Science- and Engineering-Related Ethics and Values Studies: Characteristics of an Emerging Field of Research

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68834/2/10.1177_016224399001500109.pd

Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms.</p> <p>Methods</p> <p>A review of literature was conducted. A conceptual framework was developed to guide the review, which focused on the two traditional core public health functions of the san-epid system: communicable disease surveillance, prevention and control and environmental health. The review included twenty-two former communist countries in the former Soviet Union (fSU) and in Central and Eastern Europe (CEE).</p> <p>Results</p> <p>The countries studied fall into two broad groups. Reforms were more extensive in the CEE countries than in the fSU. The CEE countries have moved away from the former centrally managed san-epid system, adopting a variety of models of decentralization. The reformed systems remain mainly funded centrally level, but in some countries there are contributions by local government. In almost all countries, epidemiological surveillance and environmental monitoring remained together under a single organizational umbrella but in a few responsibilities for environmental health have been divided among different ministries.</p> <p>Conclusions</p> <p>Progress in reform of public health services has varied considerably. There is considerable scope to learn from the differing experiences but also a need for rigorous evaluation of how public health functions are provided.</p

Community governance in primary health care: towards an international ideal type.

Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept.\ud The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. \ud Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non-governmental status. Future policy and research priorities are outlined

In Memoriam: The Volksunie 1954-2001. Death by overdose of success. A warning for mature autonomist parties?

Paper prepared for presentation at the workshop directed by L. De Winter and M. Gomez on "Autonomist Parties in Western Europe”, organised by the Institut di Ciencies Politiques i Socials, Barcelona, 20-22 December 200

The Volksunie and the bitter sweet dilemma between policy success and electoral decline

Paper présenté à l'atelier intitulé "Regionalist Parties in Western Europe", organisé dans le cadre des Joint Sessions of Workshop de l'European Consortium for Political Research à Madrid, 17-22 avril, 1994