Co-Production and Health System Reform – From Re-Imagining To Re-Making

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.     

Attributional style,depressive features,and self-esteem: Adult children of alcoholic and nonalcoholic parents

Undergraduate adult children of alcoholics (ACOAs; N=57) were compared to children of nonalcoholic parents (CONAs; N=100) on measures of the Beck Depression Inventory (BDI), selfesteem, and attributional style. ACOA status was determined using the Children of Alcoholics Screening Test (Jones, 1981). ACOAs were found to have significantly higher scores on the BDI and to have significantly lower self-esteem, as measured by the Index of Self-Esteem, than CONAs. ACOAs were also more likely to have a depressive attributional style, in that they perceived failure as more internal, stable, and global than CONAs. Further, females had significantly higher BDI scores than males.Received B.A. from West Virginia University. Research interests: adult children of alcoholics and human sexual behavior.Received Ph.D. from West Virginia University. Research interests: the impact of popular culture on adolescents and the impact of parental conflict on children.Received Ph.D. from University of Massachusetts. Research interests: adolescent suicide risk.     

Building sustainable capacity in the public sector: What can be done?

Effective government performance is central to the creation of market-oriented economies, secure and productive populations, and democratic political systems in developing countries. Capacity building to improve public sector performance is thus an important focus of development initiatives. Several implicit assumptions underlie most such efforts: that organizations or training activities are the logical site for capacity-building interventions; that administrative structures and monetary rewards determine organizational and individual performance; that organizations work well when structures and control mechanisms are in place; and that individual performance improves as a result of skill and technology transfer through training activities. Each of these assumptions is called into question by the findings of research carried out in six developing countries and reported in this article. Our studies indicate designing interventions that most constructively address sources of poor performance must follow from an assessment of a relatively broad set of variables, including the action environment in which all such activities take place. We also found that effective public sector performance is more often driven by strong organizational cultures, good management practices, and effective communication networks than it is by rules and regulations or procedures and pay scales. Our case studies further indicate that individual performance is more affected by opportunities for meaningful work, shared professional norms, teamwork, and promotion based on performance rather than it is by training in specific skills. In this article, we describe a framework or conceptual map that emphasizes that training activities, organizational performance and administrative structures are embedded within complex environments that significantly constrain their success and that often account for training or organizational failure. When it was applied in the six case study countries, the framework proved useful in identifying capacity gaps and providing a tool for the strategic design of interventions that are sensitive to the roots of performance deficits. This allows us to conclude that the assumptions underlying many capacity-building initiatives may focus attention on interventions that do not generate the highest payoffs in terms of improved performance.     

B. Reviews: general

i. SHADOWS ON THE SAND: THE MEMOIRS OP SIR GAWAIN BELL. By (SIR) GAWAIN BELL. London, C.Hurst/New York, St Martins, 1983. pp.xiv, 258, 2 maps and index. El3.50.

ii. THE SUDAN MEMOIRS OF CARL CHRISTIAN GIEGLER PASHA. Edited by RICHARD HILL. Translated from the German by THIRZA KÜPPER. With a foreword by the Pasha's great‐granddaughter, HEIDI GROHA. Oxford, Oxford University Press (for the British Academy), pp. xxxii, 231, 3 maps, 12 plates. £18.00.

iii. EGYPT IN THE REIGN OF MUHAMMAD ALI. By AFAF LUTFI AL‐SAYYID MARSOT. (Cambridge Middle East Library) Cambridge, Cambridge University Press, 1984. pp.x, 300. £25.00.

iv. URBAN NOTABLES AND ARAB NATIONALISM: THE POLITICS OF DAMASCUS. By PHILIP S. KHOURY. (Cambridge Middle East Library) Cambridge, Cambridge University Press, 1983. pp.153, 2 maps.

v. VICTIMS OF A MAP. Translated by ABDULLAH AL‐UDHARI. London, Al‐Saqi Books, 1984. pp.165. £4.95.

vi. PALESTINE AND MODERN ARAB POETRY. By KHALID A. SULAIMAN. London, Zed Books Ltd., 1984. pp.240. £6.95.

vii. L'ARABIE DU SUD: HISTOIRE ET CIVILISATION. By JOSEPH CHELHOD and others. Paris, Maisonneuve & Larose, 1984. pp.264. 21 illustrations, maps, tables. FF 94.

viii. THE TWO YEMENS. By ROBIN BIDWELL. Harlow (UK), Longman/Boulder (USA), Westview. 1983. pp.350.

ix. BAHRAIN AND THE GULF: PAST PERSPECTIVES AND ALTERNATIVE FUTURES. Edited by JEFFREY B. NUGENT and THEODORE H. THOMAS. London, Croom Helm, 1985. pp.221, 26 tables, 4 figs., bibliography. £16.95.

x. THE ARABS. New Edition. By PETER MANSFIELD. Harmondsworth, Penguin, 1985. pp.510, map, index. £4.95/$6.95.

xi. THE EVOLUTION OF MIDDLE EASTERN LANDSCAPES: AN OUTLINE TO AD 1840. By J.M. WAGSTAFF. London, Croom Helm, 1983. pp.304, 459 maps and figs., 5 tables.

xii. THE GREEK MINORITY OF ISTANBUL AND GREEK‐TURKISH RELATIONS 1918–1974. By ALEXIS ALEXANDRIS. Athens, Centre for Asia Minor Studies, 1983.

xiii. SEX AND SOCIETY IN ISLAM: BIRTH CONTROL BEFORE THE NINETEENTH CENTURY. By B.F.MUSALLAM. (Cambridge Studies in Islamic Civilizations). Cambridge, Cambridge University Press, 1983. pp.ix, 176. £17.50.

xiv. TOWARDS A JUST MONETARY SYSTEM. By MUHAMMAD U. CHAPRA. Leicester (UK), The Islamic Foundation, 1985. pp.292. £10.00 (hardback); £4.75 (paperback).

xv. INSURANCE IN AN ISLAMIC ECONOMY. By MUHAMMAD NEJATULLAH SIDDIQUI. Leicester (UK), The Islamic Foundation, 1985. £5.50 (hardback); £2.00 (paperback).

xvi. PARTNERSHIP AND PROFIT SHARING IN ISLAMIC LAW. By MUHAMMAD NEJATULLAH SIDDIQUI. Leicester (UK), The Islamic Foundation, 1985. pp.111. £6.50 (hardback); £2.25 (paperback).

xvii. THE IMMORTAL ATATURK: A PSYCHOBIOGRAPHY. By VAMIK D. VOLKAN and NORMAN ITZKOWITZ. Chicago‐London, Chicago University Press, 1984. pp.xxv, 374. £34.50.

xviii. TURKEY. MERI REPORT. Compiled by MIDDLE EAST RESEARCH INSTITUTE. London, Croom Helm, 198 3. pp.181. £35.00

xix. BORDER AND TERRITORIAL DISPUTES. Edited by ALAN J.DAY. (A Keesing's Reference Publication). Harlow, Longman, 1982. pp.406, 44 maps. £45.00

xx. ‘IF ONLY MY PEOPLE...’ By IMMANUEL JAKOBOVITS. London, Weidenfeld & Nicolson, 1984. pp.288.

xxi. L'IMPRIMERIE ARABE EN OCCIDENT (XVIe, XVIIe XVIIIe SIÈCLES). By JOSÉE BALAGNA. (Islam & Occident, 2.) Paris, Maisonneuve & Larose, 1984. pp.153. 68F.     

The impact of sunset review: A study of real estate licensing

This paper focuses on the impact that state sunset review has had on the real estate occupation's ability to restrict entry through the imposition of licensing requirements. The results presented indicate that the 1983 rejection rate for real estate brokers and salespersons was lower in states undergoing sunset review of real estate than in those states not undergoing such a review. Sunset appears to have the power to effect changes in the licensing behavior of the occupation considered in this analysis.