The influence of institutions and culture on health policies: different approaches to integrated care in England and The Netherlands

The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics.     

Advancing Knowledge through Grassroots Experiments: Connecting Culture and Sustainability

Since 2006, hundreds of communities in Canada have produced Integrated Community Sustainability Plans, based on a four-pillar model of sustainability and developed in consultation with residents and stakeholders. These community-based experiments have developed models, knowledge, and insights about the place of culture in local sustainability. Both conceptual thinking and planning practices regarding the role of culture in sustainable communities were at an embryonic stage when these initiatives took place. The discussions, plans, and implementation processes have advanced both theory and “leading edge” practices with regard to culture and community sustainability, illustrating the importance of a robust relationship between research and practice.     

Path-dependent Implementation of the European Qualifications Framework in Education. A Comparison of Norway,Germany and England

Abstract

By comparing the implementation of the European Qualifications Framework (EQF) in three education systems, this article advances the understanding of implementation processes and outcomes. The analytical framework combines concepts of norm diffusion with institutional, political and practical dimensions of implementation. Although a certain degree of norm diffusion is revealed, we find a variety of points of correspondence between national problem definitions and the EQF, varying levels of stakeholder involvement, as well as national institutional robustness against full EQF implementation. The national implementations represent different mind-sets and signify translation processes that reflect continuation of established institutional practices.     

STRICTLY LIABLE: GOVERNMENTAL USE OF THE PARENT–CHILD RELATIONSHIP AS A BASIS FOR HOLDING VICTIMS LIABLE FOR THEIR CHILD'S WITNESS TO DOMESTIC VIOLENCE

Studies estimate that between three and ten million children in the United States witness domestic violence annually. Although studies have demonstrated a co‐occurrence of domestic violence and child abuse, there is no concrete evidence to support the assumption that a child's exposure to domestic violence increases the risk to the child of abuse or neglect. Recently the New York State Court of Appeals determined that a child's witness to abuse does not suffice, in and of itself, to show that removal of the child is necessary or that removal is in the “best interests” of the child. Programs which have developed alternatives to presumptive removal understand the importance of viewing the interests of the battered parent and children as being in accord with each other rather than in opposition. Private and government sponsored programs have demonstrated some success in protecting the parent‐child relationship, ensuring the safety of both parent and child, and increasing accountability of batterers while reducing the necessity for removals. Alternative programs are less costly to the state than foster care, and emotionally less costly to the families.