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.     

Cumulative Family Risk Predicts Increases in Adjustment Difficulties across Early Adolescence

Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents’ adjustment difficulties in 416 two-parent families using four waves of annual longitudinal data (51 % female youth). Risk factors in four family domains were examined: socioeconomic, parents’ psychological realm, marital, and parenting. Cumulative family risk experienced while in 6th grade was associated concurrently with daughters’ higher internalizing problems and with increased internalizing problems during early adolescence. Cumulative family risk was associated concurrently with sons’ higher externalizing problems and with daughters’ increased externalizing problems over time. Cumulative family risk was associated concurrently with lower grades and with declining grades over time for both daughters and sons. The number of risk domains also was associated with youths’ adjustment difficulties during early adolescence, providing evidence that risk in two-parent families involves more than ineffective parenting. These findings suggest a critical need to provide strong support for families in reducing a variety of stressors across multiple family domains as their children traverse early adolescence.     

"Transcending gynocentric space”: Spatial metaphorics in feminist theory and criticism

Many studies assert that there are new gender constructions among young Scandinavian girls, who seem to be more individualized than earlier generations. In this article questions are raised as to what effect these girls’ newly won status as subjects might have on their construction of bodily gender, especially the part referred to as generative femininity. A “loss” of the generative body is argued to be a general tendency in postmodern discourse, as well as a dilemma in the individual girl's striving for being both individual and gender. This dilemma and its tentative solution is illustrated through the analysis of an 18‐year‐old Norwegian girl, who was the subject of an in‐depth interview in a three‐generational study of gender in change.     

历史主义的解释学问题

在19世纪,除了浪漫主义的解释学外,还有历史主义的解释学。它们之间的一个重要的联结点是解释学循环。除此之外,二者的密切关系在其师承和道统方面。布克、德罗伊森和狄尔泰三人的思想代表了西方19世纪下半叶解释学的一个重要的特点,那就是突出与人文科学的联系,这是以历史意识的逐步确立为中介的,但是他们,尤其是德罗伊森和狄尔泰最终都没能摆脱历史的局限。     

Managing for Legitimacy: Agency Governance in Its “Deep” Constitutional Context

Recent literature on bureaucratic structure has gone further than studying discretions given to bureaucrats in policy making, and much attention is now paid to understanding how bureaucratic agencies are managed. This article proposes that the way in which executive governments manage their agencies varies according to their constitutional setting and that this relationship is driven by considerations of the executive's governing legitimacy. Inspired by Charles Tilly (1984), the authors compare patterns of agency governance in Hong Kong and Ireland, in particular, configurations of assigned decision‐making autonomies and control mechanisms. This comparison shows that in governing their agencies, the elected government of Ireland's parliamentary democracy pays more attention to input (i.e., democratic) legitimacy, while the executive government of Hong Kong's administrative state favors output (i.e., performance) legitimacy. These different forms of autonomy and control mechanism reflect different constitutional models of how political executives acquire and sustain their governing legitimacy.     

Ingredients of institutional reputations and citizen engagement with regulators

The purpose of this study is to examine the link between the reputational components of efficacy and moral reliability of institutions, and citizens' compliance with institutional recommendations. Research on bureaucratic reputations highlights the significance of positive political reputations based on credibility and legitimacy, but the impact of these components is not systematically isolated and studied. We draw insights from political psychology to move beyond a positive‐negative valence‐based approach of reputation, and highlight the different effect of efficacy and moral reliability components of reputation on citizens' cooperation, engagement in water saving activities, and levels of complaints. We use the Cypriot Water Authority as a case study and inquire how its institutional reputation influences Cypriot citizens' behavior regarding water use. Our data was collected via a representative national survey administered to a random sample of 800 Cypriots in the spring of 2009 and show that favorable perceptions of particular components of institutional reputation shape the levels of satisfaction with specific organizational outputs.     

E‐government and public service quality in Ghana

This article contributes to the growing discourse on the potential of e‐government to transform the operations of public sector institutions, thereby improving public services. It does so by conceptualizing public service quality into efficiency, economy (cost reduction), customer satisfaction, and service accessibility and draws on qualitative data from the Ghanaian narrative for illustration. As previous studies have demonstrated, this study also affirms the potential of e‐government in improving public services delivery by increasing efficiency, reducing the cost of operations, expanding access to services, and achieving customer satisfaction. Yet, there remains a repertoire of challenges such as weak ICT infrastructure especially in towns and villages, incessant power outages and illiteracy, which are drawbacks to fully harnessing the benefits of e‐government in Ghana. The study recommends that these challenges should feature prominently in e‐government policies to increase the chances of solving them.     

Time for a New Paradigm? Past and Present Transitions in Economic Policy

This article seeks to place the UK's present economic ‘moment’ in historical context. Over the course of the decade since the 2007 financial crisis, it has increasingly been acknowledged that a cyclical crisis has become a structural crisis. The failure of most economists to predict the financial crash in the first place, and the inadequacy of economic policy in responding to its lasting effects, has led many to conclude that economics itself is in crisis. This article seeks to contribute to a better understanding of the present period of disjuncture. Drawing on theories of paradigm shift from both the physical and social sciences, we argue that the speed of change in UK economic policy is comparable to the two major historical transitions that ended with the post‐war consensus and neoliberalism. We conclude by offering some remarks on how and where the present change might take us.