Clarification Of Responsibilities Research Articles

Job Description Kejelasan Tanggung Jawab dan Aplikasinya Persfektif Hadist Nabi Muhammad SAW

This article aims to find out the job description, clarity of responsibilities and application from the perspective of the hadith of the Prophet Muhammad SAW. Data is obtained from articles published through Google Scholar. Initially, the search was carried out using relevant keywords such as "job description", "job description in the perspective of the Prophet Muhammad SAW". Data from selected articles were then analyzed using a descriptive approach to describe key findings, identify patterns and trends, and summarize key conclusions from the reviewed literature. The results of the analysis show that with the job description, the activities carried out are in accordance with the responsibilities and cannot interfere with each other's duties, there is no overlap in the implementation of duties, and communication is well formed due to the existence of a good cooperative relationship between workers. In Islam, a job or position is a mandate that must be maintained properly, because behind the mandate there is accountability. Islam also teaches not to impose oneself on a job or position that is not one's expertise

Strategy to Decrease Counterproductive Work Behavior: Implementation of Interpretive Structural Modeling

This study aims to analyze the determinant factors of Counterproductive Work Behavior (CWB) to make plan strategies for overcoming Counterproductive Work Behavior. This research used the Interpretative Structural Modeling (ISM) method. The ISM method is able to show the interrelationships between existing elements. This method can be developed to plan strategic human resource management policies related to CWB. The strategy for managing human resources related to CWB in automotive companies in Bekasi is carried out according to the level of importance based on a problem. The results showed that it is necessary to overcome Counterproductive Work Behavior by handling job stress (Task demands, Role demands, Family problems, and Economic problems) and role ambiguity (Clarity of Responsibilities, Clarity of goals, and Clarity of roles and scope of work).

Managing Sustainable Working Hours within Participatory Working Time Scheduling for Nurses and Assistant Nurses: A Qualitative Interview Study with Managers and Staffing Assistants

Aim. To bring insights into how healthcare managers and staffing assistants work to achieve sustainable working hours within a participatory scheduling system. Background. Hospital nurses and assistant nurses often work on rotating shifts, which affects their opportunities for sleep, recovery, and work-life balance. In Sweden, a participatory scheduling approach is commonly used, where working hours are planned in collaboration between employees, managers, and staffing assistants. Influence over working hours is related to positive outcomes among shift workers. However, it also places responsibility on the employee to schedule working hours that promote health and patient safety, i.e., sustainable working hours. Accordingly, the organisation has responsibilities to support the employee in this regard. Methods. Semistructured individual interviews were conducted with 11 managers and 9 staffing assistants from four Swedish regions and analysed using thematic analysis. Results. Several key factors for achieving sustainable working hours within the context of participatory scheduling were described: distribution and clarity of responsibilities, allocating time for scheduling, establishing shared responsibility, considering fairness, fostering an individual relationship with the employee, managing dissatisfaction, providing support, clarifying guidelines for sustainable scheduling, managing inconsistencies between employee requests and sustainable working hours, and considering recovery opportunities and the competence mix on shifts. Additionally, contextual factors, such as staffing levels, working procedures, working time arrangements for night work, and technological support, were highlighted as important. Conclusion. Achieving sustainable working hours within participatory scheduling involves considering the interactions between factors at the levels of the organisation, the individual, and the technological systems. Implication for Nursing Management. Nurse managers and staffing assistants must work closely with their employees during participatory scheduling to ensure sustainable working hours. Key goals in this regard include establishing a shared responsibility, clarifying responsibilities and guidelines for sustainable scheduling, and allocating time for the scheduling process.

Appropriate Technology Interventions For The Successful Of Kostratani Program: Agriculture Extension Officers’ Predictions

<p align="center"> </p><p><em>To support the achievement of Kostratani Program, socialization to agriculture extension officers (PPL) had been delivered. Through well understanding on their respective responsibilities, they might able to predict the achievement of the program targets, the factors that support and problem they faced to be overcome to get maximum achievement. To get this information a research had been carried out in three provinces namely, West Java, Lampung, and Central Java in 2021. The respondents were 51, 31, and 34 PPL in BPP from each province. Data were obtained through individual interviews referring to a structured questionnaire on five aspects with 21 indicators. The data ware analyzed based on qualitative analysis and presented descriptively. Results reported by men and women PPL respectively were:1) Socialization was obtained by 67% and 71% ;2) Clarity of the responsibility by 52% and 51%; 3)Their prediction on the Program achievements’ targets was 51% and 50%; 4) Access for on-line applications in supporting data and information was received by 47% and 47% and 5) Access for education (training, comparative studies) and incentives ( monthly honorarium and internet quota) to run the Kostratani Program was only obtained by 21% of men and 24% of women. Concluded, the main intervention needs to be given to PPLs in the BPP Kostratani Program is the access on education and incentives. Meanwhile, in synergy it is still necessary to continue the socialization about Kostratani to increase PPL's understanding of the clarity of tasks or responsibilities to get maximum achievement of Kostratanis’ targets.</em></p><p><em> </em></p><p> </p>

Nurses’ perspectives on the barriers to and facilitators of the implementation of secondary prevention for people with coronary heart disease: a qualitative descriptive study

ObjectivesTo identify the barriers to and facilitators of secondary prevention among people with coronary heart disease from the perspectives of nurses.DesignA qualitative descriptive design using face-to-face semistructured interviews.SettingThis study was...

Conflicts over Land as a Risk for Social-Ecological Resilience: A Transnational Comparative Analysis in the Southwestern Amazon

People in the department of Madre de Dios/Peru, the state of Acre/Brazil, and the department of Pando/Bolivia experience similar conflicts over land, land use, and access to resources. At the same time, each conflict reveals distinct characteristics and dynamics, arising from its history, legal regulation, institutional (in-)capacities, and culturally diverse local populations. The aim of this paper is to better understand the main drivers of social-ecological conflicts over land in and around three protected areas in this transboundary region, known as MAP, and to analyze how (environmental) institutions influence these drivers. The paper is based on a literature review and expert interviews; it focuses on conflicts around (1) gold mining in Madre de Dios, (2) extensive cattle ranching in Acre, and (3) access to communal land in Pando. Using theories of conflict research, expanded by a political ecology perspective and insights from stakeholder and expert interviews, we find that the major conflict drivers are (1) land tenure and access to land and natural resources, (2) identity and lifestyle driven transformations, (3) state and market driven agendas, and (4) networked illegal and criminal activities. Through a comparative conflict analysis, we develop four recommendations to strengthen the creation of reflexive institutions that may be able to foster social-ecological resilience in the region: (1) The clarification of responsibilities between governance institutions and their financing; (2) the awareness raising for existing power structures and opening spaces for enhanced local participation; (3) the breaking of corruptive cycles while developing economically, ecologically, and socially sustainable livelihood opportunities; and (4) taking the continuous reproduction of illegal activities into account while clarifying responsibilities, raising awareness, and breaking corruptive cycles. The results of our research therefore not only contribute to a better understanding of conflicts in the MAP region and the wider scientific literature on social-ecological conflicts and governance, but it is also the first paper that identifies entry points and prerequisites for the transformation from reactive to reflexive institutions in Amazonian societies.

The Effectiveness of Financial Incentives for Addressing Mangrove Loss in Northern Vietnam

This paper analyzes the effectiveness of existing financial incentives for mangrove conservation in Vietnam. Current conservation programs and projects have created financial incentives for mangrove protection, but the effectiveness of these incentives in addressing mangrove loss in northern Vietnam has been mixed. While financial incentives have contributed to a larger area of planted mangroves, their effectiveness is hampered by contradictory national policies, which encourage mangrove conservation on the one hand, and aquaculture expansion in mangrove areas on the other, thus making it difficult to address mangrove deforestation and degradation effectively. Mangrove conservation in Vietnam is challenged further by inequitable distribution of power and benefits, difficulties accessing information, weak law enforcement, lack of compliance, low payments for protecting mangroves, lack of full recognition of local rights, discontinued funding after policies and projects end, and lack of participation by local people in policy and project design and implementation. Conservation policies and projects should aim to protect existing mangrove forests, restore degraded mangroves and plant new ones to enhance mangrove area, quality and biodiversity. Sustainable mangrove conservation not only requires effective and sustainable financial incentives, but other enabling conditions such as addressing the conflict between mangrove conservation and aquaculture expansion, and grounding mangrove conservation projects by building on local knowledge and leadership. As these drivers are often motivated by national development goals and other sectoral development needs with ministries competing for budgets and influence, holistic land-use planning needs to be coupled with effective coordination and clarification of responsibilities between government agencies, and coordinated and consistent policies concerning these natural resources. Addressing these underlying governance issues is far more important for mangrove conservation and restoration than merely offering financial incentives as various national and international projects have attempted.

The perception of public spaces in Mexico city, a governance approach

Public spaces are considered a vital ingredient of prosperous cities as they support their sense of community, identity and culture. Understanding their relevance, the Mexican government has developed new regulatory frameworks. In 2016, the first federal legislation in Mexico was created and combined the concepts of urban development, public space, and social participation. This change affected national and local regulations. Acknowledging that public spaces are anchored to the institutional and governance context, we based our explorative research from a theoretical perspective on the Contextual Interaction Theory (CIT) and its five governance elements. Considering the regulatory and institutional framework for public spaces in Mexico, this research aims to understand how the different actors perceive the current conditions of public spaces in Mexico City. This research adopted a case study approach, and we conducted eight semi-structured interviews with stakeholders that participate in the planning process of public spaces in Mexico City. Through these interviews and revision of secondary sources, we found that all interviewed actors agree that the regulatory framework of public spaces differs with the application in practice, with legal gaps and lack of clarity in responsibilities which brings confusion among practitioners and developers of public space projects. The implementation of the public spaces policy is affected by the lack of continuity of public space projects and the discrepancies between the efforts to promote inclusive and safe public spaces, and a negative perception of society on the current conditions of public spaces.

Implicit alignment: India's National Water Policy and a human rights‐based approach to water management

AbstractAs a potential solution to water scarcity, the United Nations advocates for a human rights‐based (HRB) approach to water management, characterized by a focus on the provision of safe drinking water and sanitation, stakeholder participation, and the realization of water equity for traditionally marginalized communities. Although most states around the world suffer from some form of water scarcity or stress, not all governments have officially recognized the validity of an HRB approach to water management. India stands as an instructive case study in this regard. The Indian state suffers from physical and economic water scarcity across its urban and rural communities, but the Indian federal government has not yet explicitly recognized the human right to water as a legitimate policy approach. Interestingly, though, the right to water has been tacitly recognized within India's legal system; thus, it is worth examining whether a tacit recognition of an HRB approach to water management exists in other aspects of India's national policy. This article utilizes content analysis to explore that question by, first, identifying seven key concepts within an HRB water management approach and, second, tracing those concepts through the 1987, 2002, and 2012 iterations of India's National Water Policy. The results help to illustrate that India's National Water Policy is congruent with an HRB approach to water management, although challenges remain due to a lack of both accountability and clarification of responsibilities between the national and subsidiary governments within India.This article is categorized under: Human Water > Rights to Water Human Water > Water Governance

What matters in care continuity on the chronic care trajectory for patients and family carers?-A conceptual model.

To describe essential aspects of care continuity from the perspectives of persons with complex care needs and their family carers. Continuity of care is an important aspect of quality, safety and efficiency. For people with multiple chronic diseases and complex care needs, care must be experienced as connected and coherent, and consistent with medical and individual needs. The more complex the need for care, the greater the need for continuity across different competencies, services and roles. A constructivist grounded theory approach was applied. Sixteen patients with one or more chronic diseases needing both health care and social care, living in their private homes, and twelve family carers, were recruited. Semi-structured interviews were conducted and analysed with constructivist grounded theory. The COREQ checklist was followed. A conceptual model of care continuity was constructed, consisting of five categories that were interconnected through the core category: time and space. Patients' and family carers' experiences of care continuity were closely related to timely personalised care delivery, where access to tailored information, regardless of who was performing a care task, was essential for mutual understanding. This required clarity in responsibilities and roles, interprofessional collaboration and achieving a trusting relationship between each link in the chain of care, over time and space. To achieve care continuity, all the identified categories were important, as they worked in synergy, not in isolation. Care continuity for people with complex care needs and family carers is experienced as multidimensional, with several essential aspects that work in synergy, but varies over time and depends on each person's own resources and situational and contextual circumstances. The findings promote understanding of patients' and family carers' experiences of care continuity and may guide the delivery of care to people with complex care needs.

Interest in Sexually Transmitted Infections: Analysis of Web Search Data Terms in Eleven Large German Cities from 2015 to 2019.

Incidence of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis has increased in recent years in the US and in European countries. In order to implement effective educational programs, the interests of target populations have to be identified. Since the internet is an important source of information-gathering on health issues, this study investigates web search data in large German cities related to STIs. Google Ads Keyword Planner was used to identify STI-related terms and their search volume in eleven German cities from June 2015 to May 2019. The data obtained were analyzed descriptively with regard to total search volumes, search volumes of specific thematic areas, and search volumes per 100,000 inhabitants. Overall, 741 terms with a total search volume of 5,142,560 queries were identified, with more than 70% of all search queries including a specific disease and “chlamydia” being the overall most often searched term (n = 1,196,160). Time courses of search behavior displayed a continuous interest in STIs with synchronal and national rather than regional peaks. Volumes of search queries lacked periodic patterns. Based on the findings of this study, a more open public discussion about STIs with linkage to increased media coverage and clarification of responsibilities among all STI-treating disciplines concerning management of STIs seem advisable.

Major trauma centre Lead Clinicians: An evaluation of current practice in major trauma centres in England

Background NHS England requires there to be a clinical consultant with managerial responsibility for the Major Trauma Centre (MTC) service, who holds the title of MTC Lead Clinician. The objective of this study was to investigate the role of MTC Lead Clinician in England. Firstly, identifying the parent speciality of the current cohort and their background and training. Further aims were to ascertain what attracted clinicians to the position and to explore ideas about how to train the next generation of MTC Lead Clinicians. Methods Survey-based data collection was performed. Included were current MTC Lead Clinicians, or those with equivalent job descriptions, for adult major trauma. Paediatric MTCs and Trauma Units were excluded. Fixed choice questions were analysed using descriptive statistics. Open-ended questions were interpreted using thematic analysis. Results The response rate for the survey was 81.81%. The largest proportion of respondents were Emergency Medicine Physicians (38.9%). Previous senior leadership roles were identified as valuable previous experience. Regular attendance at conferences was deemed to be of more importance than specific training courses. Leadership, management, and financial skills were identified as key areas for further training. There was variance in both the job role and the time allocated for these duties between centres. Conclusion Currently there is variation in the parent specialty, role responsibilities and preparation for MTC Lead Clinicians in England. Our findings suggest that guidance on appropriate training, clarity in responsibilities and fostering leadership and managerial skills are important as the role develops for the future.

Supporting Australian clinical learners in a collaborative clusters education model: a mixed methods study

BackgroundNursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation.MethodsA convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data.ResultsParticipants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5 ± 0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication.ConclusionsThis evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.

P082: Ethical management of incidental findings in emergency care: A critical interpretive literature review

Introduction: Incidental findings (IFs) are findings discovered in the course of healthcare (e.g., blood tests, genetic tests, imaging) that are unrelated to the primary purpose for which a test was sought. Some IFs constitute new knowledge that have implications for patient autonomy and welfare. IFs found in emergency departments (EDs) are difficult to manage, with one study reporting that of 392 patients with IFs, 122 had no follow-up and 242 had no electronic record of the finding. Methods: A critical interpretive literature review was conducted to explore current practices regarding identification, disclosure, and management of IFs in EDs, and to identify ethical challenges that require research focus and policy reform. The search strategy included ‘incidental findings’ AND ‘emergency’ and derivatives, retrieving 12,021 studies from databases including PubMed, Scopus, and Web of Science, as well as handsearching and reference list searching. Following screening, 97 studies were included. Data was extracted, analyzed using descriptive statistics, and then critically interpreted to capture key ideas. Results: Of 97 included articles, 75 have relevant empirical data. Of the 75, most literature (89%) presented the frequency of IFs in EDs, with an average frequency of 34%. Most (84%) did not report on patient disclosure rates or follow-up rates. When reported, patient notification rates are as low as 2.6% with an average of 15% over 12 studies. Empirical studies included in the review do not address ethical principles or patient preferences on disclosure. The literature reveals suggestions to manage IFs in EDs, including implementation of automatic feedback or alert mechanisms, clarification of responsibilities within treating teams, protocols in radiology departments, and improvements to patient documentation. Test results by letter are noted as insufficient because patients are unable to ask questions. Authors suggest further research on optimal follow-up recommendations to alleviate patient and physician distress. Further results will be presented, critically interpreted, and discussed, with attention to ethical implications and challenges. Conclusion: The literature on IFs in EDs focuses too narrowly on frequency, with ad hoc suggestions for practice, research, and policy changes to improve the ethical management of IFs. Numerous factors, including crucial knowledge gaps, contribute to inadequate management of IFs arising in EDs. Research and ethics informed policy guidance is needed.

Sea Level Rise and Local Government

Local authorities in New Zealand have a significant responsibility to their communities for managing the effects of sea level rise due to climate change. However, while most local authorities are well engaged and have a clear understanding of issues arising from sea level rise, 73% report that their organisations do not receive enough direction from central government on how to respond. Territorial authorities in particular are seeking a stronger lead, such as legislative reform, clearer and more directive policy, clarification of responsibilities, or a national environmental standard on coastal hazard management. Central government direction is seen as critical to achieve a nationally consistent and equitable approach for coastal communities. This article summarises how this could be addressed, and identifies key challenges facing local government in adapting to sea level rise and climate change.

Appraisal of Contract Administration Protocols for Successful Project Undertakings

This study is intended to fill a gap in the literature on contract administration protocols. Since no organization is self-reliant, often the acquisition of sought after resources and efforts from external sources come true through contractual agreements of some form. Thus, in a project environment, there are array of contracts which are perceived as important instruments that direct and govern every project move. This, as a result, demands well-established contract administration protocols. Contract administration is a collaborative effort to accomplish clearly stipulated contract objectives. Since coordination and teamwork are extensively thought to be important contributors to success, the importance of having well-developed contractual agreements among contracting parties and good contract administration protocol is indisputable. For change trends in the business environment show that the contractual relationships between parties to a contract are likely to become more multifaceted in the future, everything possible should be done to minimise the number of disputes and the impact they may have on the performance of projects. For this effect, the parties to a contract should have better appreciation of contract conditions and their interpretations. Besides, the data analysis of this research revealed that ‘Statement of work’, ‘Work schedule’, and ‘Performance reporting’ are the top three most important considerations to be deliberated while constructing good contract content. It also disclosed that effective contract administration can be realised only if both parties to the contract observe the terms and conditions of the contract and adhere to their rights and obligations, as appropriate. In addition, contract administration practices can be enhanced if both parties demonstrate a reasonable level of flexibility accompanied by the willingness and the ability to adapt the contract terms to reflect changing circumstances. Likewise, systematic and efficient planning, execution, monitoring, and evaluation activities boost contract administration protocols. Most importantly, ‘adequate planning and explicit specifications’ followed by ‘good governance and clarity of responsibilities’ were nominated by quite significant of the respondents as demonstrated or tested strategies for enhanced contract administration protocol. On the other hand, this research also uncovered that contract administration can be used as an imperative tool to mitigate fraud and corruption. Likewise, the study discovered evidences for the existence of proven strategies that enable to manage contractual disputes effectively and efficiently. Finally, after extensive analysis of the data, operational techniques of using contract administration as a tool for successful project undertakings have emerged as the most attention worthy finding of this study.

A Mining Technology Collaboration Platform Theory and Its Product Development and Application to Support China’s Digital Mine Construction

At present, data exchange in China’s digital mine construction process is still based on paper media or electronic documents. The problems of “information islands,” “information versions,” “information faults” and “information preservation” are serious. There are many problems associated with across time and space and multidisciplinary collaborations, blocked business processes and unclear job responsibilities. These problems have seriously hindered the construction of China’s digital mine, thus restricting the safe, efficient production and sustainable development of China’s mining enterprises. Therefore, this paper proposes the concept, connotation, characteristics, architecture and technical requirements of the mining technology collaboration platform and uses it to guide the research and development and implementation of the mining technology collaboration platform of Fujian Makeng Mining Co., Ltd. The results show that the mining technology collaboration platform can solve the information and management problems existing in China’s digital mine construction and realize the centralized storage, interoperability and high sharing of all data, the integration of all involved business, business software and its participants, the clarification of responsibilities and its input and output data of each post and standardization and automation of business process. Therefore, it improves the ability to collaborate across time and space and multidisciplinary among participants, departments and professional posts, ensures high-speed flow of business processes and also improves the working efficiency and quality of mining enterprises and significantly reduces the time for business processing and business process flow and reduces production costs.

Sea-Level Rise and Local Government: Policy Gaps and Opportunities

This paper identifies some barriers, gaps and opportunities in the legal and policy options available to local government when managing the effects of sea-level rise due to climate change, and outlines the challenges facing local government in adapting to sea-level rise and climate change. Work undertaken to inform the paper includes research, engagement, and policy analysis undertaken over a two-year period, with findings tested in a survey of local authorities with coastal interface (territorial authorities) or whose authority included coastal marine area (regional and unitary councils). The range of opinions expressed through the survey process demonstrate that every region and district has its own unique characteristics and priorities. The most prominent message from our work is the desire for more commitment and involvement from central government. While local authorities are very well engaged and generally have a clear idea of issues arising from sea-level rise and climate change, 73 percent of participants said their organisations do not receive enough direction from central government on how to respond to the effects of climate change. It is acknowledged that useful guidance has been provided, such as the Ministry for the Environment’s Guidance for local government on preparing for climate change. However, territorial authorities in particular are seeking a stronger lead, such as legislative reform, clearer and more directive policy, clarification of responsibilities, guidance on the use of particular adaptation tools that currently exist, and a national environmental standard on coastal hazard management. Such direction is seen as critical not only to achieve a nationally consistent approach but also simply to achieve adoption of appropriate climate adaptation measures.

Beyond the parish pump: what next for public health?

BackgroundPublic health has had a history characterised by uncertainty of purpose, locus of control, and workforce identity. In many health systems, the public health function is fragmented, isolated and under-resourced. We use the most recent major reforms to the English National Health Service and local government, the Health and Social Care Act 2012 (HSCA12), as a lens through which to explore the changing nature of public health professionalism.MethodsThis paper is based upon a 3-year longitudinal study into the impacts of the HSCA12 upon the commissioning system in England, in which we conducted 141 interviews with 118 commissioners and senior staff from a variety of health service commissioner and provider organisations, local government, and the third sector. For the present paper, we developed a subset of data relevant to public health, and analysed it using a framework derived from the literature on public health professionalism, exploring themes identified from relevant policy documents and research.ResultsThe move of public health responsibilities into local government introduced an element of politicisation which challenged public health professional autonomy. There were mixed feelings about the status of public health as a specialist profession. The creation of a national public health organisation helped raise the profile of profession, but there were concerns about clarity of responsibilities, accountability, and upholding ‘pure’ public health professional values. There was confusion about the remit of other organisations in relation to public health.ConclusionsWhere public health professionals sit in a health system in absolute terms is less important than their ability to develop relationships, negotiate their roles, and provide expert public health influence across that system. A conflation between ‘population health’ and ‘public health’ fosters unrealistic expectations of the profession. Public health may be best placed to provide leadership for other stakeholders and professional groups working towards improving health outcomes of their defined populations, but there remains a need to clarify the role(s) that public health as a specialist profession has to play in helping to fulfil population health goals.

Dealing With Fragile States: Entry Points and Approaches for Development Cooperation

Fragile states are characterised by a great potential for crisis that endangers human security and the achievement of the Millennium Development Goals (MDGs). It is increasingly being recognized that external actors should involved, either directly or indirectly; at the same time, though, new entry points and approaches are needed (the stay engaged, but differently“ principle). Donor behavior in cases of fragile statehood can be based on two key parameters: (a) the effectiveness of state institutions, (b) the legitimacy of the respective government. In order not to create parallel and hybrid structures, donors are well-advised, in general, to focus on existing structures and coordinate their political priorities with the governments (systems and policy alignment). However, lack of development orientation, widespread corruption, or markedly repressive rule may make such a cooperation a highly problematic proposition. Thus, it will in a substantial number of cases also be necessary to engage with partners “beyond the state,” i.e. with nonstate groups, the private sector, and local governmental units. A major task for development cooperation is the (re-)creation of capabilities in six governance arenas: security, political, judicial, administrative, social, and economic governance. This must be approached on a country-by-country basis, based on empirical assessments of the current situation, and preferably drawing on the knowledge of local experts. Despite this qualification some cross-cutting priorities are identified within the study: (re)establishment of the state monopoly on the legitimate use of forces and efforts to combat ordinary crime; a functioning separation of powers (horizontal checks and balances); respect for the rule of law, and “legal empowerment” of citizens; efforts to combat corruption and to eliminate criminal economies. Donors’ ability to have a positive impact on fragile states remains limited, unless they pursue coherent policies on the national level and coordinate more effectively on the international level. The development of common country strategies, the clarification of responsibilities as well as harmonised analysis and decision-making mechanisms in the case of ‘states at risk’ are steps in the right direction.