In 2009, China initiated a new round of health reform to establish a well-functioning health system. The 2009 health reform did make some significant achievements in improving affordability and accessibility. In particular, social health insurance has been expanded significantly and various social health insurance plans have covered over 95% of total population in China by 2011. The Chinese government also has significantly increased fiscal input for health financing. However, affordability remains a serious concern as the social health insurers, as purchasers, were not very effective in containing the growth of health expenditure. Accessibility to primary care and public health is another concern. In this context, health governance reforms are necessary to address affordability and accessibility issues. Health governance set rules for key actors of the health system (including service providers, health insurers and government departments) by taking into account the strategies and incentives of these actors in their interactions. In recent years, a series of reforms in health governance have been initiated. Some progresses have been achieved. For the next stage of health reform, issues including how to further reform the governance structure of medical institutions and how to improve resource allocation in the health system are critical.

Three paradigms to deal with urban water issues are compared. The analysis focuses on their definition and objectives, the role of different stakeholders, the issues they deal with, and the possible solutions suggested. The paradigms differ in scope (from the narrow focus of the sponge city paradigm to the broad goals of eco-city paradigm) and in terms of the governance structures used to coordinate different stakeholders. The smart and sponge paradigms mainly use existing government structures. In the eco-cities approach, the citizens want to be involved through newly created governance structures. Smart and eco-city initiatives emphasize the involvement of stakeholders, while in the sponge cities approach, the initiative is often taken by the local government. Finally, in terms of expected solutions, the paradigms want to create eco- or healthy cities or improve water management to create a more healthy urban environment. After identifying the issue, alternative water-related technologies are available, like generating energy from wastewater or separating grey and brown water. Cities require different governance structures, and managing information flows in an integrated way to solve water and other issues. The experience in Europe, China, and India may help other cities choose the right paradigm.

The National Disability Insurance Scheme (NDIS) ushered in a transformative era in disability services in Australia, requiring new workforce models to meet evolving participant needs. Therapy Assistants are utilised to increase the capacity of therapy services in areas of workforce shortage. The governance arrangements required to support this emergent workforce have received limited attention in the literature. This review examined the key components and contextual factors of governance in rural settings, specifically focusing on therapy support workers under the guidance of allied health professionals in rural and remote areas. Guided by the social model of disability and the International Classification of Functioning, Disability and Health, a realist perspective was used to analyse 26 papers (after deduplication), mostly Australian and qualitative, with an emphasis on staff capabilities, training, and credentialling. Success measures were often vaguely defined, with most papers focusing on staff improvement and few focusing on client or organisational improvement. Consistent staffing, role clarity, community collaboration, and supportive leadership were identified as enabling contexts for successful governance of disability therapy support workers in rural areas. Investment in capability (soft skills) development, tailored training, competency assessment, credentialling, and supervision were identified as key activities that, when coupled with the identified enabling contexts, were likely to influence staff, client and organisational outcomes. Further research is warranted to explore long-term impacts of governance arrangements, educational program accountability, and activities targeted at enhancing staff capabilities.

With growing commercial, regulatory and scholarly interest in use of Artificial Intelligence (AI) to profile and interact with human emotion (\"emotional AI\"), attention is turning to its capacity for manipulating people, relating to factors impacting on a person\'s decisions and behavior. Given prior social disquiet about AI and profiling technologies, surprisingly little is known on people\'s views on the benefits and harms of emotional AI technologies, especially their capacity for manipulation. This matters because regulators of AI (such as in the European Union and the UK) wish to stimulate AI innovation, minimize harms and build public trust in these systems, but to do so they should understand the public\'s expectations. Addressing this, we ascertain UK adults\' perspectives on the potential of emotional AI technologies for manipulating people through a two-stage study. Stage One (the qualitative phase) uses design fiction principles to generate adequate understanding and informed discussion in 10 focus groups with diverse participants (n = 46) on how emotional AI technologies may be used in a range of mundane, everyday settings. The focus groups primarily flagged concerns about manipulation in two settings: emotion profiling in social media (involving deepfakes, false information and conspiracy theories), and emotion profiling in child oriented \"emotoys\" (where the toy responds to the child\'s facial and verbal expressions). In both these settings, participants express concerns that emotion profiling covertly exploits users\' cognitive or affective weaknesses and vulnerabilities; additionally, in the social media setting, participants express concerns that emotion profiling damages people\'s capacity for rational thought and action. To explore these insights at a larger scale, Stage Two (the quantitative phase), conducts a UK-wide, demographically representative national survey (n = 2,068) on attitudes toward emotional AI. Taking care to avoid leading and dystopian framings of emotional AI, we find that large majorities express concern about the potential for being manipulated through social media and emotoys. In addition to signaling need for civic protections and practical means of ensuring trust in emerging technologies, the research also leads us to provide a policy-friendly subdivision of what is meant by manipulation through emotional AI and related technologies.

In the present context of increasing human population demography, worldwide social crises, and rapid ecological global change, large cities are facing major socio-environmental challenges. This convokes authorities to adapt their governance and urban planning to reconcile urban development, ecological systems, and city dwellers in the most sustainable way. To achieve such goals, local officials have to associate all local actors, including city-dwellers, to the decision-making process through participatory governance and/or participatory systems. Here, we elaborated an original pilot project governance system for a \"Participatory System Combining Town Planning and Science\" (the 2PS-CiTy), as part of the revision of the Local Urban Plan (LUP) of Paris, France, into a Bioclimatic LUP held from 2020 to 2024. By implementing 2PS-CiTy, we aimed to answer \"How to turn trees into a lever for inhabitants\' engagement in urban consultation systems?\" Trees were chosen because they are emblematic elements of nature with significant roles in ecosystemic services such as urban climate regulation. Parisians were invited to (i) share in the first questionnaire some information on their knowledge about the LUP and their engagement in it, (ii) identify urban trees they consider remarkable, (iii) explain their choice in a second questionnaire, (iv) contribute to the urban consultation as part of the LUP revision, and finally, (v) give their feedback during a dedicated survey. Out of the 41 Parisians who took part in 2PS-City, 83% declared they were motivated to participate because they could contribute to the tree census, which in turn can constructively contribute to the Parisian LUP revision to bring more nature and sustainability in town. This study demonstrates that trees can be used as a lever for inhabitants\' engagement in urban consultation systems to make cities more sustainable. Our survey also showed that the 2PS-CiTy governance system could be improved by (1) developing a participatory culture among decision-makers and (2) preventing nowadays silo governance from developing the most promising public governance systems that involve the departments of green space, urban planning, and local democracy.

Optimal governance is among the key facilitators of the digital transformation of health systems intended to improve access to healthcare, quality, safety, and efficiency, and to attain universal health coverage. This paper highlights the findings of a survey assessing the status of governance of digital health in the WHO European Region. The 2022 survey is a continuation of the 2015 WHO Global Survey on eHealth. The survey focused on national digital health governance, monitoring and evaluation of digital health interventions, and funding and investment in digital health and was conducted through April to October 2022. All 53 Member States of the WHO European Region participated in the survey. The results showed that 83% of the Member States reported having a national digital health strategy in place, and 79% of the Member States reported having a health information system strategy. Most of the priorities of the national digital health strategies were devoted to increasing the accessibility, quality, safety, and efficiency of the health systems, strengthening health information systems, and improving information sharing and interoperability of data. Measures to ensure equity in access to digital healthcare services were directed towards improving broadband connectivity, information and communication technology, digital literacy, and digital health promotion. Oversight for the implementation and operation of the national digital health strategies are mostly delegated to government agencies. The prime source of funding for digital health programs was public funding, though a combination of funding sources was also noted. This analysis revealed increasing adoption of national digital health strategies for access to healthcare and creation of digital health agencies and funding programs for digital health.

Information, as the most elusive subject, is central to all forms of thought, governance, economic structure, science, and society. Regulation of information, especially within the healthcare field, is proving to be a difficult task globally, given the lack of a qualitative framework and understanding of the concept and properties of information (or data) itself. The presentation of the overall qualitative framework, comprising a qualitative analysis of information, data, and knowledge, will be valuable and of great assistance in delineating regulatory, ethical, and strategic trajectories. In addition, this framework provides insights (and answers) regarding (1) data privacy and protection; (2) delineations between information, data, and knowledge based on the important notion of trust; (3) a structured approach to establishing the necessary conditions for an open society and system, and the maintenance of said openness, based on the work of Karl Popper and Georg Wilhelm Friedrich Hegel; (4) an active agent approach that promotes autonomy and freedom and protects the open society; and (5) a data governance mechanism based on the work of Friedrich Hayek, which structures the current legal-ethical-financial and social society. This is insightful for questions relating to the extent of rights and duties, the extent of biological bodies and freedom, and the structure of relations in distributed networked systems. There is great value offered in this framework; furthermore, it provides critical insights and thoughts about (and uncovers the interplay between) academic culture, politics, science, society, and societal decay. Note that, in line with the ideas expressed in this manuscript, such as incorporation of personal experience (thereby mending the Kantian and Cartesian gap), a first-person perspective will be used, where relevant.

Solar geoengineering (also known as solar radiation modification) is garnering more attention (and controversy) among media and policymakers in response to the impacts of climate change. Such debates have become more prominent following the first-ever field trials of stratospheric aerosol injection (SAI) in 2022. How the lay public perceives solar geoengineering remains unclear, however. We use nationally representative samples (N = 3013) in Mexico, United States, and United Kingdom to examine public perceptions of risks and benefits, support, and policy preferences. We also employ an information-framing design that presented individuals with media-style reports on SAI activities differing along three dimensions: location, actor, and scale and purpose. Support for SAI is found to be generally higher in Mexico; perceptions of risks and benefits do not differ between countries. Information about SAI activities has a limited effect. There is evidence that activities conducted by universities receive more support than those by start-up companies.

Despite prevalent diversity and inclusion programs in STEM, gender biases and stereotypes persist across educational and professional settings. Recognizing this enduring bias is crucial for achieving transformative change on gender equity and can help orient policy toward more effective strategies to address ongoing disparities.

There has been a steady rise in the use of clinical decision support (CDS) tools to guide Nephrology, as well as general clinical care. Through guidance set by federal agencies and concerns raised by clinical investigators, there has been an equal rise in understanding whether such tools exhibit algorithmic bias leading to unfairness. This has spurred the more fundamental question of whether sensitive variables such as race should be included in CDS tools. In order to properly answer this question, it is necessary to understand how algorithmic bias arises. We break down three sources of bias encountered when using electronic health record data to develop CDS tools: (1) use of proxy variables, (2) observability concerns and (3) underlying heterogeneity. We discuss how answering the question of whether to include sensitive variables like race often hinges more on qualitative considerations than on quantitative analysis, dependent on the function that the sensitive variable serves. Based on our experience with our own institution\'s CDS governance group, we show how health system-based governance committees play a central role in guiding these difficult and important considerations. Ultimately, our goal is to foster a community practice of model development and governance teams that emphasizes consciousness about sensitive variables and prioritizes equity.