The influence of institutions and culture on health policies: different approaches to integrated care in England and The Netherlands

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.     

Problem solving as reinforcement in adolescent drug use: Implications for theory and policy

The problem of adolescent drug use received a great deal of attention both in criminological theory and public policy. Predominant among theories was Akers' social learning theory which examined the role of learning through a process of imitation, modeling, and reinforcement. Public policy led to the development of programs such as Drug Abuse Resistance Education (DARE) that aimed to warn youths of the dangers of drug use. In line with research findings, both theory and policy gave a central role to peers in understanding adolescent drug use. Less attention was given to another important finding in the literature, that those who used drugs often perceived the drugs as solutions to problems. Using social learning theory, the role of perceptions of drug use as an effective problem solver was examined. Results indicated that a more explicit recognition of the use of drugs to deal with problems might inform both theory and policy.     

Determining the Optimal Size of Local Government: The Case of Tasmanian Councils

We estimated the optimal size of the most significant functions performed by Tasmanian councils between 1999 and 2008 using a non‐parametric technique based on the shared input data envelopment analysis model. The principal advantage of this technique is that it not only provides an overall estimate of efficiency but it also allows for the estimation of ‘partial efficiencies’ and ‘cost shares’ when one input is shared among multiple outputs. Our results indicate that water supply and sewerage services, on average, were more efficient, whereas activities related to community health and safety and information systems warrant improvement. However, because the costs associated with water supply and sewerage services are considerably higher than the costs related to community health and safety and information systems, the elimination of these inefficiencies would result in greater cost savings for the Tasmanian local government sector.     

Ancestry and BMI Influences on Facial Soft Tissue Depths for A Cohort of Chinese and Caucasoid Women in Dunedin,New Zealand

This study measured and assessed facial soft tissue depths (FSTDs) in adult female Chinese and New Zealand (NZ) Europeans (Caucasoids). Ultrasound was used to obtain depths at nine landmarks on 108 healthy subjects (51 Chinese, 57 NZ European), erect positioned, of same age group (18–29 years). Height and weight were also recorded. Statistical analysis focused on comparison of tissue depth between the two ancestry groups and the influence of Body Mass Index (BMI) (kg/m²). Results showed mean depth differences at Supra M2 and Infra M2 landmarks significantly greater for Chinese than Caucasoid women for all three BMI Classes (BMI <20, 20 ≤ BMI < 25, 25 ≤ BMI < 30), even BMI <20. For both groups BMI positively correlated with FSTD values at all landmarks except Labrale superius. This study enabled ancestry and BMI influence on FSTDs to be observed and compared for two distinct groups. Results add to knowledge about facial tissue depth variation.     

Law enforcement and civil society in Russia

Many Russian civil society organisations are directly engaging with state law enforcement agencies, particularly the police, in joint efforts to improve the performance and change the norms and values of state officials involved in administering justice. These activities are based upon a model of state–society relations that stresses the possibility of a positive relationship of mutual assistance and partnership between the state and civil society. Such assistance is often described by these organisations as helping low-level bureaucrats better perform their core organisational tasks. This model is contrasted with two alternative models of the role of civil society, which depict civil society either as teaching citizens the norms and values associated with liberal democracy, or as a potential counter-weight to an over-reaching state. Three cases studies of cooperation between NGOs and law enforcement agencies demonstrate the utility of such an approach. Although these projects suffer from some common pathologies of civil society work in Russia, they remain important, not least because of the presence of ‘uncivil society’ extremist groups who also are trying to influence the norms and beliefs of state law enforcement officials. The civil society activities profiled here suggest that direct, cooperative engagement with the state is one important component of long-term efforts to transform the Russian state in a more liberal, ‘civil’ direction.     

The decomposition and graphical analysis of crime and sanctions data: A cross-national application

This article attempts to illustrate the utility of isoquant map analysis from the field of production theory in microeconomics for the analysis of criminal justice data. Cross-national comparisons of aggregate crime and justice data are used to demonstrate the ability of this technique to reveal important patterns that are often obscured by simple rate comparisons and multivariate treatments such as pooled time-series analysis. For each jurisdiction, aggregate trends in criminal justice processing rates are systematically analyzed as a sequence of two-input production processes: gross imprisonment rates (prison population divided by resident population) can be partitioned in terms of the crime rate and punitiveness (prison population divided by the number of offenses); punitiveness can, in turn, be partitioned in terms of severity and certainty of punishment; certainty of punishment can then be partitioned, seriatim, in terms of the incarceration rate, the conviction rate, and the arrest or clearance rate and the rate at which citizens report crimes. Cross-national data collected by Farrington, Langan, and Wikström are used to illustrate the utility of the method for displaying comparisons of the decomposition of aggregate criminal justice data for the United States, England, and Sweden.     

Expanding Accountability Through Participatory Institutions: Mayors, Citizens, and Budgeting in Three Brazilian Municipalities

As new political institutions provide Brazilians with unprecedented access to policymaking and decisionmaking venues, politicians and activists have undertaken reform efforts to promote institutional arrangements partly designed to expand accountability. The expansion of participatory decisionmaking venues may grant citizens greater authority, but these institutions could also undermine municipal councils' ability to curb the prerogatives of mayors. This article analyzes participatory budgeting in São Paulo, Recife, and Porto Alegre to illustrate that mayors have differing capacities to implement their policy preferences, and this greatly affects how accountability may be extended.     

The European Community and Biodiversity Loss: Missing the Target?

The European Community has set itself the stringent policy target of halting all biodiversity loss by 2010. It intends to achieve this target by following a dual strategy. On the one hand, the 1979 Wild Birds Directive and 1992 Habitats Directive are designed to protect important sites housing vulnerable wildlife. On the other hand, biodiversity protection is to be integrated into all other Community policies. The Community views the Common Agricultural Policy as having a vital role in both areas. It provides a mechanism through which much needed Community funding can be channelled into the management of protected wildlife sites. Equally, it also has an important influence upon biodiversity in the wider countryside. This article examines the regulatory measures that have been taken to integrate biodiversity protection into the Community's agricultural policies and assesses whether they are likely to be sufficient to enable the Community to meet its 2010 target.