A central concern of this research has been to understand more about how and why organisations change. My initial research question posed was: What is 'strategy', how does it emerge in health care organisations and how can I influence its development? This is explored within the context of my field of practice as a Director of Nursing in a National Health Service (NHS) Trust. I have approached this enquiry through using a methodology known as emergent exploration of experience (Stacey et al., 2003). This methodology is informed by insights from Complexity Science and the theories of complex responsive processes of relating. What emerged through the enquiry were a number of key areas of concern related to national healthcare strategy and the management of risk within my NHS trust. The findings from this research radically challenge the way we are practising together in my organisation in moving from the position of locating accountability for mistakes with either the individual or the system. Instead it is suggested that, as part of our ongoing process of interaction, we co-create what others are describing as a 'system' through our participation with each other. Accepting the notion of co-creation requires us to examine very carefully the influence of our own participation in the dangerous situations that arise in our everyday work, and to acknowledge our own accountability for what emerges. I am proposing that this makes a new contribution to knowledge in this field for two reasons. First, because it explores for what I believe to be the first time the validity of the theory of complex responsive processes in the discourse of risk management in health care. I am proposing that this theory has a legitimate contribution to make in this field of practice, that is worthy of further enquiry and research. Second, in making this shift to a perspective that understands accountability for error as something that we co-create in groups, my thesis poses a radical challenge to many of the activities that are traditionally undertaken when mistakes occur in organisations. Specifically, I have questioned the usefulness of approaches that seek remedies through focusing on individuals outside the context of the group and those that focus on re-engineering what other authors refer to as the 'whole system'. I offer an alternative through describing examples in my narrative of a different approach grounded in the research methodology of emergent exploration of experience. This focuses on the micro-interactions between participants in groups as a way of understanding the transformation of practice .I am arguing that such transformation may not always be an improvement, because we cannot always accurately predict the outcomes of our actions in advance. This perspective therefore also challenges the assumption made by some authors in this field, who believe it is possible to 'human-proof' systems and thus guarantee âzero defects'. In seeking an answer to my research question I have therefore moved from understanding strategy as a vision for the future that can be planned and implemented by a few powerful individuals whom others follow to a different understanding. I now see strategy as an emergent phenomenon arising from micro-interactions between people in the present â hence we co-construct our future as the actions we take in the present. From this perspective I have argued we all have the potential to influence what is emerging through our actions, for which we are constantly held to account, through both our inner dialogue with ourselves and our conversations with each other.
The world is experiencing dramatic fiscal reconstruction in the socialist and (former) socialist countries and of continuing and fascinating evolution of government structure elsewhere. Being one of the fastest growing economies over the past nearly three decades, China seems deeply embracing this global mantra of power devolution in her effort to energize local economy that was suffocated in the highly constricted state-planning system. The literature of the Chinese central-local studies suggests that fiscal decentralization from the central government to provincial governments is a key institutional factor to explain Chinese economic success. However, the literature misses various lower levels of government in China. Has the fiscal power been eventually trickled down to them? This is the question addressed in this project. This project makes several contributions to the thriving Chinese central-local study. It brings back the missing local governments in the intergovernmental debate. By linking various local governments with the national government, the findings in this project help to draw a more comprehensive and holistic picture of the intergovernmental fiscal relations in China. Such a study on the evolution of fiscal structure among local governments also adds knowledge to understand the broad economic and administrative transformation in contemporary China. Using the latest datasets of public finance, this project performs a series of statistical analysis to understand if fiscal decentralization has taken place to each level of Chineselocal governments in the reform era. This project also tests the factors that have been widely identified in the classical welfare theory as explanative factors for the fiscal arrangement at different levels of local government. This project finds out that fiscal decentralization fails to capture the main trend of the intergovernmental fiscal relations at various Chinese local governments. Instead, there has been a rather consistent pattern of fiscal centralization across those local governments during the 1990s and the early 2000s.
Practical knowledge on the design and application of multi-objective evolutionary algorithms (MOEAs) is available but well-founded theoretical analyses of the runtime are rare. Laumanns, Thiele, Zitzler, Welzel and Deb (2002) have started such an analysis for two simple mutation-based algorithms including SEMO. These algorithms search locally in the neighborhood of their current population by selecting an individual and flipping one randomly chosen bit. Due to its local search operator, SEMO cannot escape from local optima, and, therefore, has no finite expected runtime in general. In this talk, we investigate the runtime of a variant of SEMO whose mutation operator flips each bit independently. It is proven that its expected runtime is O(n^n) for all objective functions f: {0,1}^n -> R^m, and that there are bicriteria problems among the hardest problem for this algorithm. Moreover, for each d between 2 and n, a bicriteria problem with expected runtime Theta(n^d) is presented. This shows that bicriteria problems cover the full range of potential runtimes of this variant of SEMO. For the problem LOTZ (Leading-Ones-Trailing Zeroes), the runtime does not increase substantially if we use the global search operator. Finally, we consider the problem MOCO (Multi-Objective-Counting-Ones). We show that the conjectured bound O((n^2)log n) on the expected runtime is wrong for both variants of SEMO. In fact, MOCO is almost a worst case example for SEMO if we consider the expected runtime; however, the runtime is O((n^2)log n) with high probability. Some ideas from the proof will be presented.
After the collapse of the Soviet Union, and especially after passage of the 1990 law on freedom of conscience, Russian people showed increased interest in religion, moral values, and national cultural traditions. Such a phenomenon is quite understandable because the ideology of socialism had failed. Every other state also has come to bear various aspects of a multicultural society nowadays. Elements, which constitute society, such as ethnicity, culture, and religion, have become far more diversified than expected. As a result, every state is compelled to restructure its educational system, so that it may better accommodate to this growing diversity. While the specific contents of value education differ from country to country, it can generally be stated that those in advanced countries involve citizenship education, multicultural education, or education aimed at developing autonomous value judgment. On the other hand, those in developing countries involve moral education, religious education, or education aimed at developing national identity.From the early 1990s on, we have observed the decentralization of the system of education in Russia. School curricula are being revised, new elective and local initiatives in education are being encouraged, and private schools are appearing. Thus the system of education has become more flexible and there is a favorable situation to introduce religious education as an elective. In the early 1990s, the Russian Ministry of Education made the decision to introduce religious studies in Russian schools by means of curricula stressing Christian ethics and morality. High officials from the Russian Ministry of Education also approached Western Christian educators for help. The response was a collaborative effort of over 80 Western mission groups called the CoMission, which instructed Russian public school educators in the teaching of Christian ethics and morality. The CoMission was to teach those Christian beliefs that were common to all Christian denominations, but its curriculum represented a Protestant approach to Christian ethics and Scripture. In 1995 the Ministry of Education suspended the Protocol of Intention with the CoMission.By virtue of its title Alla Borodina's textbook âBasics of Orthodox Cultureâ became the symbol of the proponents of introduction of BOC. The textbook has the stamp âRecommended by the Coordinating Council on Cooperation of the Ministry of Education of Russia and the Moscow patriarchate of the Russian Orthodox Church.â The discussion about the teaching of the âBasics of Orthodox Cultureâ in public schools began as a reaction to a circular letter by Russian Minister of Education Vladimir Filippov to regional offices of administration of education in October 2002. To the letter was appended sample contents of education in the academic subject of âOrthodox Culture.â Two camps arose; on one hand were those who approve the introduction of basics of Orthodox culture into the curriculum of secondary education; on the other hand are those who categorically oppose it. Two members of a human right organization made an attempt to initiate criminal investigation against Borodina. They accused her of anti-Semitism. More than ten court sessions took place in Moscow concerning this matter. Nevertheless the âOrthodox Cultureâ has already become a regular school subject in several cities and provinces of Russia: Voronezh, Kursk, Smolensk and others.It will be a great loss for Russia's children if either the path of indoctrination or an irreligious school education is pursued. In the former case, while trying to preserve national identity and the consolidation of Russian society, they potentially lose democratic principles and freedoms. In the latter case, while trying to preserve freedoms, they lose all connection with their national spiritual tradition and,
The idea of the theory of Community Co-management was originally based on research of the fishing and pearl culturing villages of Shima district in Mie Prefecture during the 1960s. At that time, the landed quantity of cultured pearls in the district increased rapidly because of growth in number of culture establishments and an increase in density of their culturing oyster shells. However, the increase of pearl production in a limited marine area resulted in the rapid deterioration of both quality and price of cultured pearls. At around the same time, sightseeing facilities attracted attention in the district, and environmental burdens imposed by them have become heavy. Then, to realize compatible and sustainable relations with each other for the efficient use of local resources, the establishment of a new community organization composed of fishermen, pearl culture establishments, sightseeing facilities, and inhabitants as comsumers of marine products became indispensable. The management of local resources, by all interested parties, became the core function of the community. For this reason, a community can be seen as an organization for the co-management of living conditions. Modern society has increased its collective consumption, and has grown in community co-management of its living conditions. This means that a community can be seen from the view point of managerial functions. There can be an understanding of the common features and structures of rural and urban communities as well as of neighborhood communities and municipal authorities despite ecological and legislative differences. At present, the development of the decentralization of administrative systems in our country permits the official establishment of a kind of teritorrial autonomous body within a local autonomy. The concept of community co-management has become increasingly realistic.
Abstract. In undeniable signature schemes, zero-knowledgeness and non-transferability have been identified so far. In this paper, by separating these two notions, we show the first 3-move confirmation and disavowal protocols for Chaumâs undeniable signature scheme which is secure against active and concurrent attacks. Our main observation is that while the signer has one public key and one secret key, there exist two witnesses in the confirmation and disavowal proofs of Chaumâs scheme.
Decentralization of health services in Uganda, driven by the structural adjustment programme of the World Bank, was embraced by government as a means to change the health institutional structure and process delivery of health services in the country.Arising from the decentralization process, the transfer of power concerning functions from the top administrative hierarchy in health service provision to lower levels constitutes a major shift in management, philosophy, infrastructure development, communication as well as other functional roles by actors at various levels of health care.This study focused its investigation on ways and levels to which the process of decentralization of health service delivery has attained efficient and effective provision of health services.The study also examined the extent to which the shift of health service provision has influenced the role of local jurisdictions and communities.Challenges faced by local government leaders in planning and raising funds in response to decentralized health service delivery were examined.The study used a descriptive survey research design employing qualitative techniques, namely questionnaires, structured interviews, observation, and document analysis to establish the extent to which the decentralized approach to health service delivery has impacted on local governments and the vulnerable target groups such as the rural and urban poor, children, mothers, HIV/AIDS victims, orphans and refugees.Key respondents were government officials in health related management in the country at various levels.Health workers and beneficiaries of health services were interviewed to share their views and experiences of decentralized health care service provision.iii Using a conceptual framework of "Community as Client", the findings illustrate that while some local governments in the country have extended health units closer to some communities, the pursuit of a decentralized health service delivery system in Uganda over-assumed the benefits of decentralizing health care.The observations indicated that health care is not better organized; neither has decentralization provided greater involvement of local communities in mobilization and capacity building of community-based health workers.The acclaimed cost containment and reduction through duplication of services, reduction of inequities, integration of activities of different agencies and organizations involved in health care have not been achieved in concert with original expectations and assumptions of decentralization.These include: strengthened health policy and planning functions of the ministry of health, improved implementation of health programmes, greater community control and financing (ownership) and improved inter-sectoral coordination.From the findings, it would appear that the motivation for decentralizing health care was not intrinsically guided by how the decentralized health system can better serve the poor majorities in the country.The study concludes that the decentralization of health services in Uganda was not matched with commitment for provision of necessary health supplies, and delivery of health care services through a centrally coordinated national network of health facilities.The Ugandan Government in particular Ministry of Health and the government needs to evaluate the achievements and challenges faced by the health care system under decentralization within the broader perspective of health for all, as a means to establish appropriate refocusing of health care delivery for optimal benefit of the client communities.
In this collection of essays (old and new), Kai Nielsen offers a characteristically clear and forthright formulation of a perspective for which he is already well known.There is not much in the book that engages in detail with recent developments in analytic philosophy of religion; indeed, Nielsen comments that because of its habitual neglect of certain questions, philosophy of religion in this style fails to make any serious demand upon our attention: "I suppose we could analytically reconstruct and conceptually clarify Mary Baker Eddy's metaphysical tract too, but that would hardly enhance interest in it or further our understanding of the significance of religion.These analytical philosopher-theologians need first, against the antimetaphysical arguments of Wittgenstein, Davidson, Rorty, and Putnam, to give us some reason to think that there is in the sorts of things they are doing something significant" (p.20).A second, related difficulty for mainstream analytic philosophy of religion is that it is "very rationalistic"; rather than worrying about new versions of the traditional proofs, "what is crucial to face instead is whether we need a belief, however overwhelmed with intellectual impediments, in a Jewish, Christian or Islamic God to make sense of our lives and to live really human lives" (p.21).In these remarks, Nielsen sets two kinds of challenge for contemporary philosophical theology: to confront the difficulties inherent in any kind of metaphysical claim, and to consider whether religious commitment can be understood, and perhaps justified in some degree, by reference to its contribution to human flourishing.Let's take these challenges in tum.Nielsen evidently thinks it rather obvious that a metaphysically committed kind of religious belief is intellectually defective.Indeed, thinking in particular of the metaphysical dimension of religious belief, he comments: "I remain utterly flabbergasted that reflective, intelligent, and informed people ... can be believers" (p.393).Naturally Nielsen wonders whether his inability to understand the commitments of 'intelligent and informed' people raises a question about whether he has fully understood what is at stake here.Even so, the very obviousness of the case for atheism, from his point of view, seems at times to get in the way of a detailed presentation of
One objective frequently found in models of decentralized financing is that of equalization. The concern is that poorer jurisdictions receive enough resources for basic services and for development promotion, thus eliminating horizontal and vertical imbalances. In Portugal, decentralization has occurred at two levels: the local, for the whole country and the regional for the autonomous regions of the Azores and Madeira. Decentralization to local governments has undergone several changes in recent decades. The current paper focuses on testing for the presence of an equalization effect in the models adopted to finance municipalities in Portugal, since the nineteen nineties. Using the theoretical background that maintains that for the presence of an equalizing effect it is necessary that, on a per capita basis, poorer regions or localities receive relatively more transfers than the richer jurisdictions, a test is made using a data set that includes all municipalities of Portugal. The situation of the two autonomous regions is controlled with dummy variables. The hypothesis that the models used have an equalizing effect is tested through the sign of the coefficient of the regression of per capita transfers on per capita own resources. In the presence of an equalizing effect the sign will be significant and negative. It is confirmed that, for the period under analysis, the municipalities with lower per capita own revenues are those that receive more transfers per capita. There is, therefore, an equalizing effect in the current transfer system to municipalities. Using pooled data, one can also conclude that the equalization effect has become stronger with the 1998 and 2002 reviews of the system, when compared to the system in effect in 1991.
In spite of a long history of institutional reforms, Mexico still cannot assure adequate water services to its population and its aquifers and ecosystems are being degraded. Although decentralization is a principal theme of administrative reform, the National Water Commission (CNA) remains a powerful semi-autonomous organization charged with the oversight and control of local water agencies. Local urban water administrations are under intense pressure to change their management structures to ...
We examine the pyramidal ownership structure of a large sample of newly listed Chinese companies controlled by local governments or private entrepreneurs. Both types of the owners use layers of intermediate companies to control their firms. However, their pyramiding behaviors are likely affected by different property rights constraints. Local governments are constrained by the Chinese laws prohibiting free transfer of state ownership. Pyramiding allows them to credibly decentralize their firm decision rights to firm management without selling off their ownership. Private entrepreneurs are constrained by their lack of access to external funds. Pyramiding creates internal capital markets that help relieving their external financing constraints. Our empirical results support these conjectures. Local governments build more extensive corporate pyramids when they are less burdened with fiscal or unemployment problems, when they have more long-term goals, and when their firm decisions are more subject to market and legal disciplines. The more extensive pyramids are also associated with smaller "underpricing" when the firms go public. Entrepreneur owners construct more complex corporate pyramids when they do not have a very deep pocket - as indicated by whether they are among the top-100 richest people in China.
Abstract. A shuffle consists of a permutation and re-encryption of a set of input ciphertexts. One application of shuffles is to build mix-nets. We suggest an honest verifier zero-knowledge argument for the correctness of a shuffle of homomorphic encryptions. Our scheme is more efficient than previous schemes both in terms of communication and computation. The honest verifier zero-knowledge argument has a size that is independent of the actual cryptosystem being used and will typically be smaller than the size of the shuffle itself. Moreover, our scheme is well suited for the use of multi-exponentiation and batch-verification techniques. Additionally, we suggest a more efficient honest verifier zero-knowledge argument for a commitment containing a permutation of a set of publicly known messages. We also suggest an honest verifier zero-knowledge argument for the correctness of a combined shuffle-and-decrypt operation that can be used in connection with decrypting mix-nets based on ElGamal encryption. All our honest verifier zero-knowledge arguments can be turned into honest verifier zero-knowledge proofs. We use homomorphic commitments as an essential part of our schemes. When the commitment scheme is statistically hiding we obtain statistical honest verifier zero-knowledge arguments; when the commitment scheme is statistically binding we obtain computational honest verifier zero-knowledge proofs. Key words. Shuffle, Honest verifier zero-knowledge argument, Homomorphic encryption, Mix-net. 1
India has set out ambitious goals for itself in the health sector in its Tenth Five Year Plan (2002-07). It is also a signatory to the United Nations Millennium Development Goals. Attainment of these goals which are time-bound will require a massive scaling up of investment in health, especially in public primary health care. We argue for a âHealth for Allâ initiative on the part of the government akin to the âEducation for Allâ scheme which was launched nation-wide in 2001. The large amount of resources required for scaling up public investment in primary health need not be the constraint it is purported to be. We discuss several options that are available to the government for generating the necessary funds. Among the options that can generate resources domestically are reform of the governmentâs subsidies regime including implementing life-line tariffs, ear-marking taxes and disinvestment of loss-making public sector units. Health for All can also be financed by raising more resources via external assistance. Official development assistance to India at present is rather low given Indiaâs per capita income and the scale of its needs in human development terms. The scale of official development aid to India should increase several folds and committed use of funds should be made by the government in health and other priority sectors. With the 73rd and 74th amendments to the Indian Constitution which created a third tier of government comprising of elected local bodies at the village and town ward levels, a decentralized system of service delivery will eventually become a reality in India and needs to be a part of any debate on the means and modes of improving human development outcomes in India. The current system of planning and allocation of funds at the sub-national level however needs to be over-hauled if fiscal decentralization is also to become a reality.
Omar Khadeer Hussain, Elizabeth Chang, Farookh Khadeer Hussain, Tharam S. Dillon · 5 authors
Risk is associated with almost every activity that is undertaken on a daily life. Risk associated with Trust, Security and Privacy. Risk is associated with transactions, businesses, information systems, environments, networks, partnerships, etc. Generally speaking, risk signifies the likelihood of financial losses, human casualties, business destruction and environmental damages. Risk indicator gives early warning to the party involved and helps avoid deserters. Until now, risk has been discussed extensively in the areas of investment, finance, health, environment, daily life activities and engineering. However, there is no systematic study of risk in Decentralised communication, which involves e-business, computer networks and service oriented environment. In this paper, we define risk associated with trusted communication in e-business and e-transactions; provide risk indicator calculations and basic application areas.
Abstract. Most prior designated confirmer signature schemes either prove security in the random oracle model (ROM) or use general zeroknowledge proofs for NP statements (making them impractical). By slightly modifying the definition of designated confirmer signatures, Goldwasser and Waisbard presented an approach in which the Confirm and ConfirmedSign protocols could be implemented without appealing to general zero-knowledge proofs for NP statements (their Disavow protocol still requires them). The Goldwasser-Waisbard approach could be instantiated using Cramer-Shoup, GMR, or Gennaro-Halevi-Rabin signatures. In this paper, we provide an alternate generic transformation to convert any signature scheme into a designated confirmer signature scheme, without adding random oracles. Our key technique involves the use of a signature on a commitment and a separate encryption of the random string used for commitment. By adding this âlayer of indirection, â the underlying protocols in our schemes admit efficient instantiations (i.e., we can avoid appealing to general zero-knowledge proofs for NP statements) and furthermore the performance of these protocols is not tied to the choice of underlying signature scheme. We illustrate this using the Camenisch-Shoup variation on Paillierâs cryptosystem and Pedersen commitments. The confirm protocol in our resulting scheme requires 10 modular exponentiations (compared to 320 for Goldwasser-Waisbard) and our disavow protocol requires 41 modular exponentiations (compared to using a general zero-knowledge proof for Goldwasser-Waisbard). Previous schemes use the encryption of a signature paradigm, and thus run into problems when trying to implement the confirm and disavow protocols efficiently. 1
One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a way through is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents and institutional factors on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions.