. Currently, the ACToR chemical database contains information on chemical structure, in vitro bioassays and in vivo toxicology assays derived from more than 150 sources including the U.S. Environmental Protection Agency (EPA), Centers for Disease Control (CDC), U.S. Food and Drug Administration (FDA), National Institutes of Health (NIH), state agencies, corresponding government agencies in Canada, Europe and Japan, universities, the World Health Organization (WHO) and non-governmental organizations (NGOs). At the EPA National Center for Computational Toxicology, ACToR helps manage large data sets being used in a high-throughput environmental chemical screening and prioritization program called ToxCast TM

A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

Science.gov (United States)

Teerawattananon, Yot; Russell, Steve

2008-03-01

In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

Balancing influence between actors in healthcare decision making

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Babad Yair M

2011-04-01

Full Text Available Abstract Background Healthcare costs in most developed countries are not clearly linked to better patient and public health outcomes, but are rather associated with service delivery orientation. In the U.S. this has resulted in large variation in healthcare availability and use, increased cost, reduced employer participation in health insurance programs, and reduced overall population health outcomes. Recent U.S. healthcare reform legislation addresses only some of these issues. Other countries face similar healthcare issues. Discussion A major goal of healthcare is to enhance patient health outcomes. This objective is not realized in many countries because incentives and structures are currently not aligned for maximizing population health. The misalignment occurs because of the competing interests between "actors" in healthcare. In a simplified model these are individuals motivated to enhance their own health; enterprises (including a mix of nonprofit, for profit and government providers, payers, and suppliers, etc. motivated by profit, political, organizational and other forces; and government which often acts in the conflicting roles of a healthcare payer and provider in addition to its role as the representative and protector of the people. An imbalance exists between the actors, due to the resources and information control of the enterprise and government actors relative to the individual and the public. Failure to use effective preventive interventions is perhaps the best example of the misalignment of incentives. We consider the current Pareto efficient balance between the actors in relation to the Pareto frontier, and show that a significant change in the healthcare market requires major changes in the utilities of the enterprise and government actors. Summary A variety of actions are necessary for maximizing population health within the constraints of available resources and the current balance between the actors. These actions include

Balancing influence between actors in healthcare decision making.

Science.gov (United States)

Kaplan, Robert M; Babad, Yair M

2011-04-19

Healthcare costs in most developed countries are not clearly linked to better patient and public health outcomes, but are rather associated with service delivery orientation. In the U.S. this has resulted in large variation in healthcare availability and use, increased cost, reduced employer participation in health insurance programs, and reduced overall population health outcomes. Recent U.S. healthcare reform legislation addresses only some of these issues. Other countries face similar healthcare issues. A major goal of healthcare is to enhance patient health outcomes. This objective is not realized in many countries because incentives and structures are currently not aligned for maximizing population health. The misalignment occurs because of the competing interests between "actors" in healthcare. In a simplified model these are individuals motivated to enhance their own health; enterprises (including a mix of nonprofit, for profit and government providers, payers, and suppliers, etc.) motivated by profit, political, organizational and other forces; and government which often acts in the conflicting roles of a healthcare payer and provider in addition to its role as the representative and protector of the people. An imbalance exists between the actors, due to the resources and information control of the enterprise and government actors relative to the individual and the public. Failure to use effective preventive interventions is perhaps the best example of the misalignment of incentives. We consider the current Pareto efficient balance between the actors in relation to the Pareto frontier, and show that a significant change in the healthcare market requires major changes in the utilities of the enterprise and government actors. A variety of actions are necessary for maximizing population health within the constraints of available resources and the current balance between the actors. These actions include improved transparency of all aspects of medical decision

Ideas, actors and institutions: lessons from South Australian Health in All Policies on what encourages other sectors’ involvement

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Fran Baum

2017-10-01

Full Text Available Abstract Background This paper examines the extent to which actors from sectors other than health engaged with the South Australian Health in All Policies (HiAP initiative, determines why they were prepared to do so and explains the mechanisms by which successful engagement happened. This examination applies theories of policy development and implementation. Methods The paper draws on a five year study of the implementation of HiAP comprising document analysis, a log of key events, detailed interviews with 64 policy actors and two surveys of public servants. Results The findings are analysed within an institutional policy analysis framework and examine the extent to which ideas, institutional factors and actor agency influenced the willingness of actors from other sectors to work with Health sector staff under the HiAP initiative. In terms of ideas, there was wide acceptance of the role of social determinants in shaping health and the importance of action to promote health in all government agencies. The institutional environment was initially supportive, but support waned over the course of the study when the economy in South Australia became less buoyant and a health minister less supportive of health promotion took office. The existence of a HiAP Unit was very helpful for gaining support from other sectors. A new Public Health Act offered some promise of institutionalising the HiAP approach and ideas. The analysis concludes that a key factor was the operation of a supportive network of public servants who promoted HiAP, including some who were senior and influential. Conclusions The South Australian case study demonstrates that despite institutional constraints and shifting political support within the health sector, HiAP gained traction in other sectors. The key factors that encouraged the commitment of others sectors to HiAP were the existence of a supportive, knowledgeable policy network, political support, institutionalisation of the

Ideas, actors and institutions: lessons from South Australian Health in All Policies on what encourages other sectors' involvement.

Science.gov (United States)

Baum, Fran; Delany-Crowe, Toni; MacDougall, Colin; Lawless, Angela; van Eyk, Helen; Williams, Carmel

2017-10-16

This paper examines the extent to which actors from sectors other than health engaged with the South Australian Health in All Policies (HiAP) initiative, determines why they were prepared to do so and explains the mechanisms by which successful engagement happened. This examination applies theories of policy development and implementation. The paper draws on a five year study of the implementation of HiAP comprising document analysis, a log of key events, detailed interviews with 64 policy actors and two surveys of public servants. The findings are analysed within an institutional policy analysis framework and examine the extent to which ideas, institutional factors and actor agency influenced the willingness of actors from other sectors to work with Health sector staff under the HiAP initiative. In terms of ideas, there was wide acceptance of the role of social determinants in shaping health and the importance of action to promote health in all government agencies. The institutional environment was initially supportive, but support waned over the course of the study when the economy in South Australia became less buoyant and a health minister less supportive of health promotion took office. The existence of a HiAP Unit was very helpful for gaining support from other sectors. A new Public Health Act offered some promise of institutionalising the HiAP approach and ideas. The analysis concludes that a key factor was the operation of a supportive network of public servants who promoted HiAP, including some who were senior and influential. The South Australian case study demonstrates that despite institutional constraints and shifting political support within the health sector, HiAP gained traction in other sectors. The key factors that encouraged the commitment of others sectors to HiAP were the existence of a supportive, knowledgeable policy network, political support, institutionalisation of the ideas and approach, and balancing of the economic and social goals of

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand.

Science.gov (United States)

Teerawattananon, Yot; Russell, Steve

2008-09-26

This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

Performance of community health workers : situating their intermediary position within complex adaptive health systems

NARCIS (Netherlands)

Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

2017-01-01

Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income

Global Surgery 2030: a roadmap for high income country actors

Science.gov (United States)

Greenberg, Sarah L M; Abdullah, Fizan; Amado, Vanda; Anderson, Geoffrey A; Cossa, Matchecane; Costas-Chavarri, Ainhoa; Davies, Justine; Debas, Haile T; Dyer, George S M; Erdene, Sarnai; Farmer, Paul E; Gaumnitz, Amber; Hagander, Lars; Haider, Adil; Leather, Andrew J M; Lin, Yihan; Marten, Robert; Marvin, Jeffrey T; McClain, Craig D; Meara, John G; Meheš, Mira; Mock, Charles; Mukhopadhyay, Swagoto; Orgoi, Sergelen; Prestero, Timothy; Price, Raymond R; Raykar, Nakul P; Riesel, Johanna N; Riviello, Robert; Rudy, Stephen M; Saluja, Saurabh; Sullivan, Richard; Tarpley, John L; Taylor, Robert H; Telemaque, Louis-Franck; Toma, Gabriel; Varghese, Asha; Walker, Melanie; Yamey, Gavin; Shrime, Mark G

2016-01-01

The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future. PMID:28588908

Maternal care of undocumented pregnant women under the Fees Act (Medical) for Foreigners 1951. Perspectives of health and non-health actors

OpenAIRE

Loo, Pei Shan

2017-01-01

With the unprecedented international migration around the world, policies that restrict immigrants' health care access have become prevailing. In 2014, the amendment to The Fees Act (Medical) for Foreigners 1951 had further hindered the health care access of undocumented pregnant women. This qualitative study aimed to obtain perspectives of health and non-health actors regarding the implications of the amendment to the undocumented pregnant women. Ten semi-structured interviews were conducted...

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

Directory of Open Access Journals (Sweden)

Russell Steve

2008-09-01

Full Text Available Abstract Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72% respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17% whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

Actors: A Model of Concurrent Computation in Distributed Systems.

Science.gov (United States)

1985-06-01

Artificial Intelligence Labora- tory of the Massachusetts Institute of Technology. Support for the labora- tory’s aritificial intelligence research is...RD-A157 917 ACTORS: A MODEL OF CONCURRENT COMPUTATION IN 1/3- DISTRIBUTED SY𔃿TEMS(U) MASSACHUSETTS INST OF TECH CRMBRIDGE ARTIFICIAL INTELLIGENCE ...Computation In Distributed Systems Gui A. Aghai MIT Artificial Intelligence Laboratory Thsdocument ha. been cipp-oved I= pblicrelease and sale; itsI

International Political Actorness of the European Union: Evaluation Criteria

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GNATYUK N.N.

2014-06-01

Full Text Available The European Union is a completely new international entity which is hard to evaluate using traditional criteria of political actorness. Its active international presence stimulates the modeling of international actor features beyond the scope of “state-international organization” scheme. The concept of international actorness serves as a starting point for the development of appropriate analytical model. Unlike the traditional state-centered approaches which define an international actor through its affiliation witch the international system, this concept operates at the internal level of international entity and at the international structure level. Furthermore, both of these levels are treated as ontologically neutral and mutually constitutive. This basic theoretical scheme is used for elaboration of evaluation criteria of political actorness. The proposed system of criteria is based on drawing, synthesizing and developing the main writings on “new international actors” since the times of classic work by Carol A. Cosgrove and Kenneth J. Twitchett. The key elements of actorness assessed in this article include defining of capacity to act on the global scene as well as the acceptance by other actors and by international system as a whole. At the internal level, the EU’s actor capacity is measured by assessing its core elements ranging from core aspects, such as autonomy, authority, actor capability, coherence and cohesion to identity aspects. On the external level, the decisive criteria are recognition and acceptance by others which reflect expectations and perceptions of the EU. The proposed approach of evaluating the international actorness enables us to consider the political activity of the EU on the basis of coordinated system of interaction between the variables of international and domestic levels of the analysis. Furthermore, this contributes to the development of cumulative, coherent, and comprehensive theory of international

Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

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González Luz

2009-10-01

Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

Banking for health: the role of financial sector actors in investing in global health.

Science.gov (United States)

Krech, Rüdiger; Kickbusch, Ilona; Franz, Christian; Wells, Nadya

2018-01-01

The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors' business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm's employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products.

Actor-network-theory perspective on a forestry decision support system design

NARCIS (Netherlands)

Boerboom, L.G.J.; Ferritti, V.

2014-01-01

Use of decision support systems (DSS) has thus far been framed as a social process of adoption or technical process of usability. We analyze the development of a DSS as a process of institutionalization of new as well as drift of existing practices. We write an Actor-Network-Theory (ANT) account,

Institutional analysis of health system governance.

Science.gov (United States)

Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

2017-11-01

It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system

Involving new actors to achieve ART scaling-up: difficulties in an HIV/AIDS counselling and testing centre in Cameroon.

Science.gov (United States)

Yakam, J C Y Tantchou; Gruénais, M-E

2009-03-01

The high HIV/AIDS-related mortality among young adults is devastating countries in sub-Saharan Africa. The implementing capacity of the health systems is the main limiting factor of antiretroviral treatment (ART) scaling-up;(1) this capacity depends mainly on the health workforce. Tackling the issue of human resources for health is thus of paramount importance to achieve universal access to ART and for the survival of health systems in time of AIDS. To support such a process, the World Health Organization stresses the importance of task shifting(2) from medical doctors to nurses and from nurses to community health workers. Such task shifting is not easy to achieve but undoubtedly needed. This paper raises issues about the involvement of new actors(3) without precise redefinitions of roles and task-shifting procedures. We take the example of a 'Centre de Prévention et de Dépistage Volontaire du VIH/sida'(4) in one major town of the Far-North province of Cameroon (Central Africa). The study was qualitative. Observations were carried out in the service and in-depth interviews conducted with health workers and actors of Cameroon's National AIDS Control Committee. These interviews were recorded and transcribed. The material was analysed using keywords. KEY RESULT: The involvement of new actors in a context of human resources for health shortage and health system crisis creates confusion and role conflicts, which lead to frustration. It favours the appearance of chinks within which these new actors slip and 'find their way' in the system; it finally raises problems related to their legitimacy and position within the existing hierarchy. KEY POLICY MESSAGE: It is necessary, when involving new staff members (particularly when they do not belong to internationally recognized health professionals such as nurses, doctors and pharmacists), to redefine roles and build precise task-shifting procedures so that everyone may still have a place in the whole system and feel useful.

Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts.

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Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J

2014-08-26

This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.

CAPABILITIES AND ACTORS IN ERP SYSTEMS MANAGEMENT: AN EXPLORATORY STUDY IN CORPORATE USERS OF SAP ERP

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Ronaldo Zwicker

2007-10-01

Full Text Available ERP systems are now an important component of information technology architecture in most large and medium sized companies. As such, it is inevitable that the activities undertaken to align this component to business requirements, conduct its evolution and ensure its performance and availability become increasingly important to companies’ IT areas. Success of these activities relies upon knowledge and participation of various actors inside and outside the IT area, imposing challenges not observed in internally developed systems. This paper proposes a model for the analysis of ERP systems management based on a previous work on the subject with the inclusion of the IT capabilities model and a description of the actors (stakeholders involved in the process of using an ERP system in a company. The proposed model is the basis for an exploratory survey conducted with 85 Brazilian companies whose results also comprise this text. The results suggest that only part of the capabilities is present and only part of the actors effectively participates on the ERP systems management effort.

What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

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Kabir Sheikh

2016-07-01

Full Text Available Background: The unregulated availability and irrational use of tuberculosis (TB medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs – India, Tanzania, and Zambia – and to understand the factors that constrain and enable these processes. Methods: We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO, on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators’ authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. Results: In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for

ACTOR`S EXPRESSIVENESS: PHYSICAL ACTION AS A LANGUAGE OF ARCHETYPES

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CATEREVA IRINA

2016-06-01

Full Text Available Physical activity is the main element of the nonverbal expressiveness of the actor. Th e nonpsychological theatre of Europe in the second half of the 20th century was looking for the actor`s possibility of physical action for revealing the archetypal image of the character. Expressing the meanings similar among themselves in diff erent Nations, they connect the actors and spectators at the level of feelings, of the subconscious. Destroying the barriers in people’s minds which divides them into Europeans and Asians, or French and Germans, they are understandable to any audience regardless of their cultural or linguistic affiliation.

Visualising Actor Network for Cooperative Systems in Marine Technology

DEFF Research Database (Denmark)

Pan, Yushan; Finken, Sisse

2016-01-01

Awareness is a concept familiar to specialists within the field of Computer Supported Cooperative Work (CSCW). It is superior for analysing and describing some of the ad hoc work activities that unfold in cooperation. Such informal activities are outside the scope of engineers’ formal models, whi...... that shape computer systems. The aim, thus, is to portray cooperative work in a way that can be valuable for engineers implementing marine technology. We do so by way of presenting a transferring technique (2T) using insights from the CSCW field and Actor Network Theory (ANT)....

Control del cáncer cervicouterino en Colombia: la perspectiva de los actores del sistema de salud Control of cervical cancer in Colombia: the perspective of the health system

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Carolina Wiesner-Ceballos

2009-01-01

tamizaje. Se requiere un programa integrado y mejor organizado en el que participen los diferentes actores del sistema de salud.OBJECTIVES: To characterize the health system stakeholder's perspective on the basics of the political, economic, and sanitary context, as well as the ways in which control activities are being realized in four of Colombia's health departments. METHODS: This was a qualitative study of four Colombian health departments chosen for their differing cervical cancer mortality rates and their planned disease control efforts (Boyacá, Caldas, Magdalena, and Tolima. Semistructured interviews were conducted of health care managers, insurance coordinators, and public and private health institutions at the departmental and municipals levels. Focus groups comprised of professionals from health insurance companies and health care services providers were convened. Data analysis was based on the grounded theory with open codes related to the roles of health care managers, insurance companies, and heath care services provided. The technical reports were compared to the testimonies of interviewees. RESULTS: Thirty-eight interviews and 14 focus groups (70.9% response rate were conducted and 12 technical reports reviewed. Cervical cancer is not perceived to be a public health priority. Interest centers on the flow of financial resources within the health system. Findings indicated unsatisfactory communication among the stakeholders and no consensus on the subject. Planning is limited to meeting the status quo. Staffing is inadequate. Cases with positive outcomes are lost to follow-up due to the fragmentation that results from affiliation with different health care systems. CONCLUSIONS: The financial situation, normative planning, and the challenges of decentralization affect the skill-building, at-risk coverage, and the control activities needed for effective screening programs. What is needed is an integrated, more efficiently organized program in which all the

Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors.

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Supper, I; Catala, O; Lustman, M; Chemla, C; Bourgueil, Y; Letrilliart, L

2015-12-01

The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses. Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists. Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another's roles and competences, shared information, confidentiality and responsibility, team building and interprofessional training, long-term funding and joint monitoring. Interprofessional organization and training based on appropriate models should support collaboration development. The active participation of the patient is required to go beyond professional boundaries and hierarchies. Multidisciplinary research projects are recommended. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Actores Secundarios

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Manuel Gárate

2007-09-01

Full Text Available Cámara digital en mano y provistos de los recuerdos y una sesuda investigación de 3 años, los realizadores de “Actores Secundarios” nos transportan al último periodo de la dictadura militar chilena. Pero esta vez no se trata de un relato épico sobre los actores tradicionales de la lucha por la democracia, sino de una generación prácticamente olvidada y que movilizó a miles de adolescentes contra un régimen que los ahogaba. “Actores Secundarios” es una crónica construida de los fragmentos de ...

Shaping the midwifery profession in Nepal - Uncovering actors' connections using a Complex Adaptive Systems framework.

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Bogren, Malin Upper; Berg, Marie; Edgren, Lars; van Teijlingen, Edwin; Wigert, Helena

2016-12-01

To explore how actors connect in a system aiming at promoting the establishment of a midwifery profession in Nepal. A qualitative explorative study based on the framework of Complex Adaptive Systems. Semi-structured interviews were conducted with 17 key people representing eight different organisations (actors) promoting the development of the midwifery profession. The actors' connections can be described with a complex set of facilitators for and barriers to promoting the establishment of a midwifery profession. The identified facilitators for this establishment in Nepal are (1) a common goal and (2) a desire to collaborate, whilst the barriers are (1) different political interests and priorities, (2) competing interests of the nursing profession and societal views, (3) divergent academic opinions on a midwifery profession, and (4) insufficient communication. The results also showed that Nepalese society cannot distinguish between nursing and midwifery and that the public support for a midwifery profession was hence minimal. The move of midwifery from an occupation to a profession in Nepal is an on-going, challenging process. The study indicates the importance of understanding the motivations of, and barriers perceived by, actors that can promote or obstruct the establishment of the midwifery profession. It also points to the importance of informing the wider public about the role and responsibility of an autonomous midwifery profession. Copyright © 2016 Elsevier B.V. All rights reserved.

Efficient Actor Recovery Paradigm for Wireless Sensor and Actor Networks.

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Mahjoub, Reem K; Elleithy, Khaled

2017-04-14

The actor nodes are the spine of wireless sensor and actor networks (WSANs) that collaborate to perform a specific task in an unverified and uneven environment. Thus, there is a possibility of high failure rate in such unfriendly scenarios due to several factors such as power consumption of devices, electronic circuit failure, software errors in nodes or physical impairment of the actor nodes and inter-actor connectivity problem. Therefore, it is extremely important to discover the failure of a cut-vertex actor and network-disjoint in order to improve the Quality-of-Service (QoS). In this paper, we propose an Efficient Actor Recovery (EAR) paradigm to guarantee the contention-free traffic-forwarding capacity. The EAR paradigm consists of a Node Monitoring and Critical Node Detection (NMCND) algorithm that monitors the activities of the nodes to determine the critical node. In addition, it replaces the critical node with backup node prior to complete node-failure which helps balancing the network performance. The packets are handled using Network Integration and Message Forwarding (NIMF) algorithm that determines the source of forwarding the packets; either from actor or sensor. This decision-making capability of the algorithm controls the packet forwarding rate to maintain the network for a longer time. Furthermore, for handling the proper routing strategy, Priority-Based Routing for Node Failure Avoidance (PRNFA) algorithm is deployed to decide the priority of the packets to be forwarded based on the significance of information available in the packet. To validate the effectiveness of the proposed EAR paradigm, the proposed algorithms were tested using OMNET++ simulation.

Local energy governance in vermont: an analysis of energy system transition strategies and actor capacity

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Rowse, Tarah

While global, national, and regional efforts to address climate and energy challenges remain essential, local governments and community groups are playing an increasingly stronger and vital role. As an active state in energy system policy, planning and innovation, Vermont offers a testing ground for research into energy governance at the local level. A baseline understanding of the energy planning and energy organizing activities initiated at the local level can support efforts to foster a transition to a sustainable energy system in Vermont. Following an inductive, applied and participatory approach, and grounded in the fields of sustainability transitions, energy planning, and community energy, this research project identifies conditions for change, including opportunities and challenges, within Vermont energy system decision-making and governance at the local level. The following questions are posed: What are the main opportunities and challenges for sustainable energy development at the town level? How are towns approaching energy planning? What are the triggers that will facilitate a faster transition to alternative energy systems, energy efficiency initiatives, and localized approaches? In an effort to answer these questions two studies were conducted: 1) an analysis of municipal energy plans, and 2) a survey of local energy actors. Study 1 examined Vermont energy planning at the state and local level through a review and comparison of 40 municipal plan energy chapters with the state 2011 Comprehensive Energy Plan. On average, municipal plans mentioned just over half of the 24 high-level strategies identified in the Comprehensive Energy Plan. Areas of strong and weak agreement were examined. Increased state and regional interaction with municipal energy planners would support more holistic and coordinated energy planning. The study concludes that while municipalities are keenly aware of the importance of education and partnerships, stronger policy mechanisms

Study of Mobile Payment Services in India : Distribution of the roles, responsibilities and attitudes amongst actors of the payment systems

OpenAIRE

Singh Sambhy, Gurpreet

2014-01-01

Information technology and payment systems have witnessed the introduction, acceptance and wide scale deployment of electronic payment systems. The payment system ecosystem has now witnessed the introduction of mobile payment systems and their associated services. Major actors involved in mobile payment systems include telecom operators, banks, merchants and consumers. They need to aggregate their resources and develop a coherent ecosystem which would help the individual actors while also ben...

Health system capacity: maternal health policy implementation in the state of Gujarat, India

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Linda Sanneving

2013-03-01

Full Text Available Introduction: The Government of Gujarat has for the past couple of decades continuously initiated several interventions to improve access to care for pregnant and delivering women within the state. Data from the last District Family Heath survey in Gujarat in 2007–2008 show that 56.4% of women had institutional deliveries and 71.5% had at least one antenatal check-up, indicating that challenges remain in increasing use of and access to maternal health care services. Objective: To explore the perceptions of high-level stakeholders on the process of implementing maternal health interventions in Gujarat. Method: Using the policy triangle framework developed by Walt and Gilson, the process of implementation was approached using in-depth interviews and qualitative content analysis. Result: Based on the analysis, three themes were developed: lack of continuity; the complexity of coordination; and lack of confidence and underutilization of the monitoring system. The findings suggest that decisions made and actions advocated and taken are more dependent on individual actors than on sustainable structures. The findings also indicate that the context in which interventions are implemented is challenged in terms of weak coordination and monitoring systems that are not used to evaluate and develop interventions on maternal health. Conclusions: The implementation of interventions on maternal health is dependent on the capacity of the health system to implement evidence-based policies. The capacity of the health system in Gujarat to facilitate implementation of maternal health interventions needs to be improved, both in terms of the role of actors and in terms of structures and processes.

Actor-critic-based optimal tracking for partially unknown nonlinear discrete-time systems.

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Kiumarsi, Bahare; Lewis, Frank L

2015-01-01

This paper presents a partially model-free adaptive optimal control solution to the deterministic nonlinear discrete-time (DT) tracking control problem in the presence of input constraints. The tracking error dynamics and reference trajectory dynamics are first combined to form an augmented system. Then, a new discounted performance function based on the augmented system is presented for the optimal nonlinear tracking problem. In contrast to the standard solution, which finds the feedforward and feedback terms of the control input separately, the minimization of the proposed discounted performance function gives both feedback and feedforward parts of the control input simultaneously. This enables us to encode the input constraints into the optimization problem using a nonquadratic performance function. The DT tracking Bellman equation and tracking Hamilton-Jacobi-Bellman (HJB) are derived. An actor-critic-based reinforcement learning algorithm is used to learn the solution to the tracking HJB equation online without requiring knowledge of the system drift dynamics. That is, two neural networks (NNs), namely, actor NN and critic NN, are tuned online and simultaneously to generate the optimal bounded control policy. A simulation example is given to show the effectiveness of the proposed method.

Application of the actor model to large scale NDE data analysis

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Coughlin, Chris

2018-03-01

The Actor model of concurrent computation discretizes a problem into a series of independent units or actors that interact only through the exchange of messages. Without direct coupling between individual components, an Actor-based system is inherently concurrent and fault-tolerant. These traits lend themselves to so-called "Big Data" applications in which the volume of data to analyze requires a distributed multi-system design. For a practical demonstration of the Actor computational model, a system was developed to assist with the automated analysis of Nondestructive Evaluation (NDE) datasets using the open source Myriad Data Reduction Framework. A machine learning model trained to detect damage in two-dimensional slices of C-Scan data was deployed in a streaming data processing pipeline. To demonstrate the flexibility of the Actor model, the pipeline was deployed on a local system and re-deployed as a distributed system without recompiling, reconfiguring, or restarting the running application.

Intermediaries as Innovating Actors in the Transition to a Sustainable Energy System

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Julia Backhaus

2010-07-01

Full Text Available In transitions of large sociotechnical systems, intermediary organisations can emerge as mediators in between several actor groups and facilitate communication and collaboration towards common goals. They can support the establishment of new actor networks and the articulation and alignment of interests to bring about desired changes. In this article, current efforts towards a more sustainable energy system serve as an exemplary context of intermediary work. The field under scrutiny, demand side management, aims to decrease energy consumption. Unfortunately, the role and work of intermediaries as implementers of demand side management projects often remains underappreciated.
Research into the reasons of successes and failures of intermediary work and a theoretical corroboration for their practical work can help intermediaries to improve their programme designs and implementation strategies. The EC FP7-funded Changing Behaviour project aims to support intermediaries with strategic activities to improve demand side management programmes and bring about lasting behavioural changes. Paying more attention to context, stakeholders, monitoring, evaluation and learning enables the development of tailor-made, widely supported projects with higher chances of success.
In addition to practical support for their work, intermediaries can benefit from stronger policy support. Understanding and appreciation of their work as contribution to policy implementation, e.g. towards energy saving targets, could motivate such support. A stable policy and financial environment with long-term implementation plans and funding schemes provides a fertile ground for intermediary activities. Active participation of policy actors in demand side management programmes can create networks sustaining longer-lasting change.

[Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

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Roth-Deubel, André N; Molina-Marín, Gloria

2013-01-01

Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

Self-Recovering Sensor-Actor Networks

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Maryam Kamali

2010-07-01

Full Text Available Wireless sensor-actor networks are a recent development of wireless networks where both ordinary sensor nodes and more sophisticated and powerful nodes, called actors, are present. In this paper we formalize a recently introduced algorithm that recovers failed actor communication links via the existing sensor infrastructure. We prove via refinement that the recovery is terminating in a finite number of steps and is distributed, thus self-performed by the actors. Most importantly, we prove that the recovery can be done at different levels, via different types of links, such as direct actor links or indirect links between the actors, in the latter case reusing the wireless infrastructure of sensors. This leads to identifying coordination classes, e.g., for delegating the most security sensitive coordination to the direct actor-actor coordination links, the least real-time constrained coordination to indirect links, and the safety critical coordination to both direct actor links and indirect sensor paths between actors. Our formalization is done using the theorem prover in the RODIN platform.

Informal value chain actors' knowledge and perceptions about zoonotic diseases and biosecurity in Kenya and the importance for food safety and public health.

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Nyokabi, Simon; Birner, Regina; Bett, Bernard; Isuyi, Linda; Grace, Delia; Güttler, Denise; Lindahl, Johanna

2018-03-01

Zoonotic diseases, transmitted from animals to humans, are a public health challenge in developing countries. Livestock value chain actors have an important role to play as the first line of defence in safeguarding public health. However, although the livelihood and economic impacts of zoonoses are widely known, adoption of biosecurity measures aimed at preventing zoonoses is low, particularly among actors in informal livestock value chains in low and middle-income countries. The main objective of this study was to investigate knowledge of zoonoses and adoption of biosecurity measures by livestock and milk value chain actors in Bura, Tana River County, in Kenya, where cattle, camels, sheep and goats are the main livestock kept. The study utilised a mixed methods approach, with a questionnaire survey administered to 154 value chain actors. Additional information was elicited through key informant interviews and participatory methods with relevant stakeholders outside the value chain. Our results found low levels of knowledge of zoonoses and low levels of adherence to food safety standards, with only 37% of milk traders knowing about brucellosis, in spite of a sero-prevalence of 9% in the small ruminants tested in this study, and no slaughterhouse worker knew about Q fever. Actors had little formal education (between 0 and 10%) and lacked training in food safety and biosecurity measures. Adoption of biosecurity measures by value chain actors was very low or non-existent, with only 11% of butchers wearing gloves. There was a gendered dimension, evidenced by markedly different participation in value chains and lower adoption rates and knowledge levels among female actors. Finally, cultural and religious practices were shown to play an important role in exposure and transmission of diseases, influencing perceptions and attitudes to risks and adoption of biosecurity measures.

Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

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Surekha Garimella

2016-01-01

Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the

Moral actor, selfish agent.

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Frimer, Jeremy A; Schaefer, Nicola K; Oakes, Harrison

2014-05-01

People are motivated to behave selfishly while appearing moral. This tension gives rise to 2 divergently motivated selves. The actor-the watched self-tends to be moral; the agent-the self as executor-tends to be selfish. Three studies present direct evidence of the actor's and agent's distinct motives. To recruit the self-as-actor, we asked people to rate the importance of various goals. To recruit the self-as-agent, we asked people to describe their goals verbally. In Study 1, actors claimed their goals were equally about helping the self and others (viz., moral); agents claimed their goals were primarily about helping the self (viz., selfish). This disparity was evident in both individualist and collectivist cultures, attesting to the universality of the selfish agent. Study 2 compared actors' and agents' motives to those of people role-playing highly prosocial or selfish exemplars. In content (Study 2a) and in the impressions they made on an outside observer (Study 2b), actors' motives were similar to those of the prosocial role-players, whereas agents' motives were similar to those of the selfish role-players. Study 3 accounted for the difference between the actor and agent: Participants claimed that their agent's motives were the more realistic and that their actor's motives were the more idealistic. The selfish agent/moral actor duality may account for why implicit and explicit measures of the same construct diverge, and why feeling watched brings out the better angels of human nature.

System of Interactions of Social Actors in Public Communication of Science and Technology

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Miriam Graciela Miquilena

2010-11-01

Full Text Available This paper presents the results of a research aimed at explaining the system of interactions of social actors in Public Communication of Science and Technology (PCST, in the context of a social web defined by the novel systems of communication sustained on informational and communication technologies. The study’s theoretical framework highlights the strategic importance of a Public Communication  which focuses on promoting public appropriation of Science and Technology, going beyond the role of Journalism and Science Communication that informs a qualified public, to one that stablishes a bond with policies and decision making in the area, made with participation of international agencies, governments, producers of science and technology, journalists’ associations, educational institutions, and citizens. The research relies on Explicative Methodology. A revision of pertinent bibliography leads to the conclusion that the system of social interactions mediated by personal, interpersonal and grupal global communications, define the relationships in the communicational exchange of the social actor with regard to public communication of science and technology and policies aimed at its appropriation.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

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Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-03-08

Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

A Multi-Actor Dynamic Integrated Assessment Model (MADIAM)

OpenAIRE

Weber, Michael

2004-01-01

The interactions between climate and the socio-economic system are investigated with a Multi-Actor Dynamic Integrated Assessment Model (MADIAM) obtained by coupling a nonlinear impulse response model of the climate sub-system (NICCS) to a multi-actor dynamic economic model (MADEM). The main goal is to initiate a model development that is able to treat the dynamics of the coupled climate socio-economic system, including endogenous technological change, in a non-equilibrium situation, thereby o...

Medical tourism's impact for health systems: A study from three Asian countries

OpenAIRE

Ala`a Nimer AbuKhalifeh; Erwin Martinez Faller

2015-01-01

Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism’s growth for health systems, illustration ...

Practicing governance towards equity in health systems: LMIC perspectives and experience.

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Gilson, Lucy; Lehmann, Uta; Schneider, Helen

2017-09-15

The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.

Actors with Multi-Headed Message Receive Patterns

DEFF Research Database (Denmark)

Sulzmann, Martin; Lam, Edmund Soon Lee; Van Weert, Peter

2008-01-01

style actors with receive clauses containing multi-headed message patterns. Patterns may be non-linear and constrained by guards. We provide a number of examples to show the usefulness of the extension. We also explore the design space for multi-headed message matching semantics, for example first-match......The actor model provides high-level concurrency abstractions to coordinate simultaneous computations by message passing. Languages implementing the actor model such as Erlang commonly only support single-headed pattern matching over received messages. We propose and design an extension of Erlang...... and rule priority-match semantics. The various semantics are inspired by the multi-set constraint matching semantics found in Constraint Handling Rules. This provides us with a formal model to study actors with multi-headed message receive patterns. The system can be implemented efficiently and we have...

Determinants of Actor Rationality

DEFF Research Database (Denmark)

Ellegaard, Chris

Industrial companies must exercise influence on their suppliers (or supplier actors). Actor rationality is a central theme connected to this management task. In this article, relevant literature is studied with the purpose of shedding light on determinants of actor rationality. Two buyer-supplier...... relations are investigated in a multiple case study, leading to the proposal of various additional factors that determine and shape actor rationality. Moreover a conceptual model of rationality determinants in the buyer-supplier relation is proposed, a model that may help supply managers analyse...

Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

Directory of Open Access Journals (Sweden)

Corinne Grenier

2011-02-01

Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it. Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved. Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

Directory of Open Access Journals (Sweden)

Corinne Grenier

2011-02-01

Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it.Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved.Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

World Health Organization and the search for accountability: a critical analysis of the new framework of engagement with non-state actors.

Science.gov (United States)

Rached, Danielle Hanna; Ventura, Deisy de Freitas Lima

2017-07-03

The article probes the origins and content of the Framework of Engagement with Non-State Actors (FENSA) of the World Health Organization (WHO), approved on May 28, 2016, at the 69th World Health Assembly, which established different rules of collaboration to four categories of actors: nongovernmental organizations (NGOs), private sector entities, philanthropic foundations, and academic institutions. Applying the findings of International Legal Theory and based on extensive documentary research, we sought to determine whether FENSA is an appropriate accountability mechanism according to four functions of accountability: constitutional, democratic, epistemic, and populist. The article concludes that there is a risk of the prevalence of the populist function at the expense of the accountability potential that could result from the better use of the other three accountability functions.

Rewiring food systems to enhance human health and biosphere stewardship

Science.gov (United States)

Gordon, Line J.; Bignet, Victoria; Crona, Beatrice; Henriksson, Patrik J. G.; Van Holt, Tracy; Jonell, Malin; Lindahl, Therese; Troell, Max; Barthel, Stephan; Deutsch, Lisa; Folke, Carl; Jamila Haider, L.; Rockström, Johan; Queiroz, Cibele

2017-10-01

Food lies at the heart of both health and sustainability challenges. We use a social-ecological framework to illustrate how major changes to the volume, nutrition and safety of food systems between 1961 and today impact health and sustainability. These changes have almost halved undernutrition while doubling the proportion who are overweight. They have also resulted in reduced resilience of the biosphere, pushing four out of six analysed planetary boundaries across the safe operating space of the biosphere. Our analysis further illustrates that consumers and producers have become more distant from one another, with substantial power consolidated within a small group of key actors. Solutions include a shift from a volume-focused production system to focus on quality, nutrition, resource use efficiency, and reduced antimicrobial use. To achieve this, we need to rewire food systems in ways that enhance transparency between producers and consumers, mobilize key actors to become biosphere stewards, and re-connect people to the biosphere.

Belgium: Health system review.

Science.gov (United States)

Gerkens, Sophie; Merkur, Sherry

2010-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

Integrating Water, Actors, and Structure to Study Socio-Hydro-Ecological Systems

Science.gov (United States)

Hale, R. L.; Armstrong, A.; Baker, M. A.; Bedingfield, S.; Betts, D.; Buahin, C. A.; Buchert, M.; Crowl, T.; Dupont, R.; Endter-Wada, J.; Flint, C.; Grant, J.; Hinners, S.; Horns, D.; Horsburgh, J. S.; Jackson-Smith, D.; Jones, A. S.; Licon, C.; Null, S. E.; Odame, A.; Pataki, D. E.; Rosenberg, D. E.; Runburg, M.; Stoker, P.; Strong, C.

2014-12-01

Urbanization, climate uncertainty, and ecosystem change represent major challenges for managing water resources. Water systems and the forces acting upon them are complex, and there is a need to understand and generically represent the most important system components and linkages. We developed a framework to facilitate understanding of water systems including potential vulnerabilities and opportunities for sustainability. Our goal was to produce an interdisciplinary framework for water resources research to address water issues across scales (e.g., city to region) and domains (e.g., water supply and quality, urban and transitioning landscapes). An interdisciplinary project (iUTAH - innovative Urban Transitions and Aridregion Hydro-sustainability) with a large (N=~100), diverse team having expertise spanning the hydrologic, biological, ecological, engineering, social, planning, and policy sciences motivated the development of this framework. The framework was developed through review of the literature, meetings with individual researchers, and workshops with participants. The Structure-Water-Actor Framework (SWAF) includes three main components: water (quality and quantity), structure (natural, built, and social), and actors (individual and organizational). Key linkages include: 1) ecological and hydrological processes, 2) ecosystem and geomorphic change, 3) planning, design, and policy, 4) perceptions, information, and experience, 5) resource access, and 6) operational water use and management. Our expansive view of structure includes natural, built, and social components, allowing us to examine a broad set of tools and levers for water managers and decision-makers to affect system sustainability and understand system outcomes. We validate the SWAF and illustrate its flexibility to generate insights for three research and management problems: green stormwater infrastructure in an arid environment, regional water supply and demand, and urban river restoration

Identifying and Mapping Linkages between Actors in the Climate ...

African Journals Online (AJOL)

Promoting innovations in climate change requires innovation partnerships and linkages and also creating an enabling environment for actors. The paper reviewed available information on the identification and mapping of linkages between actors in the climate change innovation system. The findings showed different ...

Spanning maternal, newborn and child health (MNCH) and health systems research boundaries: conducive and limiting health systems factors to improving MNCH outcomes in West Africa.

Science.gov (United States)

Agyepong, Irene Akua; Kwamie, Aku; Frimpong, Edith; Defor, Selina; Ibrahim, Abdallah; Aryeetey, Genevieve C; Lokossou, Virgil; Sombie, Issiaka

2017-07-12

interventions is needed. This requires multi-level, multi-sectoral and multi-stakeholder engagement approaches that span current geographical, language, research and practice community boundaries in West Africa, and effectively link the efforts of actors interested in health systems strengthening with those of actors interested in MNCH outcome improvement.

Adaptive Inverse Optimal Control for Rehabilitation Robot Systems Using Actor-Critic Algorithm

Directory of Open Access Journals (Sweden)

Fancheng Meng

2014-01-01

Full Text Available The higher goal of rehabilitation robot is to aid a person to achieve a desired functional task (e.g., tracking trajectory based on assisted-as-needed principle. To this goal, a new adaptive inverse optimal hybrid control (AHC combining inverse optimal control and actor-critic learning is proposed. Specifically, an uncertain nonlinear rehabilitation robot model is firstly developed that includes human motor behavior dynamics. Then, based on this model, an open-loop error system is formed; thereafter, an inverse optimal control input is designed to minimize the cost functional and a NN-based actor-critic feedforward signal is responsible for the nonlinear dynamic part contaminated by uncertainties. Finally, the AHC controller is proven (through a Lyapunov-based stability analysis to yield a global uniformly ultimately bounded stability result, and the resulting cost functional is meaningful. Simulation and experiment on rehabilitation robot demonstrate the effectiveness of the proposed control scheme.

An Erlang Implementation of Multiparty Session Actors

Directory of Open Access Journals (Sweden)

Simon Fowler

2016-08-01

Full Text Available By requiring co-ordination to take place using explicit message passing instead of relying on shared memory, actor-based programming languages have been shown to be effective tools for building reliable and fault-tolerant distributed systems. Although naturally communication-centric, communication patterns in actor-based applications remain informally specified, meaning that errors in communication are detected late, if at all. Multiparty session types are a formalism to describe, at a global level, the interactions between multiple communicating entities. This article describes the implementation of a prototype framework for monitoring Erlang/OTP gen_server applications against multiparty session types, showing how previous work on multiparty session actors can be adapted to a purely actor-based language, and how monitor violations and termination of session participants can be reported in line with the Erlang mantra of "let it fail". Finally, the framework is used to implement two case studies: an adaptation of a freely-available DNS server, and a chat server.

World Health Organization and the search for accountability: a critical analysis of the new framework of engagement with non-state actors

Directory of Open Access Journals (Sweden)

Danielle Hanna Rached

Full Text Available The article probes the origins and content of the Framework of Engagement with Non-State Actors (FENSA of the World Health Organization (WHO, approved on May 28, 2016, at the 69th World Health Assembly, which established different rules of collaboration to four categories of actors: nongovernmental organizations (NGOs, private sector entities, philanthropic foundations, and academic institutions. Applying the findings of International Legal Theory and based on extensive documentary research, we sought to determine whether FENSA is an appropriate accountability mechanism according to four functions of accountability: constitutional, democratic, epistemic, and populist. The article concludes that there is a risk of the prevalence of the populist function at the expense of the accountability potential that could result from the better use of the other three accountability functions.

Actor-Network Procedures

NARCIS (Netherlands)

Pavlovic, Dusko; Meadows, Catherine; Ramanujam, R.; Ramaswamy, Srini

2012-01-01

In this paper we propose actor-networks as a formal model of computation in heterogenous networks of computers, humans and their devices, where these new procedures run; and we introduce Procedure Derivation Logic (PDL) as a framework for reasoning about security in actor-networks, as an extension

Contributions of Global Health Diplomacy to Health Systems in Sub ...

International Development Research Centre (IDRC) Digital Library (Canada)

New research will help boost Africa's bargaining power in global health diplomacy, ... need to assert their public health interests in global health diplomacy from an ... Brazil, and India; and 3) the involvement of African actors in getting universal ...

Harnessing the plurality of actor frames in social-ecological systems : Ecological sanitation in Bolivia

NARCIS (Netherlands)

Eelderink, M.; Vervoort, J.; Snel, D.; de Castro, F.

2017-01-01

This article uses a case study on ecological sanitation as a basis for lessons on identifying and harnessing the plurality of actor frames in social-ecological systems, thereby moving beyond the advocacy positions often taken by implementing NGOs. The study aimed to explore how perspectives between

Policy analysis of multi-actor systems

CERN Document Server

Enserink, Bert; Kwakkel, Jan; Thissen, Wil; Koppenjan, Joop; Bots, Pieter

2010-01-01

Policy analysts love solving complex problems. Their favorite problems are not just technically complex but also characterized by the presence of many different social actors that hold conflicting interests, objectives, and perceptions and act strategically to get the best out of a problem situation. This book offers guidance for policy analysts who want to assess if and how their analysis could be of help, based on the premise that problem formulation is the cornerstone in addressing complex problems. This book positions policy analysis within the theories on processes of policy making, and f

Guide Actor-Critic for Continuous Control

OpenAIRE

Tangkaratt, Voot; Abdolmaleki, Abbas; Sugiyama, Masashi

2017-01-01

Actor-critic methods solve reinforcement learning problems by updating a parameterized policy known as an actor in a direction that increases an estimate of the expected return known as a critic. However, existing actor-critic methods only use values or gradients of the critic to update the policy parameter. In this paper, we propose a novel actor-critic method called the guide actor-critic (GAC). GAC firstly learns a guide actor that locally maximizes the critic and then it updates the polic...

Importance of Actors and Agency in Sustainability Transitions: A Systematic Exploration of the Literature

Directory of Open Access Journals (Sweden)

Lisa-Britt Fischer

2016-05-01

Full Text Available This article explores the role of actors and agency in the literature on sustainability transitions. We reviewed 386 journal articles on transition management and sustainability transitions listed in Scopus from 1995 to 2014. We investigate the thesis that actors have been neglected in this literature in favor of more abstract system concepts. Results show that this thesis cannot be confirmed on a general level. Rather, we find a variety of different approaches, depending on the systemic level, for clustering actors and agency as niche, regime, and landscape actors; the societal realm; different levels of governance; and intermediaries. We also differentiate between supporting and opposing actors. We find that actor roles in transitions are erratic, since their roles can change over the course of time, and that actors can belong to different categories. We conclude by providing recommendations for a comprehensive typology of actors in sustainability transitions.

Health system's barriers hindering implementation of public-private partnership at the district level: a case study of partnership for improved reproductive and child health services provision in Tanzania.

Science.gov (United States)

Kamugumya, Denice; Olivier, Jill

2016-10-21

Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. This case study was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods. A stakeholder analysis was conducted to understand power distribution and the interests of local actors to engage non-state actors. In total 30 in-depth interviews were conducted with key informants that were identified from a stakeholder mapping activity. The initial data analysis guided further data collection in an iterative process. The provision of Reproductive and Child Health Services was used as a context. This study draws on the decision-space framework. Study findings reveal several forms of informal partnerships, and the untapped potential of non-state actors. Lack of formal contractual agreements with private providers including facilities that receive subsidies from the government is argued to contribute to inappropriate distribution of risk and reward leading to moral hazards. Furthermore, findings highlight weak capacity of governing bodies to exercise oversight and sanctions, which is acerbated by weak accountability linkages and power differences. Disempowered Council Health Services Board, in relation to engaging non-state actors, is shown to impede PPP initiatives. Effective PPP policy implementation at a local level depends on the capacity of local government officials to make choices that would embrace relational elements dynamics in strategic plans. Orientation towards collaborative efforts that create value and enable its distribution is argued to

You're a What? Voice Actor

Science.gov (United States)

Liming, Drew

2009-01-01

This article talks about voice actors and features Tony Oliver, a professional voice actor. Voice actors help to bring one's favorite cartoon and video game characters to life. They also do voice-overs for radio and television commercials and movie trailers. These actors use the sound of their voice to sell a character's emotions--or an advertised…

Actor-critic-based ink drop spread as an intelligent controller

OpenAIRE

SAGHA, Hesam; AFRAKOTI, Iman Esmaili Paeen; BAGHERISHOURAKI, Saeed

2014-01-01

This paper introduces an innovative adaptive controller based on the actor-critic method. The proposed approach employs the ink drop spread (IDS) method as its main engine. The IDS method is a new trend in soft-computing approaches that is a universal fuzzy modeling technique and has been also used as a supervised controller. Its process is very similar to the processing system of the human brain. The proposed actor-critic method uses an IDS structure as an actor and a 2-dimensional...

Food Safety Perceptions and Practices among Smallholder Pork Value Chain Actors in Hung Yen Province, Vietnam.

Science.gov (United States)

Dang-Xuan, Sinh; Nguyen-Viet, Hung; Meeyam, Tongkorn; Fries, Reinhard; Nguyen-Thanh, Huong; Pham-Duc, Phuc; Lam, Steven; Grace, Delia; Unger, Fred

2016-09-01

Pork safety is an important public health concern in Vietnam and is a shared responsibility among many actors along the pork value chain. We examined the knowledge, perceptions, and practices regarding food safety, disease, and health risk among selected pork value chain actors (slaughterhouse owners and workers, people living around slaughterhouses, pork sellers, consumers, and veterinary and public health staff) in three districts in Hung Yen Province, Vietnam. We randomly selected 52 pork value chain actors to be surveyed through questionnaires, observation checklists, key informant interviews, and focus group discussions. Most slaughterhouse workers acquired knowledge and experience of food safety through "learning by doing" rather than from training by a veterinary or public health professional. Both slaughterhouse worker and pork seller groups had some accurate perceptions about pig diseases and foodborne diseases; however, misperceptions of risk and, especially, of zoonoses were present. Furthermore, while workers and sellers often use cloths to dry the meat and clean equipment, they did not think this was a risk for meat contamination. Moreover, when sellers wear protective equipment, such as gloves, masks, or hats, consumers perceive that the sellers may have health issues they are trying to conceal and so consumers avoid buying from them. The perceived freshness of pork, along with trust in the seller and in the pork production process, were strong indicators of consumer preference. And yet, pork value chain actors tend to trust their own individual food safety practices more, rather than the practices of other actors along the chain. Veterinary and public health staff emphasized the gap between regulations and food safety practices. Education and training on food safety risks and proper handling are priorities, along with integrated and intensive efforts to improve food safety among pork value chain actors.

[Change management: An analysis of actors; perceptions about technical assistance in the Democratic Republic of Congo].

Science.gov (United States)

Ribesse, Nathalie; Iyeti, Alain; Macq, Jean

2015-01-01

Technical assistance (TA) is a common component of health system strengthening interventions. This type of intervention is too often designed and evaluated according to a logic that fails to take into account social complexity. Actors' perceptions are one element of this complexity. This article presents a study conducted in the Democratic Republic of Congo designed to identify perceptions concerning two types of technical support providers for health system strengthening: long-term technical assistants (agents of development agencies) and provincial technical advisors (agents of the Ministry of Health). Interviews were conducted with an innovative tool inspired by the principles of systems thinking. Interviewees were actors involved in a TA intervention in the province of Bandundu. Their expectations regarding TA providers were identified in terms of personal characteristics (knowledge, know-how and interpersonal skills), roles, and styles of interaction for capacity building ("interventionist/ prescriptive axes"). Interviewees emphasized the importance of mutual learning and the quality of interactions, which depends on TA provider's interpersonal skills and mutual willingness. Perceptions of TA provider's characteristics tend to be similar, but several differences were observed concerning the expectations about the roles of TAs, and the style that should be adopted for capacity building. Ignoring these differences in expectations may be a threat to the effectiveness of TA.

Interrogating resilience in health systems development.

Science.gov (United States)

van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

2017-11-01

The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mapping Health Needs to Support Health System Management in Poland

Science.gov (United States)

Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna; Szromek, Adam R.; Syrkiewicz-Świtała, Magdalena

2018-01-01

In Poland, following the example of other EU countries, the first maps of health needs prepared by the Ministry of Health were presented in 2016. The maps constitute a foundation for rational decision-making in the management of health care resources, being potentially useful for all actors in health system. This refers in particular to the institutions responsible for distribution of funds and contracting health service, but also for decision-makers, who determine the scope of funds to be utilized in the health system, or the structure of benefits provided to patients. Service providers are also addressees of the maps, to give them a basis for planning future activities. The article presents a structured assessment of the current state of affairs, based on recent experience and sets out likely directions for the development of health needs in mapping in Poland in the future. We discuss the criticism addressed toward maps by representatives of various groups acting in health care. It includes the lack of recognition of some of the key health needs, or wrong emphases, where much more attention is paid to the recognition of current resources in the health system, instead of making prognoses regarding the future developments of health needs. Nonetheless, we find that this instrument is potentially of high usability, in case of elimination of the existing weaknesses. PMID:29662876

Budget-makers and health care systems.

Science.gov (United States)

White, Joseph

2013-10-01

Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Exploring the Obstacles to Implementing Economic Mechanisms to Stimulate Antibiotic Research and Development: A Multi-Actor and System-Level Analysis.

Science.gov (United States)

Baraldi, Enrico; Ciabuschi, Francesco; Leach, Ross; Morel, Chantal M; Waluszewski, Alexandra

2016-05-01

This Article examines the potential stakeholder-related obstacles hindering the implementation of mechanisms to re-ignite the development of novel antibiotics. Proposed economic models and incentives to drive such development include: Public Funding of Research and Development ("R&D"), Tax Incentives, Milestone Prizes, End Payments, Intellectual Property ("IP") and Exclusivity Extensions, Pricing and Reimbursement Incentives, Product Development Partnerships ("PDPs"), and the Options Market for Antibiotics model. Drawing on personal experience and understanding of the antibiotic field, as well as stakeholder consultation and numerous expert meetings within the DRIVE-AB project and Uppsala Health Summit 2015, the Authors identify obstacles attributable to the following actors: Universities and Research Institutes, Small and Medium-sized Enterprises ("SMEs"), Large Pharmaceutical Companies, Marketing Approval Regulators, Payors, Healthcare Providers, National Healthcare Authorities, Patients, and Supranational Institutions. The analysis also proposes a characterization and ranking of the difficulty associated with implementing the reviewed mechanisms. Public Funding of R&D, Pricing and Reimbursement Incentives, and PDPs are mechanisms expected to meet highly systemic barriers (i.e., obstacles across the entire antibiotic value chain), imposing greater implementation challenges in that they require convincing and involving several motivationally diverse actors in order to have much effect.

Pensar e intervenir el territorio a traves de la Teoria del Actor-Red

Directory of Open Access Journals (Sweden)

Juan E. Cabrera

2011-03-01

Full Text Available El propósito de este artículo es reflexionar sobre las coincidencias entre la forma de ver el territorio como red, algunas posturas teóricas sobre su concepto y la teoría del actor-red. Sobre lo anterior se centra en proponer una forma de entender las relaciones entre actores cuando se va a intervenir el territorio a través de políticas públicas como la planificación utilizando un modelo de gestión territorial a través de las orientaciones de la TAR.   

People-centred science: strengthening the practice of health policy and systems research

Science.gov (United States)

2014-01-01

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change. PMID:24739525

Proposal for Requirement Validation Criteria and Method Based on Actor Interaction

Science.gov (United States)

Hattori, Noboru; Yamamoto, Shuichiro; Ajisaka, Tsuneo; Kitani, Tsuyoshi

We propose requirement validation criteria and a method based on the interaction between actors in an information system. We focus on the cyclical transitions of one actor's situation against another and clarify observable stimuli and responses based on these transitions. Both actors' situations can be listed in a state transition table, which describes the observable stimuli or responses they send or receive. Examination of the interaction between both actors in the state transition tables enables us to detect missing or defective observable stimuli or responses. Typically, this method can be applied to the examination of the interaction between a resource managed by the information system and its user. As a case study, we analyzed 332 requirement defect reports of an actual system development project in Japan. We found that there were a certain amount of defects regarding missing or defective stimuli and responses, which can be detected using our proposed method if this method is used in the requirement definition phase. This means that we can reach a more complete requirement definition with our proposed method.

[The health system of Brazil].

Science.gov (United States)

Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

2011-01-01

This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

What is a conservation actor?

Directory of Open Access Journals (Sweden)

Paul Jepson

2011-01-01

Full Text Available As a crisis-oriented discipline, conservation biology needs actions to understand the state of nature and thwart declines in biodiversity. Actors-traditionally individuals, institutions, and collectives-have been central to delivering such goals in practice. However, the definition of actors within the discipline has been narrow and their role in influencing conservation outcomes inadequately conceptualised. In this paper, we examine the question ′What is a conservation actor?′ Who or what creates the capacity to influence conservation values and actions? Drawing from theoretical developments in Actor-Network Theory and collective governance, we argue that the concept of an actor in conservation biology should be broadened to include non-humans, such as species and devices, because they have the agency and ability to influence project goals and outcomes. We illustrate this through four examples: the Asian elephant, International Union for Conservation of Nature red lists, the High Conservation Value approach, and an Integrated Conservation and Development Project. We argue that a broader conceptualisation of actors in conservation biology will produce new forms of understanding that could open up new areas of conservation research, enhance practice and draw attention to spheres of conservation activity that might require stronger oversight and governance.

Iranian Sanctions: An Actor-Centric Analysis

Science.gov (United States)

2012-03-01

cultivated to counterbalance other actors in the system who opposed Khamenei’s ascension, based on his weak religious credentials.42 These security...trumped up religious infraction.256 The bonyads are the Iranian economy’s dominating revenue generating entity outside the oil sector,257 mushrooming in

Actores sociales y ambitos de construccion de politicas ambientales Social actors and scenarios in the generation of environmental politics

Directory of Open Access Journals (Sweden)

Eduardo Gudynas

2001-06-01

Full Text Available Se analiza el concepto de "actores claves" en la generación de políticas ambientales. Independientemente de la definición de actor social que se maneje, el asumir la existencia de actores claves ofrece limitaciones conceptuales y prácticas, ya que éstos son coyunturales a cada situación específica. Todos pueden ser actores claves en generar políticas ambientales cumpliendo papeles diferenciales. Como alternativa se utiliza el término de "actores destacados" y se revisan aspectos sobresalientes de varios de ellos en América Latina. Seguidamente se postula que el análisis se debe centrar en los escenarios sociales donde esos actores se pueden manifestar. Se ofrece una distinción preliminar de escenarios que permite integrar a nuevos y viejos movimientos sociales y establecer relaciones de articulación y equivalencia.The concept of "key actors" in the field of environmental politics is analyzed. Beyond the definition of social actor, the assumption of the existence of key actors implies conceptual and practical limitations, as it depends of each specific situation. Everyone could be a key actor under differential roles in the generation of environmental politics. As an alternative, the term "noteworthy actors" is used and a brief review of them in Latin America is presented. The relevant question should address the social scenarios from where these actors can express themselves. A preliminary distinction of scenarios is presented, in which old and new social movements could be integrated and relationships of articulation and equivalence could be established.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

Science.gov (United States)

Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-03-01

Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of

Trail-Based Search for Efficient Event Report to Mobile Actors in Wireless Sensor and Actor Networks.

Science.gov (United States)

Xu, Zhezhuang; Liu, Guanglun; Yan, Haotian; Cheng, Bin; Lin, Feilong

2017-10-27

In wireless sensor and actor networks, when an event is detected, the sensor node needs to transmit an event report to inform the actor. Since the actor moves in the network to execute missions, its location is always unavailable to the sensor nodes. A popular solution is the search strategy that can forward the data to a node without its location information. However, most existing works have not considered the mobility of the node, and thus generate significant energy consumption or transmission delay. In this paper, we propose the trail-based search (TS) strategy that takes advantage of actor's mobility to improve the search efficiency. The main idea of TS is that, when the actor moves in the network, it can leave its trail composed of continuous footprints. The search packet with the event report is transmitted in the network to search the actor or its footprints. Once an effective footprint is discovered, the packet will be forwarded along the trail until it is received by the actor. Moreover, we derive the condition to guarantee the trail connectivity, and propose the redundancy reduction scheme based on TS (TS-R) to reduce nontrivial transmission redundancy that is generated by the trail. The theoretical and numerical analysis is provided to prove the efficiency of TS. Compared with the well-known expanding ring search (ERS), TS significantly reduces the energy consumption and search delay.

Think about and intervene in the territory through the Actor Network Theory Pensar e intervenir el territorio a traves de la Teoria del Actor-Red

Directory of Open Access Journals (Sweden)

Juan E. Cabrera

2011-03-01

Full Text Available The purpose of this article is to think about the similarities between the ways of seeing the territory as a network, some theoretical positions about the territory concept and actor network theory.
After focusing on proposing a way of understanding the relationships between actors when they will intervene in the territory through the public policies and territorial planning, i ll try to apply the ANT model of public policy management through the guidance of ANT El propósito de este artículo es reflexionar sobre las coincidencias entre la forma de ver el territorio como red, algunas posturas teóricas sobre su concepto y la teoría del actor-red.
Sobre lo anterior se centra en proponer una forma de entender las relaciones entre actores cuando se va a intervenir el territorio a través de políticas públicas como la planificación utilizando un modelo de gestión territorial a través de las orientaciones de la TAR.   

The Role of Non-State Actors in Strengthening Health Systems ...

International Development Research Centre (IDRC) Digital Library (Canada)

Home · What we do ... The services they provide vary immensely in complexity and national importance. ... for achieving universal health coverage in the form of quality health services that are accessible without the risk of financial hardship.

Understanding the complex relationships among actors involved in the implementation of public-private mix (PPM) for TB control in India, using social theory.

Science.gov (United States)

Salve, Solomon; Harris, Kristine; Sheikh, Kabir; Porter, John D H

2018-06-07

Public Private Partnerships (PPP) are increasingly utilized as a public health strategy for strengthening health systems and have become a core component for the delivery of TB control services in India, as promoted through national policy. However, partnerships are complex systems that rely on relationships between a myriad of different actors with divergent agendas and backgrounds. Relationship is a crucial element of governance, and relationship building an important aspect of partnerships. To understand PPPs a multi-disciplinary perspective that draws on insights from social theory is needed. This paper demonstrates how social theory can aid the understanding of the complex relationships of actors involved in implementation of Public-Private Mix (PPM)-TB policy in India. Ethnographic research was conducted within a district in a Southern state of India over a 14 month period, combining participant observations, informal interactions and in-depth interviews with a wide range of respondents across public, private and non-government organisation (NGO) sectors. Drawing on the theoretical insights from Bourdieu's "theory of practice" this study explores the relationships between the different actors. The study found that programme managers, frontline TB workers, NGOs, and private practitioners all had a crucial role to play in TB partnerships. They were widely regarded as valued contributors with distinct social skills and capabilities within their organizations and professions. However, their potential contributions towards programme implementation tended to be unrecognized both at the top and bottom of the policy implementation chain. These actors constantly struggled for recognition and used different mechanisms to position themselves alongside other actors within the programme that further complicated the relationships between different actors. This paper demonstrates that applying social theory can enable a better understanding of the complex relationship

Los Entornos Personales de Aprendizaje como estrategia de aprendizaje desde la Teoría del Actor-Red

OpenAIRE

Meza Cano, José Manuel; Cejas León, Roberto

2016-01-01

Este trabajo pretende visualizar los Entornos Personales de Aprendizaje desde el punto de vista de la Teoría del Actor-Red. En primer lugar, se describen los elementos centrales de la Teoría del Actor-Red, la visión de aprendizaje desde este enfoque, así como el concepto de actante y de simetría generalizada. Posteriormente se exponen los elementos clave de las definiciones sobre Entornos Personales de Aprendizaje y la visión del aprendizaje que defienden, centrada principalmente en el estudi...

Challenges and opportunities for policy decisions to address health equity in developing health systems: case study of the policy processes in the Indian state of Orissa

Directory of Open Access Journals (Sweden)

Gopalan Saji S

2011-11-01

Full Text Available Abstract Introduction Achieving health equity is a pertinent need of the developing health systems. Though policy process is crucial for planning and attaining health equity, the existing evidences on policy processes are scanty in this regard. This article explores the magnitude, determinants, challenges and prospects of 'health equity approach' in various health policy processes in the Indian State of Orissa - a setting comparable with many other developing health systems. Methods A case-study involving 'Walt-Gilson Policy Triangle' employed key-informant interviews and documentary reviews. Key informants (n = 34 were selected from the departments of Health and Family Welfare, Rural Development, and Women and Child Welfare, and civil societies. The documentary reviews involved various published and unpublished reports, policy pronouncements and articles on health equity in Orissa and similar settings. Results The 'health policy agenda' of Orissa was centered on 'health equity' envisaging affordable and equitable healthcare to all, integrated with public health interventions. However, the subsequent stages of policy process such as 'development, implementation and evaluation' experienced leakage in the equity approach. The impediment for a comprehensive approach towards health equity was the nexus among the national and state health priorities; role, agenda and capacity of actors involved; and existing constraints of the healthcare delivery system. Conclusion The health equity approach of policy processes was incomprehensive, often inadequately coordinated, and largely ignored the right blend of socio-medical determinants. A multi-sectoral, unified and integrated approach is required with technical, financial and managerial resources from different actors for a comprehensive 'health equity approach'. If carefully geared, the ongoing health sector reforms centered on sector-wide approaches, decentralization, communitization and involvement of

APPROACHES TO GLOBAL SECURITY. ACTORS, MANIFESTATIONS AND TENDENCIES

Directory of Open Access Journals (Sweden)

Gheorghe MINCULETE

2013-01-01

Full Text Available Nowadays, the world seems to be in a transition from the current system founded on the liberal social, economic and political model to a more diverse and heterogeneous model in which the determinant role is played by a number of state and non-state actors. The step from the Western system of cultural, political and predominant economic values to a more diverse and heterogeneous system makes the actors involved defend not only their visions, but also promote their own interests. The differences between visions gain relevance and clarity because the countries supporting them obtain increased power, and that is more than obvious. All this leads to a symmetric allocation of different means, which generates uncertainties and diminishes unilateral actions This transition process impacts global security especially through the asymmetric, unconventional and hybrid risks and threats manifesting worldwide.

Actors of the hydrogen sector in France

International Nuclear Information System (INIS)

2010-01-01

This document proposes brief presentations (web site address, activities) of actors operating in the hydrogen sector in France. These actors are public actors who can be incentive or financing actors (ADEME, ANR) or research institutions (CNRS, CEA, university and engineering schools, IFP, INERIS, INRETS), private actors like industrial groups (Air Liquide, AREVA, GDF Suez, Total, PSA Peugeot Citroen, Renault, Saint-Gobain, SNECMA, ST Microelectronics, 3M, Veolia Environnement) or small companies (Alca Torda Applications, Axane, CETH2, Helion, MaHytec, N-GHY, PaxiTech, Sertronic, ULLIT). It also presents the HyPAC platform created by the AFH2 and ADEME), the AFH2 (the French Association for Hydrogen), and regional initiatives

Health systems reforms in Singapore: A qualitative study of key stakeholders.

Science.gov (United States)

Ong, Suan Ee; Tyagi, Shilpa; Lim, Jane Mingjie; Chia, Kee Seng; Legido-Quigley, Helena

2018-02-19

In response to a growing chronic disease burden and ageing population, Singapore implemented Regional Health Systems (RHS) in 2008. In January 2017, the MOH announced that the six RHS clusters would be reorganised into three in 2018. This qualitative study sought to identify the health system challenges, opportunities, and ways forward for the implementation of the RHS. We conducted semi-structured interviews with 35 key informants from RHS clusters, government, academia, and private and voluntary sectors. Integration, innovation, and people-centeredness were identified as the key principles of the RHS. The RHS was described as an opportunity to holistically care for a person across the care continuum, address social determinants of health, develop new models of care, and work with social and community partners. Challenges to RHS implementation included difficulties aligning the goals, values, and priorities of multiple actors, the need for better integration across clusters, differing care capabilities and capacities across partners, healthcare financing structures that may not reflect RHS goals, scalability and evaluation of pilot programmes, and disease-centricity, provider-centricity, and medicalisation in health and healthcare. Suggested ways forward included building relationships between actors to facilitate integration; exploring innovative new models of care; clear long-term/scale-up plans for successful pilots; healthcare financing reforms to meet changing patient and population needs; and developing evaluation systems reflective of RHS principles and priorities. Copyright © 2018 Elsevier B.V. All rights reserved.

The population-development tangle. Aspects and actors.

Science.gov (United States)

Sen, G

1993-01-01

Since the 1974 Population Conference, the population field has become of interest to members of the fundamentalist right wing, feminists, and environmentalists. Therefore, it is necessary to understand the areas of agreement and disagreement among each set of actors as well as how they define the issues. Currently, development discourse is characterized by considerations of: 1) economic growth, 2) the provision of livelihoods, 3) the provision of basic needs, 4) ecological sustainability and renewability, and 5) political participation. The actors who define the terms of this discourse include: 1) corporate interests, which concentrate on economic growth; 2) international and national agencies, which place primary importance on economic growth and some importance on basic needs and ecological sustainability; 3) popular organizations and social movements, which concentrate on livelihoods, basic needs, and political participation; and 4) environmentalists, who focus on ecological sustainability, economic growth, and (occasionally) political participation. The field of population, on the other hand, is dominated by traditional populationists, whose primary focus is economic growth; developmentalists; the fundamentalist right, who are most concerned with family and control over reproduction; environmentalists; and the women's movement, which is most concerned with reproductive rights and reproductive health. When the perspective of poor women is considered, it can be seen that economic growth and ecological sustainability must support the securing of livelihoods, basic needs, political participation, and reproductive rights, and that reproductive health programs must be part of an overall health agenda.

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

Escorcia, Victor

2018-04-05

This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

Escorcia, Victor; Dao, Cuong D.; Jain, Mihir; Ghanem, Bernard; Snoek, Cees

2018-01-01

This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

Exploring the nature of governance at the level of implementation for health system strengthening: the DIALHS experience.

Science.gov (United States)

Scott, Vera; Schaay, Nikki; Olckers, Patti; Nqana, Nomsa; Lehmann, Uta; Gilson, Lucy

2014-09-01

Health system governance has been recognized as a critical element of the health system strengthening agenda. To date, health governance research often focuses at national or global levels, adopting a macro-perspective that deals with governance structures, forms and principles. Little attention has been given to a micro-perspective which recognizes the role of health system actors in governance, or to considering the operational level of the health system. This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. In an embedded case study, action learning and reflection theory were used to design and implement the intervention. Data in this article were drawn from minutes, observations and recorded reflections of the meetings and workshops that comprised the intervention. A theoretical governance framework was used both to understand the context of the intervention and to analyse the dimensions of governance relevant in the experience. The study shows how, through action learning and reflection, local managers in two organizations came to understand how the higher level misalignment of organizational structures and processes imposed governance constraints on them, and to see the impact this had on their organizational relationships. By re-framing the conflict as organizational, they were then able to create opportunities for staff to understand their context and participate in negotiating principles for communication and collaborative work. The result reduced conflict between staff in the two organizations, leading to improved implementation of programme support. Strengthening relationships among those working at local level by building collaborative norms and values is an important part of local health system governance for

Non-state actors in control of territory as 'actors of protection' in international refugee law

NARCIS (Netherlands)

Karavias, M.

2015-01-01

This article examines the concept of non-state ‘actors of protection’ in international refugee law. This concept breaks with traditional State-centric readings of international law, as it connotes that a non-state actor may offer ‘protection’ against persecution, comparable to that normally offered

The Unified Health System (SUS as a large technological system: territory, technique and politic

Directory of Open Access Journals (Sweden)

Luis Henrique Leandro Ribeiro

2018-03-01

Full Text Available The Uni ed Health System (SUS constitutes a large technological system wi- thin the Brazilian territory since it aggregates a broad and diverse materiality in organizing and managing its ows. Additionally, it has two other attributes that make it unique: high sensibility to speci cities of different places; and technical and political centralization and decentralization of its actions. The macro dimen- sion is the SUS, leading it to be understood not simply as a health system, through its: multidimensionality – elements of other life instances (social, economic, cul- tural and political; broad and unequal spectrum of actors (state and non-state who move it and the meanings of its actions; and the trans-scaleness of its con- cretion in places (local, national and international nexuses. As an infrastructure of everyday life, it is a hegemonic large technological system that acts upon objec- tive (technosphere and subjective (psychosphere conditions of existence, a con- ception that has important implications for health policy and territory integration.

Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore and Malaysia

OpenAIRE

Pocock, Nicola S; Phua, Kai Hong

2011-01-01

Abstract Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, draw...

Health system challenges of NCDs in Tunisia.

Science.gov (United States)

Ben Romdhane, Habiba; Tlili, Faten; Skhiri, Afef; Zaman, Shahaduz; Phillimore, Peter

2015-01-01

The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

Global health governance as shared health governance.

Science.gov (United States)

Ruger, Jennifer Prah

2012-07-01

With the exception of key 'proven successes' in global health, the current regime of global health governance can be understood as transnational and national actors pursuing their own interests under a rational actor model of international cooperation, which fails to provide sufficient justification for an obligation to assist in meeting the health needs of others. An ethical commitment to providing all with the ability to be healthy is required. This article develops select components of an alternative model of shared health governance (SHG), which aims to provide a 'road map,' 'focal points' and 'the glue' among various global health actors to better effectuate cooperation on universal ethical principles for an alternative global health equilibrium. Key features of SHG include public moral norms as shared authoritative standards; ethical commitments, shared goals and role allocation; shared sovereignty and constitutional commitments; legitimacy and accountability; country-level attention to international health relations. A framework of social agreement based on 'overlapping consensus' is contrasted against one based on self-interested political bargaining. A global health constitution delineating duties and obligations of global health actors and a global institute of health and medicine for holding actors responsible are proposed. Indicators for empirical assessment of select SHG principles are described. Global health actors, including states, must work together to correct and avert global health injustices through a framework of SHG based on shared ethical commitments.

Rolling-out Lean in the Saskatchewan Health Care System: Politics Derailing Policy

Directory of Open Access Journals (Sweden)

Tom McIntosh

2016-03-01

Full Text Available Following on the work of Marchildon (2013 this paper examines the political challenges faced by the government of Saskatchewan in rolling out their Lean reforms to the entire provincial health system. The government’s Lean reforms were meant as a vehicle to empower patients and workers in the redesign of service delivery and the creation of a patient-centred system. Lean focuses on continuous improvement, priority setting, employee engagement and the elimination of waste. The reforms appear to have been derailed to a significant degree insofar as key actors inside the system, the media and the public have challenged the goals of the reform, the Lean methodology and process, as well as the cost of the consultants employed to oversee the process. The government’s implementation of the roll-out suffered both from the ability of key actors to withdraw their support and challenge the viability of the reforms in public as well as from a public relations perspective that put the government on the defensive about how people inside the system were being treated with the reforms. As the government moves forward it will have to adjust its implementation processes and strategy in order to overcome the now strong resistance within the health sector.

Actor-Network Theory as a sociotechnical lens to explore the relationship of nurses and technology in practice: methodological considerations for nursing research.

Science.gov (United States)

Booth, Richard G; Andrusyszyn, Mary-Anne; Iwasiw, Carroll; Donelle, Lorie; Compeau, Deborah

2016-06-01

Actor-Network Theory is a research lens that has gained popularity in the nursing and health sciences domains. The perspective allows a researcher to describe the interaction of actors (both human and non-human) within networked sociomaterial contexts, including complex practice environments where nurses and health technology operate. This study will describe Actor-Network Theory and provide methodological considerations for researchers who are interested in using this sociotechnical lens within nursing and informatics-related research. Considerations related to technology conceptualization, levels of analysis, and sampling procedures in Actor-Network Theory based research are addressed. Finally, implications for future nursing research within complex environments are highlighted. © 2015 John Wiley & Sons Ltd.

Extended mind and after: socially extended mind and actor-network.

Science.gov (United States)

Kono, Tetsuya

2014-03-01

The concept of extended mind has been impressively developed over the last 10 years by many philosophers and cognitive scientists. The extended mind thesis (EM) affirms that the mind is not simply ensconced inside the head, but extends to the whole system of brain-body-environment. Recently, some philosophers and psychologists try to adapt the idea of EM to the domain of social cognition research. Mind is socially extended (SEM). However, EM/SEM theory has problems to analyze the interactions among a subject and its surroundings with opposition, antagonism, or conflict; it also tends to think that the environment surrounding the subject is passive or static, and to neglect the power of non-human actants to direct and regulate the human subject. In these points, actor-network theory (ANT) proposed by Latour and Callon is more persuasive, while sharing some important ideas with EM/SEM theory. Actor-network is a hybrid community which is composed of a series of heterogeneous elements, animate and inanimate for a certain period of time. I shall conclude that EM/SEM could be best analyzed as a special case of actor-network. EM/SEM is a system which can be controlled by a human agent alone. In order to understand collective behavior, philosophy and psychology have to study the actor-network in which human individuals are situated.

The Management of Political Actors in Institutions

Directory of Open Access Journals (Sweden)

Peter Odion Omoijiade

2016-10-01

Full Text Available The argument that the minimization of the dysfunctional consequences of organizational politics is no longer dependent on self-equilibrating mechanism remains valid. This inquiry is therefore framed with a view to establishing suitable strategies for managing political actors. There is a nexus between the diagnosis typology of political actors and the qualitative classes of political actors and their management strategies. In the management of mixed blessing, supportive, non-supportive and marginal political actors; collaborative, involvement, defensive and information strategies respectively were found suitable. This research is based on existing theoretical knowledge on organizational politics and stakeholders management. Data was collected from the literature by means of critical analysis and dialectic reflection on the emerging themes. The study will enhance capability in contexts where the scientific management of political actors is yet to be exemplified.

Adversarial Advantage Actor-Critic Model for Task-Completion Dialogue Policy Learning

OpenAIRE

Peng, Baolin; Li, Xiujun; Gao, Jianfeng; Liu, Jingjing; Chen, Yun-Nung; Wong, Kam-Fai

2017-01-01

This paper presents a new method --- adversarial advantage actor-critic (Adversarial A2C), which significantly improves the efficiency of dialogue policy learning in task-completion dialogue systems. Inspired by generative adversarial networks (GAN), we train a discriminator to differentiate responses/actions generated by dialogue agents from responses/actions by experts. Then, we incorporate the discriminator as another critic into the advantage actor-critic (A2C) framework, to encourage the...

Trail-Based Search for Efficient Event Report to Mobile Actors in Wireless Sensor and Actor Networks †

Science.gov (United States)

Xu, Zhezhuang; Liu, Guanglun; Yan, Haotian; Cheng, Bin; Lin, Feilong

2017-01-01

In wireless sensor and actor networks, when an event is detected, the sensor node needs to transmit an event report to inform the actor. Since the actor moves in the network to execute missions, its location is always unavailable to the sensor nodes. A popular solution is the search strategy that can forward the data to a node without its location information. However, most existing works have not considered the mobility of the node, and thus generate significant energy consumption or transmission delay. In this paper, we propose the trail-based search (TS) strategy that takes advantage of actor’s mobility to improve the search efficiency. The main idea of TS is that, when the actor moves in the network, it can leave its trail composed of continuous footprints. The search packet with the event report is transmitted in the network to search the actor or its footprints. Once an effective footprint is discovered, the packet will be forwarded along the trail until it is received by the actor. Moreover, we derive the condition to guarantee the trail connectivity, and propose the redundancy reduction scheme based on TS (TS-R) to reduce nontrivial transmission redundancy that is generated by the trail. The theoretical and numerical analysis is provided to prove the efficiency of TS. Compared with the well-known expanding ring search (ERS), TS significantly reduces the energy consumption and search delay. PMID:29077017

Improving Access to Essential Medicines: How Health Concerns can be Prioritised in the Global Governance System.

Science.gov (United States)

Sridhar, Devi

2008-07-01

This paper discusses the politics of access to essential medicines and identifies 'space' in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. These include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration.

Lone Actors: Challenges and Opportunities for Countering Violent Extremism

NARCIS (Netherlands)

Spaaij, R.; Richman, A.; Sharan, Y.

2015-01-01

This paper explores some of the key challenges and opportunities concerning the prevention and control of lone actor terrorism. It is argued that lone actors do not operate in a social vacuum and that the interaction points between lone actors and their social environments can render lone actors

The actors and privatization of sanitation services in Ciudad Juarez, Chihuahua

Directory of Open Access Journals (Sweden)

Gustavo Córdova Bojórquez

2006-07-01

Full Text Available This document offers an analysis about possibilities to implement a concession system in the recollection and disposal of non-hazardous trash collection service in Ciudad Juarez. The recognition of view points from different actors in the timeframe, applying a survey to home heads and interviews to opinion leaders, as actors key in city´s production, let us to identify a high politized item that keep off efficient and transparent public participation.

Actor/Character Dualism

DEFF Research Database (Denmark)

Riis, Johannes

2012-01-01

Our perception of agency may be inherently fallible, and this may explain not only our general awareness of actors when engaged in fictional characters but also the specific case of paradoxical characters...

Studying integrated health care systems with a structurationist approach

Science.gov (United States)

Demers, Louis; Arseneault, Stéphane; Couturier, Yves

2010-01-01

Introduction To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phenomena. One of the central tenets of this theory is that social systems, such as integrated health care systems, are recurrent social practices across time-space and are characterized by structural properties which simultaneously constrain and enable the constitutive social actors who reproduce and transform the system through their practices. We will illustrate our theoretical standpoint with empirical material gathered during the study of an integrated health care system for the frail elderly in Quebec, Canada. This system has been implemented in 1997 and is still working well in 2010. Results and conclusion To implement an integrated health care system that is both effective and sustainable, its managers must shrewdly allow for the existing system and progressively introduce changes in the way managers and practitioners at work in the system view their role and act on a daily basis.

Contributions of Global Health Diplomacy to Health Systems in Sub ...

International Development Research Centre (IDRC) Digital Library (Canada)

African policymakers and other relevant actors will be exposed to the arguments, methods, and challenges of global health diplomacy so they can engage more ... L'Association internationale de ressources en eau (IWRA), en étroite collaboration avec le CRDI, organise un webinaire intitulé "Changements climatiques et ...

Humanoids Learning to Walk: A Natural CPG-Actor-Critic Architecture.

Science.gov (United States)

Li, Cai; Lowe, Robert; Ziemke, Tom

2013-01-01

The identification of learning mechanisms for locomotion has been the subject of much research for some time but many challenges remain. Dynamic systems theory (DST) offers a novel approach to humanoid learning through environmental interaction. Reinforcement learning (RL) has offered a promising method to adaptively link the dynamic system to the environment it interacts with via a reward-based value system. In this paper, we propose a model that integrates the above perspectives and applies it to the case of a humanoid (NAO) robot learning to walk the ability of which emerges from its value-based interaction with the environment. In the model, a simplified central pattern generator (CPG) architecture inspired by neuroscientific research and DST is integrated with an actor-critic approach to RL (cpg-actor-critic). In the cpg-actor-critic architecture, least-square-temporal-difference based learning converges to the optimal solution quickly by using natural gradient learning and balancing exploration and exploitation. Futhermore, rather than using a traditional (designer-specified) reward it uses a dynamic value function as a stability indicator that adapts to the environment. The results obtained are analyzed using a novel DST-based embodied cognition approach. Learning to walk, from this perspective, is a process of integrating levels of sensorimotor activity and value.

Humanoids Learning to Walk: a Natural CPG-Actor-Critic Architecture

Directory of Open Access Journals (Sweden)

CAI eLI

2013-04-01

Full Text Available The identification of learning mechanisms for locomotion has been the subject of much researchfor some time but many challenges remain. Dynamic systems theory (DST offers a novel approach to humanoid learning through environmental interaction. Reinforcement learning (RL has offered a promising method to adaptively link the dynamic system to the environment it interacts with via a reward-based value system.In this paper, we propose a model that integrates the above perspectives and applies it to the case of a humanoid (NAO robot learning to walk the ability of which emerges from its value-based interaction with the environment. In the model,a simplified central pattern generator (CPG architecture inspired by neuroscientific research and DST is integrated with an actor-critic approach to RL (cpg-actor-critic. In the cpg-actor-critic architecture, least-square-temporal-difference (LSTD based learning converges to the optimal solution quickly by using natural gradient and balancing exploration and exploitation. Futhermore, rather than using a traditional (designer-specified reward it uses a dynamic value function as a stability indicator (SI that adapts to the environment.The results obtained are analyzed and explained by using a novel DST embodied cognition approach. Learning to walk, from this perspective, is a process of integrating sensorimotor levels and value.

Multicultural Monologues for Young Actors. The Young Actors Series.

Science.gov (United States)

Slaight, Craig, Ed.; Sharrar, Jack, Ed.

This book presents 62 monologue selections from diverse cultures for young actors to perform. The book's selections offer "quality literature by significant writers." Some of the writers represented in the book are George C. Wolfe, Miguel Pinero, Lorraine Hansberry, Amiri Baraka (LeRoi Jones), John M. Synge, Yukio Mishima, Reynolds…

Using actor-network theory to study an educational situation: an ...

African Journals Online (AJOL)

Actor-network theory allows a researcher to analyse a complex social setting involving both human and non-human actors. An actor network can be used to model a dynamic and complex set of relationships between these actors. This article describes actor-network theory and shows how it was applied to study and model ...

The Urban Decision Room : A multi actor design engineering simulation system

NARCIS (Netherlands)

Van Loon, P.P.J.; Barendse, P.; Duerink, S.

2012-01-01

This paper deals with the definition and construction of a decision based multi actor urban design model which enables the integration of the allocation of a variety of urban land uses with the distribution of different urban functions: the Urban Decision Room. Urban design (and planning) is, among

Adaptive Actor-Critic Design-Based Integral Sliding-Mode Control for Partially Unknown Nonlinear Systems With Input Disturbances.

Science.gov (United States)

Fan, Quan-Yong; Yang, Guang-Hong

2016-01-01

This paper is concerned with the problem of integral sliding-mode control for a class of nonlinear systems with input disturbances and unknown nonlinear terms through the adaptive actor-critic (AC) control method. The main objective is to design a sliding-mode control methodology based on the adaptive dynamic programming (ADP) method, so that the closed-loop system with time-varying disturbances is stable and the nearly optimal performance of the sliding-mode dynamics can be guaranteed. In the first step, a neural network (NN)-based observer and a disturbance observer are designed to approximate the unknown nonlinear terms and estimate the input disturbances, respectively. Based on the NN approximations and disturbance estimations, the discontinuous part of the sliding-mode control is constructed to eliminate the effect of the disturbances and attain the expected equivalent sliding-mode dynamics. Then, the ADP method with AC structure is presented to learn the optimal control for the sliding-mode dynamics online. Reconstructed tuning laws are developed to guarantee the stability of the sliding-mode dynamics and the convergence of the weights of critic and actor NNs. Finally, the simulation results are presented to illustrate the effectiveness of the proposed method.

Oil market structures-strategies and performances of the actors of the international petroleum system

International Nuclear Information System (INIS)

Djermaine, Rebai

1999-01-01

The rises of petroleum prices as revealed by the oil crises of the 1970's are the consequences of a beside market perverse game between artificial factors. The public management and the intervention of public authorities have contributed to the unbalancing of oil markets and to the confusion of the actor's strategies in the international petroleum system. The chronical decay of the petroleum prices indicate the slow and silent come back of the economical forces (laws). The management of an exhaustible asset like petroleum, raises lot of intriguing problems. This work aims at exploring the problems linked with this type of management where the decisions of the profession, of private and public companies and of the governments are closely interfering. The study is largely inspired of the meso-economical approach which consists in examining the markets structure and their determining factors, and the strategies and results of the actors of the world petroleum system. The examination of the structures/strategies/results sequence does not neglect the relations and feedbacks between each of these elements. The economical theory of oligopoly and cartel markets is also used to examine the way how prices are determined in petroleum markets. A critical presentation of the energy models allows to show how it is possible to understand, foresee and control the evolution of these prices and the possible supply/demand equilibrium. The study takes also into consideration the debates and controversies about the 'green tax' and its impact of petroleum supply and demand. (J.S.)

Medical tourism’s impact for health systems: A study from three Asian countries

Directory of Open Access Journals (Sweden)

Ala`a Nimer AbuKhalifeh

2015-12-01

Full Text Available Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism’s growth for health systems, illustration on the cases of Thailand, Singapore and Malaysia, three provincial centres for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growing of the medical tourist industry.

THE ANALYSIS OF ACTORS IN THE MAKING OF THE BUDGET REVENUE OF REGIONAL COST

Directory of Open Access Journals (Sweden)

Muhammad Saad

2015-07-01

Full Text Available This article is the result of research on the analysis of the policy making of the budget revenues and shopping area of Makassar city fiscal year 2009. One part of this research use approach to the actors and the relationships between actors in policy making. Within the framework of the system of policy making of Budget income and Expenditure area (Budgets Makassar city, this research is the description of the analysis of the local government and actors People’s Representative Council District Makassar city as policy makers in making Grant Makassar city

Counterterrorism in the Russian Arctic: legal framework and central actors

Directory of Open Access Journals (Sweden)

Ingvill M. Elgsaas

2017-12-01

Full Text Available Russia’s strategic interests in the Arctic coupled with a complex and diffuse terrorist threat has produced a niche topic: Arctic counterterrorism. Arctic counterterrorism is a new and underdeveloped topic that has received only limited attention. This article contributes a discussion of the legal framework and the main actors involved in countering terrorism in the Russian Arctic. The author finds that the legal framework for counterterrorism is extensive yet centered in core documents. Similarly, counterterrorism involves many and varied actors united in a relatively simple and streamlined national system for counterterrorism. Current legal regulation and organisation provide a solid base that may support efficient management of counterterrorism, also in the Arctic. A notable strength is the concentration of coordination responsibilities in the hands of one central actor, the FSB. Another important characteristic is that the system is symmetrical and follows Russia’s federal organisation with coordinating bodies for all regions including those in the Arctic. Counterterrorism legislation is kept up to date and the trend is towards tougher punishments and a wide understanding of terrorist offenses. A potential weak spot is the unclear role of the newly formed National Guard. The uncertainty surrounding the role of the National Guard in the fight against terrorism may challenge the FSB and weaken coordination of the system for counterterrorism in the future.

Inside the Actors' Studio: Exploring Dietetics Education Practices through Dialogical Inquiry

Science.gov (United States)

Fox, Ann L.; Gingras, Jacqui

2012-01-01

Two colleagues, Ann and Jacqui, came together, within the safety of an imagined actors' studio, to explore the challenges that Ann faced in planning a new graduate program in public health nutrition. They met before, during, and after program implementation to discuss Ann's experiences, and audio-taped and transcribed the discussions. When all…

Uncivil actors and violence systems in the Latin American urban domain

Directory of Open Access Journals (Sweden)

Dirk Kruijt

2014-06-01

Full Text Available The character and quality of Latin America’s democracy is in dispute. Uncertainties about its nature and future prevail in the development debate. In the early 2000s the UNDP (2004 coined the terms “low-intensity citizenship” and “low-intensity democracy” to describe the post-dictatorship democracy in the region. When in the 1980s the military establishment withdrew from the political arena and democracy was restored, a severe economic crisis affected the region, producing long lasting effects in terms of mass poverty, informality and social exclusion. In the urban domain, and especially in territories where the representatives of law and order are relatively absent, “uncivil” nonstate actors surfaced, including local drug lords and their small territorial armies; youth gangs; organised crime and the so-called “dark forces”, joined by former belligerent actors of the Andean and Central American civil wars. In this article, I will analyse and typify this erosion of formal social order and the emergence of parallel and informal structures and hierarchies throughout Latin America.

Elaborating on systems thinking in health promotion practice.

Science.gov (United States)

Naaldenberg, Jenneken; Vaandrager, Lenneke; Koelen, Maria; Wagemakers, Anne-Marie; Saan, Hans; de Hoog, Kees

2009-03-01

Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and

Designing and Conducting Health Systems Research Projects ...

International Development Research Centre (IDRC) Digital Library (Canada)

... and field testing (Part 1) and with data analysis and report writing (Part 2). ... New website will help record vital life events to improve access to services for all ... How are public health actors working with the food and drinks industry to ...

Burst Diplomacy The Diplomacies of Foreign Policy: Actors and Methods

Directory of Open Access Journals (Sweden)

Guillaume Devin

2010-12-01

Full Text Available Approaches to diplomacy tend to be restrictive because of an exclusively interstate insight. Indeed, historically, the state monopoly over diplomacy has always been challenged by private actors. Today, it is defied both from the inside because of growing public fragmentation (every ministry tends to lead its own foreign policy; subnational authorities develop their diplomatic relations and from the outside (the business sector and civil society play a growing role on the international scene. This proliferation of actors has transformed diplomatic methods. Beyond the binary division between “old diplomacy” – bilateral, secret and resident – and “new diplomacy” – multilateral, public and itinerant – this article shows that diplomacy has to adapt to number and complexity. Therefore a more global conception need now be considered. Diplomacy today is a system of multiple actors using diverse methods in order to coordinate positions of common interest in a competitive and sometimes hostile environment.

Co-evolution of social networks and continuous actor attributes

NARCIS (Netherlands)

Niezink, Nynke M.D.; Snijders, Tom A.B.

2017-01-01

Social networks and the attributes of the actors in these networks are not static; they may develop interdependently over time. The stochastic actor-oriented model allows for statistical inference on the mechanisms driving this co-evolution process. In earlier versions of this model, dynamic actor

Institutional and Actor-Oriented Factors Constraining Expert-Based Forest Information Exchange in Europe: A Policy Analysis from an Actor-Centred Institutionalist Approach

Directory of Open Access Journals (Sweden)

Tanya Baycheva-Merger

2018-03-01

Full Text Available Adequate and accessible expert-based forest information has become increasingly in demand for effective decisions and informed policies in the forest and forest-related sectors in Europe. Such accessibility requires a collaborative environment and constant information exchange between various actors at different levels and across sectors. However, information exchange in complex policy environments is challenging, and is often constrained by various institutional, actor-oriented, and technical factors. In forest policy research, no study has yet attempted to simultaneously account for these multiple factors influencing expert-based forest information exchange. By employing a policy analysis from an actor-centred institutionalist perspective, this paper aims to provide an overview of the most salient institutional and actor-oriented factors that are perceived as constraining forest information exchange at the national level across European countries. We employ an exploratory research approach, and utilise both qualitative and quantitative methods to analyse our data. The data was collected through a semi-structured survey targeted at forest and forest-related composite actors in 21 European countries. The results revealed that expert-based forest information exchange is constrained by a number of compound and closely interlinked institutional and actor-oriented factors, reflecting the complex interplay of institutions and actors at the national level. The most salient institutional factors that stand out include restrictive or ambiguous data protection policies, inter-organisational information arrangements, different organisational cultures, and a lack of incentives. Forest information exchange becomes even more complex when actors are confronted with actor-oriented factors such as issues of distrust, diverging preferences and perceptions, intellectual property rights, and technical capabilities. We conclude that expert-based forest information

Actors' portrayals of depression to test interrater reliability in clinical trials.

Science.gov (United States)

Rosen, Jules; Mulsant, Benoit H; Bruce, Martha L; Mittal, Vikas; Fox, Debra

2004-10-01

This study determined if actors could portray depressed patients to establish the interrater reliability of raters using the Hamilton Depression Rating Scale (HDRS). Actors portrayed depressed patients using scripts derived from HDRS assessments obtained at three points during treatment. Four experienced raters blindly viewed videotapes of two patients and two actors. They guessed if each interviewee was a patient or an actor and rated the certainty of their guesses. For each interview, they also rated the realism of the portrayal and completed the HDRS. Experienced raters could not distinguish actors and patients better than chance and were equally certain of their right and wrong guesses. Actors and patients received high scores on the realism of their portrayals. The HDRS scores of the actor-patient pairs were correlated. Actors can effectively portray depressed patients. Future studies will determine if actors can accurately portray patients with anxiety and psychosis.

An Actor and His Suitcase

OpenAIRE

Williams, Maurice

2013-01-01

The idea of the actor as journeyman is as old as the profession itself. The travel troupes of yesteryear laid the groundwork for the theatres of Shakespeare and the regional theatre circuit here in America. So if there is one thing an actor must have: it's a good suitcase. Or two. One for the rags and trinkets he, or she, holds dear; and another for all the skills he, or she, brings to every project.When I left the east coast for San Diego I brought with me those two suitcases. Luckily for me...

A cross-case comparative analysis of international security forces' impacts on health systems in conflict-affected and fragile states.

Science.gov (United States)

Bourdeaux, Margaret; Kerry, Vanessa; Haggenmiller, Christian; Nickel, Karlheinz

2015-01-01

Destruction of health systems in fragile and conflict-affected states increases civilian mortality. Despite the size, scope, scale and political influence of international security forces intervening in fragile states, little attention has been paid to array of ways they may impact health systems beyond their effects on short-term humanitarian health aid delivery. Using case studies we published on international security forces' impacts on health systems in Haiti, Kosovo, Afghanistan and Libya, we conducted a comparative analysis that examined three questions: What aspects, or building blocks, of health systems did security forces impact across the cases and what was the nature of these impacts? What forums or mechanisms did international security forces use to interact with health system actors? What policies facilitated or hindered security forces from supporting health systems? We found international security forces impacted health system governance, information systems and indigenous health delivery organizations. Positive impacts included bolstering the authority, transparency and capability of health system leadership. Negative impacts included undermining the impartial nature of indigenous health institutions by using health projects to achieve security objectives. Interactions between security and health actors were primarily ad hoc, often to the detriment of health system support efforts. When international security forces were engaged in health system support activities, the most helpful communication and consultative mechanisms to manage their involvement were ones that could address a wide array of problems, were nimble enough to accommodate rapidly changing circumstances, leveraged the power of personal relationships, and were able to address the tensions that arose between security and health system supporting strategies. Policy barriers to international security organizations participating in health system support included lack of mandate, conflicts

Actors at work

NARCIS (Netherlands)

Nobakht, Behrooz

2016-01-01

The core contributions of this thesis target the intersection of object orientation, actor model, and concurrency. We choose Java as the main target programming language and as one of the mainstream object-oriented languages. We formalize a subset of Java and its concurrency API to facilitate formal

Action adaptation during natural unfolding social scenes influences action recognition and inferences made about actor beliefs.

Science.gov (United States)

Keefe, Bruce D; Wincenciak, Joanna; Jellema, Tjeerd; Ward, James W; Barraclough, Nick E

2016-07-01

When observing another individual's actions, we can both recognize their actions and infer their beliefs concerning the physical and social environment. The extent to which visual adaptation influences action recognition and conceptually later stages of processing involved in deriving the belief state of the actor remains unknown. To explore this we used virtual reality (life-size photorealistic actors presented in stereoscopic three dimensions) to see how visual adaptation influences the perception of individuals in naturally unfolding social scenes at increasingly higher levels of action understanding. We presented scenes in which one actor picked up boxes (of varying number and weight), after which a second actor picked up a single box. Adaptation to the first actor's behavior systematically changed perception of the second actor. Aftereffects increased with the duration of the first actor's behavior, declined exponentially over time, and were independent of view direction. Inferences about the second actor's expectation of box weight were also distorted by adaptation to the first actor. Distortions in action recognition and actor expectations did not, however, extend across different actions, indicating that adaptation is not acting at an action-independent abstract level but rather at an action-dependent level. We conclude that although adaptation influences more complex inferences about belief states of individuals, this is likely to be a result of adaptation at an earlier action recognition stage rather than adaptation operating at a higher, more abstract level in mentalizing or simulation systems.

Stakeholder learning for health sector reform in Lao PDR.

Science.gov (United States)

Phillips, Simone; Pholsena, Soulivanh; Gao, Jun; Oliveira Cruz, Valeria

2016-09-01

Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Engaging Actors for Integrating Health Policy and Systems Research into Policy Making: Case Study from Haryana State in India

Directory of Open Access Journals (Sweden)

Shankar Prinja

2017-09-01

Full Text Available Background & objective: Good examples of evidence generation using Health Policy and Systems Research (HPSR in low and middle income countries (LMIC; and its application in policy making are scarce. In this paper, we describe the experience of establishing a system of HPSR from the Haryana state in India, outline how the HPSR is being utilized for policy making and programmatic decision making, and analyse the key factors which have been critical to the implementation and uptake of HPSR. Methods: Multiple methods are employed in this case study, ranging from unstructured in-depth interviews, review of the program and policy documents, and participatory notes from the meetings. The steps towards creation of a knowledge partnership between stakeholders are outlined. Four case studies i.e. development of a plan for universal health care (UHC, nutrition policy, centralized drug procurement system and use of RAPID appraisal method highlight the use of research evidence in agenda setting, policy formulation and policy implementation respectively. Results: Our analysis shows that the most important factor which contributed to Haryana model of HPSR was the presence of a dedicated and motivated team in National Rural Health Mission (NRHM at state level, many of whom were researchers by previous training. Overall, we conclude by highlighting the need for establishing an institutional mechanism at Central and State level where health service administrators and managers, academicians and researchers working in the field of health system from medical colleges, public health schools, management and technology institutions and social science universities can identify health system research priorities. Increased budgetary allocation for HPSR is required.

Engaging Actors for Integrating Health Policy and Systems Research into Policy Making: Case Study from Haryana State in India

Directory of Open Access Journals (Sweden)

Shankar Prinja

2017-09-01

Full Text Available Background & objective: Good examples of evidence generation using Health Policy and Systems Research (HPSR in low and middle income countries (LMIC; and its application in policy making are scarce. In this paper, we describe the experience of establishing a system of HPSR from the Haryana state in India, outline how the HPSR is being utilized for policy making and programmatic decision making, and analyse the key factors which have been critical to the implementation and uptake of HPSR. Methods: Multiple methods are employed in this case study, ranging from unstructured in-depth interviews, review of the program and policy documents, and participatory notes from the meetings. The steps towards creation of a knowledge partnership between stakeholders are outlined. Four case studies i.e. development of a plan for universal health care (UHC, nutrition policy, centralized drug procurement system and use of RAPID appraisal method highlight the use of research evidence in agenda setting, policy formulation and policy implementation respectively. Results: Our analysis shows that the most important factor which contributed to Haryana model of HPSR was the presence of a dedicated and motivated team in National Rural Health Mission (NRHM at state level, many of whom were researchers by previous training. Overall, we conclude by highlighting the need for establishing an institutional mechanism at Central and State level where health service administrators and managers, academicians and researchers working in the field of health system from medical colleges, public health schools, management and technology institutions and social science universities can identify health system research priorities. Increased budgetary allocation for HPSR is required.

Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health

Science.gov (United States)

2013-01-01

Background Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Discussion Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Summary Effective global “eHealth Governance” focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence. PMID:24131576

Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health.

Science.gov (United States)

Mackey, Tim K; Liang, Bryan A

2013-10-16

Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Effective global "eHealth Governance" focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence.

Evidence for Informing Health Policy Development in Low- Income Countries (LICS: Perspectives of Policy Actors in Uganda

Directory of Open Access Journals (Sweden)

Juliet Nabyonga-Orem

2015-05-01

Full Text Available Background Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs, the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods Using exploratory qualitative methods, we conducted interviews with 51 key informants using an indepth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion What LICslike Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making.

The moral problem of worse actors

Directory of Open Access Journals (Sweden)

Scott Wisor

2014-05-01

Full Text Available Individuals and institutions sometimes have morally stringent reasons to not do a given action. For example, an oil company might have morally stringent reasons to refrain from providing revenue to a genocidal regime, or an engineer might have morally stringent reasons to refrain from providing her expertise in the development of weapons of mass destruction. But in some cases, if the agent does not do the action, another actor will do it with much worse consequences. For example, the oil company might know their assets will be bought by a company with worse environmental and labor practices. Or the engineer might know her position will be filled by a more ambitious and amoral engineer. I call this the moral problem of worse actors (MPWA. MPWA gives reason, at least some of the time, to consider otherwise morally impermissible actions permissible or even obligatory. On my account, doing the action in the circumstances of MPWA remains morally objectionable even if permissible or obligatory, and this brings additional moral responsibilities and obligations to the actor. Similarly, not doing the action in the circumstances of MPWA may also bring additional (but different moral responsibilities and obligations. Acknowledging MPWA creates considerable challenges, as many bad actors may appeal to it to justify morally objectionable action. In this paper, I develop a set of strategies for individuals and institutions to handle MPWA. This includes appeals to integrity and the proper attribution of expressive responsibility, regulatory responsibility, and compensatory responsibility. I also address a set of related concerns, including worries about incentivizing would-be bad actors, concerns about epistemic uncertainty, and the problem of mala in se exceptions.

Actor/Actant-Network Theory as Emerging Methodology for ...

African Journals Online (AJOL)

4carolinebell@gmail.com

2005-01-31

Jan 31, 2005 ... to trace relationships, actors, actants and actor/actant-networks .... associated with a particular type of social theory (Latour, 1987; ..... the Department of Environmental Affairs and Tourism, Organised Business and Organised.

The interplay of institutions, actors and technologies in socio-technical systems - An analysis of transformations in the Australian urban water sector

NARCIS (Netherlands)

Fuenfschilling, Lea; Truffer, Bernhard

2016-01-01

Literature on socio-technical transitions has primarily emphasized the co-determination of institutions and technologies. In this paper, we want to focus on how actors play a mediating role between these two pillars of a socio-technical system. By introducing the theoretical concept of institutional

Managing Actors, Resources, and Activities in Innovation Ecosystems – A Design Science Approach

OpenAIRE

Valkokari , Katri; Amitrano , Cristina ,; Bifulco , Francesco; Valjakka , Tiina

2016-01-01

Part 13: Design Science and Business Models - Design Science Research; International audience; Through a design science approach, the paper explores how actors in a network create and sustain competitive advantage independently and through participation in a system of actors (i.e., a collaborative network) who are not hierarchically managed but, rather, act toward their own goals within the innovation ecosystem. In accordance with design studies, the relevance of research and its quality are ...

Poland health system review.

Science.gov (United States)

Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

2011-01-01

, particularly in areas such as pharmaceuticals, are highly regressive. The health status of the Polish population has improved substantially, with average life expectancy at birth reaching 80.2 years for women and 71.6 years for men in 2009. However, there is still a vast gap in life expectancy between Poland and the western European Union (EU) countries and between life expectancy overall and the expected number of years without illness or disability. Given its modest financial, human and material health care resources and the corresponding outcomes, the overall financial efficiency of the Polish system is satisfactory. Both allocative and technical efficiency leave room for improvement. Several measures, such as prioritizing primary care and adopting new payment mechanisms such as diagnosis-related groups (DRGs), have been introduced in recent years but need to be expanded to other areas and intensified. Additionally, numerous initiatives to enhance quality control and build the required expertise and evidence base for the system are also in place. These could improve general satisfaction with the system, which is not particularly high. Limited resources, a general aversion to cost-sharing stemming from a long experience with broad public coverage and shortages in health workforce need to be addressed before better outcomes can be achieved by the system. Increased cooperation between various bodies within the health and social care sectors would also contribute in this direction. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; they describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. World

Efficient model learning methods for actor-critic control.

Science.gov (United States)

Grondman, Ivo; Vaandrager, Maarten; Buşoniu, Lucian; Babuska, Robert; Schuitema, Erik

2012-06-01

We propose two new actor-critic algorithms for reinforcement learning. Both algorithms use local linear regression (LLR) to learn approximations of the functions involved. A crucial feature of the algorithms is that they also learn a process model, and this, in combination with LLR, provides an efficient policy update for faster learning. The first algorithm uses a novel model-based update rule for the actor parameters. The second algorithm does not use an explicit actor but learns a reference model which represents a desired behavior, from which desired control actions can be calculated using the inverse of the learned process model. The two novel methods and a standard actor-critic algorithm are applied to the pendulum swing-up problem, in which the novel methods achieve faster learning than the standard algorithm.

A false dichotomy? Mental illness and lone-actor terrorism.

Science.gov (United States)

Corner, Emily; Gill, Paul

2015-02-01

We test whether significant differences in mental illness exist in a matched sample of lone- and group-based terrorists. We then test whether there are distinct behavioral differences between lone-actor terrorists with and without mental illness. We then stratify our sample across a range of diagnoses and again test whether significant differences exist. We conduct a series of bivariate, multivariate, and multinomial statistical tests using a unique dataset of 119 lone-actor terrorists and a matched sample of group-based terrorists. The odds of a lone-actor terrorist having a mental illness is 13.49 times higher than the odds of a group actor having a mental illness. Lone actors who were mentally ill were 18.07 times more likely to have a spouse or partner who was involved in a wider movement than those without a history of mental illness. Those with a mental illness were more likely to have a proximate upcoming life change, more likely to have been a recent victim of prejudice, and experienced proximate and chronic stress. The results identify behaviors and traits that security agencies can utilize to monitor and prevent lone-actor terrorism events. The correlated behaviors provide an image of how risk can crystalize within the individual offender and that our understanding of lone-actor terrorism should be multivariate in nature.

Using attractiveness model for actors ranking in social media networks.

Science.gov (United States)

Qasem, Ziyaad; Jansen, Marc; Hecking, Tobias; Hoppe, H Ulrich

2017-01-01

Influential actors detection in social media such as Twitter or Facebook can play a major role in gathering opinions on particular topics, improving the marketing efficiency, predicting the trends, etc. This work aims to extend our formally defined T measure to present a new measure aiming to recognize the actor's influence by the strength of attracting new important actors into a networked community. Therefore, we propose a model of the actor's influence based on the attractiveness of the actor in relation to the number of other attractors with whom he/she has established connections over time. Using an empirically collected social network for the underlying graph, we have applied the above-mentioned measure of influence in order to determine optimal seeds in a simulation of influence maximization. We study our extended measure in the context of information diffusion because this measure is based on a model of actors who attract others to be active members in a community. This corresponds to the idea of the IC simulation model which is used to identify the most important spreaders in a set of actors.

An Actor's Approach to Management Conceptual framework and company practices

DEFF Research Database (Denmark)

of Contents Foreword: Actor-based managemet - long-term and sustainable management (Bo Prangsgaard) Chapter 1. Introduction (Morten Jakobsen, Inga-Lill Johansson & Hanne Nørreklit) Chapter 2. Actors and reality: a conceptual framework for creative governance (Lennart Nørreklit) Chapter 3. An actor...

Recollection and unitization in associating actors with extrinsic and intrinsic motions.

Science.gov (United States)

Kersten, Alan W; Earles, Julie L; Berger, Johanna D

2015-04-01

Four experiments provide evidence for a distinction between 2 different kinds of motion representations. Extrinsic motions involve the path of an object with respect to an external frame of reference. Intrinsic motions involve the relative motions of the parts of an object. This research suggests that intrinsic motions are represented conjointly with information about the identities of the actors who perform them, whereas extrinsic motions are represented separately from identity information. Experiment 1 demonstrated that participants remembered which actor had performed a particular intrinsic motion better than they remembered which actor had performed a particular extrinsic motion. Experiment 2 replicated this effect with incidental encoding of actor information, suggesting that encoding intrinsic motions leads one to automatically encode identity information. The results of Experiments 3 and 4 were fit by Yonelinas's (1999) source-memory model to quantify the contributions of familiarity and recollection to memory for the actors who carried out the intrinsic and extrinsic motions. Successful performance with extrinsic motion items in Experiment 3 required participants to remember in which scene contexts an actor had appeared, whereas successful performance in Experiment 4 required participants to remember the exact path taken by an actor in each scene. In both experiments, discrimination of old and new combinations of actors and extrinsic motions relied strongly on recollection, suggesting independent but associated representations of actors and extrinsic motions. In contrast, participants discriminated old and new combinations of actors and intrinsic motions primarily on the basis of familiarity, suggesting unitized representations of actors and intrinsic motions. (c) 2015 APA, all rights reserved).

The health professions and the performance of future health systems in low-income countries: support or obstacle?

Science.gov (United States)

Dussault, Gilles

2008-05-01

This paper discusses the present and future role of the health professions in health services delivery systems in low-income countries. Unlike richer countries, most low-income countries do not have a tradition of labour market regulation and the capacity of the professions themselves to regulate the provision of health services by their members tends to be weak. The paper looks at the impact of professional monopolies on the performance of health services delivery systems, e.g. equity of access, effectiveness of services, efficiency in the use of scarce resources, responsiveness to users' needs, including protection against the financial impact of utilising health services. It identifies issues which policy-makers face in relation to opening the health labour market while guaranteeing the safety and security of services provided by professionals. The suggestion is made that a "social contract", granting privileges of practice in exchange of a commitment to actively maintain and enhance the quality of their services, may be a viable course of action. This would require that the actors in the policy process collaborate in strengthening the capacity of regulatory agencies to perform their role.

The Grand Strategy of Nonstate Actors: Theory and Implications

Directory of Open Access Journals (Sweden)

Garrett Pierman

2015-12-01

Full Text Available This article addresses the Realist assumption that only actors that are states can be considered to have a strategic culture. The primary issue raised is the question of the ability of non-state actors to have a strategic culture. Al-Qaida is used as a theoretical case study. Ultimately this article rejects the idea of territoriality in strategic culture formulation and calls for academics and policymakers alike to adopt a broader conception of actors on the international, stage. This broader conception of actors would necessitate rich case studies to be done in the future in order to seek an understanding of the strategic culture of the non-state actors which academics and policymakers must deal with in the modern security environment. In particular, the article finds that the assumptions held about al-Qaida thus far are wrong and, in reality, the group has ambitions that are cosmic in nature, which will necessitate change in the strategies used to fight against terrorism.

The key role of supply chain actors in groundwater irrigation development in North Africa

Science.gov (United States)

Lejars, Caroline; Daoudi, Ali; Amichi, Hichem

2017-09-01

The role played by supply chain actors in the rapid development of groundwater-based irrigated agriculture is analyzed. Agricultural groundwater use has increased tremendously in the past 50 years, leading to the decline of water tables. Groundwater use has enabled intensification of existing farming systems and ensured economic growth. This "groundwater economy" has been growing rapidly due to the initiative of farmers and the involvement of a wide range of supply chain actors, including suppliers of equipment, inputs retailers, and distributors of irrigated agricultural products. In North Africa, the actors in irrigated production chains often operate at the margin of public policies and are usually described as "informal", "unstructured", and as participating in "groundwater anarchy". This paper underlines the crucial role of supply chain actors in the development of groundwater irrigation, a role largely ignored by public policies and rarely studied. The analysis is based on three case studies in Morocco, Tunisia and Algeria, and focuses on the horticultural sub-sector, in particular on onions and tomatoes, which are irrigated high value crops. The study demonstrates that although supply chain actors are catalyzers of the expansion of groundwater irrigation, they could also become actors in adaptation to the declining water tables. Through their informal activities, they help reduce market risks, facilitate credit and access to subsidies, and disseminate innovation. The interest associated with making these actors visible to agricultural institutions is discussed, along with methods of getting them involved in the management of the resource on which they depend.

Change-actors in the U.S. electric energy system: The role of environmental groups in utility adoption and diffusion of wind power

International Nuclear Information System (INIS)

Doblinger, Claudia; Soppe, Birthe

2013-01-01

We study the contribution of environmental groups to new technology adoption and diffusion by dominant incumbents. Building on institutional and social movement theory, we develop a theoretical framework that sheds light on environmental groups as change-actors. We theorize that by approaching embedded key constituents with various strategic actions, environmental groups affect taken-for-granted beliefs, build legitimacy for renewable energy technologies, and convince skeptical constituents to support the new technology. We verify our theoretical framework with a case study of wind power development in Colorado. We find that environmentalists educate constituents on the benefits of the new technology, engage in activities leading to regulatory and legislative decisions for wind, while also providing direct assistance to the utility. As a result, utilities are both pressured and encouraged to adopt and diffuse wind power on a large-scale. This research directs attention to the role of environmental groups as change-actors and the legitimating effects of their actions. It highlights their part in creating a more favorable institutional environment for new technologies while directly influencing the incumbent's technology choice. This paper contributes to an understanding of bottom-up, actor-initiated changes in energy systems taking into account both the systemic technological infrastructure and the institutional context. - Highlights: • We study environmentalists′ impact on utility-scale renewable technology diffusion. • Incumbent-dominated systems hinder the diffusion of new technologies. • Environmental groups′ strategic actions increase legitimacy for new technologies. • Environmental groups′ legitimating actions affect incumbent′s technology choice. • Environmental groups create a favorable institutional context for new technologies

Greece: Health system review.

Science.gov (United States)

Economou, Charalambos

2010-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

New Actors and Alliances in Development

DEFF Research Database (Denmark)

Richey, Lisa Ann; Ponte, Stefano

2014-01-01

‘New actors and alliances in development’ brings together an interdisciplinary group of scholars exploring how development financing and interventions are being shaped by a wider and more complex platform of actors than usually considered in the existing literature. The contributors also trace...... a changing set of key relations and alliances in development – those between business and consumers; ngos and celebrities; philanthropic organisations and the state; diaspora groups and transnational advocacy networks; ruling elites and productive capitalists; and ‘new donors’ and developing country...

Expectations as a key to understanding actor strategies in the field of fuel cell and hydrogen vehicles.

Science.gov (United States)

Budde, Björn; Alkemade, Floortje; Weber, K Matthias

2012-07-01

Due to its environmental impact, the mobility system is increasingly under pressure. The challenges to cope with climate change, air quality, depleting fossil resources imply the need for a transition of the current mobility system towards a more sustainable one. Expectations and visions have been identified as crucial in the guidance of such transitions, and more specifically of actor strategies. Still, it remained unclear why the actors involved in transition activities appear to change their strategies frequently and suddenly. The empirical analysis of the expectations and strategies of three actors in the field of hydrogen and fuel cell technology indicates that changing actor strategies can be explained by rather volatile expectations related to different levels. Our case studies of the strategies of two large car manufacturers and the German government demonstrate that the car manufacturers refer strongly to expectations about the future regime, while expectations related to the socio-technical landscape level appear to be crucial for the strategy of the German government.

Optimal Placement of Actors in WSANs Based on Imposed Delay Constraints

Directory of Open Access Journals (Sweden)

Chunxi Yang

2014-01-01

Full Text Available Wireless Sensor and Actor Networks (WSANs refer to a group of sensors and actors linked by wireless medium to probe environment and perform specific actions. Such certain actions should always be taken before a deadline when an event of interest is detected. In order to provide such services, the whole monitor area is divided into several virtual areas and nodes in the same area form a cluster. Clustering of the WSANs is often pursued to give that each actor acts as a cluster-head. The number of actors is related to the size and the deployment of WSANs cluster. In this paper, we find a method to determine the accurate number of actors which enables them to receive data and take actions in an imposed time-delay. The k-MinTE and the k-MaxTE clustering algorithm are proposed to form the minimum and maximum size of cluster, respectively. In those clustering algorithms, actors are deployed in such a way that sensors could route data to actors within k hops. Then, clusters are arranged by the regular hexagon. At last, we evaluate the placement of actors and results show that our approach is effective.

Games as Actors - Interaction, Play, Design, and Actor Network Theory

DEFF Research Database (Denmark)

Jessen, Jari Due; Jessen, Carsten

2014-01-01

When interacting with computer games, users are forced to follow the rules of the game in return for the excitement, joy, fun, or other pursued experiences. In this paper, we investigate how games a chieve these experiences in the perspective of Actor Network Theory (ANT). Based on a qualitative......, and by doing so they create in humans what in modern play theory is known as a “state of play”...

Semantics for Communicating Actors with Interdependent Real-Time Deadlines

DEFF Research Database (Denmark)

Knoll, Istvan; Ravn, Anders Peter; Skou, Arne

2009-01-01

on the results, these tools must use consistent semantics for the model. Yet, a monolithic semantic model is just as complex as the entity it describes. In order to circumvent this issue, we define a three level semantics giving independent definitions of the functionality of actors, the temporal properties...... of communications, and finally imposing deadlines on the timing of dependent actors. With this approach the semantics is used directly in developing a simulator supporting the nondeterminism of the abstract semantics such that e.g. potential race conditions can be detected. The layers are also planned to underpin...... independent specialized verification tools. The verification task for timed, hybrid systems can thus be divided into the continuous, discrete, and timing domains with automated translation to specialized tools, and this promises better scalability than simulation or model checking of one complex model....

Globalization of health insecurity: the World Health Organization and the new International Health Regulations.

Science.gov (United States)

Aginam, Obijiofor

2006-12-01

The transnational spread of communicable and non-communicable diseases has opened new vistas in the discourse of global health security. Emerging and re-emerging pathogens, according to exponents of globalization of public health, disrespect the geo-political boundaries of nation-states. Despite the global ramifications of health insecurity in a globalizing world, contemporary international law still operates as a classic inter-state law within an international system exclusively founded on a coalition of nation-states. This article argues that the dynamic process of globalization has created an opportunity for the World Health Organization to develop effective synergy with a multiplicity of actors in the exercise of its legal powers. WHO's legal and regulatory strategies must transform from traditional international legal approaches to disease governance to a "post-Westphalian public health governance": the use of formal and informal sources from state and non-state actors, hard law (treaties and regulations) and soft law (recommendations and travel advisories) in global health governance. This article assesses the potential promise and problems of WHO's new International Health Regulations (IHR) as a regulatory strategy for global health governance and global health security.

Technology strategy as macro-actor

DEFF Research Database (Denmark)

Tryggestad, Kjell

2003-01-01

-human entities to the explanatory repertoire of strategy research, another line of inquiry is pursued. The performative perspective thus proposed, is inspired by the classical work of Von Clausewitz and the recent anthropology of science, technology and organizational identities. In the proposed perspective...... case account for how the strategic technology and the strategic collective emerge and co-produce each other as a macro-actor, only to become transformed in unexpected ways - as common technology and reflective human subjects.In the concluding section, it is argued that the humanity of the reflective...... outcomes, as providers of explanations and observations. The expression `technological strategy as macro-actor' summarizes these findings and the associated implications for research and practice....

Global health actors no longer in favor of user fees: a documentary study.

Science.gov (United States)

Robert, Emilie; Ridde, Valéry

2013-07-26

Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. The principle of "user pays" seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced

Veneto Region, Italy. Health system review.

Science.gov (United States)

Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

2012-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

Engaging Actors in Co-Designing Heterogeneous Innovations

DEFF Research Database (Denmark)

Jørgensen, Ulrik; Lindegaard, Hanne; Rosenqvist, Tanja Schultz

2011-01-01

In this paper we share and analyze our experiences staging a co-design process in which we through different interventions engage important actors in designing. Our experiences are taking from an innovation and research project about user-involvement in textile design processes. As the project...... in our project’s agenda by going through the different stages of translation. The paper is finalized with reflections on the difficulties in engaging actors in a co-design process and transporting results into the existing framed context of design and architectural work....... related to translating and transporting the results of these different events due to the institutional and professional framing of projects and design processes. We are analyzing these through an actor network approach and use the translation term to describe how the participants slowly became engaged...

Research on virtual actor action editing and movement control

Institute of Scientific and Technical Information of China (English)

Wenhu QIN; Yuhui WU; Zhengxu ZHAO

2008-01-01

To directly use a virtual surface model for action editing and movement control, a general method for creating virtual actor skeleton models and controlling movement is presented. The method includes judging borderlines of the block virtual surface model, calculat-ing the joints, confirming the above block, and using the block hierarchical layout to create the skeleton model. Then, according to the virtual actor model and move-ment restriction, the study focuses on the generation of movement animation using the key frame technique and smoothing movement technique by automatically adding animation and adjusting the actor's pose by different weights on movement amplitude. Finally, movement control of the actor in the virtual environment is implemented by real-time control and path point control, which achieve a good result.

Transnational Diaspora and Civil Society Actors Driving MNE Internationalisation

DEFF Research Database (Denmark)

Rana, Mohammad Bakhtiar; Elo, Maria

2016-01-01

Multinational enterprises (MNEs) are viewed as proactive global economic actors that enter new and emerging markets with intentional strategies, building on their inherent resources and firm-specific advantages. However, an international joint venture involves numerous actors in the market entry...... and civil society actors. It provides evidence of the reactive internationalisation of an MNE, showing how the transnational diaspora drove the MNE’s internationalisation and how a civil society actor, in conjunction with a diaspora member, facilitated the creation of an international joint venture (IJV...... and organisational capability base for this process, which would not have happened without their market-driving and enabling influence. The findings illustrate the central role of transnational diaspora entrepreneurship and the related innovation, motivation, contextual intelligence, networking and funding...

What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

Science.gov (United States)

Mirzoev, Tolib; Kane, Sumit

2017-01-01

Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health

What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework.

Science.gov (United States)

Mirzoev, Tolib; Kane, Sumit

2017-01-01

Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people's interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people's interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system

An Interconnection of Armed Conflict and Health Service system in Rolpa District of Nepal

Directory of Open Access Journals (Sweden)

Sachin Kumar Ghimire

2009-08-01

Full Text Available The health service system is the part of the political system. Likewise, political systems should be an integral part of the health system. Contrary to this, local political tussle, national level power conflicts, long-term civil war, and crises in the bureaucracy have led to the continuous ignorance of people’s health issues in Rolpa. War is always detrimental for people's health, health service system and social well-being of the population. The chronic condition of exclusion prevalent in large section of the society is the “favorable” fertile ground to capitalize the expectations toward inclusive and healthy condition in Rolpa. The process of capitalizing such historical exclusion in the name of “revolution” gives rise to new sects of political actors. However, rising expectations and aspirations toward “equitable society” have been resulting in severe frustrations because no significant changes have been done to address the general living conditions of people. The continuous rise and fall of expectations after all lead to infinitive journey of producing ill health that could be extremely detrimental to people's expectation, even to live a normal life as a human.

[Public health and mental health: methodological tools to evaluate the Brazilian Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System].

Science.gov (United States)

Onocko-Campos, Rosana Teresa; Furtado, Juarez Pereira

2006-05-01

This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System (SUS). The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing the importance of reclaiming and guaranteeing the roles of various social actors to shape the assessment process, the need for collecting and standardizing academic studies on the topic, and the importance of promoting a new research field focusing on public health policies to support policymakers, managers, and health teams in reshaping their practices.

Aggregated Computational Toxicology Resource (ACTOR)

Data.gov (United States)

U.S. Environmental Protection Agency — The Aggregated Computational Toxicology Resource (ACTOR) is a database on environmental chemicals that is searchable by chemical name and other identifiers, and by...

The Political Context for Transnational Actor Soft Power

DEFF Research Database (Denmark)

Bertelsen, Rasmus Gjedssø

2015-01-01

There is growing awareness and understanding of the role of non-state actors for the smart power of states. However, there is not yet a clear understanding of the impact of the political context and the state for non-state actors and their soft power. We look at American missionary universities...

The Rights of Private Economic Actors Under the World Trade Organization Agreements in Indonesia

Directory of Open Access Journals (Sweden)

Intan Soeparna

2012-09-01

Full Text Available Nothing in the Uruguay Round mentions directly about rights of private economic actors. It seems that the relationship to private economic actors (or may be individual does not exist within the WTO Agreements, because as a general rule, private parties are not legal subjects of the international legal order. However, this article will prevail upon this situation, by looking closer at the essence of the WTO Agreements to discern the rights of private economic actors that derive from the WTO. The main question of this article is to what extent then Indonesia is dealing with the rights of private economic actors under the WTO Agreements? The background of this questionis because four years after ratifying the WTO Agreements, Indonesia has been facing what is arguably the most serious multidimensional crisis in 1997, some difficult situations have arisen from the crisis; therefore, the society hesitated to accept the open world trading system. The society seemed look askance to the implementation of the WTO Agreements. But Indonesian Government took major step to reduce the skepticism of society toward liberalization, by readjusting its national laws conform to the WTO Agreements with the intention to support the rights of national economic actors under the WTO Agreements in order to achieve total benefits of the WTO rules.

Building institutions for an effective health system: lessons from China's experience with rural health reform.

Science.gov (United States)

Bloom, Gerald

2011-04-01

This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China's experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change. Copyright © 2011 Elsevier Ltd. All rights reserved.

Analysing Personal Characteristics of Lone-Actor Terrorists: Research Findings and Recommendations

OpenAIRE

Roy, de, van Zuijdewijn J.; Bakker, E.

2016-01-01

This Research Note presents the outcome of a project that looked at the personal characteristics of lone-actor terrorists. It is part of the larger Countering Lone-Actor Terrorism (CLAT) project. The project described here aimed to improve understanding of, and responses to, the phenomenon of (potentially) violent lone-actors based on an analysis of 120 cases from across Europe. The Research Note focuses on the personal characteristics of lone-actor terrorists.[1] First of all, it presents th...

Counter-terrorism and the protection of civilians: Armed non-state actors

OpenAIRE

Munive, Jairo; Somer, Jonathan

2015-01-01

Recent events in the Middle East present the latest and undoubtedly not the last challenge to international engagement with armed non-state actors. Over the last many years international humanitarian law has increasingly regulated the behaviour of armed non-state actors with regard to the protection of civilians. At the same time, counter-terror measures have increasingly addressed such conduct, as well as controlled the extent to which other actors may interact with armed non-state actors. Y...

La percepción de los actores de la seguridad alimentaria

Directory of Open Access Journals (Sweden)

Ponce, Gloria

2005-10-01

Full Text Available This paper presents the results of a survey on the Spanish food safety system carried out in order to ascertain the perceptions of the food and biotechnology industry, with special attention to the transgenic food debate. Regarding the efficiency of the food safety system, the industry holds an ambivalent vision, altough it tends to confer to the European area and the EFSA (European Food Safety Authority greater levels of confidence and effectiveness than to the AESA (Spanish Food Safety Agency. A comparison with other surveys shows that consumer perception is also ambivalent, pointing to a significant lack of acceptation of the food safety system among the relevant social actors.

Este artículo presenta los resultados de una encuesta sobre el funcionamiento del sistema de seguridad alimentaria en España, con especial atención al tema de los alimentos transgénicos (a causa del debate social que suscitaron. La encuesta muestra que la valoración que la industria alimentaria española hace del sistema de seguridad alimentaria, tanto a nivel de España como a nivel de la Unión Europea, es ambivalente, especialmente por las dudas sobre la independencia y eficacia en su funcionamiento. Una comparación con datos de otras encuestas revela que la percepción de otros actores, especialmente de los consumidores, es igualmente ambivalente, indicando una importante falta de aceptación entre diferentes actores sociales relevantes para el sistema.

'Special' non-human actors in the 'inclusive' early childhood classroom

DEFF Research Database (Denmark)

Watson, Karen; Millei, Zsuzsa; Petersen, Eva Bendix

2015-01-01

of classrooms. In this article, we pay attention to ‘special’ non-human actors present in an ‘inclusive’ early childhood classroom. These ‘special’ non-human actors are so named as they operate in the classroom as objects specific for the child with a diagnosis. The ‘special’ non-human actors, in the specific...... case the wrist band, the lock and the scooter board, take on meaning within discourses in the ‘inclusive’ classroom. We illuminate how these non-human actors contribute to the constitution of the ‘normal’ and the regulation of educators and children. To trouble the working of power and the control...

NAVIGATING PROTOTYPING SPACES FOR CO-DESIGN OF ACTOR-NETWORKS

DEFF Research Database (Denmark)

Pedersen, Signe; Brodersen, Søsser

2017-01-01

of diverse actors in what we term prototyping spaces. In these prototyping spaces, prototypes play an important role in visualising controversies, enabling matters of concern to be negotiated, and making knowledge transparent throughout the design process. Based on a case study of a pilot program to make...... of temporary prototyping spaces, which are to be staged and facilitated to allow various actors to negotiate matters of concern. Designers then translate the resulting knowledge and insights into pro-totypes for use in subsequent spaces and eventually into an actor-network com-prising the final solution....

Percepción de actores involucrados en el estado de conservación del Humedal Torca-Guaymaral, Bogotá-Colombia (Perception of actors involved in the conservation status of the Torca-Guaymaral wetland, Bogotá-Colombia

Directory of Open Access Journals (Sweden)

Ellie Anne López Barrera

2017-06-01

Full Text Available RESUMEN El Humedal Torca-Guaymaral se localiza en un territorio estratégico de conectividad ecológica del borde norte de la ciudad de Bogotá en Colombia. Sin embargo, la complejidad relacionada con los actores y la gobernanza del territorio, han impedido que el sistema socio-ecológico se desarrolle hacia un proceso de preservación de los componentes ambientales que lo conforman, generándose un deterioro en la calidad ambiental del territorio. En este contexto, el objetivo del presente estudio es aproximarse a la percepción de los actores involucrados en la conservación del humedal, y al mismo tiempo generar un espacio de intercambio de experiencias y conocimientos entre estos, que conlleve a la apropiación y formulación de soluciones conjuntas para mejorar la gestión del sistema socio-ecológico. Metodologías aplicadas como la cartografía social y el diálogo de actores, permiten identificar la percepción de actores involucrados en el estado de conservación del Humedal Torca-Guaymaral, para obtener un diagnóstico inicial de la situación ambiental actual del ecosistema. ABSTRACT The Torca-Guaymaral wetland is located in a strategic area of ecological connectivity in the northern region of Bogota city. However, the complexity related to the actors and the governance of the territory, have prevented the socio-ecological system development towards a process of environmental preservation, thus resulting in the deterioration of environmental quality. In this context, the objective of this study is to approach the perception of actors involved in the wetland conservation process, while creating a space for exchange of experiences and knowledge between them, formulating joint solutions and improve the management of the socio-ecological system. Methodologies involve the use of social cartography and stakeholder dialogue, to identify the perception of actors involved in the conservation status of the Torca-Guaymaral wetland, for an

Actor-network Theory and cartography of controversies in Information Science

OpenAIRE

LOURENÇO, Ramon Fernandes; TOMAÉL, Maria Inês

2018-01-01

Abstract The present study aims to discuss the interactions between the Actor-network Theory and the Cartography of Controversies method in Information Science research. A literature review was conducted on books, scholarly articles, and any other sources addressing the Theory-Actor Network and Cartography of Controversies. The understanding of the theoretical assumptions that guide the Network-Actor Theory allows examining important aspects to Information Science research, seeking to identif...

Bombing alone: tracing the motivations and antecedent behaviors of lone-actor terrorists,.

Science.gov (United States)

Gill, Paul; Horgan, John; Deckert, Paige

2014-03-01

This article analyzes the sociodemographic network characteristics and antecedent behaviors of 119 lone-actor terrorists. This marks a departure from existing analyses by largely focusing upon behavioral aspects of each offender. This article also examines whether lone-actor terrorists differ based on their ideologies or network connectivity. The analysis leads to seven conclusions. There was no uniform profile identified. In the time leading up to most lone-actor terrorist events, other people generally knew about the offender's grievance, extremist ideology, views, and/or intent to engage in violence. A wide range of activities and experiences preceded lone actors' plots or events. Many but not all lone-actor terrorists were socially isolated. Lone-actor terrorists regularly engaged in a detectable and observable range of activities with a wider pressure group, social movement, or terrorist organization. Lone-actor terrorist events were rarely sudden and impulsive. There were distinguishable behavioral differences between subgroups. The implications for policy conclude this article. © 2013 American Academy of Forensic Sciences.

Learning to Run with Actor-Critic Ensemble

OpenAIRE

Huang, Zhewei; Zhou, Shuchang; Zhuang, BoEr; Zhou, Xinyu

2017-01-01

We introduce an Actor-Critic Ensemble(ACE) method for improving the performance of Deep Deterministic Policy Gradient(DDPG) algorithm. At inference time, our method uses a critic ensemble to select the best action from proposals of multiple actors running in parallel. By having a larger candidate set, our method can avoid actions that have fatal consequences, while staying deterministic. Using ACE, we have won the 2nd place in NIPS'17 Learning to Run competition, under the name of "Megvii-hzw...

Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

Directory of Open Access Journals (Sweden)

Elisabeth Paul

2018-01-01

Full Text Available Background Performance-based financing (PBF is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC followed suit through a health system strengthening (HSS project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the “PBF package” functions and produces effects. Methods An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms, as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and

Postdecisional counterfactual thinking by actors and readers.

Science.gov (United States)

Girotto, Vittorio; Ferrante, Donatella; Pighin, Stefania; Gonzalez, Michel

2007-06-01

How do individuals think counterfactually about the outcomes of their decisions? Most previous studies have investigated how readers think about fictional stories, rather than how actors think about events they have actually experienced. We assumed that differences in individuals' roles (actor vs. reader) can make different information available, which in turn can affect counterfactual thinking. Hence, we predicted an effect of role on postdecisional counterfactual thinking. Reporting the results of eight studies, we show that readers undo the negative outcome of a story by undoing the protagonist's choice to tackle a given problem, rather than the protagonist's unsuccessful attempt to solve it. But actors who make the same choice and experience the same negative outcome as the protagonist undo this outcome by altering features of the problem. We also show that this effect does not depend on motivational factors. These results contradict current accounts of counterfactual thinking and demonstrate the necessity of investigating the counterfactual thoughts of individuals in varied roles.

Exploring agency beyond humans: the compatibility of Actor-Network Theory (ANT and resilience thinking

Directory of Open Access Journals (Sweden)

Angga Dwiartama

2014-09-01

Full Text Available At first glance, the compatibility of social theory and resilience thinking is not entirely evident, in part because the ontology of the former is rooted in social interactions among human beings rather than ecological process. Despite this difference, resilience thinking engages with particular aspects of social organization that have generated intense debates within social science, namely the role of humans as integral elements of social-ecological systems and the processes through which given social structures (including material relations are either maintained or transformed. Among social theoretical approaches, Actor-Network Theory (ANT is noted for its distinctive approach to these aspects. ANT proposes that human and nonhuman components (both referred to as actants have the same capacity to influence the development of social-ecological systems (represented as actor-networks by enacting relations and enrolling other actors. We explore the notion of agency that is employed in resilience thinking and ANT in order to extend our understandings of human-environment relationships through complementary insights from each approach. The discussion is illustrated by reference to ongoing assessment of resilience as it is experienced and expressed in two distinctive agricultural production systems: Indonesian rice and New Zealand kiwifruit. We conclude by establishing the potential for ANT to provide more profound theoretical conceptualizations of agency, both human and nonhuman, in analyses of social ecological systems.

Soft Power in Central Asia: Actors and Its Activities

Directory of Open Access Journals (Sweden)

Marina M. Lebedeva

2014-01-01

Full Text Available Article considers theoretical aspects of soft power concept and its use by various actors in Central Asia. It is noted that scholars as well as practitioners are paying insufficient attention to such key concepts position J. Nye, as an attraction. As a result the efficiency of the use of soft power is significantly reduced. It also shows that the attractiveness is not a universal characteristic. For this reason, attractiveness and hence soft power of different actors are different and aimed at different segments of the population. These differences lead to competition of actors, but they do not reduce interaction in the region to zero-sum game. Specific forms and directions of the soft power of Russia, the U.S., the EU and China in Central Asia are discussed. The article emphasizes that the Central Asian states are not just recipients of soft power of external actors, but also themselves form behavioral strategies that are attractive to others.

The role of social actors in times of crisis / El papel de los actores sociales en tiempos de crisis

Directory of Open Access Journals (Sweden)

Iván Medina Iborra

2013-10-01

Full Text Available The aim of this article is to analyze the performance of the two main trade unions (UGT and CCOO and the employers’ association CEOE during the economic crisis. The analysis focuses on their position on major reforms, on their ideological differences over various public policies, as well as on their ability to negotiate collective bargaining agreements. We depart from the command of the Spanish Constitution of 1978, which in its seventh article gives trade unions and business associations a prominent role in representing economic interests, to suggest that social actors would be likely to reduce their chances of veto in times of economic crisis given the exceptional situation. However, the article confirms a gap in the approaches of social actors and the few options for a strong social dialogue. This leads to a greater distance between the social actors and the public opinion, as evidenced by the results derived from the survey on ‘Culture and Political Representation in Spain’.

Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

Science.gov (United States)

Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

2017-09-01

Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

Using social network analysis to understand actor participation and ...

African Journals Online (AJOL)

Peripheral actors advocate issues of compensation and land grabbing from buffer zone establishment and wetland resources uses for livelihoods, but are unable to influence the central actors's agenda. SNA E-I Index reveals that government organisations are more cohesive and able to form strong ties with donors to ...

The semiotic actor : From signs to socially constructed meaning

NARCIS (Netherlands)

Helmhout, M.; Jorna, R.J.J.M.; Gazendam, H.W.M.

A semiotic actor creates, uses and transfers or communicates meaning with the help of signs in order to interact with other actors and society. For a complete understanding of the cognitive and social phenomena related to this process, we state that social science and cognitive science cannot stay

A human resources project implementation. An actor-network theory perspective

Directory of Open Access Journals (Sweden)

Gibrán Rivera González

2012-01-01

Full Text Available Este artículo tiene dos objetivos principales. Primero, sugerir el uso de la Teoría del Actor-Red (ANT por sus siglas en inglés como una teoría que puede ser utilizada para analizar la implementación de un proyecto de recursos humanos (llamado ModeCo, Modelo de Competencias; y, segundo, proveer un entendimiento inicial sobre algunos de los principales eventos y situaciones que dieron forma al ritmo de la implementación de este proyecto. Este artículo se basa en una investigación cualitativa, la cual toma una perspectiva informada por la Teoría del Actor-Red (Callon, 1986; Latour, 1987; Law, 1992 que es utilizada como mecanismo de entendimiento para describir cómo un proyecto es implementado en una Universidad con múltiples campus en México. En este trabajo se ofrecen, primero, una serie de enunciados que capturan la manera en cómo la Teoría del Actor-Red fue útil para entender el proceso de implementación; y, segundo, se exponen los principales eventos y situaciones que afectaron dicho proceso de implementación. En esta investigación adoptamos un modelo interpretativo (Walsham, 1995; Walsham, 2006, mismo que se vale del uso de una batería de métodos, principalmente el uso de doce entrevistas semiestructuradas con diferentes actores del proyecto, documentos del proyecto y asistencia virtual a reuniones del Comité Directivo de recursos humanos. En términos de análisis nuestra investigación está basada en los principios propuestos por Klein and Myers (1999 para estudios interpretativos.

Metropolises in emerging countries: actors in energy transitions? Lessons from Cape Town (South Africa)

International Nuclear Information System (INIS)

Jaglin, Sylvy

2017-01-01

The role of cities, as places and drivers of the energy transition is increasingly recognized. The research project Termos tested the robustness of this assumption in four cities of emerging countries by asking two questions: to what extent do urban local actors really drive an urban energy transition and of what kind? To what extent are their actions supporting an urban territorialisation of energy systems? The paper first presents the findings of this comparative research, which he then extends with the case study of Cape Town. It analyzes why, despite their energy and environmental voluntarism, the municipality have little room of manoeuvre, while the changes observed seem to strengthen the stranglehold of the 'central sphere' in the energy system. Analyzing this as the expression of a conflict between a strong national electricity sector and an alternative approach to energy issues carried by urban actors, it highlights the resulting tensions and their impact on the municipal actions, both limited by resistance but also 'swallowed up' by actors from the central sphere. The paper finally draws lessons from this example to enrich the general analysis of dynamics observed in other cities of emerging countries

The Eu as a strategic global policy actor

DEFF Research Database (Denmark)

Chatzopoulou, Sevasti; Ansell, Christopher

that shapes and is being shaped by the EU strategic choices. This process is facilitated by the existing EU institutions and structures, the administrative and technical expertise capacity when it responds to the internal and external challenges (environment, sustainable development climate and circular......This article aims to complement the existing literature on the EU as a global actor and demonstrates that the EU’s entrepreneurship on policy, ideas and knowledge production contributes to the evolution of the EU as a strategic global policy actor. While the number of significant studies on the EU...... as a global actor proliferated the last decades, these studies concentrate on the EU’s role in a fragmented manner, focusing either on specific normative or more economic and trade issues, and thus often competing between themselves. This article acknowledges these contributions and aims to take them further...

Health system strengthening in Myanmar during political reforms: perspectives from international agencies.

Science.gov (United States)

Risso-Gill, Isabelle; McKee, Martin; Coker, Richard; Piot, Peter; Legido-Quigley, Helena

2014-07-01

Myanmar has undergone a remarkable political transformation in the last 2 years, with its leadership voluntarily transitioning from an isolated military regime to a quasi-civilian government intent on re-engaging with the international community. Decades of underinvestment have left the country underdeveloped with a fragile health system and poor health outcomes. International aid agencies have found engagement with the Myanmar government difficult but this is changing rapidly and it is opportune to consider how Myanmar can engage with the global health system strengthening (HSS) agenda. Nineteen semi-structured, face-to-face interviews were conducted with representatives from international agencies working in Myanmar to capture their perspectives on HSS following political reform. They explored their perceptions of HSS and the opportunities for implementation. Participants reported challenges in engaging with government, reflecting the disharmony between actors, economic sanctions and barriers to service delivery due to health system weaknesses and bureaucracy. Weaknesses included human resources, data and medical products/infrastructure and logistical challenges. Agencies had mixed views of health system finance and governance, identifying problems and also some positive aspects. There is little consensus on how HSS should be approached in Myanmar, but much interest in collaborating to achieve it. Despite myriad challenges and concerns, participants were generally positive about the recent political changes, and remain optimistic as they engage in HSS activities with the government.

Actor roles in transition: Insights from sociological perspectives

OpenAIRE

Wittmayer, Julia; Avelino, Flor; van Steenbergen, F.; Loorbach, Derk

2016-01-01

textabstractTo date, the field of transition research lacks a suitable vocabulary to analyse the (changing) interactions and relations of actors as part of a sustainability transition. This article addresses this knowledge gap by exploring the potential of the concept of 'roles' from social interaction research. The role concept is operationalized for transition research to allow the analysis of (changing) roles and relations between actor roles as indicative of changes in the social fabric a...

Branching points for transition pathways: assessing responses of actors to challenges on pathways to a low carbon future

International Nuclear Information System (INIS)

Foxon, Timothy J.; Pearson, Peter J.G.; Arapostathis, Stathis; Carlsson-Hyslop, Anna; Thornton, Judith

2013-01-01

This paper describes initial analysis of branching points on a set of transition pathways to a UK low carbon electricity future by 2050. As described in other papers in this special issue, we are exploring and analysing a set of core transition pathways, based on alternative governance patterns in which the ‘logics’ of market actors, government actors and civil society actors, respectively dominate. This core pathway analysis is enhanced by analyses of branching points within and across the pathways, which informs how competition between different logics plays out at key decision points. Branching points are defined as key decision points at which choices made by actors, in response to internal or external stresses or triggers, determine whether and in what ways the pathway is followed. A set of initial branching points for our three core transition pathways is identified through project and stakeholder workshops, and drawing on analysis of actors’ choices and responses at past branching points in energy system transitions. The potential responses of the actors are identified at these branching points, and risk mitigation strategies are formulated for the dominant actors to reinforce that pathway, as well as opportunities for actors to move away from the pathway. - Highlights: Transition Pathways is analysing three potential pathways to a low carbon future. ► Stresses lead to branching points, where actors make choices, creating pathways. ► These choices may lead to path-dependency. ► Differences in governance logics within transition pathways are also analysed. ► Studying branching points adds theoretical understanding and policy relevance to TP.

Understanding Regional Actors: A Case Study

National Research Council Canada - National Science Library

Harden, James

2002-01-01

.... It is possible the estimation process could improve if greater attention was given to the interests, challenges, and opportunities of the regional actors involved, rather than concentrating on U.S. interests...

Finding The Most Important Actor in Online Crowd by Social Network Analysis

Science.gov (United States)

Yuliana, I.; Santosa, P. I.; Setiawan, N. A.; Sukirman

2017-02-01

Billion of people create trillions of connections through social media every single day. The increasing use of social media has led to dramatic changes in the of way science, government, healthcare, entertainment and enterprise operate. Large-scale participation in Technology-Mediated Social Participation (TMSP) system has opened up incredible new opportunities to deploy online crowd. This descriptive-correlational research used social network analysis (SNA) on data gathered from Fanpage Facebook of Greenpeace Indonesia related to important critical issues, the bushfires in 2015. SNA identifies relations on each member by sociometrics parameter such as three centrality (degree, closeness and betweenesse) for measuring and finding the most important actor in the online community. This paper use Fruchterman Rein-gold algorithm to visualize the online community in a graph, while Clauset-Newman-Moore is a technique to identify groups in community. As the result found 3735 vertices related to actors, 6927 edges as relation, 14 main actors in size order and 22 groups in Greenpeace Indonesia online community. This research contributes to organize some information for Greenpeace Indonesia managing their potency in online community to identify human behaviour.

[Local public health networks. Apropos of an experience].

Science.gov (United States)

Guix, Joan; Bocio, Ana; Ferràs, Joaquim; Margalef, Jordi; Osanz, Anna C; Serrano, Mónica; Sentenà, Anna

2013-01-01

Public health action on a territory is complex and requires the involvement of multiple actors, who do not always act coordinately. Networks of organizations structures including the whole of the local actors facilitate the generation of synergies and enable greater effectiveness and efficiency of the joint action from the different actors on a same landscape. We present 3 years experience of four Public Health Committees in a region of Catalonia (Spain), composed by the main actors in public health planning. Each of the committees is organized on a plenary and working groups on issues arising from the regional health diagnosis, and coincident with the Health Plan of the Region. Coordination in no case implies the loss or dilution of the firm of the actor generator of intervention initiative in public health, but their empowerment and collaboration by the other actors. In conclusion welcomes the creation of a culture of collaboration and synergies between the different organizations concerned. Lack of specificity is observed in establishing operational objectives, and the need for greater coordination and involvement of the components of the various working groups. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

United Kingdom (England): Health system review.

Science.gov (United States)

Boyle, Seán

2011-01-01

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

American Long-Distance Locomobility and the Spaces of Actor-Network Theory

Directory of Open Access Journals (Sweden)

Michael Minn

2016-03-01

Full Text Available Much of the discourse surrounding national intercity passenger rail service in the United States revolves around why it has lagged so far behind European and Asian counterparts. However, a more interesting question might be why it has survived despite competition from faster, more nimble transport modes, discriminatory public policy, and the ascension of neoliberal discourse hostile to public endeavor. This paper uses the concept of durability in actor-network theory to offer some insights into how the system has achieved a remarkable but problematic stability, and how that durability relates to an imagined role for national intercity passenger rail in a future of increasingly constrained material resources. This paper also demonstrates the application of actor-network theory (ANT in a way that can serve as a useful introduction to and template for the use of that methodology.

ACToR Chemical Structure processing using Open Source ...

Science.gov (United States)

ACToR (Aggregated Computational Toxicology Resource) is a centralized database repository developed by the National Center for Computational Toxicology (NCCT) at the U.S. Environmental Protection Agency (EPA). Free and open source tools were used to compile toxicity data from over 1,950 public sources. ACToR contains chemical structure information and toxicological data for over 558,000 unique chemicals. The database primarily includes data from NCCT research programs, in vivo toxicity data from ToxRef, human exposure data from ExpoCast, high-throughput screening data from ToxCast and high quality chemical structure information from the EPA DSSTox program. The DSSTox database is a chemical structure inventory for the NCCT programs and currently has about 16,000 unique structures. Included are also data from PubChem, ChemSpider, USDA, FDA, NIH and several other public data sources. ACToR has been a resource to various international and national research groups. Most of our recent efforts on ACToR are focused on improving the structural identifiers and Physico-Chemical properties of the chemicals in the database. Organizing this huge collection of data and improving the chemical structure quality of the database has posed some major challenges. Workflows have been developed to process structures, calculate chemical properties and identify relationships between CAS numbers. The Structure processing workflow integrates web services (PubChem and NIH NCI Cactus) to d

Mapping industrial systems - a supply network perspective on enabling technologies, processes and actors

OpenAIRE

Srai, Jagjit Singh

2016-01-01

This is the author accepted manuscript. The final version is available from InderScience Publishers via http://dx.doi.org/10.1504/IJMTM.2017.10002927 This paper develops a multi-layered multi-stage mapping approach to explore the characteristics of emerging industry supply networks (EI SNs), and how enabling production technologies and supply chain processes are supported by institutional, industrial and supply network actors. The mapping methodology involves the systematic capture of mate...

From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening.

Science.gov (United States)

Barasa, Edwine W; Cloete, Keith; Gilson, Lucy

2017-11-01

Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, we reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, we propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue to deliver services of good quality and respond effectively to wider health challenges. We call this capacity everyday resilience; (2) health system resilience entails more than bouncing back from shock. In complex adaptive systems (CAS), resilience emerges from a combination of absorptive, adaptive and transformative strategies; (3) nurturing the resilience of health systems requires understanding health systems as comprising not only hardware elements (such as finances and infrastructure), but also software elements (such as leadership capacity, power relations, values and appropriate organizational culture). We also reflect on current criticisms of the concept of resilient health systems, such as that it assumes that systems are apolitical, ignoring actor agency, promoting inaction, and requiring that we accept and embrace vulnerability, rather than strive for stronger and more responsive systems. We observe that these criticisms are warranted to the extent that they refer to notions of resilience that are mismatched with the reality of health systems as CAS. We argue that the observed weaknesses of resilience thinking can be addressed by reframing and applying a resilience lens that is better suited to the attributes of health systems as CAS. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Lone Actor Terrorist Attack Planning and Preparation: A Data-Driven Analysis.

Science.gov (United States)

Schuurman, Bart; Bakker, Edwin; Gill, Paul; Bouhana, Noémie

2017-10-23

This article provides an in-depth assessment of lone actor terrorists' attack planning and preparation. A codebook of 198 variables related to different aspects of pre-attack behavior is applied to a sample of 55 lone actor terrorists. Data were drawn from open-source materials and complemented where possible with primary sources. Most lone actors are not highly lethal or surreptitious attackers. They are generally poor at maintaining operational security, leak their motivations and capabilities in numerous ways, and generally do so months and even years before an attack. Moreover, the "loneness" thought to define this type of terrorism is generally absent; most lone actors uphold social ties that are crucial to their adoption and maintenance of the motivation and capability to commit terrorist violence. The results offer concrete input for those working to detect and prevent this form of terrorism and argue for a re-evaluation of the "lone actor" concept. © 2017 The Authors. Journal of Forensic Sciences published by Wiley Periodicals, Inc. on behalf of American Academy of Forensic Sciences.

Design of an mHealth System for Maternal and Children HIV care.

Science.gov (United States)

Koesoema, Allya P; Ariani, Arni; Irawan, Yoke S; Soegijoko, Soegijardjo

2017-07-01

While progress has been made to slow down its spread and increase uptake of treatment, human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is still a highly significant health problem for many low- and middle-income countries (LMICs). Specifically, almost half of new HIV patients in Asia Pacific were children. The prevention of mother-to-child transmission faces complex socioeconomic and other problems. With the increasing growth of mobile technologies in LMICs, especially in Asia Pacific, mHealth, the application of mobile technology for health applications, has a significant potential to help alleviate these problems. In this paper, we propose the design of an mHealth System for Maternal and Children HIV care. It includes specialized portals for patients, family/community members, healthcare providers, healthcare referral system, payers and drug supply chain. While each portal is customized towards the needs of a particular actor, such as treatment scheduling and education for patients, and epidemiological data management for healthcare referrals, all the different elements are integrated through a central server to form an integrated system with a secured data exchange environment. This proposed integrative design is aimed to facilitate efficient, timely and coordinated information dissemination, analysis, and care across the healthcare system, and is intended for application in developing countries, especially in the Asia Pacific region.

Necessity for Consistent and Understandable Engagement Policies with Non-State Actors

National Research Council Canada - National Science Library

Fitzpatrick, Andrew P

2008-01-01

How does a nonstate actor, namely a recognized armed insurgent group, transition to the political realm from insurgent to state actor, and what are the implications of such transitions for U.S. foreign policy...

EU–Hamas actors in a state of permanent liminality

DEFF Research Database (Denmark)

Pace, Michelle; Pallister-Wilkins, Polly

2018-01-01

This article contributes to the debate on liminality within International Relations (IR) theory by focusing on the actorness of the European Union (EU) and Hamas. The concept of liminality as a transitional process is applied to frame the situation of both the EU and Hamas as political actors in......-between socially established categories. This article explores how the liminal identity of these two actors impacts, on the one hand, their relations with each other and, on the other hand, their relations of ‘self’. Exploring the procedural relations of the EU and Hamas, it argues for the necessity of recognising...... liminal categories in IR theory and practice, while, at the same time, it highlights the limits of such in-between categories in a world order still structured around the state....

Advancing the application of systems thinking in health: sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh.

Science.gov (United States)

Sarriot, Eric G; Kouletio, Michelle; Jahan, Dr Shamim; Rasul, Izaz; Musha, Akm

2014-08-26

Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required a method, an explicit set of processes, to guide their decisions and choices during and after the project. Concern chose the Sustainability Framework method to generate creative thinking from stakeholders, create a common vision, and monitor progress. The Framework is based on participatory and iterative steps: defining (mapping) the local system and articulating a long-term vision, describing scenarios for achieving the vision, defining the elements of the model, and selecting corresponding indicators, setting and executing an assessment plan,, and repeated stakeholder engagement in analysis and decisions . Formal assessments took place up to 5 years post-project (2009). Strategic choices for the project were guided by articulating a collective vision for sustainable health, mapping the system of actors required to effect and sustain change, and defining different components of analysis. Municipal authorities oriented health teams toward equity-oriented service delivery efforts, strengthening of the functionality of Ward Health Committees, resource leveraging between municipalities and the Ministry of Health, and mitigation of contextual risks. Regular reference to a vision (and set of metrics (population health, organizational and community capacity) mitigated political factors. Key structures and processes were maintained following elections and political changes. Post-project achievements included the maintenance or improvement 5 years post-project (2009) in 9 of the 11 health indicator gains realized during the project (1999-2004). Some elements of performance and capacity weakened, but reductions in the equity gap

Literacy testing objects as co-actors in framing bilingual childrens literacy development

DEFF Research Database (Denmark)

Holm, Lars

Literacy testing objects as co-actors in framing bilingual children´s literacy development Based on Latour´s theoretical perspective that human beings delegate roles and responsibility to artifacts, it becomes important to track and research the objects that circulate within and between “sites...... of human social interaction” (Latour, 2005). Latour argues that objects – e.g. a literacy testing instrument – play a central role through the meaning, human beings delegate to objects. In this way objects become co-actors in a network through the agency human actors delegate to them, and objects mediate...... categories and artifacts based on the local context. The second is termed “globalising connects” that brings local actors in line with bigger and remote networks. In order to understand the semiotic function of artifacts in a meaning making network an ethnographic oriented approach with a focus on actor...

When nurses are also patients: Intimate partner violence and the health system as an enabler of women's health and agency in Johannesburg.

Science.gov (United States)

Sprague, Courtenay; Woollett, Nataly; Parpart, Jane; Hatcher, Abigail M; Sommers, Theresa; Brown, Shelley; Black, Vivian

2016-01-01

While violence against women is a recognised global health problem, women's agency in marginalised settings is poorly understood, particularly in relation to health systems. We explored agency as a practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner violence (IPV) in Johannesburg. Interviews conducted from August 2013 to March 2014 generated rich descriptions from respondents in five health facilities. Nurses' self-reported IPV matched national prevalence of 24-31%. Findings revealed the way in which agency is enacted by nurses, allowing them the economic means to leave abusive partnerships, yet disabling them from agency and health promotion in their workplace. At the same time, nurses expanded agentic possibilities for patients by enabling a national response to IPV within South African health clinics - one that is largely undocumented. We posit that nurses can serve as important agentic actors in public health systems in low- and middle-income country settings by assisting patients to address IPV, even in the absence of targeted training and guidelines. To ensure the health and well-being of women experiencing IPV, nurses should be supported by the health sector to respond skilfully to patients and to safely process their own experiences of violence.

Environmental governance in China: Interactions between the state and "nonstate actors".

Science.gov (United States)

Guttman, Dan; Young, Oran; Jing, Yijia; Bramble, Barbara; Bu, Maoliang; Chen, Carmen; Furst, Kathinka; Hu, Tao; Li, Yifei; Logan, Kate; Liu, Lingxuan; Price, Lydia; Spencer, Michael; Suh, Sangwon; Sun, Xiaopu; Tan, Bowen; Wang, Harold; Wang, Xin; Zhang, Juan; Zhang, Xinxin; Zeidan, Rodrigo

2018-08-15

In the West, limited government capacity to solve environmental problems has triggered the rise of a variety of "nonstate actors" to supplement government efforts or provide alternative mechanisms for addressing environmental issues. How does this development - along with our efforts to understand it - map onto environmental governance processes in China? China's efforts to address environmental issues reflect institutionalized governance processes that differ from parallel western processes in ways that have major consequences for domestic environmental governance practices and the governance of China "going abroad." China's governance processes blur the distinction between the state and other actors; the "shadow of the state" is a major factor in all efforts to address environmental issues. The space occupied by nonstate actors in western systems is occupied by shiye danwei ("public service units"), she hui tuanti ("social associations") and e-platforms, all of which have close links to the state. Meanwhile, international NGOs and multinational corporations are also significant players in China. As a result, the mechanisms of influence that produce effects in China differ in important ways from mechanisms familiar from the western experience. This conclusion has far-reaching implications for those seeking to address global environmental concerns, given the importance of China's growing economy and burgeoning network of trade relationships. Copyright © 2018 Elsevier Ltd. All rights reserved.

Eschewing New World Order Tensions: Interpretations and Metaphors for Colombian Health System

Directory of Open Access Journals (Sweden)

Juan Carlos Aceros Gualdrón

2003-11-01

Full Text Available This article exemplifies a kind of tension that has been caused by the emergent world order; specifically, the one that has been established between the economic and social rationalities. In order to do so, it portrays the description that the ?Asociación Nacional Pro-Referendo Ley 100? (ANPR made of the Colombia?s Health System in an article called: ?Documento Parcial Preparatorio?. From this article we can highlight some metaphores that exemplify the before metioned tension, the actors involve in it and the proposed political action. In addition to that, there is a use of the cyborg image (Haraway,1991, the idea of the symbiotic contract (Serres, 1990, and the concept of the organizational government (Schvarstein, 2003 to translate the ANPR`s discourse and seek new ways of thinking. This article should not be taken as a reflection of the Health System?s reality. Instead, it should be taken as a possible reading to be given a second thought in order to produce a broader vision of the situation and a new point of view.

[Colombia: what has happened with its health reform?].

Science.gov (United States)

Gómez-Arias, Rubén Darío; Nieto, Emmanuel

2014-01-01

The health reform adopted in Colombia in 1993 was promoted by different agencies as the model to follow in matters of health policy. Following the guidelines of the Washington Consensus and the World Bank, the Government of Colombia, with the support of national political and economic elites, reorganized the management of health services based on market principles, dismantled the state system, increased finances of the sector, assigned the management of the system to the private sector, segmented the provision of services, and promoted interaction of actors in a competitive scheme of low regulation. After 20 years of implementation, the Colombian model shows serious flaws and is an object of controversy. The Government has weakened as the governing entity for health; private groups that manage the resources were established as strong centers of economic and political power; and violations of the right to health increased. Additionally, corruption and service cost overruns have put a strain on the sustainability of the system, and the state network is in danger of closing. Despite its loss of prestige at the internal level, various actors within and outside the country tend to keep the model based on contextual reforms.

Articulación del actor-red: análisis de las mediaciones en torno a la Ley 975 de 2005 de Colombia (Ley de Justicia y Paz

Directory of Open Access Journals (Sweden)

Jennifer Del Toro-Granados

2015-12-01

Full Text Available El presente trabajo pretendió reflexionar a partir de la teoría del actor-red en las mediaciones que hicieron posible y determinaron la proclamación de la ley 975 de 2005 o ley de justicia y paz. Se concluye que existieron diversos actores humanos y no humanos que fueron enrolados con el objetivo de expedir una ley que derivó en un proceso de impunidad y legitimación de la escalada paramilitar en Colombia; además se establece el plano jurídico como un espacio de disputas donde los intereses de los victimarios se enfrentan con los intereses de las víctimas en un juego político que ubica a estos últimos actores en nuevas situaciones de victimización.

GAVE multi-actor process. A exemplified study with recommendations for a follow-up traject; GAVE multi-actor proces. Een voorbeeldstudie met aanbevelingen voor het vervolgtraject

Energy Technology Data Exchange (ETDEWEB)

Diepenmaat, H.B. [Actors Procesmanagement, Zeist (Netherlands)

2000-02-01

The focus is on GAVE as an integral multi-actor process, as a collaboration process in which the parties have to find each other. The reason for this multi-actor approach is that the parties themselves have to realise the importance of sustainable energy. A multi-actor approach uses this crucial fact as the starting point. By means of the use of specific multi-actor methods and insights, it is possible during the collaboration process to develop a clear idea of the content of the joint path and the intended collaborative future, while paying specific attention to the individual roles of the players. Based on this, a well- considered and promising realisation path can be followed. The objective of this study is to illustrate - on the basis of two GAVE options - how the multi-actor approach can support the GAVE programme. In doing this, emphasis is placed on examples, the demonstration of added value of such an approach, and making recommendations for the future. Two experiments have been carried out on the basis of the Trinity approach. The Trinity approach is a set of methods specifically developed for supporting change processes which involve many parties (i.e. multi-actor processes). Trinity helps those involved to obtain a clear picture of both the route to be followed and the future situation to be aimed at. The term 'picture' must be understood literally: an important aspect of Trinity is the collaboration and communication with multi-actor models (also referred to as actorprints). By means of a diagram technique (figures and arrows) these models demonstrate the cohesion between the roles and activities of the various parties involved. The modelling process is instrumental in this; the actual result is that the image that is developed is formed and backed up by the participants in the process. Within these experiments, we have, so far, worked mainly in the shadow of the current GAVE process. A forceful participative use of the actor approach is

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

Directory of Open Access Journals (Sweden)

Elena Boriani

2017-07-01

Full Text Available Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety, human, and ecosystem health (1. In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Resolving the challenges in the international comparison of health systems: the must do's and the trade-offs.

Science.gov (United States)

Forde, Ian; Morgan, David; Klazinga, Niek S

2013-09-01

Countries are increasingly publishing health system performance statistics alongside those of their peers, to identify high performers and achieve a continuously improving health system. The aim of the paper is to identify, and discuss resolution of, some key methodological challenges, which arise when comparing health system performance. To illustrate the issues, we focus on two OECD flagship initiatives: the System of Health Accounts (SHA) and the Health Care Quality Indicators (HCQI) project and refer to two main actors: a coordinating agency, which proposes and collates performance data and second, data correspondents in constituent health systems, who submit data to the coordinating centre. Discussion is structured around two themes: a set of must-do's (legitimacy of the coordinating centre, validity of proposed indicators, feasibility of data collection and technical support for data correspondents) and a set of trade-offs (depth vs. breadth in the number of system elements compared, aggregation vs. granularity of data, flexibility vs. consistency of indicator definitions and inclusion criteria). Robust fulfillment of the must-do's and transparent resolution of the trade-offs both depend upon effective collaboration between the coordinating centre and data correspondents, and a close working relationship between a technical secretariat and a body of experts. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The need of a multi-actor perspective to understand expectations from virtual presence: managing elderly homecare informatics.

Science.gov (United States)

Mettler, Tobias; Vimarlund, Vivian

2011-12-01

Different studies have analysed a wide range of use cases and scenarios for using IT-based services in homecare settings for elderly people. In most instances, the impact of such services has been studied using a one-dimensional approach, either focusing on the benefits for the patient or health service provider. The objective of this contribution is to explore a model for identifying and understanding outcomes of IT-based homecare services from a multi-actor perspective. In order to better understand the state of the art in homecare informatics, we conducted a literature review. We use experiences from previous research in the area of informatics to develop the proposed model. The proposed model consists of four core activities 'identify involved actors', 'understand consequences', 'clarify contingencies', 'take corrective actions', and one additional activity 'brainstorming IT use'. The primary goal of innovating organisations, processes and services in homecare informatics today, is to offer continued care, better decision support both to practitioners and patients, as well as effective distribution of resources. A multi-actor analysis perspective is needed to understand utility determination for the involved stakeholders.

Emotional labor actors: a latent profile analysis of emotional labor strategies.

Science.gov (United States)

Gabriel, Allison S; Daniels, Michael A; Diefendorff, James M; Greguras, Gary J

2015-05-01

Research on emotional labor focuses on how employees utilize 2 main regulation strategies-surface acting (i.e., faking one's felt emotions) and deep acting (i.e., attempting to feel required emotions)-to adhere to emotional expectations of their jobs. To date, researchers largely have considered how each strategy functions to predict outcomes in isolation. However, this variable-centered perspective ignores the possibility that there are subpopulations of employees who may differ in their combined use of surface and deep acting. To address this issue, we conducted 2 studies that examined surface acting and deep acting from a person-centered perspective. Using latent profile analysis, we identified 5 emotional labor profiles-non-actors, low actors, surface actors, deep actors, and regulators-and found that these actor profiles were distinguished by several emotional labor antecedents (positive affectivity, negative affectivity, display rules, customer orientation, and emotion demands-abilities fit) and differentially predicted employee outcomes (emotional exhaustion, job satisfaction, and felt inauthenticity). Our results reveal new insights into the nature of emotion regulation in emotional labor contexts and how different employees may characteristically use distinct combinations of emotion regulation strategies to manage their emotional expressions at work. (c) 2015 APA, all rights reserved.

Cognitively Central Actors and Their Personal Networks in an Energy Efficiency Training Program

Science.gov (United States)

Hytönen, Kaisa; Palonen, Tuire; Hakkarainen, Kai

2014-01-01

This article aims to examine cognitively central actors and their personal networks in the emerging field of energy efficiency. Cognitively central actors are frequently sought for professional advice by other actors and, therefore, they are positioned in the middle of a social network. They often are important knowledge resources, especially in…

Health system strengthening in the context of CMAM

International Nuclear Information System (INIS)

Israel, Anne-Dominique; Gallagher, Maureen

2014-01-01

pertinently tackle those constrains/ barriers. AM specialists need to join efforts with health specialists to achieve the reduction of the barriers identified as “common”. In order to strengthen coverage, the approach to health systems strengthening has to be two-fold – to increase availability and access as part of the health system. Taking on a more horizontal approach with AM integrated to basic package of health services can support improved availability. In turn, to increase access for AM, there is a need to identify barriers that are specific to SAM/ MAM management within that package. These barriers could be what the “Acute malnutrition champions” could focus on while strengthening the capacity of health actors to mainstream acute malnutrition management in their activities. Efforts have to be coordinated with the health system in order to ensure that the various barriers are addressed nonetheless. (author)

A climate game based on a Multi-Actor Dynamic Integrated Assessment Model (MADIAM)

Science.gov (United States)

Weber, M.; Hasselmann, K.

2003-04-01

In November 2002 a special exhibition on climate issues opened in the German Museum for Science and Techniques ('Deutsches Museum') in Munich. Within this exposition we present an interactive game in which visitors control future climate policy by adopting the role of either the government, a CEO (Chief Executive Officer) of a global company or a typical private household of an industrialized country. The players endeavor to maintain a sustainable climate in the future (global goal) while pursuing their own individual welfare goals. Task of the exhibition visitor is to combine the personal interests of the actor he is adopting with the global goal. The individual goal of government is maintain economic growth while avoiding conflicts due to inter-regional or societal inequalities. The CEO seeks to maximize total profits (business earnings). The goal of households is to maximize wages and interest earnings. The evolution of the economic system and climate is governed by the decisions of the actors. Government sets economic side conditions in terms of carbon taxes, subsidies for R&D or market infusion support for climate-friendly technologies, and transfers development aid to less advanced regions. The CEOs decide how much to invest in a number of alternative investment options and in which region. Households influences the economy by their purchasing and savings decisions. The model considers four regions, three real actors (mentioned above) and two different goods (climate-adverse and a climate-friendly). We introduce four different kinds of energy (coal, oil/gas, nuclear, renewable). A World Bank handles money flows. At different points in time the actors can cooperate with other actors in order to reach the global goal Stochastic elements regarding future technology and future climate are included. A touch-screen monitor with user friendly interface is used to present animations and videos. An animated climate scientist uses a climate simulator to compute future

Two-actor conflict with time delay: A dynamical model

Science.gov (United States)

Qubbaj, Murad R.; Muneepeerakul, Rachata

2012-11-01

Recent mathematical dynamical models of the conflict between two different actors, be they nations, groups, or individuals, have been developed that are capable of predicting various outcomes depending on the chosen feedback strategies, initial conditions, and the previous states of the actors. In addition to these factors, this paper examines the effect of time delayed feedback on the conflict dynamics. Our analysis shows that under certain initial and feedback conditions, a stable neutral equilibrium of conflict may destabilize for some critical values of time delay, and the two actors may evolve to new emotional states. We investigate the results by constructing critical delay surfaces for different sets of parameters and analyzing results from numerical simulations. These results provide new insights regarding conflict and conflict resolution and may help planners in adjusting and assessing their strategic decisions.

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam.

Science.gov (United States)

Delabouglise, A; Antoine-Moussiaux, N; Phan, T D; Dao, D C; Nguyen, T T; Truong, B D; Nguyen, X N T; Vu, T D; Nguyen, K V; Le, H T; Salem, G; Peyre, M

2016-03-01

Economic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non-monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non-monetary benefit) which was mainly obtained from other private actors and media. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

[The French health care funding system for research and innovation in oncology].

Science.gov (United States)

Wiernik, Harvey; Katz, Gregory; Coulonjou, Hélène; Salagnac, André; Kletz, Frédéric; Thariat, Juliette

2018-06-01

This article provides an overview of the French health system with respect to allocation of public resources to hospitals, to encourage research and innovation, particularly in the field of oncology. It is explained in a historical, economic and scientific perspective. Important structural and conceptual reforms (T2A, HPST law, etc.) have been carried out. These have significantly impacted the way public funding is allocated. Funding of innovation and research has been modified into a more incentive logic, aimed at strengthening competitiveness between all health care actors. The funding allocation system has evolved towards a more ubiquitous redistribution, including non-academic and private institutions. The baseline endowment includes indicators relating to scientific publications (60% of the endowment), teaching (25%) and clinical trials (15%). Research funding is then redistributed by regional health agencies, and used in health care institutions at the discretion of the directorates. Other funding sources such as calls for grants, funding for mobile research centers and teams, tumor banks and temporary user licenses are also part of the funding by the French Ministry of health. Changes in the health research funding system have an incentive purpose. They have significantly modified the global healthcare landscape. Feedback on these changes will be necessary to assess the success of the reinforcement of the dynamics of research and innovation. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria.

Science.gov (United States)

Chima, Charles Chikodili; Homedes, Nuria

2015-06-01

Three global health initiatives (GHIs) - the US President's Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank Multi-Country HIV/AIDS Program - finance most HIV services in Nigeria. Critics assert that GHIs burden fragile health systems in resource-poor countries and that health system limitations in these countries constrain the achievement of the objectives of GHIs. This study analyzed interactions between HIV GHIs and the Nigerian Health System and explored how the impact of the GHIs could be optimized. A country case study was conducted using qualitative methods, including: semi-structured interviews, direct observation, and archival review. Semi-structured interviews were held with key informants selected to reach a broad range of stakeholders including policymakers, program managers, service providers, representatives of donor agencies and their implementing partners; the WHO country office in Nigeria; independent consultants; and civil society organizations involved in HIV work. The fieldwork was conducted between June and August 2013. HIV GHIs have had a mixed impact on the health system. They have enhanced availability of and access to HIV services, improved quality of services, and strengthened health information systems and the role of non-state actors in health care. On the negative end, HIV donor funding has increased dependency on foreign aid, widened disparities in access to HIV services, done little to address the sustainability of the services, crowded out non-HIV health services, and led to the development of a parallel supply management system. They have also not invested significantly in the production of new health workers and have not addressed maldistribution problems, but have rather contributed to internal brain drain by luring health workers from the public sector to non-governmental organizations and have increased workload for existing health workers. There is poor policy direction

Logistics Performance of Actors in the Wine Supply Chain

OpenAIRE

Chandes , Jerôme; Estampe , Dominique

2003-01-01

International audience; In an environment marked by ever-greater international competition, wine sector companies have been seriously questioning the structure of their entire logistics chain. This is due to the emergence of new actors (i.e., large retailers); the diversification of service providers' product offers; and the different rapprochements between actors in this branch. These are all signals that have caused companies to question their logistics strategies as shown in the ISLI survey.

The European Union as a Comprehensive Police Actor

Directory of Open Access Journals (Sweden)

Stephen Anthony Rozée

2011-12-01

Full Text Available The European Union (EU has responded to changing security threats by seeking to increase cooperation between the law enforcement agencies of the Member States, granting further powers to Europol and other intelligence-sharing institutions, and by undertaking police missions beyond EU borders. The literature relating to EU policing is generally focused on the ‘internal’ and ‘external’ dimensions, or on specific aspects of police activity. This tendency to concentrate on narrow or isolated areas of policing has led to a significant gap regarding the broader analysis of the EU as a comprehensive police actor. Important questions about the nature of EU policing as a whole, as well as the contribution of policing activities to the EU’s security agenda, remain unexplored in the literature. This article aims to define what is meant by ‘comprehensive policing’ and to indentify criteria by which the comprehensiveness of EU-level policing may be measured. In addition to this, an integrated actorness/police comprehensiveness framework will be presented as a tool for assessing the EU as a comprehensive police actor.

Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

Science.gov (United States)

Nuti, Sabina

2017-01-01

Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

The psychosocial work environment and certified occupational health and safety management systems in the public sector – experience from two Danish municipalities

DEFF Research Database (Denmark)

Hasle, Peter; Hohnen, Pernille; Helbo, Anne

2014-01-01

Certified occupational health and safety management (OHSM) systems are expected to cover the psychosocial work environment. We studied certified OHSM systems implemented in two medium-sized to large Danish municipalities. The cases show that the process of adopting OHSM systems from...... their traditional base in manufacturing to a public sector with a focus on the psychosocial work environment is difficult and complex. The management system seems to help maintaining systematic OHS activities but the actors are still searching for ways to fit the systems to the peculiarities of the psychosocial...

Technology, conflict early warning systems, public health, and human rights.

Science.gov (United States)

Pham, Phuong N; Vinck, Patrick

2012-12-15

Public health and conflict early warning are evolving rapidly in response to technology changes for the gathering, management, analysis and communication of data. It is expected that these changes will provide an unprecedented ability to monitor, detect, and respond to crises. One of the potentially most profound and lasting expected change affects the roles of the various actors in providing and sharing information and in responding to early warning. Communities and civil society actors have the opportunity to be empowered as a source of information, analysis, and response, while the role of traditional actors shifts toward supporting those communities and building resilience. However, by creating new roles, relationships, and responsibilities, technology changes raise major concerns and ethical challenges for practitioners, pressing the need for practical guidelines and actionable recommendations in line with existing ethical principles. Copyright © 2012 Pham and Vinck. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

[Policy analysis: study of public policy of environmental health in a metropolis of northeastern Brazil].

Science.gov (United States)

Lyra, Tereza Maciel; Araújo Júnior, José Luiz do Amaral Correa de

2014-09-01

The analysis of health policies has improved in Brazil despite a plethora of different methodological approaches. Based on the model developed by Walt and Gilson in 1994, the Environmental Health Program (EHP) of Recife as a policy based on the Health Promotion principles of the Unified Health System (SUS) and Agenda 21 was analyzed. An attempt was made to understand the context during the development and implementation of the EHP, the drafting process and which actors influenced the EHP agenda content and proposal. A qualitative case study was conducted, with semi-structured interviews with key actors. In terms of context, the findings include the influence of the municipal election, the socio-sanitary characteristics of Recife, the choice of the Secretary of Health and the management teams, acceptance by the technicians and the funding increase. In terms of the process, the acceptance of the managers must be stressed. Regarding the actors, the managers, sector technicians, non-sectorial actors with viability studies stood out. The content of the EHP coincided with the SUS and Health Promotion principles. Implementation was influenced by the dengue fever epidemic (2002), and cultural institutional factors that put pressure on the order of implementation of the planned actions.

[Health system sustainability from a network perspective: a proposal to optimize healthy habits and social support].

Science.gov (United States)

Marqués Sánchez, Pilar; Fernández Peña, Rosario; Cabrera León, Andrés; Muñoz Doyague, María F; Llopis Cañameras, Jaime; Arias Ramos, Natalia

2013-01-01

The search of new health management formulas focused to give wide services is one of the priorities of our present health policies. Those formulas examine the optimization of the links between the main actors involved in public health, ie, users, professionals, local socio-political and corporate agents. This paper is aimed to introduce the Social Network Analysis as a method for analyzing, measuring and interpreting those connections. The knowledge of people's relationships (what is called social networks) in the field of public health is becoming increasingly important at an international level. In fact, countries such as UK, Netherlands, Italy, Australia and U.S. are looking formulas to apply this knowledge to their health departments. With this work we show the utility of the ARS on topics related to sustainability of the health system, particularly those related with health habits and social support, topics included in the 2020 health strategies that underline the importance of the collaborative aspects in networks.

Health system challenges in organizing quality diabetes care for urban poor in South India.

Science.gov (United States)

Bhojani, Upendra; Devedasan, Narayanan; Mishra, Arima; De Henauw, Stefaan; Kolsteren, Patrick; Criel, Bart

2014-01-01

Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes and other chronic conditions.

Health system challenges in organizing quality diabetes care for urban poor in South India.

Directory of Open Access Journals (Sweden)

Upendra Bhojani

Full Text Available BACKGROUND: Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. METHODS: We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. RESULT: There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. CONCLUSIONS: Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes

Social movements and the construction of crisis actors

DEFF Research Database (Denmark)

Bourne, Angela; Chatzopoulou, Sevasti

2015-01-01

of social movements occurs when they collaborate with similar movements in other countries, claim a European identity, invoke Europe-wide solidarity, contest authorities beyond the state and ascribe responsibility for solving the crisis to European Union (EU). By targeting EU authorities, social movements......This article examines the Europeanization of social movements following the European sovereign debt crisis. It develops a theoretical framework to measure degrees of social movement Europeanization, incorporating targets, participants, and issue frame dimensions of mobilization. Europeanization...... may contribute to the construction of the EU as a crisis actor and through deliberative processes define the roles and identities of such actors....

The role of institutions as actors influencing Uganda’s cassava sector

Directory of Open Access Journals (Sweden)

Cedric Mutyaba

2016-04-01

Full Text Available We aim at mapping out a detailed framework that reveals the proportionate flow of cassava and its products along the value chain (VC. Furthermore, we aim at establishing the role of institutions and the linkages between institutions and other VC actors that influence the cassava VC in Uganda. We use both primary and secondary data obtained from four regions in Uganda. Results show that farmers, processors, transporters, traders, consumers and institutions are the major actors. There are four categories of institutions, viz, government, non-government, community based organisations and international agencies. Roles performed by institutions include: development and enforcement of policies, Research and Development (R&D, capacity building, and creation of market access linkages for cassava and its products. Findings reveal that there is no clear nexus and no coordination among farmers/producers, processors, traders, transporters and consumers. However, institutions are well coordinated and play various roles along the VC to influence the dynamics of actors. Policy-wise it is important to establish strong private-public partnerships to bridge the impaired linkages between the actors (farmers/producers, processors, traders, transporters, and consumers and institutions. Strong partnerships are envisaged to reduce the associated transaction costs amongst the actors.

Lone Actor Terrorist Attack Planning and Preparation : A Data-Driven Analysis

NARCIS (Netherlands)

Schuurman, B.W.; Bakker, E.; Gill, P.; Bouhana, N.

2017-01-01

This article provides an in-depth assessment of lone actor terrorists’ attack planning and preparation. A codebook of 198 variables related to different aspects of pre-attack behavior is applied to a sample of 55 lone actor terrorists. Data were drawn from open-source materials and complemented

Analysing Personal Characteristics of Lone-Actor Terrorists : Research Findings and Recommendations

NARCIS (Netherlands)

Roy, de van Zuijdewijn J.; Bakker, E.

2016-01-01

This Research Note presents the outcome of a project that looked at the personal characteristics of lone-actor terrorists. It is part of the larger Countering Lone-Actor Terrorism (CLAT) project. The project described here aimed to improve understanding of, and responses to, the phenomenon of

Not My Problem: Vicarious Conflict Adaptation with Human and Virtual Co-Actors

Directory of Open Access Journals (Sweden)

Michiel M. Spapé

2016-04-01

Full Text Available The Simon effect refers to an incompatibility between stimulus and response locations resulting in a conflict situation and, consequently, slower responses. Like other conflict effects, it is commonly reduced after repetitions, suggesting an executive control ability, which flexibly rewires cognitive processing and adapts to conflict. Interestingly, conflict is not necessarily individually defined: the Social Simon effect refers to a scenario where two people who share a task show a conflict effect where a single person does not. Recent studies showed these observations might converge into what could be called vicarious conflict adaptation, with evidence indicating that observing someone else’s conflict may subsequently reduce one’s own. While plausible, there is reason for doubt: both the social aspect of the Simon Effect, and the degree to which executive control accounts for the conflict adaptation effect, have become foci of debate in recent studies. Here, we present two experiments that were designed to test the social dimension of the effect by varying the social relationship between the actor and the co-actor. In Experiment 1, participants performed a conflict task with a virtual co-actor, while the actor-observer relationship was manipulated as a function of the similarity between response modalities. In Experiment 2, the same task was performed both with a virtual and with a human co-actor, while heart-rate measurements were taken to measure the impact of observed conflict on autonomous activity. While both experiments replicated the interpersonal conflict adaptation effects, neither showed evidence of the critical social dimension. We consider the findings as demonstrating that vicarious conflict adaptation does not rely on the social relationship between the actor and co-actor.

Towards Feature Selection in Actor-Critic Algorithms

National Research Council Canada - National Science Library

Rohanimanesh, Khashayar; Roy, Nicholas; Tedrake, Russ

2007-01-01

.... They demonstrate that two popular representations for value methods -- the barycentric interpolators and the graph Laplacian proto-value functions -- can be used to represent the actor so as to satisfy these conditions...

Development prospects of health and reform of the fiscal system in bosnia and herzegovina.

Science.gov (United States)

Salihbasic, Sehzada

2011-01-01

The functions of the health system, according to the key objectives and relationships within the sub-systems that are available to the policy makers and managers in the Health Care system in Bosnia and Herzegovina - B&H, have been elaborated in detail, with the analytical overview of relevant indicators, thus confirming the limitations of the health promotion in B&H. The ability to overcome the expressed problems is in the startup of process for structural adjustment of the health sector, reform of the health care system and its financing. The reform in health system implies fundamental changes that need to take place, in B&H, as a state in health policy and institutions in the health care system, in order to improve the functioning of health systems with the aim of ensuring better health of the population. Reform implies the existence of documents with clearly formulated health policy objectives, for which the state stands, and for which a consensus was reached on the national level with all key actors in the political structure: public promotion of the basic principles for carrying out the reform, its implementation within a reasonable time frame, the corresponding effects for providers and customer satisfaction, as well as improving health services' efficacy (i.e. micro and macro) and the quality of healthcare. In this article, we elaborated the criteria for the classification of health systems, whereby the scientifically-based and empirical analysis is conducted on the health system in B&H and elaborated the key levers of the system. Leveraged organizational arrangements relating to the economic and political environment, organization and management functions, in connection with the services of finance, funds, customers and service providers, from which it follows the framework of state legislation related to health policy and health institutions at the state level are responsible for finance, planning, the organization, payment, regulation and conduct. If we

Bombing Alone: Tracing the Motivations and Antecedent Behaviors of Lone-Actor Terrorists*,†,‡

Science.gov (United States)

Gill, Paul; Horgan, John; Deckert, Paige

2014-01-01

This article analyzes the sociodemographic network characteristics and antecedent behaviors of 119 lone-actor terrorists. This marks a departure from existing analyses by largely focusing upon behavioral aspects of each offender. This article also examines whether lone-actor terrorists differ based on their ideologies or network connectivity. The analysis leads to seven conclusions. There was no uniform profile identified. In the time leading up to most lone-actor terrorist events, other people generally knew about the offender’s grievance, extremist ideology, views, and/or intent to engage in violence. A wide range of activities and experiences preceded lone actors’ plots or events. Many but not all lone-actor terrorists were socially isolated. Lone-actor terrorists regularly engaged in a detectable and observable range of activities with a wider pressure group, social movement, or terrorist organization. Lone-actor terrorist events were rarely sudden and impulsive. There were distinguishable behavioral differences between subgroups. The implications for policy conclude this article. PMID:24313297

Biomass markets. Growth strategy and challenges for French actors

International Nuclear Information System (INIS)

2015-01-01

This study comprises three reports. The first one is an executive summary which focuses on the main aspects of the evolution of the activity in the biomass sector, and highlights factors of change and their strategic consequences. The second one proposes an overview of the situation of biomass French markets, analyses growth strategies adopted by actors of the biomass sector (development of new production capacities, international growth, development of strategies based on several energies, diversification of prospects, innovation and improvement of installation efficiency), and discusses the main strategic challenges on the medium term. The third report proposes a presentation of the context of French biomass markets (political, regulatory and energetic framework, energetic assessment and assessment of the waste-based sector, economic context, housing stock, and other contextual factors), a presentation of the biomass French market (data for 2005-2013, dynamics of three specific segments: solid biomass, renewable urban wastes, and biogas), and a description of the competitive landscape (economic structure, actors) and of the 15 main actors

Third Level of International Relations: Characteristics of Sub-State Actors

Directory of Open Access Journals (Sweden)

Sergey P. Arteev

2016-01-01

Full Text Available The article is in the genre of the review for textbook O. V. Plotnikova and O. Y. Dubrovina International relations of the regions States: characteristics and features (Moscow: Norma; INFRA-M, 2016. 192 p.. Textbook on international activities of sub-state/subnational actors in international relations. Under the sub-state/subnational actors refers to the regions of the States. The authors propose an along with interstate relations (first level and supranational organizations (second level to distinguish a third level of international relations - international relations of the regions in Federal and unitary States. The topic is very relevant due to the ongoing restructuring of the architecture of international relations and world politics. In addition, these processes lead to involvement in international relations new actors. The resulting configuration and the role of traditional players. In addition to long-term evolutionary processes, we should not forget about the position of Russia in the last few years. It is obvious that the current tensions around the Russian Federation may not be fully resolved with the old methods. At the same time, sub-state/ subnational actors as subjects of a combined nature, the role played by regions of the Russian Federation, able to combine harmoniously in its international activities as the techniques characteristic of the traditional actors - States and developments in the tools of non-traditional actors - international non-governmental and non-profit organizations etc. As a result of positive results can be achieved faster and at the interstate level. The review considers the subject and the relevance of the topic, presents the analysis of the content of the work. Marked strengths of the textbook, including those associated with the consideration of the diagonal ties and the political components in the international activities of the regions. In addition to the advantages, attention is paid to the analysis of

The Psychological Self as Actor, Agent, and Author.

Science.gov (United States)

McAdams, Dan P

2013-05-01

The psychological self may be construed as a reflexive arrangement of the subjective "I" and the constructed "Me," evolving and expanding over the human life course. The psychological self begins life as a social actor, construed in terms of performance traits and social roles. By the end of childhood, the self has become a motivated agent, too, as personal goals, motives, values, and envisioned projects for the future become central features of how the I conceives of the Me. A third layer of selfhood begins to form in the adolescent and emerging adulthood years, when the self as autobiographical author aims to construct a story of the Me, to provide adult life with broad purpose and a dynamic sense of temporal continuity. An integrative theory that envisions the psychological self as a developing I-Me configuration of actor, agent, and author helps to synthesize a wide range of conceptions and findings on the self from social, personality, cognitive, cultural, and developmental psychology and from sociology and other social sciences. The actor-agent-author framework also sheds new light on studies of self-regulation, self-esteem, self-continuity, and the relationship between self and culture. © The Author(s) 2013.

Who Needs What? Some Thoughts on the Possibility of Using Psychology in Actor Training.

Science.gov (United States)

Vulova, Marina

2001-01-01

Contends that the aim of professional actor training is to reveal and develop an actor's individuality. Proposes that the responsibility of drama teachers is to lead training in such away that students feel accepted, understood, and respected. Proposes that psychodrama is the most appropriate method for student and professional actors' personal…

Consensus and contention in the priority setting process: examining the health sector in Uganda.

Science.gov (United States)

Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

2015-06-01

Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Can "giving preference to my patients" be explained as a role related duty in public health care systems?

Science.gov (United States)

Holm, Søren

2011-03-01

Most of us have two strong intuitions (or sets of intuitions) in relation to fairness in health care systems that are funded by public money, whether through taxation or compulsory insurance. The first intuition is that such a system has to treat patients (and other users) fairly, equitably, impartially, justly and without discrimination. The second intuition is that doctors, nurses and other health care professionals are allowed to, and may even in some cases be obligated to give preference to the interests of their particular patients or clients over the interests of other patients or clients of the system. These two intuitions are in potential conflict. One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the 'right' to give their patients preferential treatment. And one of the possible side-effects of allowing individual health care professionals to give preference to 'their clients' is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to 'your' patients in certain circumstances.

Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore and Malaysia

Directory of Open Access Journals (Sweden)

Phua Kai Hong

2011-05-01

Full Text Available Abstract Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, drawing on the cases of Thailand, Singapore and Malaysia, three regional hubs for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growth of the medical tourist industry. This article calls for a universal definition of medical tourism and medical tourists to be enunciated, as well as concerted data collection efforts, to be undertaken prior to any meaningful empirical analysis of medical tourism's impact on health systems.

Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore and Malaysia

Science.gov (United States)

2011-01-01

Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, drawing on the cases of Thailand, Singapore and Malaysia, three regional hubs for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growth of the medical tourist industry. This article calls for a universal definition of medical tourism and medical tourists to be enunciated, as well as concerted data collection efforts, to be undertaken prior to any meaningful empirical analysis of medical tourism's impact on health systems. PMID:21539751

Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore and Malaysia.

Science.gov (United States)

Pocock, Nicola S; Phua, Kai Hong

2011-05-04

Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism's growth for health systems, drawing on the cases of Thailand, Singapore and Malaysia, three regional hubs for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growth of the medical tourist industry. This article calls for a universal definition of medical tourism and medical tourists to be enunciated, as well as concerted data collection efforts, to be undertaken prior to any meaningful empirical analysis of medical tourism's impact on health systems.

Multi-actor decision making using mixed reality technologies Urban projects and multi-actor collaboration

OpenAIRE

Basile,, Maria; Ozdirlik, Burcu; Terrin,, Jean-Jacques

2009-01-01

International audience; This paper is based on the results of an ongoing research project, IPCity, on the application of mixed reality technologies in urban environments. It questions the relevance of traditional language and communication medium such as drawings, perspectives and 3D models in the co-production of urban projects in multi-actor working environments. It then discusses the possible use of “mixed reality technologies” as alternative medium through five workshops organised within ...

La dimensión social del actor local en el talento territorial

Directory of Open Access Journals (Sweden)

Juan Carlos Delgado Barrios

2018-01-01

Full Text Available Esta investigación parte de la definición del actor local en los planteamientos expuestos por García (2007, Fernández (2008 y Arocena (2002. Los actores locales con su capacidad asociativa ligada a decisiones y acciones, a influencias de poder o de experticia para el desarrollo territorial. Este artículo estudia la dimensión social, -el capital social -, del actor local, dentro del talento territorial. Esta dimensión está vinculada con la exigencia a los actores locales involucrados en el desarrollo territorial de contar con altos niveles de organización social para la producción, participación social protagónica, auto dependencia, confianza en los sistemas e instituciones de la participación, capacidad de articulación con otros actores organizados o encomunidades, así como, con otros territorios y con redes territoriales del desarrollo. Metodológicamente es una investigación exploratoria, de análisis de un territorio como laboratorio vivencial a partir de un enfoque sistémico procesal, desde la metodología sistémica interpretativa, sustentada en referencias bibliográficas y electrónicas dando apoyo a las reflexiones y experiencias del autor sobre el tema abordado de manera inductiva y constructivista. Como resultado se presentan la conceptualización de la dimensión social del actor local y su rol en el desarrollo territorial a partir de un territorio referencial bajo investigación (Zona Sur del Lago de Maracaibo. Concluyendo con la identificación de tres escenarios de actuación del actor local dentro dela dimensión social del talento territorial.

Neuroimaging of the joint Simon effect with believed biological and non-biological co-actors.

Science.gov (United States)

Wen, Tanya; Hsieh, Shulan

2015-01-01

Performing a task alone or together with another agent can produce different outcomes. The current study used event-related functional magnetic resonance imaging (fMRI) to investigate the neural underpinnings when participants performed a Go/Nogo task alone or complementarily with another co-actor (unseen), whom was believed to be another human or a computer. During both complementary tasks, reaction time data suggested that participants integrated the potential action of their co-actor in their own action planning. Compared to the single-actor task, increased parietal and precentral activity during complementary tasks as shown in the fMRI data further suggested representation of the co-actor's response. The superior frontal gyrus of the medial prefrontal cortex was differentially activated in the human co-actor condition compared to the computer co-actor condition. The medial prefrontal cortex, involved thinking about the beliefs and intentions of other people, possibly reflects a social-cognitive aspect or self-other discrimination during the joint task when believing a biological co-actor is present. Our results suggest that action co-representation can occur even offline with any agent type given a priori information that they are co-acting; however, additional regions are recruited when participants believe they are task-sharing with another human.

Qualitative analysis of governance trends after health system reforms in Latin America: lessons from Mexico.

Science.gov (United States)

Arredondo, A; Orozco, E; Recaman, A L

2018-03-01

Health policies in Latin America are centered on the democratization of health. Since 2003, during the last generation of reforms, health systems in this region have promoted governance strategies for better agreements between governments, institutions, and civil society. In this context, we develop an evaluative research to identify trends and evidence of governance after health care reforms in six regions of Mexico. Evaluative research was developed with a retrospective design based on qualitative analysis. Primary data were obtained from 189 semi-structured interviews with purposively selected health care professionals and key informants. Secondary data were extracted from a selection of 95 official documents on results of the reform project at the national level, national health policies, and lines of action for good governance. Data processing and analysis were performed using ATLAS.ti and PolicyMaker. A list of main strengths and weaknesses is presented as evidence of health system governance. Accountability at the federal level remains prescriptive; in the regions, a system of accountability and transparency in the allocation of resources and in terms of health democratization strategies is still absent. Social protection and decentralization schemes are strategies that have allowed for improvements with a proactive role of users and civil society. Regarding challenges, there are still low levels of governance and difficulties in the effective conduct of programs and reform strategies together with a lack of precision in the rules and roles of the different actors of the health system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The influence of socio cultural dynamics on convergence communication of aquaculture agribusiness actors

Science.gov (United States)

Oktavia, Y.

2018-03-01

This research aims to: (1) Analyze the level of socio-cultural dynamics of agibusiness aquaculture actors. (2) Analyze the influence of socio-cultural dynamics on convergence communication of capacity development of aquaculture agribusiness actors.Data was collected by questionnaire and interview of group members on agribusiness. Data analyze was done by descriptive and inferential statistics with using SEM method. The result of descriptive statistics on 284 agribusiness members showed that: Socio-cultural dynamics of agibusiness aquaculture actors was in low category, as shown by lack of the role of customary institutions and quality of local leadership.The communication convergence is significantly and positively influenced by the communication behavior of agribusiness actors in access information.

Actors of the hydrogen sector in France; Les acteurs de l'hydrogene en France

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-01

This document proposes brief presentations (web site address, activities) of actors operating in the hydrogen sector in France. These actors are public actors who can be incentive or financing actors (ADEME, ANR) or research institutions (CNRS, CEA, university and engineering schools, IFP, INERIS, INRETS), private actors like industrial groups (Air Liquide, AREVA, GDF Suez, Total, PSA Peugeot Citroen, Renault, Saint-Gobain, SNECMA, ST Microelectronics, 3M, Veolia Environnement) or small companies (Alca Torda Applications, Axane, CETH2, Helion, MaHytec, N-GHY, PaxiTech, Sertronic, ULLIT). It also presents the HyPAC platform created by the AFH2 and ADEME), the AFH2 (the French Association for Hydrogen), and regional initiatives

Action learning for health system governance: the reward and challenge of co-production.

Science.gov (United States)

Lehmann, Uta; Gilson, Lucy

2015-10-01

Health policy and systems research (HPSR) is centrally concerned with people, their relationships and the actions and practices they can implement towards better health systems. These concerns suggest that HPS researchers must work in direct engagement with the practitioners and practice central to the inquiry, acknowledging their tacit knowledge and drawing it into generating new insights into health system functioning. Social science perspectives are of particular importance in this field because health policies and health systems are themselves social and political constructs. However, how can social science methodologies such as action research and narrative and appreciative enquiry enable such research, and how can methodologies from different disciplines be woven together to construct and make meaning of evidence for 'this' field? This article seeks to present 'methodological musings' on these points, to prompt wider discussion on the practice of HPSR. It draws on one long-term collaborative action learning research project being undertaken in Cape Town, South Africa. The District Innovation and Action Learning for Health System Development project is an action research partnership between two South African academic institutions and two health authorities focused, ultimately, on strengthening governance in primary health care.Drawing on this experience, the article considers three interrelated issues: The diversity and complexities of practitioner and research actors involved in co-producing HPSR; The nature of co-production and the importance of providing space to grapple across different systems of meaning;The character of evidence and data in co-production. There is much to be learnt from research traditions outside the health sector, but HPSR must work out its own practices--through collaboration and innovation among researchers and practitioners. In this article, we provide one set of experiences to prompt wider reflection and stimulate engagement on the

Fractal actors and infrastructures

DEFF Research Database (Denmark)

Bøge, Ask Risom

2011-01-01

-network-theory (ANT) into surveillance studies (Ball 2002, Adey 2004, Gad & Lauritsen 2009). In this paper, I further explore the potential of this connection by experimenting with Marilyn Strathern’s concept of the fractal (1991), which has been discussed in newer ANT literature (Law 2002; Law 2004; Jensen 2007). I...... under surveillance. Based on fieldwork conducted in 2008 and 2011 in relation to my Master’s thesis and PhD respectively, I illustrate fractal concepts by describing the acts, actors and infrastructure that make up the ‘DNA surveillance’ conducted by the Danish police....

MediCoordination: a practical approach to interoperability in the Swiss health system.

Science.gov (United States)

Müller, Henning; Schumacher, Michael; Godel, David; Omar, Abu Khaled; Mooser, Francois; Ding, Sandrine

2009-01-01

Interoperability and data exchange between partners in the health sector is seen as one of the important domains that can improve care processes and in the long run also decrease costs of the health care system. Data exchange can assure that the data on the patient are as complete as possible avoiding potential mistreatments, and it can avoid double examinations if the data required are already available. On the other hand, health data is a sensible point for many people and strong protection needs to be implemented to protect patient data against misuse as well as tools to let the patient manage his/her own data. Many countries have eHealth initiatives in preparation or already implemented. However, health data exchange on a large scale still has a fairly long way to go as the political processes for global solutions are often complicated. In the MediCoordination project a pragmatic approach is selected trying to integrate several partners in health care on a regional scale. In parallel with the Swiss eHealth strategy that is currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and external partners are targeted in MediCoordination to implement concrete added-value scenarios of information exchange between hospitals and external medical actors.

Actor-specific contributions to the deforestation slowdown in the Brazilian Amazon.

Science.gov (United States)

Godar, Javier; Gardner, Toby A; Tizado, E Jorge; Pacheco, Pablo

2014-10-28

Annual deforestation rates in the Brazilian Amazon fell by 77% between 2004 and 2011, yet have stabilized since 2009 at 5,000-7,000 km(2). We provide the first submunicipality assessment, to our knowledge, of actor-specific contributions to the deforestation slowdown by linking agricultural census and remote-sensing data on deforestation and forest degradation. Almost half (36,158 km(2)) of the deforestation between 2004 and 2011 occurred in areas dominated by larger properties (>500 ha), whereas only 12% (9,720 km(2)) occurred in areas dominated by smallholder properties (deforestation rates fell during this period by 68-85% for all actors, the contribution of the largest landholders (>2,500 ha) to annual deforestation decreased over time (63% decrease between 2005 and 2011), whereas that of smallholders went up by a similar amount (69%) during the same period. In addition, the deforestation share attributable to remote areas increased by 88% between 2009 and 2011. These observations are consistent across the Brazilian Amazon, regardless of geographical differences in actor dominance or socioenvironmental context. Our findings suggest that deforestation policies to date, which have been particularly focused on command and control measures on larger properties in deforestation hotspots, may be increasingly limited in their effectiveness and fail to address all actors equally. Further reductions in deforestation are likely to be increasingly costly and require actor-tailored approaches, including better monitoring to detect small-scale deforestation and a shift toward more incentive-based conservation policies.

Characteristics of pornography film actors: self-report versus perceptions of college students.

Science.gov (United States)

Griffith, James D; Hayworth, Michelle; Adams, Lea T; Mitchell, Sharon; Hart, Christian

2013-05-01

The assumed characteristics of individuals in the adult entertainment industry have been used to advocate positions for and against pornography. Although prior studies have investigated perceptions of porn actors, no data on the actual characteristics of this group exist. The present study compared the self-reports of 105 male and 177 female porn actors to the perceptions of 399 college students on childhood sexual abuse (CSA), self-esteem, work and non-work sexual behaviors, and safe sex issues. College students were asked to identify the characteristics associated with either a male or female porn star. College students provided underestimates for both female and male porn actors on self-esteem, age of first intercourse, lifetime number of partners outside of work, ideal experience in a romantic partner, concerns regarding sexually transmitted diseases (STDs), enjoyment of sex, and condom use during a first time sexual encounter, but overestimated earnings. Additional differences among male porn stars included an underestimate of the number of partners at work. For female porn stars, college students underestimated their enjoyment of work, the probability of catching an STD, and having unprotected sex. Although there were no significant differences on perceived rates of childhood abuse of porn actors, the incidence of CSA among the porn actor participants were within the ranges of the general population. The majority of college student stereotypes were not supported regarding the perceptions of porn actors. These findings were discussed within the context of attributing unfounded characteristics of individuals to an entire industry.

Pesticide use in banana and plantain production and risk perception among local actors in Talamanca, Costa Rica

Energy Technology Data Exchange (ETDEWEB)

Barraza, Douglas, E-mail: dbarraza@una.ac.cr [Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia (Costa Rica); Technology and Agrarian Development Group, Wageningen University (Netherlands); Jansen, Kees [Technology and Agrarian Development Group, Wageningen University (Netherlands); Wendel de Joode, Berna van; Wesseling, Catharina [Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia (Costa Rica)

2011-07-15

The Talamanca County in Costa Rica has large-scale banana and small-scale plantain production, probably causing pesticide exposure in indigenous children. We explored to what extent different community actors are aware of children's pesticide hazards and how their awareness related to socio-economical and cultural conditions. Methods comprised eight focus groups with fathers and mothers separately, 27 semi-structured interviews to key actors, and field observations. As a whole, the indigenous plantain farmers and banana plantation workers had some general knowledge of pesticides concerning crop protection, but little on acute health effects, and hardly any on exposure routes and pathways, and chronic effects. People expressed vague ideas about pesticide risks. Inter-community differences were related to pesticide technologies used in banana and plantain production, employment status on a multinational plantation versus smallholder status, and gender. Compared to formalized practices on transnational company plantations, where workers reported to feel protected, pesticide handling by plantain smallholders was not perceived as hazardous and therefore no safety precautions were applied. Large-scale monoculture was perceived as one of the most important problems leading to pesticide risks in Talamanca on banana plantations, and also on neighboring small plantain farms extending into large areas. Plantain farmers have adopted use of highly toxic pesticides following banana production, but in conditions of extreme poverty. Aerial spraying in banana plantations was considered by most social actors a major determinant of exposure for the population living nearby these plantations, including vulnerable children. We observed violations of legally established aerial spraying distances. Economic considerations were most mentioned as the underlying reason for the pesticide use: economic needs to obtain the production quantity and quality, and pressure to use pesticides by

Pesticide use in banana and plantain production and risk perception among local actors in Talamanca, Costa Rica

International Nuclear Information System (INIS)

Barraza, Douglas; Jansen, Kees; Wendel de Joode, Berna van; Wesseling, Catharina

2011-01-01

The Talamanca County in Costa Rica has large-scale banana and small-scale plantain production, probably causing pesticide exposure in indigenous children. We explored to what extent different community actors are aware of children's pesticide hazards and how their awareness related to socio-economical and cultural conditions. Methods comprised eight focus groups with fathers and mothers separately, 27 semi-structured interviews to key actors, and field observations. As a whole, the indigenous plantain farmers and banana plantation workers had some general knowledge of pesticides concerning crop protection, but little on acute health effects, and hardly any on exposure routes and pathways, and chronic effects. People expressed vague ideas about pesticide risks. Inter-community differences were related to pesticide technologies used in banana and plantain production, employment status on a multinational plantation versus smallholder status, and gender. Compared to formalized practices on transnational company plantations, where workers reported to feel protected, pesticide handling by plantain smallholders was not perceived as hazardous and therefore no safety precautions were applied. Large-scale monoculture was perceived as one of the most important problems leading to pesticide risks in Talamanca on banana plantations, and also on neighboring small plantain farms extending into large areas. Plantain farmers have adopted use of highly toxic pesticides following banana production, but in conditions of extreme poverty. Aerial spraying in banana plantations was considered by most social actors a major determinant of exposure for the population living nearby these plantations, including vulnerable children. We observed violations of legally established aerial spraying distances. Economic considerations were most mentioned as the underlying reason for the pesticide use: economic needs to obtain the production quantity and quality, and pressure to use pesticides by other

[The 2010 earthquake in Chile: the response of the health system and international cooperation].

Science.gov (United States)

López Tagle, Elizabeth; Santana Nazarit, Paula

2011-08-01

Understand the health system and international cooperation response to the catastrophic situation left by the earthquake and tsunami of 27 February 2010 in Chile, and draft proposals for improving strategies to mitigate the devastating effects of natural disasters. Descriptive and qualitative study with a first phase involving the analysis of secondary information-such as news articles, official statements, and technical reports-and a second phase involving semistructured interviews of institutional actors in the public health sector responsible for disaster response and users of the health system who acted as leaders and/or managers of the response. The study was conducted between May and October 2010, and information-gathering focused on the Maule, Bío Bío, and Metropolitan regions. Procedures for recording, distributing, and controlling donations were lacking. The health services suffered significant damage, including the complete destruction of 10 hospitals. The presence of field hospitals and foreign medical teams were appreciated by the community. The family health model and the commitment of personnel helped to ensure the quality of the response. While public health management was generally good, problems dealing with mental health issues were encountered due to a lack of local plans and predisaster simulations. The poor were the most affected. Women became social leaders, organizing the community. Although the health response to the emergency was satisfactory, both the health system and the mobilization of international assistance suffered from weaknesses that exacerbated existing inequities, revealing the need for multisectoral participatory mitigation plans for better disaster preparedness.

The legislative actor in the Nobel era: Quo Vadis EU?

Directory of Open Access Journals (Sweden)

Ana Isabel Xavier

2013-05-01

Full Text Available The idea of a political union, as well as an economic union of Europe, beyond free circulation of persons, goods and services, has always been included in the ideals of the building of Europe. However, its de jure formalization only occurs on November 1, 1993, when the Treaty of Maastricht is in force and a new political and strategic actor is in place: the European Union (EU. Since then, literature has "defined" the European Union in order to clearly establish what this UPO - Unidentified Political Object (an expression by Jacques Delors in the 1990s - is or what it can be. One of the ideas which has been a focus of discussion is that of "legislative actor" (Manners, 2001; 2002, which claims that the European Union has progressed towards normativity, both internally as well as externally, to its close neighbors and its relations with the rest of the world. This paper aims to contribute to the discussion on Europe's quality or condition to impose rules. We will begin by systematizing a series of achievements which, according to Manners, lead to the triangle democracy, Human Rights and good governance in the signing of the Treaty of Lisbon on December 13, 2007 and its entering in full force on December 1, 2009. However, this paper does not disregard the fact that the concept "legislative actor" has been (reworked and perfected by its author and other scholars due to criticism and empirical studies and has thus been altered, enhanced and argued against. Therefore, some concepts will be studied whose arguments will allow us to question the internal and external dimension of the actor European Union. We will also explore the symbolic power of the Union in the development of tools and capacity to be acknowledged as an actor able to face current threats and challenges but whose profile may not be different from other actors in international relations. Finally, we will discuss the impact of the EU having been awarded the Nobel Peace Prize in 2012 on

Political actors playing games: Theory and experiments

NARCIS (Netherlands)

Kamm, A.

2015-01-01

Political actors exert enormous influence over our daily lives. Their influence on economic activities cannot be underestimated. Voters determine the distribution of political power, political candidates choose policy platforms that they intend to enact if elected, and legislators bargain to arrive

Static Safety for an Actor Dedicated Process Calculus by Abstract Interpretation

OpenAIRE

Garoche, Pierre-Loïc; Pantel, Marc; Thirioux, Xavier

2006-01-01

International audience; The actor model eases the definition of concurrent programs with non uniform behaviors. Static analysis of such a model was previously done in a data-flow oriented way, with type systems. This approach was based on constraint set resolution and was not able to deal with precise properties for communications of behaviors. We present here a new approach, control-flow oriented, based on the abstract interpretation framework, able to deal with communication of behaviors. W...

Full House: A Retrospective Analysis of High Sexually Transmitted Infection Prevalence among Adult Film Actors at a Singular Residence.

Science.gov (United States)

Kendrick, Katherine; Brown, Veronica; Lords, Caleb; Matthias, James; Henning, Ian; Blackmore, Carina; Likos, Anna

2016-09-01

During a routine human immunodeficiency virus (HIV) investigation, Florida Department of Health staff identified a house (house A) in which over 150 individuals had resided at least briefly. Further investigation revealed that house A is used by the producer of a small adult film production company to board his actors. This report describes sexually transmitted infection (STI) prevalence among male actors in gay adult films residing in a common Florida residence. LexisNexis Accurint was used to identify house A residents since October 2002 when the producer arrived. Information on STIs and interview data were obtained from Florida's STI surveillance system. An infection was considered to be associated with residence in house A if the date of diagnosis occurred 6 months before an individual's residence start date through 6 months after his residence end date. Excluding the producer, 150 men resided in house A starting from September 2003 to July 2015. Forty-six individuals had a reported case of HIV, syphilis, gonorrhea, and/or chlamydia with 92 infections total. Forty-two (46%) infections among 24 men were considered associated with residence in house A. LexisNexis Accurint was a useful tool for identifying house A residents, a highly mobile and highly sexually active population. There is a high prevalence of STIs among residents, but it is unclear where transmission is occurring. Settings like house A are good candidates for HIV pre-exposure prophylaxis and active STI screenings and may be an opportunity for public health officials to intervene in high-risk groups to reduce STI rates in the community.

Innovation barriers originating from the differing logics of network actors:

DEFF Research Database (Denmark)

Aarikka-Stenroos, Leena; Alaranta, Mar

2016-01-01

The recent IMP and innovation network research has highlighted that diverse aspects of actors' heterogeneity such as differing goals, knowledge bases, capabilities and competences, perceptions, power, position, and culture play a role in the development of collaborative innovation....../organization, inter-organizational and ecosystem levels. Our results advance knowledge on the diversity of barriers in collaborative innovation and commercializing science and how they relate to the different actors: a body of knowledge that is increasingly discussed among IMP stream....

Ecological Nutrition: Redefining Healthy Food in Health Care

OpenAIRE

Klein, Kendra C.

2013-01-01

Within what can be called the healthy food in health care (HFHC) movement, a growing coalition of actors are leveraging scientific data on the environmental health impacts of the conventional, industrial food system to inspire and legitimize a range of health care initiatives aligned with alternative agrifood ideals. They are shifting the definition of food-related health from a nutritionism model, eating the right balance of nutrients and food groups, to what I call an ecological nutrition ...

Conceptual Models for Ecosystem Management through the Participation of Local Social Actors: the Río Cruces Wetland Conflict

Directory of Open Access Journals (Sweden)

Luisa E. Delgado

2009-06-01

Full Text Available In 2004, the emigration and death of black-necked swans (Cygnus melancoryphus from the Río Cruces wetland (Valdivia, Chile triggered one of the largest ecosocial conflicts in Chilean history. The main local social actors of this still unsolved conflict are the Chilean government, a pulp-mill company, and a local nongovernmental organization. The central issues of the conflict are disagreement over the reason for the swans' migration, the need to restore the black-necked swan population in the wetland, and the relationship between economic development and wetland conservation. We applied a physical, ecological, and social system approach to generate conceptual or qualitative ecosystem models representing the perceptions of all social actors. Our results showed that each actor group perceived the ecosystem in a different and, in some cases, divergent way. Furthermore, all of them carried only partial representations of the wetland and the conflict. We linked all the models to generate an integrated view of the Río Cruces wetland ecosystem. We propose that this approach can be replicated as a tool for generating synthetic, integrated conceptual models of ecosystems, even in the presence of strong divergence and a lack of consensus among social actors.

Competing actors in the climate change arena in Mexico: A network analysis.

Science.gov (United States)

Ortega Díaz, Araceli; Gutiérrez, Erika Casamadrid

2018-06-01

This paper analyzes the actors in the climate change arena and their influence in directing Mexico toward policies that decrease greenhouse gas emissions, such as the carbon tax and climate change law. The network analysis of the agreement of these laws and public policies in Mexico is a lesson for any country that is in the process of designing and adopting environmental laws. The research is performed using a network analysis that is derived from interviews with various main actors and a discourse analysis of the media. Results show that actors do not coordinate their efforts-they meet frequently but in different inter-ministerial commissions-and do not enforce the same policies. The actors in the industry have formed strong coalitions against the carbon tax and the General Law on Climate Change, whereas international institutions have formed coalitions that support these policies and laws. Copyright © 2018 Elsevier Ltd. All rights reserved.

Sistema de salud de Cuba The health system of Cuba

Directory of Open Access Journals (Sweden)

Emma Domínguez-Alonso

2011-01-01

Full Text Available En este trabajo se describen las condiciones de salud de Cuba y el sistema cubano de salud, incluyendo su estructura y cobertura, sus fuentes de financiamiento, su gasto en salud, los recursos físicos, materiales y humanos de los que dispone, y las actividades de rectoría e investigación que desarrolla. También se discute la importancia de sus instituciones de investigación y se describe el papel de los usuarios de los servicios en la operación y evaluación del sistema, así como las actividades que en este sentido desarrollan la Federación de Mujeres Cubanas y los Comités de Defensa de la Revolución. La parte final de este trabajo se dedica a discutir las innovaciones más recientes dentro de las que destacan las redes de cardiología, la Misión Milagro y la Batalla de Ideas.This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro and the Battle of Ideas (Batalla de Ideas.

Examining the use of health systems and policy research in the health policymaking process in Israel: views of researchers.

Science.gov (United States)

Ellen, Moriah E; Lavis, John N; Shemer, Joshua

2016-09-01

All too often, health policy and management decisions are made without making use of or consulting with the best available research evidence, which can lead to ineffective and inefficient health systems. One of the main actors that can ensure the use of evidence to inform policymaking is researchers. The objective of this study is to explore Israeli health systems and policy researchers' views and perceptions regarding the role of health systems and policy research (HSPR) in health policymaking and the barriers and facilitators to the use of evidence in the policymaking process. A survey of researchers who have conducted HSPR in Israel was developed. The survey consisted of a demographics section and closed questions, which focused on support both within the researchers' organisations and the broader environment for KTE activities, perceptions on the policymaking process, and the potential influencing factors on the process. The survey was sent to all health systems and policy researchers in Israel from academic institutions, hospital settings, government agencies, the four health insurance funds, and research institutes (n = 107). All responses were analyzed using descriptive statistics. For close-ended questions about level of agreement we combined together the two highest categories (agree or strongly agree) for analysis. Thirty-seven respondents participated in the survey. While many respondents felt that the use of HSPR may help raise awareness on policy issues, the majority of respondents felt that the actual use of HSPR was hindered for many reasons. While facilitators do exist to support the use of research evidence in policymaking, numerous barriers hinder the process such as challenges in government/provider relations, policymakers lacking the expertise for acquiring, assessing, and applying HSPR and priorities in the health system drawing attention away from HSPR. Furthermore, it is perceived by a majority of respondents that the health insurance funds

Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

DEFF Research Database (Denmark)

Andersen, Anne Bendix; Frederiksen, Kirsten; Kolbæk, Raymond

2017-01-01

of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order...... policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three......-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises...

Examining actors into boosting the provision of universal service in the Vietnamese context

DEFF Research Database (Denmark)

Do Manh, Thai; Williams, Idongesit

2017-01-01

are very important in formulating and implementing universal service policy. Originality/value - There have been a few studies applying actor network theory in analysing the formulation of policy, especially in universal service. The paper wants to close this gap.......Purpose - The paper looks at the formulation of the BMGF-VN project to examine which actors participated in the formulation of this project, how their interests were translated into this project, and what lessons may be drawn for the formulation and implementation of universal service policy...... in Vietnam in general. Design/methodology/approach - The paper recruits the actor network theory and qualitative analysis to analyse the BMGF-VN project. Findings - the involvement of non-government actors in formulating and implementing the project, the focus not only on the supply side but also demand side...

Exploring the influence of the Global Fund and the GAVI Alliance on health systems in conflict-affected countries.

Science.gov (United States)

Patel, Preeti; Cummings, Rachael; Roberts, Bayard

2015-01-01

Global Health Initiatives (GHIs) respond to high-impact communicable diseases in resource-poor countries, including health systems support, and are major actors in global health. GHIs could play an important role in countries affected by armed conflict given these countries commonly have weak health systems and a high burden of communicable disease. The aim of this study is to explore the influence of two leading GHIs, the Global Fund and the GAVI Alliance, on the health systems of conflict-affected countries. This study used an analytical review approach to identify evidence on the role of the Global Fund and the GAVI Alliance with regards to health systems support to 19 conflict-affected countries. Primary and secondary published and grey literature were used, including country evaluations from the Global Fund and the GAVI Alliance. The WHO heath systems building blocks framework was used for the analysis. There is a limited evidence-base on the influence of GHIs on health systems of conflict-affected countries. The findings suggest that GHIs are increasingly investing in conflict-affected countries which has helped to rapidly scale up health services, strengthen human resources, improve procurement, and develop guidelines and protocols. Negative influences include distorting priorities within the health system, inequitable financing of disease-specific services over other health services, diverting staff away from more essential health care services, inadequate attention to capacity building, burdensome reporting requirements, and limited flexibility and responsiveness to the contextual challenges of conflict-affected countries. There is some evidence of increasing engagement of the Global Fund and the GAVI Alliance with health systems in conflict-affected countries, but this engagement should be supported by more context-specific policies and approaches.

Corporate actors in Western European television news

NARCIS (Netherlands)

Verhoeven, P.

2009-01-01

News about corporations can be understood as an interdependent relationship among the public relations function, organizational logic and the logic of the media. This research addresses the visibility and role of corporate actors in Western European public television news. A quantitative content

Reforma sanitaria, equidad y derecho a la salud en Colombia Health reform, equity, and the right to health in Colombia

Directory of Open Access Journals (Sweden)

Mario Hernández

2002-08-01

Full Text Available Se presenta una visión de largo plazo para la valoración de los avances en la equidad y en el derecho a la salud de la reforma del sistema de salud en Colombia. En medio de un sistema político restringido, los actores del campo de la salud en Colombia han construido opciones de tipo individualista que tienden a legalizar las desigualdades ligadas a la capacidad de pago de las personas. A pesar de los complejos mecanismos de regulación establecidos en el nuevo Sistema General de Seguridad Social en Salud, la tendencia apunta hacia una consolidación de las mismas desigualdades tradicionales y al distanciamiento de una garantía plena, equitativa y universal del derecho a la salud.The author develops a long-term perspective to assess advances in equity and the right to health in the Colombian health system reform. In a restricted political system, actors in the field of health in Colombia have chosen individualistic alternatives to legalize inequities in individual purchasing power for services. Despite the complex regulations established in the General System for Social Security in Health, there is a trend towards consolidating traditional inequities and to further restrict opportunities for achieving the right to health with full, equitable, universal guarantees.

The effects of beliefs about AIDS-related death on quality of life in Chinese married couples with both husband and wife infected with HIV: examining congruence using the actor-partner interdependence model.

Science.gov (United States)

Yu, Nancy Xiaonan

2017-06-17

This cross-sectional study examined the actor and partner effects of beliefs about AIDS-related death on quality of life in Chinese married couples in which both were living with HIV. A total of 49 married couples in central China who were both infected with HIV completed measures to assess their beliefs about AIDS-related death and quality of life. In the actor-partner interdependence model, the husband-wife dyad showed congruence in their beliefs about AIDS-related death (r = .40) and quality of life-mental health summary (r = .31), respectively, within the couple. Both actor and partner effects of beliefs about AIDS-related death on the quality of life-mental health summary, rather than the quality of life-physical health summary, were significant within the husband-wife dyad. Our findings indicate the dyadic interdependence of beliefs about AIDS-related death and the quality of life-mental health summary in married couples. Psychosocial interventions that target a reduction of negative death beliefs and enhancement of well-being in the context of HIV should treat the couple as a unit.

Thinking about complexity in health: A systematic review of the key systems thinking and complexity ideas in health.

Science.gov (United States)

Rusoja, Evan; Haynie, Deson; Sievers, Jessica; Mustafee, Navonil; Nelson, Fred; Reynolds, Martin; Sarriot, Eric; Swanson, Robert Chad; Williams, Bob

2018-01-30

As the Sustainable Development Goals are rolled out worldwide, development leaders will be looking to the experiences of the past to improve implementation in the future. Systems thinking and complexity science (ST/CS) propose that health and the health system are composed of dynamic actors constantly evolving in response to each other and their context. While offering practical guidance for steering the next development agenda, there is no consensus as to how these important ideas are discussed in relation to health. This systematic review sought to identify and describe some of the key terms, concepts, and methods in recent ST/CS literature. Using the search terms "systems thinkin * AND health OR complexity theor* AND health OR complex adaptive system* AND health," we identified 516 relevant full texts out of 3982 titles across the search period (2002-2015). The peak number of articles were published in 2014 (83) with journals specifically focused on medicine/healthcare (265) and particularly the Journal of Evaluation in Clinical Practice (37) representing the largest number by volume. Dynamic/dynamical systems (n = 332), emergence (n = 294), complex adaptive system(s) (n = 270), and interdependent/interconnected (n = 263) were the most common terms with systems dynamic modelling (58) and agent-based modelling (43) as the most common methods. The review offered several important conclusions. First, while there was no core ST/CS "canon," certain terms appeared frequently across the reviewed texts. Second, even as these ideas are gaining traction in academic and practitioner communities, most are concentrated in a few journals. Finally, articles on ST/CS remain largely theoretical illustrating the need for further study and practical application. Given the challenge posed by the next phase of development, gaining a better understanding of ST/CS ideas and their use may lead to improvements in the implementation and practice of the Sustainable Development

A systemic integrative framework to describe comprehensively a swine health system, Flanders as an example.

Science.gov (United States)

Rojo-Gimeno, Cristina; Dewulf, Jeroen; Maes, Dominiek; Wauters, Erwin

2018-06-01

A well-functioning swine health system is crucial to ensure a sustainable pig production. Yet, little attention has been paid to understand it. The objective of this study was to unravel the complexity of a swine health system by using a systems-thinking approach for the case of Flanders (Northern part of Belgium). To that end, qualitative interviews were held with 33 relevant stakeholders. A hybrid thematic analysis was conducted which consisted of two phases. First, an inductive thematic analysis was conducted and second, the resulting themes were classified into the building blocks of a systemic framework. This framework combined a structural and a functional analysis that allowed to identify the key actors and their functions. Additionally, a transformational analysis was performed to evaluate how structures and the entire swine health system enable or disable functions. Findings revealed that the Flemish swine health system presents several merits such as the synchronization of policies and sector's agreements to reduce the antimicrobial use in the pig sector and the presence of a rich network of universities and research institutes that contribute to the education of health professionals. Nevertheless, several systemic failures were observed at different levels such as the lack of a good professional body representing the swine veterinarians, the tradition that veterinary advice is provided for 'free' by feed mill companies, and the shortage of reliable farm productivity data. Both latter failures may hinder swine practitioners to provide integrative advice. While few veterinarians are remunerated per hour or per visit by farmers, the most common business model used by veterinarians is largely based on the sale of medicines. Thus, veterinarians encounter often a conflict of interest when advising on preventive vaccinations and, in turn, farmers distrust their advice. On a positive note, alternatives to the traditional business model were suggested by both

Stochastic actor-oriented models for network change

NARCIS (Netherlands)

Snijders, T.A.B.

1996-01-01

A class of models is proposed for longitudinal network data. These models are along the lines of methodological individualism: actors use heuristics to try to achieve their individual goals, subject to constraints. The current network structure is among these constraints. The models are continuous

An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

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Chan Brian T

2011-10-01

Full Text Available Abstract Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv effective strategies for HIV/AIDS care in other settings should be

Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

Science.gov (United States)

Hallo De Wolf, Antenor; Toebes, Brigit

2016-12-01

The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

Agente Comunitário de Saúde: um novo ator no cenário da saúde do Brasil Community Health Agent: a new actor in the Brazilian health scenario

Directory of Open Access Journals (Sweden)

Andréa Sabino Filgueiras

2011-01-01

Full Text Available O Programa de Agentes Comunitários de Saúde (PACS foi introduzido no Brasil em 1991 como uma tática para o desenvolvimento de atividades relacionadas à prevenção de doenças e educação em saúde. Em 1994, o Ministério da Saúde propôs o Programa de Saúde da Família (PSF como estratégia de reestruturação da atenção à saúde. Essas propostas introduzem, no cenário da saúde, um novo ator, o Agente Comunitário de Saúde (ACS, desempenhando importante papel na atenção básica, ao agir como um elo entre famílias, usuários e serviço de saúde. O estudo toma como objeto o trabalho desenvolvido pelos ACS em uma unidade do PSF do município de Volta Redonda-RJ. Tem como objetivo discutir os aspectos facilitadores e limitantes das atividades designadas aos ACS. Trata-se de uma pesquisa do tipo descritiva, com abordagem qualitativa. A análise de dados se deu por categorias analíticas, que emergiram a partir dos dados encontrados nas entrevistas. Após a apreciação dos dados, pôde-se constatar que os ACS do PSF de Volta Redonda ainda não recebem formação destinada à execução de suas atividades e que consideram a experiência prática como o principal motor para o desempenho delas. O trabalho em equipe é reconhecido como espaço de circulação de saberes científicos e o saber popular como mediador entre a equipe e a população. Os ACS têm como eixo de trabalho a visita domiciliar, focada principalmente na doença.The Community Health Agents Program (PACS was created in 1991 as a strategy to implement the SUS, developing activities related to prevention and health education. In 1994, the Health Ministry proposed the Family Health Program (PSF as a strategy for restructuring the dominant care model. With the emergence of these two programs, there is the emergence of a new actor in the health scenario, the Community Health Agent (ACS. This actor plays an important role in basic care, acting as a link between families

Neuroimaging of the joint Simon effect with believed biological and non-biological co-actors

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Tanya eWen

2015-09-01

Full Text Available Performing a task alone or together with another agent can produce different outcomes. The current study used event-related functional magnetic resonance imaging (fMRI to investigate the neural underpinnings when participants performed a Go/Nogo task alone or complementarily with another co-actor (unseen, whom was believed to be another human or a computer. During both complementary tasks, reaction time data suggested that participants integrated the potential action of their co-actor in their own action planning. Compared to the single-actor task, increased parietal and precentral activity during complementary tasks as shown in the fMRI data further suggested representation of the co-actor’s response. The superior frontal gyrus of the medial prefrontal cortex was differentially activated in the human co-actor condition compared to the computer co-actor condition. The medial prefrontal cortex, involved thinking about the beliefs and intentions of other people, possibly reflects a social-cognitive aspect or self-other discrimination during the joint task when believing a biological co-actor is present. Our results suggest that action co-representation can occur even offline with any agent type given a priori information that they are co-acting; however additional regions are recruited when participants believe they are task-sharing with another human.

Neuroimaging of the joint Simon effect with believed biological and non-biological co-actors

Science.gov (United States)

Wen, Tanya; Hsieh, Shulan

2015-01-01

Performing a task alone or together with another agent can produce different outcomes. The current study used event-related functional magnetic resonance imaging (fMRI) to investigate the neural underpinnings when participants performed a Go/Nogo task alone or complementarily with another co-actor (unseen), whom was believed to be another human or a computer. During both complementary tasks, reaction time data suggested that participants integrated the potential action of their co-actor in their own action planning. Compared to the single-actor task, increased parietal and precentral activity during complementary tasks as shown in the fMRI data further suggested representation of the co-actor’s response. The superior frontal gyrus of the medial prefrontal cortex was differentially activated in the human co-actor condition compared to the computer co-actor condition. The medial prefrontal cortex, involved thinking about the beliefs and intentions of other people, possibly reflects a social-cognitive aspect or self-other discrimination during the joint task when believing a biological co-actor is present. Our results suggest that action co-representation can occur even offline with any agent type given a priori information that they are co-acting; however, additional regions are recruited when participants believe they are task-sharing with another human. PMID:26388760

Effect of Acting Experience on Emotion Expression and Recognition in Voice: Non-Actors Provide Better Stimuli than Expected.

Science.gov (United States)

Jürgens, Rebecca; Grass, Annika; Drolet, Matthis; Fischer, Julia

Both in the performative arts and in emotion research, professional actors are assumed to be capable of delivering emotions comparable to spontaneous emotional expressions. This study examines the effects of acting training on vocal emotion depiction and recognition. We predicted that professional actors express emotions in a more realistic fashion than non-professional actors. However, professional acting training may lead to a particular speech pattern; this might account for vocal expressions by actors that are less comparable to authentic samples than the ones by non-professional actors. We compared 80 emotional speech tokens from radio interviews with 80 re-enactments by professional and inexperienced actors, respectively. We analyzed recognition accuracies for emotion and authenticity ratings and compared the acoustic structure of the speech tokens. Both play-acted conditions yielded similar recognition accuracies and possessed more variable pitch contours than the spontaneous recordings. However, professional actors exhibited signs of different articulation patterns compared to non-trained speakers. Our results indicate that for emotion research, emotional expressions by professional actors are not better suited than those from non-actors.

African Initiated Churches’ potential as development actors

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Philipp Öhlmann

2016-11-01

Full Text Available African Initiated Churches (AICs are not yet recognised as relevant actors of community development interventions. While it has been acknowledged that many of them provide coping mechanisms in adverse environments, support in social transformation and social capital, little information is available on their role as development actors. In this article, we evaluate the potential of AICs as partners of international development agencies for community development. We draw on interviews and focus group discussions with leaders of various AICs conducted in South Africa in February and March 2016. In particular, we examine the churches’ understanding of development, their view on the separation of spiritual and development activities and their priorities. Moreover, we outline the development activities which they are currently engaged in and analyse the structures they have in place to do so. Our findings indicate that AICs are increasingly active in community development and offer various entry points for possible cooperation.

Defining and Theorizing Terrorism: A Global Actor-Centered Approach

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Omar Lizardo

2015-08-01

Full Text Available Arriving at a consensual definition of the phenomenon of terrorism has been a particularly difficult undertaking. Some definitions are either too specific or too vague, concentrating on some essential “terrorist” aspect of the actions, strategies, or types of non-state organizations that engage in terrorism. In this paper I draw on global approaches from international relations and world systems theories to propose a definition of terrorism that skirts these issues by concentrating on terrorist actors rather than terrorist behavior. I argue that this approach has several advantages, including the dissolution of several empirical and analytical problems produced by more essentialist definitions, and the location of terrorism within a two dimensional continuum of collective-violence phenomena in the international system which discloses important theoretical insights. I proceed to examine the characteristics of terrorism by comparing it with other forms of violence in the international system. I propose that terrorism may be part of the cycles and trends of unrest in the world system, responding to the same broad families of global dynamics as other forms of system-level conflict.

Advancing the application of systems thinking in health: analysing the contextual and social network factors influencing the use of sustainability indicators in a health system--a comparative study in Nepal and Somaliland.

Science.gov (United States)

Blanchet, Karl; Palmer, Jennifer; Palanchowke, Raju; Boggs, Dorothy; Jama, Ali; Girois, Susan

2014-08-26

Health systems strengthening is becoming a key component of development agendas for low-income countries worldwide. Systems thinking emphasizes the role of diverse stakeholders in designing solutions to system problems, including sustainability. The objective of this paper is to compare the definition and use of sustainability indicators developed through the Sustainability Analysis Process in two rehabilitation sectors, one in Nepal and one in Somaliland, and analyse the contextual factors (including the characteristics of system stakeholder networks) influencing the use of sustainability data. Using the Sustainability Analysis Process, participants collectively clarified the boundaries of their respective systems, defined sustainability, and identified sustainability indicators. Baseline indicator data was gathered, where possible, and then researched again 2 years later. As part of the exercise, system stakeholder networks were mapped at baseline and at the 2-year follow-up. We compared stakeholder networks and interrelationships with baseline and 2-year progress toward self-defined sustainability goals. Using in-depth interviews and observations, additional contextual factors affecting the use of sustainability data were identified. Differences in the selection of sustainability indicators selected by local stakeholders from Nepal and Somaliland reflected differences in the governance and structure of the present rehabilitation system. At 2 years, differences in the structure of social networks were more marked. In Nepal, the system stakeholder network had become more dense and decentralized. Financial support by an international organization facilitated advancement toward self-identified sustainability goals. In Somaliland, the small, centralised stakeholder network suffered a critical rupture between the system's two main information brokers due to competing priorities and withdrawal of international support to one of these. Progress toward self

One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

Science.gov (United States)

Leung, Zee; Middleton, Dean; Morrison, Karen

2012-05-16

There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

Understanding Obstacles to Peace: Actors, Interests, and Strategies ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-02-24

Feb 24, 2011 ... Understanding Obstacles to Peace: Actors, Interests, and Strategies in Africa's ... The case studies all employ methods of “thick description” process tracing ... Addressing Africa's unmet need for family planning by intensifying ...

Interface Between Research, Development and Local Actors in ...

African Journals Online (AJOL)

Interface Between Research, Development and Local Actors in Enhancing ... Open Access DOWNLOAD FULL TEXT ... Environmental sustainability is a key area of focus in academic and development circles mainly because of the role that the ...

Modelling the lay expert for first-year medical students: the actor-patient as teacher.

Science.gov (United States)

Nestel, Debra; Muir, Elizabeth; Plant, Marilyn; Kidd, Jane; Thurlow, Sue

2002-09-01

Actors are widely used in medical education as simulated patients. In this session, the role of actors was extended to 'simulated students' and facilitators in an introductory communication session. After an initial activity with the entire cohort of first-year students, groups of 20 students worked with either an actor or medical teacher in three activities. The activities aimed to raise students' awareness of the range of communication challenges in medical education and practice. After the session, students completed evaluation forms based on their experiences in the session. The results revealed no difference between students who were facilitated by actors or medical teachers in relation to meeting the learning objectives and their ratings of the usefulness of the activities to support learning. The actors who participated in this session were experienced in working with medical students. Their enhanced role provides students with an opportunity to identify with and reflect on the expertise of a lay teacher and to consider extending their definition of a learning opportunity to more informal encounters.

The radioactivity measurement in the Loire catchment basin. Actors, networks, data inventory

International Nuclear Information System (INIS)

2008-01-01

The objective of this report on the Loire watershed was to broaden at all the nuclear installations of the watershed the method of synthesis made for Saint-Laurent-des-Eaux nuclear power plant, by resting on the whole of actors doing the radioactivity measurements in environment. This report shows that these actors are numerous. The measurement plans implemented have for objective to establish the radiological situation of environment, near or not the nuclear facilities, to detect the abnormal increase of radioactivity, to evaluate the exposure of populations to the ambient radioactivity, or to check the conformity of practices (nuclear activities) and products. This assessment enlightens the lack of a real global strategy in the organisation of the radioactivity measurement at the level of the watershed. The inventory of available data for the Loire watershed allowed to show the diversity of measurements realised. The I.R.S.N. is face to a complex situation of data return in the frame of the implementation of an information system of the national network of radioactivity measurement in environment. (N.C.)

REPUTATIONAL CAPITAL OF POLITICAL ACTORS AS PUBLIC PROCUREMENT

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A. E. Rudakova

2015-01-01

Full Text Available The author examines the reputational characteristics of the formation of political actors at the expense of the state budget, the specificity of the mechanism of implementation of government procurement and modern Russian practice.

Revitalizing REDD+ Policy Processes in Vietnam: The Roles of State and Non-State Actors

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Thu Ba Huynh

2017-02-01

Full Text Available Vietnam was one of the first countries to introduce the National REDD+ (Reduced Emissions from Deforestation and Forest Degradation Action Program in 2012. The country has recently revised the Program to aim for a more inclusive 2016–2020 strategy and a vision to 2030. This study explores how Vietnam policy actors view REDD+ policy development and their influence in these processes. The results can contribute to the discussion on how policy actors can effectively influence policy processes in the evolving context of REDD+ and in the types of political arrangements represented in Vietnam. We examined the influence of state and non-state actors on the 2012 National REDD+ Action Program (NRAP processes, and explored factors that may have shaped this influence, using a combination of document analysis and semi-structured interviews with 81 policy actors. It was found that non-state actors in REDD+ are still on the periphery of decision making, occupying “safe” positions, and have not taken either full advantage of their capacities, or of recent significant changes in the contemporary policy environment, to exert stronger influence on policy. We suggest that REDD+ policy processes in Vietnam need to be revitalized with key actors engaging collectively to promote the possibilities of REDD+ within a broader view of social change that reaches beyond the forestry sector.

La figura del consum’actor justo francés: ¿consumidor y ciudadano?

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Gabriela Parodi∗

2015-07-01

Full Text Available El neologismo consum’actor (consumidor-actor es utilizado en diferentes espacios sociales para dirigirse a los consumidores susceptibles de ejercer una forma de compromiso través del consumo. El artículo muestra cómo la figura del consum’actor cumple una función de tipo ideal en la promoción del consumo de productos del comercio justo para el caso de promotores y consumidores franceses entrevistados en el marco de una investigación sociológica. Observando el mecanismo de recalificación del consumidor en consum’actor analizamos cómo se fabrica una argumentación tendiente a politizar ese acto de compra, interrogando la lógica de acción de los promotores. La reflexividad de los consumidores justos sobre las prácticas asociadas con el consum’actor permitió conocer los límites en la apropiación de esta figura. La porosidad de campos (mercado, consumo, política movilizados en la argumentación para su caracterización explica la distancia entre aquella función y los límites de su apropiación como figura social del compromiso ciudadano

Introducing Health Impact Assessment

DEFF Research Database (Denmark)

Mannheimer, L N; Gulis, G; Lehto, J

2007-01-01

health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...

[A framework to support action in population mental health].

Science.gov (United States)

Mantoura, Pascale; Roberge, Marie-Claude; Fournier, Louise

In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

Transnational health care: from a global terminology towards transnational health region development.

Science.gov (United States)

Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

2012-11-01

Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The key actor: a qualitative study of patient participation in the handover process in Europe

Science.gov (United States)

Flink, Maria; Hesselink, Gijs; Pijnenborg, Loes; Wollersheim, Hub; Vernooij-Dassen, Myrra; Dudzik-Urbaniak, Ewa; Orrego, Carola; Toccafondi, Giulio; Schoonhoven, Lisette; Gademan, Petra J; Johnson, Julie K; Öhlén, Gunnar; Hansagi, Helen; Olsson, Mariann; Barach, Paul

2012-01-01

Background Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation. Objective The aim of this paper is to explore the patients’ experiences and perspectives related to the handovers between their primary care providers and the inpatient hospital. Methods A qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries. Results The analysis revealed three themes: patient positioning in the handover process; prerequisites for patient participation and patient preferences for the handover process. Patients’ participation ranged from being the key actor, to sharing the responsibility with healthcare professional(s), to being passive participants. For active participation patients required both personal and social resources as well as prerequisites such as information and respect. Some patients preferred to be the key actor in charge; others preferred their healthcare professionals to be the key actors in the handover. Conclusions Patients’ participation is related to the healthcare system, the activity of healthcare professionals’ and patients’ capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses. PMID:23112290

Environmental assessment for sustainable development: process, actors and practice

International Nuclear Information System (INIS)

Andre, P.; Delisle, C.E.; Reveret, J.-P.

2003-01-01

Multiple environmental problems afflict our contemporary world and have been the subject of discussions during many international meetings. All declarations resulting from these meetings insist on including environmental problems and on environmental assessment (EA) as an important tool to achieve this. This book aims to reach three objectives. First, it introduces EA to people from different disciplines, and therefore it opens up the perspective of new disciplinary horizons. Second, the authors discuss EA as a socio-political process rather than emphasizing methodologies. Third, this book draws mainly on the experience in Francophone countries which is still poorly disseminated. This book focusses on process and actors. Thus, the subject matter is divided into five major parts: the history and major issues of EA from a sustainable development perspective (Chapters 1 to 3); the actors, i.e. the Project Proponent and consulting firms, the public, the decision maker and international actors (Chapters 4 to 7); methods and tools including public participation (Chapters 8 and 9); processes in practice through step by step processes in practice and case studies (Chapters 10 and 11); and, finally, recent and upcoming developments in EA, including elements of strategic environmental assessment (Chapters 12 and 13). An index facilitates searching for information. The reader is also invited to consult the book's website

Policy Actors: Doing Policy Work in Schools

Science.gov (United States)

Ball, Stephen J.; Maguire, Meg; Braun, Annette; Hoskins, Kate

2011-01-01

This paper considers the "policy work" of teacher actors in schools. It focuses on the "problem of meaning" and offers a typology of roles and positions through which teachers engage with policy and with which policies get "enacted". It argues that "policy work" is made up of a set of complex and…

Innovation in the plural of the alpine cre-actors

Directory of Open Access Journals (Sweden)

Andréa Finger-Stich

2009-06-01

Full Text Available The capacity to innovate for a sustainable development of alpine territories cannot depend only on economic, legal and political conditions defined by the State at national and international levels. It depends also on local conditions that situate historically and geographically the actors in a continuity of social and ecological relationships. This approach highlights the collective – thus organisational – dimensions of the innovation process, including the imagination, the development, the implementation and even the diffusion of a new practice. Our point of view is that for contributing to the sustainable development of the Alps, innovations need to change the ecological, political, social and cultural relationships engaging the actors in these territories. This change affects as much the object territory as the subject actor of the territory. This is why innovating in the Alps means also innovating the Alps and the alpine actors (Cosalp, 2008. Based on a research about local people’s participation in the management of alpine communal forests, the article shows the importance of local interactions involving actors of diverse occupation, gender, age and origins1.La capacité d’innovation pour un développement durable des territoires alpins ne peut dépendre uniquement de conditions économiques, légales et politiques définies par les Etats aux échelles nationale et internationale. Elle dépend aussi de conditions locales, qui situent historiquement et géographiquement les acteurs dans une continuité de relations sociales et écologiques. Cette perspective accentue l’importance de la dimension collective, donc organisationnelle, du processus d’innovation, allant de l’imagination, puis au développement, à la réalisation – voire la diffusion – d’une nouvelle pratique. Le point de vue de cet article est qu’une innovation, pour contribuer au développement durable des Alpes, doit changer les relations �

Children's Moral Judgments as a Function of Intention, Damage, and an Actor's Physical Harm.

Science.gov (United States)

Suls, Jerry; Kalle, Robert J.

1979-01-01

Examines children's moral judgments of story characters who accidently harm themselves. Children in kindergarten and in grades 3 and 5 rated actors in stories which varied in terms of intention, damage, and harm to the actor. (SS)

Actor bonds after relationship dissolution

DEFF Research Database (Denmark)

Skaates, Maria Anne

2000-01-01

Most of the presented papers at the 1st NoRD Workshop can be classified as belonging to the business marketing approach to relationship dissolution. Two papers were conceptual, and the remaining six were empirical studies. The first conceptual study by Skaates (2000) focuses on the nature...... of the actor bonds that remain after a business relationship has ended. The study suggests that an interdisciplinary approach would provide a richer understanding of the phenomenon; this could be achieved by using e.g. Bourdieu's sociological concepts in dissolution research....

The Plurilingual Social Actor. Language, Citizenship and Education

Science.gov (United States)

Coste, Daniel; Simon, Diana-Lee

2009-01-01

The paper critically discusses key theoretical concepts and definitions attached to the notion of a "plurilingual social actor", and assesses their impact and implications for European language policies and for the development of plurilingualism and citizenship in schools. (Contains 11 notes.)

PROGNOSTICAL COMPETENCE OF THE FUTURE TEACHERS-ACTORS: TO THE ISSUE OF THE CONCEPT DEFINITION

Directory of Open Access Journals (Sweden)

Elena Viktorovna Tsalko

2016-02-01

Full Text Available In this paper on the basis of the notions of competence, forecasting, prognostical competence the author’s definition of future actors-teachers’ prognostical competence is developed. Under prognostic competence of future actors-teachers we understand a special competence that allows the subject, engaged in professional activities as a performer of roles in the theater (movies, TV, as well as performing teaching activities in the field of arts, to receive the necessary anticipatory information about the phenomenon under investigation (on performing roles in the theatre, films, and television, on the learning process and actors-teachers training. Components of prognostical competence as a type of competencies (cognitive, instrumental and operational and motivational-value are singled out. The feature of the future actor-teacher’s professional activities in the context of prognostical competence is viewed. It is the simultaneous solving the artistic-creative, organizational and teaching-upbringing problems.Purpose. The purpose of the paper is the definition of prognostical competence of future teachers-actors.Methodology. In the research the methods of theoretical level are used: comparison, analysis and synthesis, generalization, concretization; analytical methods; idealization and modeling.Result. The result of the research is the development of the author’s concept of «prognostical competence of the future teachers-actors».Practical implications. Application of the results: The results may be applied to the work of teachers-actors’ trainers as well as the researchers in Pedagogy.

The precariousness of the franchise state: Voluntary sector health services and international NGOs in Tanzania, 1960s - mid-1980s.

Science.gov (United States)

Jennings, Michael

2015-09-01

This paper challenges conventional narratives on the role of international non-governmental organisations (INGOs) in the delivery of health services in Tanzania. Adopting an historical gaze which focuses on the 1960s to mid-1980s the paper argues that the 'franchise state' in the Tanzanian health system was not created by collusion between international donors and INGOs, underpinned by a set of health sector reforms that advocated the use of non-state actors; but was rather the legacy of the colonial health system bequeathed to the post-independence state. It was a system in which voluntary non-state actors (but, importantly, not INGOs) were already entrenched as key providers; and in which many of the features of the franchise state - fragmentation, structural weaknesses, lack of accountability to users - were already long established. But if INGOs did not create these features, as their critics attest, they did contribute to the maintenance and extension of these features. The short-term perspectives of NGOs, their small-scale piecemeal engagement, and the extra demands they placed upon their voluntary actor partners, left little scope for the development of sustainable, national and accountable solutions to the health needs of the country. In exploring these ideas, the paper contributes to a more nuanced understanding of the path dependency that created Tanzania's health system. The analysis also contributes to a deepening of the understanding of the make-up of the voluntary sector beyond a narrow gaze on the institution of the INGO. Copyright © 2015 Elsevier Ltd. All rights reserved.

The link between UHC reforms and health system governance: lessons from Asia.

Science.gov (United States)

Hort, Krishna; Jayasuriya, Rohan; Dayal, Prarthna

2017-05-15

Purpose The purpose of this paper is to examine how and to what extent the design and implementation of universal health coverage (UHC) reforms have been influenced by the governance arrangements of health systems in low- and middle-income countries (LMIC); and how governments in these countries have or have not responded to the challenges of governance for UHC. Design/methodology/approach Comparative case study analysis of three Asian countries with substantial experience of UHC reforms (Thailand, Vietnam and China) was undertaken using data from published studies and grey literature. Studies included were those which described the modifications and adaptations that occurred during design and implementation of the UHC programme, the actors and institutions involved and how these changes related to the governance of the health system. Findings Each country adapted the design of their UHC programmes to accommodate their specific institutional arrangements, and then made further modifications in response to issues arising during implementation. The authors found that these modifications were often related to the impacts on governance of the institutional changes inherent in UHC reforms. Governments varied in their response to these governance impacts, with Thailand prepared to adopt new governance modes (which the authors termed as an "adaptive" response), while China and Vietnam have tended to persist with traditional hierarchical governance modes ("reactive" responses). Originality/value This study addresses a gap in current knowledge on UHC reform, and finds evidence of a complex interaction between substantive health sector reform and governance reform in the LMIC context in Asia, confirming recent similar observations on health reforms in high-income countries.

Nociones del conflicto en actores escolares

Directory of Open Access Journals (Sweden)

Carlos Eduardo Valderrama H

2001-10-01

Full Text Available Este artículo busca contribuir a la reflexión sobre la problemática del conflicto escolar a partir de algunas nociones que ciertos actores escolares tienen sobre el mismo, sus manifestaciones, sus causas u orígenes y las maneras como afirman se resuelve en sus instituciones. Desde una perspectiva que pretende inscribirse en el campo de la comunicación-educación, se describe la heterogeneidad de las posturas manifestadas por estudiantes, docentes y directivos y se intentan comprender éstas a partir de algunos postulados teóricos planteados por la sociología del conflicto y la pedagogía crítica.This essay contributes to an ongoing debate on the problematic of school conflict, working from certain concepts that some of the actors in schools have about conflict, its manifestations, causes or origins, and the manners in which they manifest that they are resolved. From a perspective that wants to inscribe itself in the field of communication-education, it describes the heterogeneity of the different views put forward by students, teaches, and school directors, and searches to understand these based on certain theoretical postulates derived from the fields of sociology of conflict and critical pedagogy.

Local authorities and electricity: territories, actors and issues within the local public service in France

International Nuclear Information System (INIS)

Bouvier, G.

2005-06-01

In France, the role of local authorities in the organization of the electricity supply system is largely unknown mainly due to the size of the state-owned utility Electricite de France (EDF). Local authorities and their groupings played a major role in the electrification of the national territory and have kept important prerogatives as conceding authorities of this service of general interest. These groupings also became the tools of the soft power of local actors. The geopolitical analysis of the relationships between local municipalities and electric power stakeholders shows the diversity of actors and opinions. Stuck between market liberalization issues and decentralization to local authorities, these groupings tend to reinforce their competencies. Furthermore, decentralization goes along with a reinforcement of the political involvement in local energy policy and with conflicts on the adequate territorial scale for theses policies. (author)

New market actors: economic social movements and politicized consumers

Directory of Open Access Journals (Sweden)

Fátima Portilho

2009-10-01

Full Text Available This article presents reflections on new market actors, and economic social movements in particular - that is, those in which actors build a new culture of political action that seeks to reappropriate the economy through their own values. Some examples of this are the movements organized around “solidarity economics”, fair trade, geographic indications, “slow food” and consumer organization. This interface of social movements and the market may be the most marked, differentiated and polemic trait of contemporary political mobilizations. Nonetheless, beyond economic social movements, this article simultaneously emphasizes and problematizes political action within the sphere of individual consumption, that is, that which has been referred to as “political consumption”. Keywords: economic social movements, consumer movements, political consumption.

Actors and Practices

DEFF Research Database (Denmark)

Balslev, Lars

Actors and practices – An institutional study on management accounting change in Air Greenland My former CEO was one of the first executives in Greenland to formally implement an extensive commercial strategy to identify the contradictory forces of social obligations and commercial strivings...... societal obligation. He noted that: “…there is some inherent conflict in having the type of ownership we have, one in which the commercial owner demands higher profits or they will sell their shares, and the other two government owners, where one wishes to have the lowest possible fares and better...... infrastructure and the other one just wants less trouble. Well! This is the ongoing inherent conflict of the owner composition we just have to deal with.” He emphasized that SAS, the more “commercial oriented” owner and private shareholder, wanted higher profits and gains, whereas the Government of Greenland...

Passenger Rail SOEs as Domestic Institutional Market Actors

DEFF Research Database (Denmark)

Tolstrup Christensen, Lene

2018-01-01

sectorial challenges. In Sweden, this role has a new public governance form as the monopoly over time is fully dismantled. In Denmark, over time marketization is put on hold due to problems with the SOE as a market actor, but the SOE is nevertheless safeguarded in a new Weberian model as a sector......Purpose: The purpose of this paper is to make an empirical-based conceptualization of the contemporary domestic state-owned enterprises (SOEs) as domestic institutional market actors (IMAs) in the marketization of public service delivery. Design/methodology/approach: The paper is based...... on a qualitative comparative case study of the SOEs in passenger rail in Denmark and Sweden from 1990 to 2015. Findings: The paper shows how marketization results in a layered institutional set-up of public service delivery based on both competition and monopoly where the SOE becomes what we call an IMA bridging...

Agriculture, health, and wealth convergence: bridging traditional food systems and modern agribusiness solutions.

Science.gov (United States)

Dubé, Laurette; Webb, Patrick; Arora, Narendra K; Pingali, Prabhu

2014-12-01

The causes of many vexing challenges facing 21st-century society are at the nexus of systems involved in agriculture, health and wealth production, consumption, and distribution. Using food as a test bed, and on the basis of emerging roadmaps that set achievable objectives over a 1- to 3-year horizon, we introduce this special feature with convergence thinking and practice at its core. Specifically, we discuss academic papers structured around four themes: (1) evidence for a need for convergence and underlying mechanisms at the individual and societal levels; (2) strategy for mainstreaming convergence as a driver of business engagement and innovation; (3) convergence in policy and governance; (4) convergence in metrics and methods. Academic papers under each theme are accompanied by a roadmap paper reporting on the current status of concrete transformative convergence-building projects associated with that theme. We believe that the insights provided by these papers have the potential to enable all actors throughout society to singly and collectively work to build supply and demand for nutritious food, in both traditional and modern food systems, while placing the burdens of malnutrition and ill health on their core strategic agendas. © 2014 New York Academy of Sciences.

Elegant Coercion and Iran: Beyond the Unitary Actor Model

National Research Council Canada - National Science Library

Moss, J. C

2005-01-01

.... At its core, then, coercion is about state decision-making. Most theories of coercion describe states as if they were unitary actors whose decision-making results from purely rational cost-benefit calculations...

Resenha: Power, Interdependence and Nonstate Actors in World Politics

Directory of Open Access Journals (Sweden)

Katiuscia Moreno Galhera Espósito

2011-10-01

Full Text Available Resenha do livro: Moravcsik, Andrew; Milner, Helen V. (org.. Power, Interdependence and Nonstate Actors in World Politics. New Jersey: Princeton University Press, 2009. ISBN 978-0-691-14027-8

Searching for realism, structure and agency in Actor Network Theory.

Science.gov (United States)

Elder-Vass, Dave

2008-09-01

Superficially, Actor Network Theory (ANT) and critical realism (CR) are radically opposed research traditions. Written from a realist perspective, this paper asks whether there might be a basis for finding common ground between these two traditions. It looks in turn at the questions of realism, structure, and agency, analysing the differences between the two perspectives and seeking to identify what each might learn from the other. Overall, the paper argues that there is a great deal that realists can learn from actor network theory; yet ANT remains stunted by its lack of a depth ontology. It fails to recognize the significance of mechanisms, and of their dependence on emergence, and thus lacks both dimensions of the depth that is characteristic of critical realism's ontology. This prevents ANT from recognizing the role and powers of social structure; but on the other hand, realists would do well to heed ANT's call for us to trace the connections through which structures are constantly made and remade. A lack of ontological depth also underpins ANT's practice of treating human and non-human actors symmetrically, yet this remains a valuable provocation to sociologists who neglect non-human entities entirely.

Sistema Único de Saúde: espaços decisórios e a arena política de saúde The Unified National Health System: decision-making forums and the political arena in health

Directory of Open Access Journals (Sweden)

Soraya Vargas Côrtes

2009-07-01

Full Text Available O artigo analisa o impacto da criação do novo Conselho Nacional de Saúde, em 1990, e das comissões intergestores, em 1993, sobre a arena política de saúde e sobre a configuração das relações entre atores estatais e societais no âmbito do Sistema Único de Saúde. As três principais conclusões do artigo são as seguintes: a criação de fóruns nos quais atores estatais podem construir acordos que viabilizem a coordenação federativa das ações de gestão fortaleceu as posições desses atores na arena política da área; atores sociais, liderados por representantes de entidades de profissionais de saúde, foram compelidos, mas também buscaram ativamente, a apresentar suas demandas e propostas em fóruns participativos que tratavam principalmente de questões políticas secundárias, perdendo assim, ao longo do período, capacidade de influir sobre o processo decisório da área; atores de mercado pouco se envolveram em fóruns participativos, dando preferência a exercer influência diretamente sobre os decisores públicos e a implementar estratégias adaptativas para aumentar seus lucros.This article analyzes the creation of new political arenas in the Brazilian health sector as well as shifts in power relations among state and social political actors in the context of public health system reform, focusing on the last two decades. The three main conclusions are the following: The creation of forums in which government actors can establish agreements that allow the shared national, State, and municipal coordination of management measures have strengthened the positions of these actors in the health political arena. Social actors, led by representatives of professional health societies, were both urged (and also took the initiative to submit their demands and proposals through participatory forums that dealt mainly with secondary political issues, thus steadily losing the capacity to influence the real decision-making process in

Effects of Actor-Network Theory in Accounting Research

DEFF Research Database (Denmark)

Justesen, Lise Nederland; Mouritsen, Jan

2011-01-01

Purpose – This paper aims to discuss how Bruno Latour's version of actor-network theory has influenced accounting research. It also seeks to show that Latour's writings contain unexplored potential that may inspire future accounting research. Design/methodology/approach – The paper takes the form...

Actor/Actant-Network Theory as Emerging Methodology for ...

African Journals Online (AJOL)

This paper deliberates on actor/actant-network theory (AANT) as methodology for policy research in environmental education (EE). Insights are drawn from work that applied AANT to research environmental policy processes surrounding the formulation and implementation of South Africa's Plastic Bags Regulations of 2003.

Consumer culture theory (re)visits actor-network theory

DEFF Research Database (Denmark)

Bajde, Domen

2013-01-01

The vocabulary and tactics developed by actor-network theory (ANT) can shed light on several ontological and epistemological challenges faced by consumer culture theory. Rather than providing ready-made theories or methods, our translation of ANT puts forward a series of questions and propositions...

Actor roles in transition: Insights from sociological perspectives

NARCIS (Netherlands)

J.M. Wittmayer (Julia); F. Avelino (Flor); F. van Steenbergen; D.A. Loorbach (Derk)

2016-01-01

textabstractTo date, the field of transition research lacks a suitable vocabulary to analyse the (changing) interactions and relations of actors as part of a sustainability transition. This article addresses this knowledge gap by exploring the potential of the concept of 'roles' from social

[Social actors in HIV/AIDS prevention: opposition and interests in educational policy in Mexico, 1994-2000].

Science.gov (United States)

Granados-Cosme, José Arturo; Nasaiya, Kittipong; Brambila, Alberto Torres

2007-03-01

Studies and recommendations by health agencies have emphasized the importance of education in HIV-AIDS prevention. Mexico has included topics on sexuality and HIV-AIDS in school programs, triggering resistance by some social actors. The current study seeks to clarify the various positions and interests and their influence on the textbook content. A literature search was conducted on the period during which the last educational reform was implemented in Mexico. The discourse analysis focused on the ethnography of communication, which identified: the various actors' positions, arguments, actions, economic and political power, and relations to others. The results show that those who oppose the inclusion of these themes in the school curriculum base their position on tradition, contrary to modernization and secularization of social life, and that their positions range from refusal to raising conditions. Networks have been formed that provide such groups with significant economic and political power. Government has given in to some demands by partially modifying the textbook contents. The current analysis proposes to reflect on the potential repercussions of such actions on the control of the epidemic.

Comparisons of Multilevel Modeling and Structural Equation Modeling Approaches to Actor-Partner Interdependence Model.

Science.gov (United States)

Hong, Sehee; Kim, Soyoung

2018-01-01

There are basically two modeling approaches applicable to analyzing an actor-partner interdependence model: the multilevel modeling (hierarchical linear model) and the structural equation modeling. This article explains how to use these two models in analyzing an actor-partner interdependence model and how these two approaches work differently. As an empirical example, marital conflict data were used to analyze an actor-partner interdependence model. The multilevel modeling and the structural equation modeling produced virtually identical estimates for a basic model. However, the structural equation modeling approach allowed more realistic assumptions on measurement errors and factor loadings, rendering better model fit indices.

Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care.

Science.gov (United States)

Gilson, Lucy; Elloker, Soraya; Olckers, Patti; Lehmann, Uta

2014-06-16

New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors' sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC. The paper draws on observational, interview, and reflective data collected as part of the District Innovation and Action Learning for Health Systems Development (DIALHS) project being implemented in Cape Town, South Africa. Undertaken collaboratively between health managers and researchers, the project is implemented through cycles of action-learning, including systematic reflection and synthesis. It includes a particular focus on how local health managers can better support front line facility managers in strengthening PHC. The results illuminate how the collective understandings of staff working at the primary level - of their working environment and changes within it - act as a barrier to centrally-led initiatives to strengthen PHC. Staff often fail to take ownership of such initiatives and experience them as disempowering. Local area managers, located between the centre and the service frontline, have a vital role to play in providing a leadership of sensemaking to mediate these challenges. Founded on personal values, such leadership entails, for example, efforts to nurture PHC-aligned values and mind-sets among staff; build relationships and support the development of shared meanings about change; instil a culture of collective inquiry and mutual accountability; and role-model management practices, including using language to signal meaning. PHC will only become a lived reality within the South African health system when frontline staff are able to make sense of policy intentions and

Neuromuscular control of the point to point and oscillatory movements of a sagittal arm with the actor-critic reinforcement learning method.

Science.gov (United States)

Golkhou, Vahid; Parnianpour, Mohamad; Lucas, Caro

2005-04-01

In this study, we have used a single link system with a pair of muscles that are excited with alpha and gamma signals to achieve both point to point and oscillatory movements with variable amplitude and frequency.The system is highly nonlinear in all its physical and physiological attributes. The major physiological characteristics of this system are simultaneous activation of a pair of nonlinear muscle-like-actuators for control purposes, existence of nonlinear spindle-like sensors and Golgi tendon organ-like sensor, actions of gravity and external loading. Transmission delays are included in the afferent and efferent neural paths to account for a more accurate representation of the reflex loops.A reinforcement learning method with an actor-critic (AC) architecture instead of middle and low level of central nervous system (CNS), is used to track a desired trajectory. The actor in this structure is a two layer feedforward neural network and the critic is a model of the cerebellum. The critic is trained by state-action-reward-state-action (SARSA) method. The critic will train the actor by supervisory learning based on the prior experiences. Simulation studies of oscillatory movements based on the proposed algorithm demonstrate excellent tracking capability and after 280 epochs the RMS error for position and velocity profiles were 0.02, 0.04 rad and rad/s, respectively.

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades.

Science.gov (United States)

Koduah, Augustina; van Dijk, Han; Agyepong, Irene Akua

2015-05-30

Development of health policy is a complex process that does not necessarily follow a particular format and a predictable trajectory. Therefore, agenda setting and selecting of alternatives are critical processes of policy development and can give insights into how and why policies are made. Understanding why some policy issues remain and are maintained whiles others drop off the agenda is an important enquiry. This paper aims to advance understanding of health policy agenda setting and formulation in Ghana, a lower middle-income country, by exploring how and why the maternal (antenatal, delivery and postnatal) fee exemption policy agenda in the health sector has been maintained over the four and half decades since a 'free antenatal care in government facilities' policy was first introduced in October 1963. A mix of historical and contemporary qualitative case studies of nine policy agenda setting and formulation processes was used. Data collection methods involved reviews of archival materials, contemporary records, media content, in-depth interviews, and participant observation. Data was analysed drawing on a combination of policy analysis theories and frameworks. Contextual factors, acting in an interrelating manner, shaped how policy actors acted in a timely manner and closely linked policy content to the intended agenda. Contextual factors that served as bases for the policymaking process were: political ideology, economic crisis, data about health outcomes, historical events, social unrest, change in government, election year, austerity measures, and international agendas. Nkrumah's socialist ideology first set the agenda for free antenatal service in 1963. This policy trajectory taken in 1963 was not reversed by subsequent policy actors because contextual factors and policy actors created a network of influence to maintain this issue on the agenda. Politicians over the years participated in the process to direct and approve the agenda. Donors increasingly

The Roles and Movements of Actors in the Deforestation of Brazilian Amazonia

OpenAIRE

Philip M. Fearnside

2008-01-01

Containing the advance of deforestation in Brazilian Amazonia requires understanding the roles and movements of the actors involved. The importance of different actors varies widely among locations within the region, and also evolves at any particular site over the course of frontier establishment and consolidation. Landless migrants have significant roles in clearing the land they occupy and in motivating landholders to clear as a defense against invasion or expropriation. Colonists in offic...

The actors of the photovoltaic sector in France

International Nuclear Information System (INIS)

Houot, G.

2010-01-01

The author reviews the 192 actors in the French photovoltaic sector, they are classified into 9 categories: 1) the solar plant owner, 2) the developer: he sets projects and his role stops when the project is ready to be sold to an investor, 3) the design office: it leads technical studies and manages the construction works), 4) the installer: he fits the solar panels, 5) the operator of the solar plant, 6) the wholesaler of equipment, 7) the manufacturer of solar panels and photovoltaic systems, 8) the provider or manufacturer of components and materials for the photovoltaic industry, and 9) the provider of specialized services such as insurance, staff training, the follow-up of legal issues... For each company, a brief historical account, the range of activities, the strength of manpower and the turnover are reported. (A.C.)

Is carbon lock-in blocking investments in the hydrogen economy? A survey of actors' strategies

International Nuclear Information System (INIS)

Bento, Nuno

2010-01-01

The difficulty of introducing hydrogen and fuel cells in the market stems from the fact that they are not an evolutionary innovation such as biofuels or hybrid cars. Instead they create a disruption in technological utilization. The domination of oil technologies sets a socio-economical context favoring actors involved in the current paradigm, and gives less opportunity to alternative fuels to develop and challenge the status quo. If this hypothesis is correct, then companies interested in the hydrogen economy would not become active because of an unstable context or contradictory interests concerning the replacement of the present system. A review of actions and announcements of main actors shows that technology readiness and the absence of infrastructure are the major justifications to delay investments. Some measures are discussed, which could be deployed in order to reduce uncertainties, such as regulation of carbon emissions from cars, technological subvention, and partnerships for infrastructure implementation.

Tomorrow's Energy Prices: An Analysis of System, Actors and Shaping Factors. Crude price drop and its consequences

International Nuclear Information System (INIS)

Chevalier, Jean-Marie; Chauvin, Dominique

2017-01-01

If one sector in recent decades has been a byword for how difficult it is to anticipate future developments at the global level, it has been the energy sector. We have seen fears over the dangers of a hydrocarbon shortage, the announcement of 'peak oil' and a boom in shale gas and oil. Forecasts based on major trends within the field have been revised as non-conventional sources with a substantial impact on price levels have emerged. Added to this is the need to confront climate change and hence to revamp our modes of energy production to give an enhanced role to renewables. In such a context, as Jean-Marie Chevalier stresses here, it is quite tricky to say how energy prices will develop or how energy production systems will change. This is why, in addition to the overview of possible developments in the prices of oil, natural gas and coal which this article provides, it particularly stresses the many elements of uncertainty that still prevail. Chevalier demonstrates the multiplicity of factors - and actor - involved in the way energy systems and prices develop and highlights the key elements that will play a role in enhancing or curbing those developments in the medium-to-long term. (author)

How did policy actors use mass media to influence the Scottish alcohol minimum unit pricing debate? Comparative analysis of newspapers, evidence submissions and interviews

Science.gov (United States)

Hilton, Shona

2015-01-01

Aims: To explore how policy actors attempted to deliberately frame public debate around alcohol minimum unit pricing (MUP) in the UK by comparing and contrasting their constructions of the policy in public (newspapers), semi-public (evidence submissions) and private (interviews). Methods: Content analysis was conducted on articles published in ten national newspapers between 1 January 2005 and 30 June 2012. Newsprint data were contrasted with alcohol policy documents, evidence submissions to the Scottish Parliament's Health and Sport Committee and 36 confidential interviews with policy stakeholders (academics, advocates, industry representatives, politicians and civil servants). Findings: A range of policy actors exerted influence both directly (through Parliamentary institutions and political representatives) and indirectly through the mass media. Policy actors were acutely aware of mass media's importance in shaping public opinion and used it tactically to influence policy. They often framed messages in subtly different ways, depending on target audiences. In general, newspapers presented the policy debate in a “balanced” way, but this arguably over-represented hostile perspective and suggested greater disagreement around the evidence base than is the case. Conclusions: The roles of policy actors vary between public and policy spheres, and how messages are communicated in policy debates depends on perceived strategic advantage. PMID:26045639

The organic food supply chain in relation to information management and the interaction between actors

OpenAIRE

Kottila, Marja-Riitta; Maijala, Adeline; Rönni, Päivi

2005-01-01

Conventional retailers play a significant role in selling organic food, and therefore, it is important to understand how the demand - supply chain of organic food works as an element of the conventional food system. The proportion of organic food in the conventional food chains is small, and this poses a great challenge to the performance of the chain. Surveys and case specific studies on consumers and supply chain actors indicate that the changes in the conventional food system have an impac...

The role of multisensor data fusion in neuromuscular control of a sagittal arm with a pair of muscles using actor-critic reinforcement learning method.

Science.gov (United States)

Golkhou, V; Parnianpour, M; Lucas, C

2004-01-01

In this study, we consider the role of multisensor data fusion in neuromuscular control using an actor-critic reinforcement learning method. The model we use is a single link system actuated by a pair of muscles that are excited with alpha and gamma signals. Various physiological sensor information such as proprioception, spindle sensors, and Golgi tendon organs have been integrated to achieve an oscillatory movement with variable amplitude and frequency, while achieving a stable movement with minimum metabolic cost and coactivation. The system is highly nonlinear in all its physical and physiological attributes. Transmission delays are included in the afferent and efferent neural paths to account for a more accurate representation of the reflex loops. This paper proposes a reinforcement learning method with an Actor-Critic architecture instead of middle and low level of central nervous system (CNS). The Actor in this structure is a two layer feedforward neural network and the Critic is a model of the cerebellum. The Critic is trained by the State-Action-Reward-State-Action (SARSA) method. The Critic will train the Actor by supervisory learning based on previous experiences. The reinforcement signal in SARSA is evaluated based on available alternatives concerning the concept of multisensor data fusion. The effectiveness and the biological plausibility of the present model are demonstrated by several simulations. The system showed excellent tracking capability when we integrated the available sensor information. Addition of a penalty for activation of muscles resulted in much lower muscle coactivation while keeping the movement stable.

Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

Science.gov (United States)

Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

2017-12-01

Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

Actor modelling and its contribution to the development of integrative strategies for management of pharmaceuticals in drinking water.

Science.gov (United States)

Titz, Alexandra; Döll, Petra

2009-02-01

Widespread presence of human pharmaceuticals in water resources across the globe is documented. While some, but certainly not enough, research on the occurrence, fate and effect of pharmaceuticals in water resources has been carried out, a holistic risk management strategy is missing. The transdisciplinary research project "start" aimed to develop an integrative strategy by the participation of experts representing key actors in the problem field "pharmaceuticals in drinking water". In this paper, we describe a novel modelling method, actor modelling with the semi-quantitative software DANA (Dynamic Actor Network Analysis), and its application in support of identifying an integrative risk management strategy. Based on the individual perceptions of different actors, the approach allows the identification of optimal strategies. Actors' perceptions were elicited by participatory model building and interviews, and were then modelled in perception graphs. Actor modelling indicated that an integrative strategy that targets environmentally-responsible prescription, therapy, and disposal of pharmaceuticals on one hand, and the development of environmentally-friendly pharmaceuticals on the other hand, will likely be most effective for reducing the occurrence of pharmaceuticals in drinking water (at least in Germany where the study was performed). However, unlike most other actors, the pharmaceutical industry itself does not perceive that the production of environmentally-friendly pharmaceuticals is an action that helps to achieve its goals, but contends that continued development of highly active pharmaceutical ingredients will help to reduce the occurrence of pharmaceuticals in the water cycle. Investment in advanced waste or drinking water treatment is opposed by both the wastewater treatment company and the drinking water supplier, and is not mentioned as appropriate by the other actors. According to our experience, actor modelling is a useful method to suggest effective

Intelligent policy making? Key actors' perspectives on the development and implementation of an early years' initiative in Scotland's public health arena.

Science.gov (United States)

Deas, L; Mattu, L; Gnich, W

2013-11-01

Increased political enthusiasm for evidence-based policy and action has re-ignited interest in the use of evidence within political and practitioner networks. Theories of evidence-based policy making and practice are being re-considered in an attempt to better understand the processes through which knowledge translation occurs. Understanding how policy develops, and practice results, has the potential to facilitate effective evidence use. Further knowledge of the factors which shape healthcare delivery and their influence in different contexts is needed. This paper explores the processes involved in the development of a complex intervention in Scotland's National Health Service (NHS). It uses a national oral health programme for children (Childsmile) as a case study, drawing upon key actors' perceptions of the influence of different drivers (research evidence, practitioner knowledge and values, policy, and political and local context) to programme development. Framework analysis is used to analyse stakeholder accounts from in-depth interviews. Documentary review is also undertaken. Findings suggest that Childsmile can be described as an 'evidence-informed' intervention, blending available research evidence with knowledge from practitioner experience and continual learning through evaluation, to plan delivery. The importance of context was underscored, in terms of the need to align with prevailing political ideology and in the facilitative strength of networks within the relatively small public health community in Scotland. Respondents' perceptions support several existing theoretical models of translation, however no single theory offered a comprehensive framework covering all aspects of the complex processes reported. Childsmile's use of best available evidence and on-going contribution to knowledge suggest that the programme is an example of intelligent policy making with international relevance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Putting Gino's lesson to work: Actor-network theory, enacted humanity, and rehabilitation.

Science.gov (United States)

Abrams, Thomas; Gibson, Barbara E

2016-02-01

This article argues that rehabilitation enacts a particular understanding of "the human" throughout therapeutic assessment and treatment. Following Michel Callon and Vololona Rabeharisoa's "Gino's Lesson on Humanity," we suggest that this is not simply a top-down process, but is cultivated in the application and response to biomedical frameworks of human ability, competence, and responsibility. The emergence of the human is at once a materially contingent, moral, and interpersonal process. We begin the article by outlining the basics of the actor-network theory that underpins "Gino's Lesson on Humanity." Next, we elucidate its central thesis regarding how disabled personhood emerges through actor-network interactions. Section "Learning Gino's lesson" draws on two autobiographical examples, examining the emergence of humanity through rehabilitation, particularly assessment measures and the responses to them. We conclude by thinking about how rehabilitation and actor-network theory might take this lesson on humanity seriously. © The Author(s) 2016.

Bridging centrality: A new indicator to measure the positioning of actors in R&D networks

Energy Technology Data Exchange (ETDEWEB)

Scherngell, T.; Wanzenboeck, I.; Berge, L.

2016-07-01

In the recent past, we can observe growing interest in the STI community in the notion of positioning indicators, shifting emphasis to actors in the innovation process and their R&D inter-linkages with other actors. In relation to this, we suggest a new approach for assessing the positioning of actors relying on the notion of bridging centrality (BC). Based on the concept of bridging paths, i.e. a set of two links connecting three actors across three different aggregate nodes (e.g. organisations, regions or countries), we argue that triangulation in networks is a key issue for knowledge recombinations and the extension of an actor's knowledge base. As bridges are most often not empirically observable at the individual level of research teams, we propose an approximated BC measure that provides a flexible framework for dealing with the aggregation problem in positioning actors. Hereby, BC is viewed as a function of an aggregate node's (i) participation intensity in the network, (ii) its openness to other nodes (i.e. the relative outward orientation of network links), and iii) the diversification of links to other nodes. In doing so, we provide an integrative perspective that enables us to achieve a better understanding of the positioning of certain actors in R&D networks. An illustrative example on the co-patent network of European regions demonstrates the performance and usefulness of our BC measure for networks constructed at the aggregated level, i.e. regions in our example. A region's outward orientation and the diversification of its network links moderates the influence of regional scale on network centrality. This is a major strength of the measure, and it paves the way for future studies to examine the role of certain aggregate node's, and, by this, contributes to the debate on positioning indicators in the STI context. (Author)

Getting acquainted: Actor and partner effects of attachment and temperament on young children's peer behavior.

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McElwain, Nancy L; Holland, Ashley S; Engle, Jennifer M; Ogolsky, Brian G

2014-06-01

Guided by a dyadic view of children's peer behavior, this study assessed actor and partner effects of attachment security and temperament on young children's behavior with an unfamiliar peer. At 33 months of age, child-mother attachment security was assessed via a modified Strange Situation procedure, and parents reported on child temperament (anger proneness and social fearfulness). At 39 months, same-sex children (N = 114, 58 girls) were randomly paired, and child dyads were observed during 3 laboratory visits occurring over 1 month. Actor-partner interdependence models, tested via multilevel modeling, revealed that actor security, partner anger proneness, and acquaintanceship (e.g., initial vs. later visits) combined to predict child behavior. Actor security predicted more responsiveness to the new peer partner at the initial visit, regardless of partner anger proneness. Actor security continued to predict responsiveness at the 2nd and 3rd visits when partner anger was low, but these associations were nonsignificant when partner anger was high. Actor security also predicted a less controlling assertiveness style at the initial visit when partner anger proneness was high, yet this association was nonsignificant by the final visit. The findings shed light on the dynamic nature of young children's peer behavior and indicate that attachment security is related to behavior in expected ways during initial interactions with a new peer, but may change as children become acquainted. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Opening the black box of quality improvement collaboratives: an Actor-Network theory approach

Directory of Open Access Journals (Sweden)

Broer Tineke

2010-09-01

Full Text Available Abstract Background Quality improvement collaboratives are often labeled as black boxes because effect studies usually do not describe exactly how the results were obtained. In this article we propose a way of opening such a black box, by taking up a dynamic perspective based on Actor-Network Theory. We thereby analyze how the problematisation process and the measurement practices are constructed. Findings from this analysis may have consequences for future evaluation studies of collaboratives. Methods In an ethnographic design we probed two projects within a larger quality improvement collaborative on long term mental health care and care for the intellectually disabled. Ethnographic observations were made at nine national conferences. Furthermore we conducted six case studies involving participating teams. Additionally, we interviewed the two program leaders of the overall projects. Results In one project the problematisation seemed to undergo a shift of focus away from the one suggested by the project leaders. In the other we observed multiple roles of the measurement instrument used. The instrument did not only measure effects of the improvement actions but also changed these actions and affected the actors involved. Conclusions Effectiveness statistics ideally should be complemented with an analysis of the construction of the collaborative and the improvement practices. Effect studies of collaboratives could benefit from a mixed methods research design that combines quantitative and qualitative methods.

Global health funding: how much, where it comes from and where it goes.

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McCoy, David; Chand, Sudeep; Sridhar, Devi

2009-11-01

Global health funding has increased in recent years. This has been accompanied by a proliferation in the number of global health actors and initiatives. This paper describes the state of global heath finance, taking into account government and private sources of finance, and raises and discusses a number of policy issues related to global health governance. A schematic describing the different actors and three global health finance functions is used to organize the data presented, most of which are secondary data from the published literature and annual reports of relevant actors. In two cases, we also refer to currently unpublished primary data that have been collected by authors of this paper. Among the findings are that the volume of official development assistance for health is frequently inflated; and that data on private sources of global health finance are inadequate but indicate a large and important role of private actors. The fragmented, complicated, messy and inadequately tracked state of global health finance requires immediate attention. In particular it is necessary to track and monitor global health finance that is channelled by and through private sources, and to critically examine who benefits from the rise in global health spending.

Quebec mental health services networks: models and implementation

Directory of Open Access Journals (Sweden)

Marie-Josée Fleury

2005-06-01

Full Text Available Purpose: In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. Data sources: The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada with the author as principal investigator. Description: Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. Discussion and conclusion: To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.

A qualitative assessment of health extension workers' relationships with the community and health sector in Ethiopia : opportunities for enhancing maternal health performance

NARCIS (Netherlands)

Kok, Maryse C; Kea, Aschenaki Z.; Datiko, Daniel G; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Tulloch, Olivia

2015-01-01

BACKGROUND: Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study

The Interactive Constitution of Actors in Industrial Networks: The Case of the Norwegian City of Alesund

OpenAIRE

Frans Prenkert

2013-01-01

The actor-dimension of the Activitiy-Resource-Actor (ARA)-model has not gained the same attention among Industrial Marketing and Purchasing (IMP) scholars as the resource and activity dimensions. However, the issue of what an actor actually is, in the sense of its interactive constitution, is important from an industrial marketing and purchasing perspective that emphasizes the interactive character of the business landscape. This is adressed in this paper. As a concequence of their interactiv...

Demystifying facilitation of multi-actor learning processes

OpenAIRE

Groot, A.E.

2002-01-01

This thesis aims to demystify the facilitation of participatory processes in order to improve the performance of the facilitation professional. As our society is increasingly recognised as pluralistic, characterised by multiple actors with different interests, values and perceptions, participation has become a popular means of bringing about social and technical change. Across the globe, whether in agricultural devel...

Beyond Pain: Coercing Violent Non-State Actors

Science.gov (United States)

2010-01-01

same collection by Abraham Maslow , “A Theory of Motivation,” 174- 175, taken from Psychological Review, 50 (1943). 15 For excellent study of global...utility now? Despite a persistent threat, contemporary theory and practice are not oriented on the VNSA problem. Focus remains on inter-state...actors make imperfect decisions resulting in unexpected behaviors. This is contrary to the underlying premise of classical coercion theory , which

Proceedings (slides) of the ANCCLI-IRSN seminar: 'environment - health: what monitoring in territories by the different actors'

International Nuclear Information System (INIS)

2012-01-01

Relations between the operation of nuclear facilities and the health of populations are recurrent topics. For this reason, the national association of information committees and local commissions (ANCCLI), and the radiation protection and nuclear safety institute (IRSN) have jointly organized this seminar devoted to the monitoring of environment and public health. Its aim was to share the experience of the different actors in order to help the local commissions of information (CLI) in carrying out their own actions on these topics. The first day, the Golfech, Gravelines, Cadarache and Saint-Laurent-Des-Eaux CLIs presented their local environmental monitoring actions and their impact studies for facilities effluents. IRSN presented its methodology for the elaboration of its annual radiological status of the French environment. A round table permitted the different intervening parties to exchange about their monitoring goals. The second day, the Tricastin and Gravelines CLI, as well as the health care supervision institute InVS), presented different studies and attempts of answers to the health-impact questions coming from the surrounding communities. The contributions and limitations of public health studies were discussed through a presentation of the joint ANCCLI/IRSN/InVS methodological guidebook 'public health in the vicinity of nuclear facilities: how to approach the questions asked'. This document gathers the slides of the available presentations: 1 - Environmental monitoring by the Tarn-et-Garonne departmental laboratory in partnership with the Golfech's CLI (A. Calafat); 2 - Environmental monitoring by the Tarn-et-Garonne veterinary laboratory (V. Rossetto); 3 - Independent environmental monitoring by the Tarn-et-Garonne and occasional expertises around the Gravelines site (F. Cazier); 4 - Study of the impact on Durance river of the liquid radiological effluents of CEA-Cadarache site (C. Fourcaud); 5 - Study of the impact on Loire river of the chemical

Chinas carbon-intensity target: climate actors and policy developments

Energy Technology Data Exchange (ETDEWEB)

Stensdal, Iselin

2012-11-01

China has become the largest GHG emitting country, and announced in 2009 its first policy objective measured in carbon emissions. The carbon-intensity target is to reduce the carbon intensity by 40-45 % by 2020 compared to 200 levels. Since then there has been further policy developments in order to attain the reduction carbon intensity and steer China towards a low-carbon development. The 12th 5-year plan (2011-2015) is strong on incentives for reducing China's carbon intensity such as energy conservation measures and the establishment of new market-based mechanisms. While the central government forms the policies, the implementation is dependent on a range of actors. In addition to the climate change bureaucracy, the positive forces and actors on GHG mitigation is presented. All in all, there are promising developments in China for the years to come.(auth)

Sovereign Wealth Funds as Global Economic and Political Actors: Defining of Notions

Directory of Open Access Journals (Sweden)

Андрей Алексеевич Кинякин

2014-12-01

Full Text Available The article devoted to consideration of sovereign wealth funds (SWF as economic and political actors as well as analysis of different forms of their activity in the contemporary global economics and politics. The author comes to the conclusion, that sovereign wealth funds play not only the role of providers of interests of the national states, but being the special purpose vehicles (SPV, designated to fulfill the different tasks, turn out to be the new type of global actors.

Reciprocal Associations Among Maternal and Child Characteristics of At-Risk Families: A Longitudinal Actor-Partner Interdependence Model.

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Claridge, Amy M; Wojciak, Armeda S; Lettenberger-Klein, Cassandra G; Pettigrew, Haley V; McWey, Lenore M; Chaviano, Casey L

2015-07-01

Researchers have found linear associations among maternal and child characteristics. However, family systems theorists suggest that relationships are more complex and family members are interdependent. We used actor-partner interdependence modeling to unravel associations among maternal and child characteristics to predict outcomes in adolescence. We used data from 361 mother-child dyads from the Longitudinal Studies of Child Abuse and Neglect and found both actor and partner effects. Maternal depression and history of victimization were associated with children's later reports of lower mother-adolescent relationship quality. Children's perceptions of relationship quality were also associated with mothers' later depressive symptoms and perceptions of relationship quality. Overall, results highlighted interdependence among mothers and their children over time. We discuss implications for marriage and family therapists. © 2014 American Association for Marriage and Family Therapy.

Banking for health: the role of financial sector actors in investing in global health

Science.gov (United States)

Kickbusch, Ilona; Franz, Christian; Wells, Nadya

2018-01-01

The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors’ business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm’s employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products. PMID:29736278

Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda.

Science.gov (United States)

Holvoet, Nathalie; Inberg, Liesbeth

2014-07-01

In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Hugh Grant's Image Restoration Discourse: An Actor Apologizes.

Science.gov (United States)

Benoit, William L.

1997-01-01

Examines the strategies used by actor Hugh Grant (in his appearances on talk shows) to help restore his reputation after he was arrested for lewd behavior with a prostitute. Uses this case as a springboard to contrast entertainment image repair with political and corporate image repair, arguing that important situational differences can be…

Renewable energy sources. Non-traditional actors on the international market

International Nuclear Information System (INIS)

1999-01-01

Five of Sweden's technical attaches have investigated the non-traditional actors activity within the field of renewable energy sources. Countries studied are USA, Japan, France, Germany and Great Britain

Actor-Network Theory and Tourism : Ordering, materiality and multiplicity

NARCIS (Netherlands)

Duim, van der V.R.; Ren, C.; Jóhannesson, G.T.

2012-01-01

The recent surfacing of actor-network theory (ANT) in tourism studies correlates to a rising interest in understanding tourism as emergent thorough relational practice connecting cultures, natures and technologies in multifarious ways. Despite the widespread application of ANT across the social

Modeling the Personal Health Ecosystem.

Science.gov (United States)

Blobel, Bernd; Brochhausen, Mathias; Ruotsalainen, Pekka

2018-01-01

Complex ecosystems like the pHealth one combine different domains represented by a huge variety of different actors (human beings, organizations, devices, applications, components) belonging to different policy domains, coming from different disciplines, deploying different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. For correctly modeling such systems, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. However, most of the existing standards, specifications and tools for describing, representing, implementing and managing health (information) systems reflect the advancement of information and communication technology (ICT) represented by different evolutionary levels of data modeling. The paper presents a methodology for integrating, adopting and advancing models, standards, specifications as well as implemented systems and components on the way towards the aforementioned ultimate approach, so meeting the challenge we face when transforming health systems towards ubiquitous, personalized, predictive, preventive, participative, and cognitive health and social care.

Capacity building for global health diplomacy: Thailand’s experience of trade and health

Science.gov (United States)

Thaiprayoon, Suriwan; Smith, Richard

2015-01-01

A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the ‘Trade-Related Aspects of Intellectual Rights (TRIPS) plus’ provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors. PMID