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 Challenges to Cooperation Posed by the Nexus of Terrorism and Organized Crime: Comparing the Situations Between the Andean and the Sahel Regions

The recent conflict in the Sahel area is another case where the nexus of terrorism and organized crime causes challenges to the international community. Comparing the situation with that of the Andean region brings forth the challenges faced when dealing with this type of conflict: the states’ weak presence in the remote regions, the insurgents’ ability to offer income and “security” to the people, immediate threat to international investments, unresolved political/regional issues, the marriage of convenience of insurgents/terrorists and organized crime, internal divisions of the insurgent groups and also ideologies surviving or suffering after the elimination of their leaders.     

Adolescent Daughters’ Romantic Competence: The Role of Divorce,Quality of Parenting,and Maternal Romantic History

This study examined the links between parental divorce, quality of maternal parenting, spousal relationships and middle adolescent romantic competence in 80 mother-adolescent daughter pairs (40 divorced). Mothers were asked to describe their attitudes and behaviors with regard to their daughters’ romantic behavior. In addition, mothers were interviewed about their own romantic experiences when they were at the age of their daughters. Adolescent girls (mean age = 16.98 years; range 16–18) were administered a comprehensive interview about romantic competence. Findings indicated that adolescent girls from divorced families showed lower levels of romantic competence, which were expressed in their behavior, attitudes toward relationships and skill in handling those relationships. Divorce was found to have had an adverse effect on girls’ romantic competence, whereas continued adaptive parenting and spousal relationships alleviated the effect of divorce. Mothers’ coherent representation of their own adolescent romantic experiences also alleviated the effect of divorce on daughters’ romantic behavior. Results show the important role of family relationships in fostering romantic competence among adolescent girls.     

Family Cohesion and Romantic and Sexual Initiation: A Three Wave Longitudinal Study

Although the relation between family relationships and the timing of sexual debut has been the focus of many studies, research on mediating factors is scarce. This study examines whether low levels of family cohesion result in an earlier onset of romantic and sexual experiences, and whether the link between family cohesion and an early sexual debut is mediated by early romantic initiation. A longitudinal sample of 314 adolescent girls and 222 boys, aged 12–17 at Wave 1, completed questionnaires at three measurement points with three year intervals. The results showed that sexual debut followed romantic initiation for 77% of the participants. For early adolescent females (aged 12–14), high levels of family cohesion resulted in a later sexual debut and this association was fully mediated by a delay of romantic initiation. Among boys and older girls, timing of romantic initiation did not mediate the link between family cohesion and timing of sexual initiation. Early adolescent girls who have negative relationships with their parents turn to romantic relationships for intimacy and support, which subsequently provide the opportunity for an early sexual debut. Low levels of family cohesion thus primarily precipitate romantic initiation and sexual initiation appears to be secondary to this process among girls in this age group.     

Peer Selection and Socialization in Adolescent Depression: The Role of School Transitions

Previous studies have indicated homophily in depressive symptoms among adolescent friends, resulting from both peer selection and socialization processes. However, developmental differences and the role of school transitions in these processes have not been elucidated. A sample of 367 (51% female) adolescents was followed from 6th to 11th grade to investigate prospective relationships between adolescents’ and their friends’ depressive symptoms in middle school and in high school. Results revealed that students selected friends with similar levels of depressive symptoms after each school transition. Additionally, friends appeared to socialize adolescents to become more similar in depressive affect in late middle school years. These findings suggest normative selection effects after school transitions, followed by socialization effects in middle school, but not high school.