INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Silence and Articulation—Whiteness,Racialization and Feminist Memory Work

Racialization is a constant process of “doing race”. Critical whiteness studies make efforts to address the silencing of whiteness in mainstream white feminism. In this article memory work is explored as a possible method for studies of whiteness as an unmarked majority position. The focus is on methodological practices or “how‐to‐do” questions. Starting from feminist epistemology the author investigates ways of practising the epistemological standpoint of situated knowledges. Feminist epistemology, despite its disagreements, has pointed to the importance of positioning work for scientific knowledge production. The relationship between racialization as an analytical concept and whiteness as dominant majority position is complicated. Usually memory work is employed to address gender or more specifically femininity, but, as argued here, it is well suited to investigations of racialization, too. The analysis shows that silent avoidance of matters associated with whiteness helps keep the majority position in place; whiteness is co‐produced with silence through avoidance in concrete everyday situations. Despite a number of problematic aspects, memory work proved productive in bridging the gap between an epistemological standpoint and the nitty‐gritty work of doing empirical research. It helped clarify racialization as a relational phenomenon and shows how lack of attention to or awareness of race has implications for scientific knowledge production.     

The Pivotal Role of Adolescent Autonomy in Secondary School Classrooms

Student engagement is an important contributor to school success, yet high school students routinely describe themselves as disengaged. Identifying factors that alter (increase) engagement is a key aspect of improving support for student achievement. This study investigated students’ perceptions of autonomy, teacher connection, and academic competence as predictors of changes in student engagement within the classroom from the start to the end of a course. Participants were 578 (58% female) diverse (67.8% White, 25.2% African American, 5.1% Hispanic, 1.2% Asian American) high school students from 34 classrooms who provided questionnaire data both at the start and the end of a single course. Novel results from a cross-lagged model demonstrated that students who perceived their classrooms as allowing and encouraging their own autonomy in the first few weeks increased their engagement throughout the course, rather than the typical decline in engagement that was demonstrated by students in other classrooms. This finding is unique in that it extended to both students’ perceptions of engagement and observations of student engagement, suggesting a fairly robust pattern. The pertinence of this finding to adolescent developmental needs and its relationship to educational practice is discussed.     

Internalizing Symptoms: Effects of a Preventive Intervention on Developmental Pathways from Early Adolescence to Young Adulthood

This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.     

(ALL THE) SINGLE LADIES

In the film fragment Smart B**ch, two women—a black Sudanese-Australian and a white American-Australian—share what it means to be diasporic travellers and explore their similarities and differences within evolving feminist discourses which have in some ways abandoned the subaltern for the subdivided. No longer content to criticise the ways in which we speak for and to each other, and to accommodate hierarchies of class, race and sexuality, this ethnocinematic dialogue prefers these film personae to speak with each other and their audience using Conquergood and Denzin as performance ethnography guides, while challenging hegemonic notions of diaspora to include such diversities as adoptees, queers, and others.     

Is Educational Achievement a Turning Point for Incarcerated Delinquents Across Race and Sex?

Research has linked the role of education to delinquency, but much of the focus has been on general population samples and with little attention to demographic differences. Employing a cumulative disadvantage framework that integrates elements of informal social control and labeling theories, this article examines whether academic achievement serves as a positive turning point and re-directs juvenile delinquents away from subsequent offending. Attention is also given to race/sex contingencies. Using a sample of 4,147 delinquents released from Florida correctional institutions (86% male, 57% non-White, average age at release = 16.8 years), propensity score analysis yielded two findings: youth with above average academic achievement while incarcerated were significantly more likely to return to school post-release, and youth with above average attendance in public school were significantly less likely to be re-arrested in the 1-year post-release period. While the academic gains were pronounced among African-American males, the preventive effects of school attendance are similar across race and sex, suggesting that education can be a part of a larger prevention effort that assists juvenile delinquents in successful community re-entry.     

Special Section Introduction: Thriving in Context: Findings from the 4-H Study of Positive Youth Development

The positive youth development perspective, a strength-based relational developmental systems model that focuses on mutually influential relationships between individuals and contexts, has been used to study thriving across the second decade of life. However, more attention has been paid empirically to identifying the features of the individual (e.g., intentional self regulation, hope, or purpose) or to enumerating the role of context-general ecological assets than to the nature of individual-context relationships linked to thriving within specific contexts. The goal of this special section is to provide initial research reports about context-specific instances of the thriving process. The research focuses on two contexts where many youth spend a considerable amount, and often the majority, of their time—school and out-of-school time sports activities.