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.     

The EU’s Democratic Deficit and Repeated Referendums in Ireland

This analysis tackles the question of whether the democratic deficit in the European Union is associated with repeated referendums—giving voters a second chance to vote “yes” for EU treaties. Looking at repeated referendums in Ireland on the Nice and Lisbon treaties, I argue that, broadly speaking, these referendums failed to give Irish voters the meaningful ability to contest the direction of EU policy or to choose among alternative policy options, an example of how the democratic deficit can endure even when the EU incorporates electoral mechanisms. I first discuss how this theoretical insight is evidenced by five aspects of the Irish referendums. Then, I examine three of these aspects more closely in case studies of the Nice and Lisbon referendums, focusing on how leaders (1) conceptualized the failure of the initial referendums as deriving from voter incomprehension, (2) planned repeated referendums in an additional effort to ratify the treaties, and (3) mobilized “yes” voters through extreme predictions about the consequences of second “no” outcomes. I conclude by discussing socio-economic trends seen from 2003 to 2014 and their implications for issues related to the EU’s democratic deficit.     

Not Worth the Fuss After All? Cross-sectional and Prospective Data on Violent Video Game Influences on Aggression, Visuospatial Cognition and Mathematics Ability in a Sample of Youth

The United States Supreme Court’s recent decision relating to violent video games revealed divisions within the scientific community about the potential for negative effects of such games as well as the need for more, higher quality research. Scholars also have debated the potential for violent games to have positive effects such as on visuospatial cognition or math ability. The current study sought to extend previous literature by using well-validated clinical outcome measures for relevant constructs, which have generally been lacking in past research. Cross-section data on aggression, visuospatial cognition, and math achievement were available for a sample of 333 (51.7 % female) mostly Hispanic youth (mean age = 12.76). Prospective 1-year data on aggression and school GPA were available for 143 (46.2 % female) of those youth. Results from both sets of analysis revealed that exposure to violent game had neither short-term nor long-term predictive influences on either positive or negative outcomes. A developmental analysis of the cross-sectional data revealed that results did not differ across age categories of older children, preadolescents or adolescents. Analysis of effect sizes largely ruled out Type II error as a possible explanation for null results. Suggestions for new directions in the field of video game research are proffered.     

Sleep Disturbance and Depressive Symptoms in Adolescence: The Role of Catastrophic Worry

Depression is a common and debilitating disorder in adolescence. Sleep disturbances and depression often co-occur with sleep disturbances frequently preceding depression. The current study investigated whether catastrophic worry, a potential cognitive vulnerability, mediates the relationship between adolescent sleep disturbances and depressive symptoms, as well as whether there are gender differences in this relationship. High school students, ages 16–18, n = 1,760, 49 % girls, completed annual health surveys including reports of sleep disturbance, catastrophic worry, and depressive symptoms. Sleep disturbances predicted depressive symptoms 1-year later. Catastrophic worry partially mediated the relationship. Girls reported more sleep disturbances, depressive symptoms, and catastrophic worry relative to boys. The results, however, were similar regardless of gender. Sleep disturbances and catastrophic worry may provide school nurses, psychologists, teachers, and parents with non-gender specific early indicators of risk for depression. Several potentially important practical implications, including suggestions for intervention and prevention programs, are highlighted.     

The Impact of Emotional Disturbances on the Arrest Trajectories of Youth as They Transition into Young Adulthood

This article identifies the arrest trajectories of youth from ages 12 through 24 years old and tests hypotheses derived from Moffitt’s developmental taxonomic theory of crime concerning the impact of various emotional disturbances on the specific trajectories of the youth involved. The study uses exclusively administrative data sets and includes a gender and racially diverse sample of 10,360 youth (30.7 % females) who were arrested at least once between ages 12 and 24 in the early 2000s. Latent class growth analysis was employed in order to identify distinct arrest trajectories of youth in the sample. Multinomial logistic regression was used to identify diagnostic and other characteristics associated with membership in the specific trajectories predicted by Moffitt’s theory. Five trajectory classes were identified, 3 of which were consistent with taxonomic theory including high and classic adolescence limited trajectory classes and a “snared adolescence limited class” described more recently by Moffitt. The distribution of youth among the 5 classes was very different for those with and without emotional disturbances. Youth with emotional disturbances in their late adolescent years were more likely to fall into the high arrest trajectory class and much less likely to fall into the low arrest trajectory class. Compared to youth without an emotional disturbance, youth with psychotic disorders were more than twice as likely to fall into the high as into the low arrest trajectory class. Youth with disruptive behavior disorders were more than twice as likely to fall into the high and intermediate classes as into the low trajectory class. Anxiety and depressive disorders were not associated with significantly greater likelihood of falling into any one of the trajectory classes. Youth in the snared adolescence limited class were more likely than those in the classic adolescence limited class to be male, black versus white and in the foster care enrollment category lending some support to Moffitt’s conceptualization of this class as an adolescence limited class composed of youth who are snared by involvement in the criminal justice and or social services systems. Implications of these results for public policy and the study of adolescence are discussed.     

Involved-Vigilant Parenting and Socio-Emotional Well-being Among Black Youth: The Moderating Influence of Natural Mentoring Relationships

Positive relationships with parents and nonparental adults have the potential to bolster Black adolescents’ socio-emotional well-being. Though each type of intergenerational relationship has been linked to more positive youth outcomes, few studies have examined the interactive influences of parenting and natural mentoring relationships on the socio-emotional development of Black youth. In the current study, we examined associations between involved-vigilant parenting and the psychological well-being and social skills of Black early adolescents (n = 259; 58 % female; mean age = 13.56, SD = .96) across types of natural mentoring relationships. Using K-means cluster analysis, we identified two types of mentoring relationships (less connected and more connected) based on relationship length, involvement, closeness, and frequency of contact. Youth with more connected mentoring relationships (n = 123) had higher psychological well-being and social skills than youth with no mentor (n = 64) or less connected mentors (n = 72). Youth without a natural mentor and youth with less connected mentors did not differ in their levels of social skills or psychological well-being. Structural equation modeling was conducted to determine if associations between involved-vigilant parenting and youths’ psychological well-being and social skills varied among youth with a more connected mentoring relationship in comparison to youth without a mentor or with a less connected mentor, controlling for participants’ gender, age, school, and parental education. The positive associations between involved-vigilant parenting and adolescents’ psychological well-being and social skills were weaker among adolescents with a more connected mentoring relationship in comparison to their peers without or with a less connected mentoring relationship. These results suggest that youth may be more strongly influenced by involved-vigilant parenting in the absence of a strongly connected natural mentoring relationship.     

Attributes that Differentiate Children Who Sip Alcohol from Abstinent Peers

Sipping alcohol during childhood may be a marker of differentiation as regards children’s future risk of underage drinking; yet very little is known about alcohol use when it occurs among elementary school-aged children. The purpose of the present study is to examine alcohol sipping behavior in a sample of third-grade school children to learn whether sipping is associated with attributes that could increase children’s likelihood of further underage drinking. We collected telephone interview data from 1,050 mothers and their third grade children (mean age 9.2 years; 48.2 % male) residing in the Southeastern United States. The majority of mothers were White non-Hispanic (69.02 %) or Black non-Hispanic (21.3 %); most (85 %) lived in households shared with fathers or other adult caretakers. We hypothesized that children who sip alcohol would score lower than abstinent peers on indicators of competence and score higher on indicators of exposure to alcohol-specific socialization by parents and peers. A multivariate model controlling for frequency of parent alcohol use and demographic covariates showed that children who had sipped alcohol were significantly less likely than abstinent peers to affirm indicators of competence and significantly more likely to affirm indicators of exposure to alcohol specific socialization by parents and by same age peers. These preliminary findings suggest that developmental attributes associated with risk of underage drinking begin to differentiate at least as young as middle childhood. Research is needed to test prospectively for continuity between alcohol risk attributes present in middle childhood and future alcohol use.     

Associations Between Adolescents’ Perceived Discrimination and Prosocial Tendencies: The Mediating Role of Mexican American Values

Experiences with perceived discrimination (e.g., perceptions of being treated unfairly due to race or ethnicity) are expected to impact negatively youths’ prosocial development. However, resilience often occurs in light of such experiences through cultural factors. The current longitudinal study examined the influence of perceived discrimination on the emergence of Mexican American adolescents’ later prosocial tendencies, and examined the mediating role of Mexican American values (e.g., familism, respect, and religiosity). Participants included 749 adolescents (49 % female) interviewed at 5th, 7th, and 10th grade. Results of the current study suggested that, although perceived discrimination was associated negatively with some types of prosocial tendencies (e.g., compliant, emotional, and dire) and related positively to public prosocial helping, the associations were mediated by youths’ Mexican American values. Directions for future research are presented and practical implications for promoting adolescents’ resilience are discussed.     

The Peer Context and the Development of the Perpetration of Adolescent Dating Violence

The peer context is a central focus in research on adolescent risk behaviors but few studies have investigated the role of the peer context in the perpetration of adolescent dating violence. This longitudinal study examined between-subjects and within-person contemporaneous and lagged effects of peer attributes, measured with social network analyses, on trajectories of dating violence perpetration and determined if effects varied by grade and/or sex of the adolescent. Data are from adolescents who participated in a five-wave panel study beginning when they were in 7 through 9th grade and ending when they were in 10 through 12th grade (n = 3,412); half were male, 40.5 % were white, 49.9 % were black and 10.4 % were of another race/ethnicity. Significant between-subjects effects indicate that adolescents who typically have friends who use dating violence, and girls who are typically high in social status, are at increased risk for using dating violence throughout adolescence. Adolescents who typically have high quality friendships and girls who typically have friends with pro-social beliefs are at decreased risk for using dating violence throughout adolescence. Significant within-person contemporaneous effects indicate that both boys and girls reported lower levels of dating violence than usual at times when they had more friends with pro-social beliefs, and reported higher levels of dating violence than usual at times when they had higher social status. None of the lagged effects were significant and none of the effects varied across grade. These findings suggest that the peer context plays an important role in the development of the perpetration of adolescent dating violence.