The tendency today to privatise many activities hitherto considered the exclusive preserve of the state has given rise to sharp debate. The specific nature of humanitarian emergencies elucidates in particularly stark contrast some of the main challenges connected to the privatisation and outsourcing of essential public services, such as the provision of drinking water and health care. Privatising the realms of defence and security, which are at the very core of state prerogative, raises several legal and humanitarian concerns. This article focuses on the roles and responsibilities of the various parties involved in armed conflicts, especially those of private companies engaged in security, intelligence and interrogation work, and in the provision of water supply and health services. It highlights the need for humanitarian and development actors to grasp better the potential risks and opportunities related to privatisation and outsourcing with a view to supplying effective protection and assistance to communities affected by war. 相似文献
Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.
Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P0), 1–4 weeks after the completion of project implementation (P1), and 4–5 months later (P2). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.
The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.
The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.
Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P0 and P1 (P0 = 4.8%, P1 = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P2 time period (P2 = 25.7%; P < .001, for P0 vs. P2) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P0 time period and compared to the comparison schools.
Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings. 相似文献
This paper takes a new look at the importance of context – institutional and political – in effective public engagement processes. It does so through a rare comparative opportunity to examine the effectiveness of processes of public engagement in two UK waste authorities, where the same waste company was involved as both the primary contractor for the delivery of the waste management service (including new energy-from-waste facilities) and, furthermore, the same staff delivered the public engagement. Interrogating these cases affords the opportunity to place flesh on the bones of the sometimes ‘abstract’ skeleton of context. While engagement processes support effective local governance in an era of partnerships and deliberative democracy, the paper identifies that the methods adopted cannot be played out devoid of detailed understanding and response to local context, including the strength of partnership working between the public and private sector, the degree of political support for engagement, and the extent to which a traditional institutional paternalism still dominates. 相似文献