Establishing a system of family practice clinics with physicians from its medical staff enabled Mercy Hospital Medical Center, Des Moines, IA, not only to meet consumers' changing needs and wants but also to develop a long-term strategy for survival. The joint venture, which has grown to 9 clinics and 30 physicians since its inception in 1983, does not restrict the hospital from entering into similar relationships with other physician groups. Neither does it restrict physicians from entering new arrangements or using other hospitals. Each clinic operates quasi-autonomously in serving its own patients, and issues such as hiring, firing, hours of operation, and local public relations are handled in a decentralized manner. Other matters--insurance coverage, marketing programs, accounting and data processing systems--are standardized throughout the organization. Challenges involved in undertaking such a project include overcoming resistance from employees, building public awareness of the project, and creating an open, trusting relationship between physicians and administrators. It is particularly important to foster the support of physicians "outside" the partnership and to include those who remain in private practice in marketing efforts.
A solution to the following fundamental communication problem is presented. Suppose that n tokens are arbitrarily distributed among n processors with no processor having more than K tokens. The problem is to specify a bounded-degree network topology and an algorithm that can distribute the tokens uniformly among the processors. The first result is a tight $\Theta (K + \log n)$ bound on the complexity of this problem. It is also shown that an approximate version of this problem can be solved deterministically in $O(K + \log n)$ on any expander graph with sufficiently large expansion factor. In the second part of this work, it is shown how to extend the solution for the approximate distribution problem to an optimal probabilistic algorithm for the exact distribution problem on a similar class of expander graphs. Note that communication through an expander graph is a necessary condition for an $O(K + \log n)$ solution of the problem. These results have direct applications to the efficient implementation of many-to-one and one-to-many communication requests, as well as to the solution of load-balancing problems in distributed systems.
A perfect zero-knowledge interactive proof is a protocol by which Alice can convince Bob of the truth of some theorem in a way that yields no information as to how the proof might proceed (in the sense of Shannon's information theory). We give a general technique for achieving this goal for any problem in NP (and beyond). The fact that our protocol is perfect zero-knowledge does not depend on unproved cryptographic assumptions. Furthermore, our protocol is powerful enough to allow Alice to convince Bob of theorems for which she does not even have a proof. Whenever Alice can convince herself probabilistically of a theorem, perhaps thanks to her knowledge of some trap-door information, she can convince Bob as well without compromising the trap-door in any way. This results in a non-transitive transfer of confidence from Alice to Bob, because Bob will not be able to subsequently convince someone else that the theorem is true. Our protocol is dual to those of [GMW1, BC].
RECENT STUDIES Christian ethics have uncovered a of convergence between pacifist convictions and just-war tenets. Although it is easy to assume that just-war ideas and pacifism are wholly incompatible approaches to the morality of warfare, James Childress argues that pacifists and just-war theorists actually share a common starting point: a presumption against the use of force. Childress uses W. D. Ross's language of prima-facie duties to show how pacifism and just-war thought converge. The duty not to kill or injure others (nonmaleficence) is a duty within each approach. For the pacifist, nonmaleficence is an absolute duty admitting of no exceptions. For just-war theorists, nonmaleficence is a prima-facie duty, that is, a duty that is usually binding but may be overridden exceptional circumstancesâ particularly when innocent life and human rights are at stake. Primafacie duties are not absolute, but place the burden of proof on those who wish to override them when they conflict with other duties, in virtue of the totality of... ethically relevant circumstances. War poses just those exceptional circumstances which the duty of nonmaleficence may be overridden. In this way Childress both highlights the point of contact between pacifism and just-war tenets and reconstructs the essential logic of the jus ad bellum. To override a prima-facie duty, however, is not to abandon it. Such duties continue to function the situation or the subsequent course of action. That is, a prima-facie duty leaves residual effects or moral traces; after overriding such a duty, our conduct must be affected by it. In the context of war, this means that the duty of nonmaleficence exerts a pressure upon the conditions and methods of war. War must be a last resort, pursued for the ends of peace, declared by a competent authority, carried out by limited means, etc. In other words, Childress reconstructs the logic of the jus bello without departing from his
The paper investigates the structure and development of planning procedures suitable for matching the needs of the road infrastructure, in relation to other transport facility requirements, with available resources. A hierarchial framework involving all parties involved in financing and providing transport facilities in which planning procedures should be developed is suggested. This involves the investigation of alternative national options through the collation and interpretation of needs derived from decentralized road management systems and from information concerning other modes of transport.
This article argues that (1) the clarity of a policy intention depends upon the appropriateness of the organizational form to implement it, and (2) the assumptions held by policymakers regarding organization form, in practice, often lead to offsetting or contradictory implementations. The study examines a major recent policy reorganization-Florida's transformation of eight autonomous human services agencies into a single department. Its avowed purposes were to integrate and decentralize services. Elmore's (1978) fourfold model is employed to assess those intentions. The findings indicated that implementation became troubled as policymakers adopted inappropriate organizational assumptions to support their intentions. The conclusions suggest that implementation had to accommodate opposing dimensions of organizational strategy and managerial structure.
Although education in Latin America is a highly profitable investment, the present financial puts constraints on the amount of resources available for investment in the sector. Also, resources already devoted to education may not be used as efficiently as they could, and they may be inequitably distributed among different groups in the population. This paper presents a number of facts and issues related to the financing of education in Latin America and discusses some possible solutions. It is argued that cost-recovery in higher education, combined with the increased availability of educational credit and decentralization through private schools, may be the best policy package for addressing many crisis issues in education. Such a package would lead to a higher level of efficiency, in the sense that existing resources devoted to education will be better utilized. It will also attract more resources to a sector in which investments exhibit a high social profitability. Beyond the efficiency effect, charging for higher education would paradoxically be socially more equitable relative to the present situation of indiscriminate subsidies. THE FINANCING OF HIGHER EDUCATION IN LATIN AMERICA: ISSUES AND LINES OF ACTION As in other parts of the world, education in Latin America is a highly profitable investment. However, the present financial puts constraints on the amount of resources available for investment in the sector. Also, resources already devoted to education may not be used as efficiently as they could, and they may be inequitably distributed among different groups in the population. The purpose of this paper is, first, to present a number of facts and issues related to the financing of education in Latin America and, second, to discuss some possible solutions. While the focus of the paper is higher education in Latin America, other levels of education and world regions are incorporated in the analysis for comparative purposes. 1j I. Some General Trends As shown in Table 1, the social returns to investment in education in Latin America are substantial and, as in other parts of the / One caveat is in order at the outset. The paper heavily relies on a set of statistics that although are the relatively best and the only available, they leave much to be desired in terms of comprehensiveness and comparability across countries. For example, the 1985 Unesco Statistical Yearbook cites a 120 percent gross primary enrollment ratio for Colombia, although observers suggest that only one third of a given age group actually complete the primary cycle. world they are highest at the primary level. Nevertheless, university education exhibits a 16 percent rate of return which is well above any criterion discount rate (say, 10 percent). This means that expansion of any level of education in the region would be a good social investment. (Appendix Table A-1 gives estimates of the returns to education in individual Latin American countries). Table 1: The Returns to Investment in Education by Country Type and Level (Percent) Region Social Private Primary Secondary Higher Primary Secondary Higher Latin America 26 18 16 32 23 23 Developing countries 24 15 13 31 19 22 Developed countries 11 9 12 12 Source: Psacharopoulos (1985), Table 1. Note: Private returns take into account only the cost of education to the individual. In contrast, social returns are based on the full cost of education to society, so they are comparatively lower. Data were not available because no control group of illiterates was available. These magnitudes are likely to be under-estimates of the true social rates since they do not reflect non-market effects, which are expected to be substantial. Society as a whole gains from having a literate and numerate population, and there are indirect benefits, affecting health and fertility, which are not easily measured in monetary terms (but see Haveman and Wolfe, 1984).
The purpose of this paper is to document recent reforms in the administration and financing of education in Chile and to describe how they have been implemented. In primary and secondary education, the reforms consisted of decentralizing public schools by transferring them to municipalities and by encouraging the private sector to operate subsidized tuition-free schools. In higher education, the reforms consisted of allowing the private sector to create higher education institutions, raising tuition fees in public and private subsidized universities, introduction of student loans to needy students and a per-student payment for transferring public funds to universities. Although it is too early to say whether or not the reforms have succeeded, the paper makes several conclusions. Firstly, these well conceived and planned reforms have faced several implementation problems. Secondly, although the per-student payment system has worked well in primary and secondary schools, it has not done so well at the university level. Lastly, the private sector has responded rapidly to subsidized tuition-free schools and higher education institutions; tuition in public and private subsidized universities has increased; and student loans now constitute a large part of university financing.
Key Settlement Policy divides rural settlements into two types?those in which expansion is allowed and those in which it is not. Although suitability for residential expansion is not completely synonymous with suitability for infrastructure investment (nor vice versa) the designation of Key Settlement or non-Key Settlement status does not have a significant impact on infrastructure and service provision. In the light of central and local public expenditure economies and of the 1985 Transport Act, therefore, key Settlement Policy takes on a renewed political importance. In 1982 the Warwickshire policy was changed, involving some changes in designation, and also a beginning of decentralization of designation decisions away from the county to the constituent districts. The change was justified by the argument that the policy had previously been ineffective. However, analysis of the 17 key settlements and 17 control non-key settlements from 1966 to 1981, with respect to population change, refusal rates, Planning Inspectors' decision letters, and appeal decisions, shows that the policy was effective. It is argued that the reason for the policy change in 1982 stems from central government and County Council political objectives, and that decentralization of designation powers to districts constitutes a loss of accountability for rural policy in Warwickshire. PRESENT GOVERNMENT POLICIES toward rural areas emphasize efficiency, rationalization, and cost-cutting of rural services. Many village schools are closing as school rolls fall nationally, and as local authorities search for economies. The national bill for subsidizing the bus companies is threatening to reach ?1 billion annually, and legislation now before Parliament seeks radically to reduce this vast sum by means of privatization, a measure which will cut unprofitable bus routes considerably, mainly in rural areas. Also, as the Post Office looks for greater efficiency, an acceleration of closures of rural post offices may occur. It is in this context that we investigate Warwickshire County Council's rural settlement policy. Rural settlement policies, because of the trend towards cutbacks in services, are increasingly coming to the forefront of politics in rural areas. Such policies are, and will increasingly become, the main instrument for deciding which settlements should suffer from loss of rural services, since they indicate settlement hierarchies, and therefore serve as a means of discriminating between those settlements which should be favoured ('key settlements') and those which should suffer from cutbacks. Although many of the threatened services are being privatized and thus are moving ostensibly out of the local political arena, any decision on specific cutbacks in specific areas will necessarily implicate local government. Local politicians will be unable to avoid the political storms and subsequent unpopularity thus created. The government has repeatedly made clear that any loss of services resulting from privatization should occur only after consultation with the relevant local authority. Other services, such as education and social services, obviously implicate local politicians more directly, in their continuing search for economies. Moreover, changes in government thinking on the financing of local government continually emphasize the need to make local politicians more accountable for the costs of local services to the local voters. The present Conservative Government has, since 1979, carried an election pledge to implement this change?by reforming the rating system. Furthermore, suggestions currently being considered emphasize a
The certification of suicide as the manner of death is frequently contested in court by the victim's survivors, particularly when there are life insurance benefits at stake. The evidence upon which the opinion of suicide is based must, therefore, meet the standard of proof required in law, if it is to be sustained by the courts. This standard of proof and some of its contingent common law doctrines are discussed, with references to several judicial opinions from cases which involved contested suicides.
This report discusses the benefits and applicability of Firm Fixed-Price, Fixed-Price Award Fee, Cost Plus Award Fee and Hybrid contracts for use in installation support service contracts. Impacts on the Commercial Activities and Small Business programs are discussed. Recommendations for specific actions to improve installation support contracts are presented.
In this chapter I discuss the emergence and development of the two major decentralized civilizations of the first millennium b.c. , Phoenicia and Greece. I concentrate on Greece because it is considerably better documented: We can distinguish the principal phases of its dialectic of development. I argue that the massive contributions of both peoples to the development of social power is to be attributed to the decentralized, multi-level nature of their civilizations, appropriate for taking advantage of the geopolitical, military, and economic legacy of their region, especially that bequeathed by the Near Eastern empires of domination. I suggest that two principal dialectics can be discerned in the emergence of Phoenicia and Greece as âleading edgesâ of contemporary power. The first, discussed briefly and tentatively, concerns the possibility that these civilizations were part of a macro historical process. In this case, decentralized multi power-actor civilizations lying on the marches of established empires of domination exploited the success plus the institutional rigidity of those empires to âemerge interstitiallyâ and establish their own autonomous power organizations. After a long, successful process of power development, however, their own organizations became institutionalized and rigid. Now they become vulnerable in their turn to new empires of domination lying on their marches. Such a process can be traced in the first millennium b.c. The extent to which it was, indeed, part of a macro historical process will be left to the concluding chapter. The second dialectic concerns that âmiddle periodâ of developmental success.
The North Pacific right whale population was hunted commercially between 1835 and 1935, at which time the species received protection. Commercial whalers harvested over 15,000 North Pacific right whales during this period, so reducing the population that today there are an estimated 100-200 right whales in the North Pacific. The American Pacific Whaling Company operated in the Gulf of Alaska and eastern Bering Sea during 1917-39. We report the distribution, sexes, and lengths of 20 right whales recorded in the company logbooks and ledgers. These records identify that right whale catches were widely distributed on the whaling grounds and tended to decrease over the May-October whaling season. Of the 17 whales for which sex and length data were documented, 11 were females. Their average length exceeded that of males. Lengths of the whales indicated that 41 percent of the catch were sexually mature; two females carried fetuses. Although the sample size is small, these results suggest that the North Pacific right whale population was inhabiting its historic summering grounds after the period of heavy exploitation in the 1800s, reproducing as late as 1926, and supporting a subadult cohort at least until the species was protected.Key words: right whale, North Pacific Ocean, Alaska, Distribution
Despite a long history of decentralization, Sudan only truly introduced regionalization as a form of government in 1972 for the South and in 1980 for the North. Its introduction created at least three problems regarding the fiscal and financial relationship between the central government and its subordinate regional governments, viz. how to allocate funds efficiently, how to allocate taxing powers rationally and efficiently, and how to share revenue. A review of the central government's financial position reveals that it is hardly in a position to shoulder additional expenditure brought about by the creation of regional governments. On the other hand, a review of regional governments' financing also reveals their inability to raise sufficient funds locally. At present the regions depend rather heavily on the central government's meagre recurrent budget. However, the criteria for allocating funds from the centre to the regions are inefficient and inequitable, and there is no clear framework of regional planning and investment policies. The author suggests alternative criteria for the allocation of central funds to the regions. Bibliogr., notes.
At the beginning of the nineteen eighties the observers of Italian local government system were divided between those who, looking at the unexpected social and economic development of the peripheral areas, labelled the situation as âneolocalismâ and those who, emphasizing the total dependence of the municipalities on the central government grants, spoke of âneocentralismâ. The difficulty in assessing the centralized or decentralized nature of the Italian systemâit is suggested in this paperâdepends on the inadequacy of such concepts to cope with the complexities of contemporary political systems. From a reconstruction of the local finance reforms, which is able to show the possible objectives of such a policy, the outcomes of its implementation, as well as the actors of the process, their rationales, and their interactions, it is concluded that the intergovernmental relations have not been altered in favor of the central power and that the traditional fragmentation of the Italian political administrative system has been strenghtened. Conceptualizing intergovernmental relations as policies gives a much more realistic and promising way to depict the issue than does the simplistic zero-sum assumption implied in the traditional centralization-decentralization debate.