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Susanne Lohmann 《管理》2003,16(1):95-110
Institutions constrain political choices and thus commit the future path of policy. Well–designed institutions square the circle of generating commitment that is both credible and flexible. This article develops an audience–cost theory of flexible commitment that addresses some vexing questions. Where does institutional commitment come from? Why is institutional commitment feasible when policy commitment is not? How can an institution achieve credible and flexible commitment without flexibility undermining credibility by opening the back door to defections? How does partial commitment work, or how is it possible for defections to occur in an equilibrium with credible commitment? Why do policy–makers sometimes respect institutional constraints and other times defect on institutional commitments? Why are some defections punished severely, while others are instantly forgiven and forgotten? 相似文献
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The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics. 相似文献
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Diagnostic Value of PSA and AP Tests for the Detection of Spermatozoa in Postmortem Swabs from the Genital and Anal Region in Males 下载免费PDF全文
Laurence Weitzig M.D. Ann Sophie Schroeder M.D. Ph.D. Christa Augustin Ph.D. Tobias Raupach M.D. M.M.E. Susanne Sehner M.Sc. Sven Anders M.D. M.M.E. 《Journal of forensic sciences》2015,60(1):41-44
The aim of this study was to clarify whether positive results for prostate‐specific antigen (PSA) and acid phosphatase (AP) occur in postmortem swabs from the genito‐anal region in males (n = 80; 4 regions) and females (n = 20; 3 regions) and to calculate the positive predictive value (PPV) concerning the presence of spermatozoa. In male subjects, the highest incidence of positive test results was found in urethral swabs (PSA 76%, AP 71%) and the lowest frequencies appeared in perianal and rectal swabs (15–20%). Microscopic evaluation for spermatozoa was positive between 39% in urethral swabs and 1% in rectal swabs. PPV regarding positive identification of spermatozoa was 33.3% for PSA and 31.5% for AP. The combination of both tests yielded a PPV of 38.2%. In female cases, no spermatozoa were identified, and one case was PSA‐ and AP‐positive in perianal swabs. Our findings indicate that PSA and AP tests are of limited value for the postmortem detection of spermatozoa in male subjects. 相似文献
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Susanne Lütz 《Politische Vierteljahresschrift》2003,44(2):231-243
Ohne Zusammenfassung 相似文献
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While both India and Brazil are seriously affected by the HIV/AIDS epidemic, each country has chosen a different approach to providing affordable pharmaceutical treatment. Whereas the Indian government has paved the way for market-driven solutions, Brazilian public authorities are strongly involved in the research and production of HIV/AIDS medication. Brazilian regulations permit comprehensive and free provision of HIV/AIDS drugs, whereas the majority of the affected population in India does not receive adequate pharmaceutical treatment. To explain the different policy outputs, we draw on the developmental state literature. Efficient decisionmaking structures, a devoted bureaucracy, and effective policy instruments enable public authorities to provide public goods even in the context of relative scarcity. We show that the assumptions of developmental state theory have to be complemented by the assessment of civil society actors' potential to trigger governmental interventions in the market. 相似文献