<p> The need for public school construction and the cost of funding that construction has been the source of considerable concern and debate as far back as the late nineteenth century and has carried forward through the first decade of the twenty-first century. Although it is estimated that the United States has spent almost $750 billion on school construction since 1900, studies have also pointed out that only six percent of the schools were built since 1980. Numerous studies since 1990 to the current day have placed estimates as high as $322 billion needed to meet current needs for renovation, repair, and new construction. </p><p> The need and cost for funding public school construction is also within the context of how these costs are funded in the United States. Most school construction, with some exceptions, is heavily dependent upon local government, in other words the local taxpayer as the source of funds for the needed construction. This study focused on the needs of Winchester, Virginia, a small city located in the Northern end of the Shenandoah Valley. Winchester Public Schools and the local government were faced with $50 million in local school construction needs for its only high school, a historic building of iconic stature. The prevailing thought among many was that this figure was too high, or exceeded the fiscal capacity of local government. When the estimated cost began to rise, local decision makers were faced with the dilemma of what to do. The conclusion was to take the unheard of step of conducting a capital campaign to raise funds in order to assist in the renovation and restoration John Handley High School. </p><p> The methodology used was to conduct semi-structured interviews of persons, purposefully chosen, who were involved in the decision-making or in some way were involved in the capital campaign environment. The intent was to explore attitudes and beliefs about the school and the fundraising effort. The results reveal a fascinating story about the school&rsquo;s original benefactor and the forces of social capital and attachment to the school that occurred over its history. These forces ignited the effort to raise private funds to renovate and the restore the school that resulted in the donations of funds in excess of six million dollars and has yet to come to a conclusion. The study reveals not only the beliefs and attitudes of the individuals involved, but also the attachment that an entire community has for its beloved school and the community spirit it symbolically represents.</p>

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L’internationalisation de l’action publique sanitaire est aujourd’hui incontestable, et cette thèse représente une contribution intellectuelle à l’analyse de ce phénomène reconnu mais encore à explorer dans les détails. Partant d’un point très précis voire étroit, la substitution progressive dans le vocabulaire et les pratiques de l’Organisation mondiale de la Santé (OMS) de l’éducation sanitaire par la promotion de la santé, on retrace un parcours autrement considérable qui n’engage rien moins que les représentations historiques et politiques qui ont conduit à la mise en place de politiques publiques dans le domaine sanitaire, et ce à l’international. A la croisée de l’histoire des idées et de l’analyse des politiques publiques internationales, c’est une méthodologie innovante – articulant démarche intellectuelle et recherche empirique, notamment par l’observation participante et la conduite d’entretiens – que nous mobilisons pour retracer l’histoire et le fonctionnement réel de l’OMS.Notre travail se présente comme une histoire d’enchevêtrements de savoir(s), de jeux de pouvoir et de processus d’institutionnalisation dans des contextes changeants. Partant de l’émergence, dès le XVIIIe siècle, de l’éducation sanitaire comme stratégie visant la modification des comportements individuels puis de son inscription au sein de l’OMS, on en arrive à la question du changement de l’action publique (internationale). L’affirmation progressive de la promotion de la santé à partir des années 1980 traduit le travail de sens opéré par des acteurs (de l’OMS) qui, confrontés à des tensions liées à des modifications dans les équilibres jusqu’alors établis, modifient leurs discours et leurs pratiques afin de conserver, ou d’acquérir, une capacité à orienter l’action publique. Surtout, notre recherche montre que l’action publique sanitaire (internationale) se caractérise aujourd’hui par l’effort pour concilier – dans un contexte de complexification des enjeux, d’hétérogénéité croissante des savoirs et de multiplication des acteurs susceptibles d’intervenir au nom de la santé publique – des registres de légitimation (la défense de la liberté individuelle et la nécessité d’une action collective au nom de ce « bien commun » qu’est la santé) et des stratégies d’action (individuelles et collectives) non seulement différentes mais qui souvent même s’opposent. / This doctoral thesis is an intellectual contribution to the analysis of the unquestionable, process of internationalization of public health policies. Starting from a precise and even narrow point—the transition from “health education” to “health promotion” in the discourses and practices put forward by the World Health Organization (WHO)—we retrace the historical and political representations that shape public health-related policies at the international level. This interdisciplinary work, at the crossroad of the history of ideas and the international public policies analysis, is based on an innovating methodology which articulates an intellectual and empirical research to the analysis of the history and the functions of the WHO.This history is one of knowledge intertwining with games of power and institutional processes in shifting contexts. Starting with the emergence as early as the XVIIIth century of health education as a strategy for changing personal behaviors and its inclusion far later in the WHO structure, we move to the question of (international) public (health) policies transformations. The progressive affirmation of health promotion in the 1980’s reflects how WHO instances reframed the meaning of their work, when confronted to the tensions provoked by the shifting balance of well-established conceptions, and how they modified their discourse and their practice in order to keep or acquire a capacity to influence public action.. Above all, our research shows that (international) public health policies are today characterized by a attempt to combine—in a context of complexified issues and increased heterogeneity in knowledge as well as of a greater number of stakeholders in public health (action)—an array of legitimizing discourses ranging from the defense of individual freedom and the need for collective action on behalf of health as a “common good” to (individual and collective) strategies of action that are not only different but often conflicting.

In Zusammenhang mit der Einführung des Pflegeversicherungsgesetzes stellt die Arbeit die stationäre Altenpflege in Deutschland besonders dar. Im analytischen Rahmen der Arbeit wird der klassischen sozialwissenschaftlichen Unterteilung: Makro-Meso-Mikro eine zusätzliche Meta-Ebene hinzugefügt, welche den epistemologischen Hintergrund umfasst. Mit Hilfe des Modells der narrierenden Organisation kann so gezeigt werden, wie - am Beispiel der stationären Altenpflege - narrative Sinnstiftung in Organisationen abläuft. Dabei liegt ein Fokus darauf, was vom Außerorganisationalen des analytischen Rahmens in den sechs verschiedenen Fällen zur Sinnstiftung beiträgt. Nach einer sehr umfassenden qualitativen Auseinandersetzung schließt die Arbeit mit einem allgemeinen Modell, welches als Vorschlag zur Erforschung von Organisationen gesehen werden kann.

In Zusammenhang mit der Einführung des Pflegeversicherungsgesetzes stellt die Arbeit die stationäre Altenpflege in Deutschland besonders dar. Im analytischen Rahmen der Arbeit wird der klassischen sozialwissenschaftlichen Unterteilung: Makro-Meso-Mikro eine zusätzliche Meta-Ebene hinzugefügt, welche den epistemologischen Hintergrund umfasst. Mit Hilfe des Modells der narrierenden Organisation kann so gezeigt werden, wie - am Beispiel der stationären Altenpflege - narrative Sinnstiftung in Organisationen abläuft. Dabei liegt ein Fokus darauf, was vom Außerorganisationalen des analytischen Rahmens in den sechs verschiedenen Fällen zur Sinnstiftung beiträgt. Nach einer sehr umfassenden qualitativen Auseinandersetzung schließt die Arbeit mit einem allgemeinen Modell, welches als Vorschlag zur Erforschung von Organisationen gesehen werden kann.