A typology of power in implementation: Building on the exploration, preparation, implementation, sustainment (EPIS) framework to advance mental health and HIV health equity

Background Persistent inequities in HIV health are due, in part, to barriers to successful HIV-related mental health intervention implementation with marginalized groups. Implementation Science (IS) has begun to examine how the field can promote health equity. Lacking is a clear method to analyze how power is generated and distributed through practical implementation processes and how this power can dismantle and/or reproduce health inequity through intervention implementation. The aims of this paper are to (1) propose a typology of power generated through implementation processes, (2) apply this power typology to expand on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to advance HIV and mental health equity and (3) articulate questions to guide the explicit examination and distribution of power throughout implementation. Methods This paper draws on the work of an Intermediary Purveyor organization implementing trauma-informed care and harm reduction organizational change with HIV service organizations. The expanded framework was developed through analyzing implementation coaching field notes, grant reporting, and evaluation documents, training feedback, partner evaluation interviews, and existing implementation literature. Results The authors identify three types of power working through implementation; (1) discursive power is enacted through defining health-related problems to be targeted by intervention implementation, as well as through health narratives that emerge through implementation; (2) epistemic power influences whose knowledge is valued in decision-making and is recreated through knowledge generation; and (3) material power is created through resource distribution and patterns of access to health resources and acquisition of health benefits provided by the intervention. Decisions across all phases and related to all factors of EPIS influence how these forms of power striate through intervention implementation and ultimately affect health equity outcomes. Conclusions The authors conclude with a set of concrete questions for researchers and practitioners to interrogate power throughout the implementation process. Plain language summary Over the past few years, Implementation Science researchers have committed increased attention to the ways in which the field can more effectively address health inequity. Lacking is a clear method to analyze how implementation processes themselves generate power that has the potential to contribute to health inequity. In this paper, the authors describe and define three types of power that are created and distributed through intervention implementation; discursive power, epistemic power, and material power. The authors then explain how these forms of power shape factors and phases of implementation, using the well-known EPIS (exploration, preparation, implementation, sustainment) framework. The authors draw from their experience working with and Intermediary Purveyor supporting HIV service organizations implementing trauma-informed care and harm reduction organizational change projects. This paper concludes with a set of critical questions that can be used by researchers and practitioners as a concrete tool to analyze the role of power in intervention implementation processes.

The Strange Journey of the Tributary System

Scholars of international relations have embraced the tributary system as the dominant lens to studying historical orders of East Asia. Hendrik Spruyt’s The World Imagined, a rare gem in the study of comparative international orders, argues that the tributary system articulated the ontology of the historical East Asia international society. This article cautions against two common pitfalls. First, the tributary system is a modern conceptual construct that can blind researchers to other types of political orders existing throughout East Asia’s diverse landscape and history, thus contributing to a Sinocentric bias. Both the Mongols and the Tibetans adopted a distinctive set of rules of inter-polity conduct that have little to do with the Chinese tributary system. Second, the tributary system perpetuates the myth that East Asia has been historically peaceful, while glossing over the numerous interpolity warfare that took place in the region as well as internal conflicts within the same cultural sphere of a state. I argue that our understanding of international orders can be substantially enriched when we take material power seriously and study its interplay with ideational factors.

Privacy Worlds: Exploring Values and Design in the Development of the Tor Anonymity Network

This paper explores, through empirical research, how values, engineering practices, and technological design decisions shape one another in the development of privacy technologies. We propose the concept of “privacy worlds” to explore the values and design practices of the engineers of one of the world’s most notable (and contentious) privacy technologies: the Tor network. By following Tor’s design and development we show a privacy world emerging—one centered on a construction of privacy understood through the topology of structural power in the Internet backbone. This central “cipher” discourse renders privacy as a problem that can be “solved” through engineering, allowing the translation and representation of different groups of imagined users, adversaries, and technical aspects of the Internet in the language of the system. It also stabilizes a “flattened,” neutralized conception of privacy, risking stripping it of its political and cultural depth. We argue for an enriched empirical focus on design practices in privacy technologies, both as sites where values and material power are shaped, and as a place where the various worlds that will go on to cluster around them—of users, maintainers, and others—are imagined and reconciled.

Turkish foreign policy in a post-western order: strategic autonomy or new forms of dependence?

Turkish foreign policy has dramatically transformed over the last two decades. In the first decade of the Justice and Development Party's (AKP) rule, the ‘logic of interdependence’ constituted the driving motive of Turkish foreign policy. In the second decade, however, the ‘logic of interdependence’ and the soft power-driven ‘mediator–integrator’ role were gradually replaced with a quest for ‘strategic autonomy’, accompanied by interventionism, unilateralism and coercive diplomacy. This article explores the causes of this dramatic shift. We argue that ‘strategic autonomy’, which goes beyond a moderate level of status-seeking compatible with Turkey's material power credentials, has a double connotation in the Turkish context. First, it constitutes a framework for the Turkish ruling elite to align with the non-western great powers and balance the US-led hierarchical order. Second, and more importantly, it serves as a legitimating foreign policy discourse for the government to mobilize its electoral base at home, fragment opposition and accrue popular support. We conclude that the search for autonomy from its western allies and the move towards the Russia–China axis has led to Turkey's isolation and permitted the emergence of new forms of dependence.

Foreign Election Interference and Open-Source Anarchy

Russian meddling in the 2016 elections in the United States sparked debates in liberal democracies about how to counter foreign election interference. These debates reveal the seriousness of the threat and the complexity of responses to it, including how to protect voting systems and what actions social media companies should take against disinformation. This chapter argues that international anarchy changes in ways that leading theories of international relations do not capture. The chapter develops the concept of “open-source anarchy” to understand how anarchy changed after the Cold War and to analyze why foreign election interference has gained prominence during the second decade of the twenty-first century. In open-source anarchy, changes in the structure of material power, technologies, and ideas permit less powerful states and nonstate actors to affect more directly and significantly how anarchy functions. The concept helps explain how Russia exploited the internet and social media to interfere in elections in the United States—the world’s leading democracy, foremost source of technological innovation, and most powerful country. Open-source anarchy also illuminates the struggles that the United States and other democracies have experienced in preventing, protecting against, and responding to foreign election interference.

International Status and Japan

Beyond material power, states and people have shown themselves to be also interested in status, claiming and demonstrating their ostensibly rightful place atop (or near the top of) some kind of acknowledged hierarchy. Because status signaling is so pervasive, even ubiquitous, in global politics, it would be difficult to say that status matters especially to Japan. But it does seem to matter particularly to Japan, in the sense that there are particular motifs and themes that have been astonishingly consistent, not to mention widely exploitable and open-ended, in Japanese social debates about the country’s place as a potential global leader. This chapter traces debates about status, and argues that narrative is essential to understanding how status claims work and why they matter. It then sets three highly charged episodes—all of them involving arguments about Japan’s international position—against the backdrop of a widely shared postwar narrative about Japan.

14. The politics of international law

This chapter draws together the key themes of this book, using contemporary debates over the nature and future of international order, and explores likely sources of continuity and change in the politics of international law. It begins by expanding on the concept of international order and, more specifically, the so-called liberal international order that has framed international politics in the postwar period. The chapter asks whether and why the liberal international order is in crisis and how it is likely to evolve. It then turns to the rise of non-Western powers, a phenomenon that many observers have argued is contributing to the crisis of the current order. The focus is on what the changing balance of material power may reveal about the present and future of international law. Finally, the chapter offers some tentative conclusions about the politics of international law two decades into the twenty-first century.

Thoughts on Power Transitions, Past and Future

This chapter reviews the patterns found in the book and draws conclusions about the rise of China and India today. It argues that economic power, military power, and narratives about becoming a great power are all essential elements that rising powers which became great powers possessed, and in order to actively rise, these countries recognized the current norms of great power and initially played by the rules of the international order. Those that did not possess all those elements stayed reticent. Particularly, the absence of narratives about how to become a great power stymied these countries from active behavior on the world stage even when they possessed important elements of material power. This difference between active and reticent powers helps us understand why some nations rise to become great powers, as well as the differences between China and India today.

Science, Technology, and Peaceful Change in World Politics

This chapter undertakes a three-dimensional survey of the role of science and technology in peaceful change in world politics. One dimension is a sociology of knowledge on S/T and change in IR and its influence on the subdisciplines of security studies, international organization, and international political economy. The second dimension is the manner in which S/T has shaped the emergence of actors, interests, material power, social purposes, and grammars of international order to produce our contemporary late-modern Anthropocene age. Woven through this survey is the third dimension, contestation over S/T and its effects—at the micro and meso levels of analysis—that create the dynamic, open-ended movements and countermovements that brought humankind from the preindustrial order to the Anthropocene. The chapter considers next how IR can improve its theories of change and the prospects for this volume’s maximalist definition of peaceful change, beginning with some criteria for distinguishing what actually constitutes “peaceful” change. One of the most profound changes the world faces is rethinking both our paradigms and governance structures in light of climate change and the Fourth Industrial Revolution, as these will profoundly alter the actual workings of economies and societies, remaking global politics in the process.

Autonomous heating system during transformation of thermal energy formed in server stations

Results of design modeling of air-conditioning and central air of premises of server stations are presented. The estimation of thermal balance of typical server station is made. The potential of thermal energy which can be used is estimated it is useful for needs of central heating, to save power resources, and not to pollute environment thermal emissions. The detailed analysis of components of is material-power balance is made. The mathematical model of central air is developed for these purposes. Analysis problems of the heat substances exchange processes, the drainage of air connected with processes, occurring at its cooling are considered. The designing and operation problems interfaced with the heat substances exchange in air coolers are considered. The heat pump scheme of system is offered the central heating, utilizing warmly server station at air conditioning indoors. The model is offered and results of optimization of parameters heat pump schemes are considered. Results can be applied at designing of central airs of premises of server stations with passing recycling of thermal emissions for needs of central heating.