Suchergebnisse

Résumé.De mars 2006 à décembre 2007, le Québec a été secoué par un débat sociétal sur la question de la gestion de la diversité culturelle. Cette «crise» aurait été alimentée par untsunami médiatiquetraitant de divers cas d'accommodements juridiques ou d'ajustements administratifs accordés dans les services publics à des citoyens québécois issus de l'immigration dans la grande région de Montréal (Giasson et coll., 2008). Par le biais d'une couverture étendue, les médias ont attiré l'attention de la population sur ces pratiques d'accommodement. L'article présente les données exploratoires d'une analyse de contenu de la couverture faite par onze journaux québécois du climat de l'opinion des Québécois en matière de diversité et d'immigration pendant la phase intensive de développement du débat. L'étude montre que dans leur analyse des sondages d'opinion et dans la présentation générale des tendances de l'opinion publique sur les accommodements raisonnables, les journaux ont mis l'accent sur l'évaluation du malaise des répondants envers l'immigration et la diversité religieuse plutôt que sur l'ouverture de la population québécoise envers la diversité et sur l'apport social de l'immigration, renforçant ainsi davantage l'impression populaire qu'une crise sociale majeure se déroulait et qu'il existait un fossé entre les Québécois «de souche», les Québécois issus de l'immigration et les autres Canadiens.Abstract.From March 2006 to December 2007, the province of Quebec experienced a contentious public debate on diversity. The "crisis" was fueled by a "media tsunami" during which news outlets actively reported on numerous cases of reasonable accommodation practices or administrative agreements in public services granted in the Greater Montreal region to citizens of immigrant background (Giasson et al., 2008). Through this extensive coverage, the media brought these instances of accommodation to the public's attention. The research studies the press coverage that 11 daily newspapers dedicated to the state of public opinion in Quebec during the active and intense development phase of the "crisis". The study shows that in their analysis of polls and their general framing of the mood of public opinion towards reasonable accommodation, newspapers focused mostly on the malaise in the population toward immigration and religious diversity rather than on its openness to diversity and to the positive social outcomes of immigration. In doing so, the media further anchored the popular impression that a serious social crisis was ongoing and that a wide gap in tolerance existed between Francophone Quebeckers, Quebeckers of recent immigrant background and other Canadians.

PurposeThe purpose of this paper is to introduce the contexts in which this special issue developed, along with the wider context in which research such as that included is conducted. It is believed that without the persistence of researchers in this field, the situation would be even worse.Design/methodology/approachPapers were selected from those submitted following a call for papers which went out after the Inaugural Equal Opportunities International Conference held at the University of East Anglia in July 2008. Two of the selected papers use qualitative, and two use quantitative, methodologies. The research was conducted in Belgium, Germany and the United Kingdom. Each seeks to develop theory based upon fresh empirical work.FindingsCompelling evidence provides insight to ways in which majority and minority ethnic employees experience organizations differently, along with the resultant differential outcomes, including career paths, quality and opportunities.Research limitations/implicationsThis paper maintains that each paper in this special issue (within its own context and as it currently stands) represents a robust example of qualitative or quantitative research in the field.Practical implicationsFrom the evidence of each paper published here, it is clear that academics and practitioners alike will gain insights to employer and employee behaviours at the level of the labour market and within the workplace itself. Such insights should encourage further action on the part of both. Employers should be prompted to review their polices and practices in the light of anti‐discriminatory legislation in such a way as to minimize discrimination therein.Social implicationsThis paper draws attention to matters of persistent inequality which remain so even in enlightened times wherein quite extensive legislation is in place to outlaw such inequality. As such, the guest editors would like to see, as a result of both academics and practitioners reading the work within this, and all other, editions of the journal, concerted efforts, in the case of the former, to continue to conduct and disseminate high‐profile research in the area of discrimination and equal opportunity, and, in the latter, to address their policies and practices. In the latter context, the guest editors would like to see an impact on public and private employment policies and the seriousness with which corporate social responsibility is undertaken. In that respect, public attitudes might eventually be seen to be changing for the more equitable.Originality/valueThe paper brings together the findings of four different pieces of original research in such a way as to demonstrate the commitment of researchers to addressing inequality in today's workplaces, which themselves continue to be inequitable.

Organizations are increasingly relying on team-based structures as work becomes more complex, nonroutine, and knowledge intensive. Teams comprised of individuals with diverse skills and expertise may be well suited to perform such work. However, as teams become more prevalent, organizations may struggle with ways to exercise control. Formal controls, with their focus on prespecified rules, performance targets, and hierarchical relationships, may be less effective in a teamwork environment than clan control, in which work-related behavior is motivated by shared norms and values, as well as a common vision, and individuals attempt to be accepted or "regular" members of a team. However, little is known about the antecedents of clan control. Much of the existing empirical research on the antecedents of control has been influenced by Ouchi's (Ouchi, W. G. 1977. The relationship between organizational structure and organizational control. Admin. Sci. Quart. 22 95–113) framework, which posits clan control is used when managers lack knowledge of means–ends relationships and are unable to measure outcomes. This paper adopts the view that clan control is a "people" or social process and argues that social capital, a construct that reflects connections and relationships among individuals, is a missing, key antecedent of clan control. In particular, we posit that the existence of social capital enables team members, as well as project managers, to facilitate clan control within a team, i.e., team-based clan control. A model is developed and hypotheses are tested using survey data collected from 95 information systems project teams. The results suggest that social capital assets are associated with team-based clan control. Recognizing that the project manager typically has a different level of organizational authority than team members, additional hypotheses are developed relating characteristics of the project manager to team-based clan control. The results of these tests suggest that team-based clan control is also dependent on the manager's knowledge of business processes and the application area, coupled with the extent to which he observes the behaviors of the project team. Thus, our results suggest that there are conditions under which team-based clan control is facilitated by the project team as a whole (including team members and project managers), as well as conditions under which team-based clan control is facilitated by project managers in their role as team leaders. Implications and suggestions for future work are discussed.

Cyclical economical growth is natural and unavoidable phenomenon, at the same time the less amplitudes of economical cycles fluctuations are, the more attractive economy of a country is. Countries sustain ultimate difficulties when financial crises happen in a certain country. Latterly such crises mostly come into play as the prices bubble burst. The current financial crisis started from the crisis of secondary dwelling credits in the USA. After prices bubble burst it has spread worldwide and unavoidably claimed following victims: crashed two most famous underwriting banks of the world Lehman Brothers and Merrill Lynch, two biggest mortgage banks of the USA Fannie Mae and Freddie Mac, substantially fell down all stock indexes. It is evident that the world realizes the extent of this problem and probable results because similar crises had place during XX century. They impacted on economical and political regional course of that time rather strongly. But modern economies of various countries are involved in more noticeable degree, so forthcoming consequences of this crisis will be rather heavier. It is interesting how in such circumstances banks and other financial institutions manage their assets in financial markets. Also the question is whether an object of the better property diversification wouldn't become the ground for a financial markets fall. Research object – stock market during financial crisis period. Purpose of this study is to explore and summarize theoretical nonfiction and design an investment portfolio hedged from cyclic economic fluctuations. Exposition of financial bubble theories, their significance for economics, mean reason, different interpretation of bubbles analysis, stable market sector identification, and portfolio formation helps to gain the purpose. In the first part nonfiction is analyzed seeking to find leading financial bubble theories. In reference to these theories, mean reason and consequence is outline here. This part also identifies basic government tools, which can help to reduce outcomes and prevent from financial crisis in future. In the second part investment criteria is brought to light, which is necessary for portfolio formation. Techniques for portfolio formation are analyzed. In the third part market sectors is analyzed with an aim to identify those who suffers least from cyclical economical fluctuations. Analysis has shown, that least impact from financial crisis was in sectors based on daily consumtion needs: consumer staples, health care and utilities stock market sectors. From these identified sectors portfolio has been constructed, which risk and return estimation compared with primary stock market indices of America, Eupope an Asia was much better. Otherwise gold as an alternative investment was better.

Background: Studies of water-related gastrointestinal infections are usually directed at outbreaks. Few have examined endemic illness or compared rates across different water supply and sewage disposal systems. We conducted a cohort study of physician visits and hospitalizations for endemic intestinal infectious diseases in a mixed rural and urban community near Vancouver, Canada, with varied and well-characterized water and sewage systems. Methods: Cohort members and their disease events were defined via universal health insurance data from 1995 through 2003. Environmental data were derived from municipal, provincial, and federal government sources. Logistic regression was used to examine associations between disease events and water and sewage systems, socio-demographic characteristics, and temporal factors. Results: The cohort included 126,499 individuals and approximately 190,000,000 person-days. Crude incidence rates were 1,353 physician visits and 33.8 hospitalizations for intestinal infectious diseases per 100,000 person-years. Water supply chlorination was associated with reduced physician visit incidence (OR: 0.92, 95% CI 0.85-1.0). Two water systems with the highest proportions of surface water had increased incidence (ORs: 1.57, 95% CI 1.39-1.78; and 1.45, 95% CI 1.28-1.64). Private well water and well depth were not associated with increased risk, likely because of residents' awareness of and attention to water quality. There was increased crude incidence with increasing precipitation in the population served by surface water supplies, but this trend did not remain with adjustment for other variables. Municipal sewer systems were associated with increased risk (OR: 1.26, 95% CI 1.14-1.38). Most socio-demographic variables had predicted associations with risk: higher rates in females, in the very young and the elderly, and in residents of low income areas. Increased duration of area residence was associated with reduced risk (OR, duration ≥ 6 years: 0.69, 95% CI 0.60-0.80 vs. < 1 year: 1.16, 95% CI 1.03-1.30). Conclusions: This large cohort study, with objective data on exposures and outcomes, demonstrated associations between endemic infectious intestinal diseases and factors related to water supply, sewage disposal, socio-demographics, and duration of residency. The results did not always follow prior expectations based on studies examining outbreaks and single systems, and underscore the importance of studying factors associated with endemic disease across water and sewage system types. ; Applied Science, Faculty of ; Civil Engineering, Department of ; Pathology and Laboratory Medicine, Department of ; Population and Public Health (SPPH), School of ; Science, Faculty of ; Non UBC ; Medicine, Faculty of ; Resources, Environment and Sustainability (IRES), Institute for ; Reviewed ; Faculty

Cyclical economical growth is natural and unavoidable phenomenon, at the same time the less amplitudes of economical cycles fluctuations are, the more attractive economy of a country is. Countries sustain ultimate difficulties when financial crises happen in a certain country. Latterly such crises mostly come into play as the prices bubble burst. The current financial crisis started from the crisis of secondary dwelling credits in the USA. After prices bubble burst it has spread worldwide and unavoidably claimed following victims: crashed two most famous underwriting banks of the world Lehman Brothers and Merrill Lynch, two biggest mortgage banks of the USA Fannie Mae and Freddie Mac, substantially fell down all stock indexes. It is evident that the world realizes the extent of this problem and probable results because similar crises had place during XX century. They impacted on economical and political regional course of that time rather strongly. But modern economies of various countries are involved in more noticeable degree, so forthcoming consequences of this crisis will be rather heavier. It is interesting how in such circumstances banks and other financial institutions manage their assets in financial markets. Also the question is whether an object of the better property diversification wouldn't become the ground for a financial markets fall. Research object – stock market during financial crisis period. Purpose of this study is to explore and summarize theoretical nonfiction and design an investment portfolio hedged from cyclic economic fluctuations. Exposition of financial bubble theories, their significance for economics, mean reason, different interpretation of bubbles analysis, stable market sector identification, and portfolio formation helps to gain the purpose. In the first part nonfiction is analyzed seeking to find leading financial bubble theories. In reference to these theories, mean reason and consequence is outline here. This part also identifies basic government tools, which can help to reduce outcomes and prevent from financial crisis in future. In the second part investment criteria is brought to light, which is necessary for portfolio formation. Techniques for portfolio formation are analyzed. In the third part market sectors is analyzed with an aim to identify those who suffers least from cyclical economical fluctuations. Analysis has shown, that least impact from financial crisis was in sectors based on daily consumtion needs: consumer staples, health care and utilities stock market sectors. From these identified sectors portfolio has been constructed, which risk and return estimation compared with primary stock market indices of America, Eupope an Asia was much better. Otherwise gold as an alternative investment was better.

OBIETTIVI: I farmaci biotech, prodotti attraverso la biologia molecolare, costituiscono una grande innovazione in oncologia. Il loro alto costo può tuttavia rappresentare una criticità per la sostenibilità del servizio sanitario nazionale ed è pertanto rilevante valutarne con attenzione i benefici ed i rischi, per giustificarne l'utilizzo e definirne appropriatezza prescrittiva ed implicazioni di politica sanitaria. Attraverso la tecnica della revisione sistematica della letteratura e della meta-analisi abbiamo analizzato l'efficacia, la sicurezza e l'appropriatezza del Trastuzumab, importante farmaco biotech per la terapia del tumore della mammella. MATERIALI: Sono stati analizzati tutti gli studi randomizzati controllati (RCT) che hanno valutato l'efficacia e la sicurezza del Trastuzumab da solo o in associazione versus chemioterapia standard in donne di ogni età, con tumore mammario HER-2 positivo. La ricerca degli studi si è svolta su MEDLINE, EMBASE, TOXNET, BIOSIS, ASCO e sul registro del Cochrane Breast Cancer Group. Due revisori hanno valutato la qualità degli RCT. I risultati sono stati sintetizzati e inseriti nelle meta-analisi dividendo gli studi in sottogruppi: tumore precoce e metastatico, alta e bassa qualità, durata del trattamento, somministrazione sequenziale e concomitante. I risultati sono espressi come hazard ratio (HR) per i dati di sopravvivenza e rischio relativo (RR) per gli outcome binari e riportano gli intervalli di confidenza al 95% (IC). RIASSUNTO: Sono stati inclusi 8 RCT riguardanti il tumore mammario precoce e 4 sul tumore metastatico. I dati sulla sopravvivenza e sopravvivenza libera da malattia o da progressione favorivano significativamente i regimi contenenti Trastuzumab sia nel tumore precoce (HR 0.66, IC 0.57-0.77 e HR 0.60, IC 0.50-0.71) che in quello metastatico (HR 0.79, IC 0.67-0.94 e HR 0.56, IC 0.48-0.64). Si evidenziava peraltro anche un aumentato rischio di scompenso cardiaco grave (RR 5.11, IC 2.70-9.66 e RR 3.75, IC 1.68-8.39), ! soprattu tto nelle pazienti trattate per più di 6 mesi. L'efficacia del trattamento non era influenzata dallo stato linfonodale od ormonale, dalle dimensioni del tumore o dall'età. CONCLUSIONI: Il Trastuzumab migliora certamente la sopravvivenza delle pazienti. Ci troviamo però insicuri riguardo alla magnitudine del beneficio del farmaco ed alla durata dello stesso nel tempo. I dati rivelano, infatti, che il farmaco è gravato da un'importante cardiotossicità, che erode il beneficio netto. Gli studi analizzati, inoltre, sono caratterizzati da bias, che potrebbero enfatizzare erroneamente l'efficacia reale. È necessario pertanto definire con cautela l'appropriatezza prescrittiva di questo farmaco.

Personalised Travel Planning, a form of mobility management planning targeted at the trip-origin (in other words at residential areas), has proved to be a reliable and cost-effective means of reducing car usage in favour of other more sustainable travel forms. These direct-marketing schemes, which target communities with individually tailored travel information materials, succeed in reducing car usage with no investment in hard infrastructure. The concept, when subjected to rigorous academic and other independent scrutiny, has reportedly achieved consistent mode transfers away from car-usage of five to fifteen per cent. This has often taken place in lowdensity areas of high car ownership rates and results have been maintained over time. In Australia, every major city has commissioned personalised travel planning programmes. In the UK, the government has, on foot of successful pilot studies, recommended the implementation of such schemes across all local authorities. Recently, three "Smarter Travel Town" initiatives in the UK – where suites of "soft" transport planning measures were piloted – suggested that personalised travel planning can be a core and successful component of any such program. This study seeks to assess the applicability of such concepts within the Greater Dublin Area. Initial evidence suggests the methodology is applicable with potentially high benefit : cost ratios. A pilot survey, undertaken as part of earlier research, revealed that within five selected newly developed areas individuals' response to the concept is comparable, if not more favourable to that revealed in other travel markets. A benchmarking study carried out in Drimnagh during March 2010 – as part of the Dublin City Council Smarter Travel Town bid – demonstrated high levels of community receptivity to such a scheme. The context and revealed market response indicates that such schemes are likely to achieve a successful outcome within Dublin. Indeed, one recent pilot, at Adamstown, yielded very positive results after a thorough programme was piloted to more than 200 households. Assessment of the initiative in other markets suggests certain cautions. A groundbreaking UK study, "Smarter Choices", which thoroughly assesses all "soft", or behavioural transport planning initiatives in the UK, warns that such initiatives should only be implemented alongside complementary demand-management measures. Otherwise, gains in reduced congestion will only be lost to alternate users not targeted by the scheme. Nevertheless, the evidence suggests that Personalised Travel Planning, when combined with demand management and introduced to areas where available public transport capacity exists, has the potential to make significant impacts on car usage within the Greater Dublin Area.

Abstract: Discussions on the role of markets in healthcare easily lead to political and unfruitful polarized positions. Actors arguing in favour of markets as a solution for the quality/cost conundrum entrench themselves against others pointing out the risk of markets for the delivery and governance of healthcare. These binary options of more or less marketization preclude a more empirical analysis of how markets, as multiple arrangements, are constructed and what their consequences are for public values like affordability and quality. To empirically explore the relation between markets and public values in healthcare, in this paper we analyze the construction of a market for hospital care in the Netherlands, based on a system of diagnoserelated groups (DBCs), and the development of a market for long term care based on care-load packages (ZZPs). In these cases we address the intended result of care markets according to various policy actors, the visible and invisible work done by various actors to make markets work and the values enacted in market practices. We show that where policy aims within these markets focus on providing choice and increasing diversity of care institutions, the instruments of DBCs and ZZPs rather produce isomorphism and homogenization. Furthermore, the strong influence of financial instruments in shaping healthcare markets assume that cost and quality can both be strengthened while it in fact has a profound influence on how public values like quality get defined in practice. These translations between values pursued and outcomes produced indicate that conceptualizing the role of the state as defining public values that markets (have to) implement is problematic, as this removes crucial normative work in the shaping of our welfare states to the realm of the technical operationalization of markets. An alternative relation between state, market and society can be conceived once we accept that such values are shaped in practice and that the relationship between policy aims and policy consequences can never be fully captured through a logic of implementation. This then calls for an experimental role of the state: a state that sees market developments as experimental devices in which the aim is a good composition of public values. We propose this experimentation could for example focus on market developments that do not ascribe a privileged status to financial devices and price-mechanism, such as a market for the DBC A-segment, in which prices are not freely negotiable. Such experiments

Background: In 2003, the governments of Belgium, France, Germany, the Netherlands and Switzerland agreed that there was a need in Europe for a treatment programme for adolescents with cannabis use disorders and other behavioural problems. Based on an exhaustive literature review of evidence-based treatments and an international experts meeting, Multidimensional Family Therapy (MDFT) was selected for a pilot study first, which was successful, and then for a joint, transnational randomized controlled trial named INCANT (INternational CAnnabis Need for Treatment).Methods/design: INCANT is a randomized controlled trial (RCT) with an open-label, parallel group design. This study compares MDFT with treatment as usual (TAU) at and across sites in Brussels, Berlin, Paris, The Hague and Geneva. Assessments are at baseline and at 3, 6, 9 and 12 months after randomization. A minimum of 450 cases in total is required; sites will recruit 60 cases each in Belgium and Switzerland, and a maximum of 120 each in France, Germany and the Netherlands.Eligible for INCANT are adolescents from 13 through 18 years of age with a cannabis use disorder (dependence or abuse), with at least one parent willing to take part in the treatment. Randomization is concealed to, and therefore beyond control by, the researcher/site requesting it. Randomization is stratified as to gender, age and level of cannabis consumption.Assessments focus on substance use; mental function; behavioural problems; and functioning regarding family, school, peers and leisure time.For outcome analyses, the study will use state of the art latent growth curve modelling techniques, including all randomized participants according to the intention-to-treat principle.INCANT has been approved by the appropriate ethical boards in Belgium, France, Germany, the Netherlands, Switzerland, and the University of Miami Miller School of Medicine. INCANT is funded by the (federal) Ministries of Health of Belgium, Germany, the Netherlands, Switzerland, and by MILDT: the Mission Interministerielle de Lutte Contra la Drogue et de Toximanie, France.Discussion: Until recently, cannabis use disorders in adolescents were not viewed in Europe as requiring treatment, and the co-occurrence of such disorders with other mental and behavioural problems was underestimated. This has changed now.Initially, there was doubt that a RCT would be feasible in treatment sectors and countries with no experience in this type of study. INCANT has proven that such doubts are unjustified. Governments and treatment sites from the five participating countries agreed on a sound study protocol, and the INCANT trial is now underway as planned.

Over the last few decades public policy and public management methods have been very much concerned with the management of risk. Risk by definition is quantifiable, or if not quantifiable, something that can be 'managed'. In contrast, the preparedness perspective places far more emphasis on the need to deal with uncertainty – challenges that cannot be easily quantified, accurately forecasted or managed. Although the distinction between risk and uncertainty is not clear-cut (and is often the troubled area where policy-makers find themselves working), a strong bias towards framing the challenge as 'manageable' risk can, in practice, be distinguished from the more important challenge of handling substantive uncertainty. The preparedness perspective stresses the key role of governments in managing the economic, social, environmental and national security consequences of this substantive uncertainty. Preparedness also clarifies why government funding for basic research is so important: basic research, in essence, translates ignorance into risk. We explore the unknown because we want to find out more about it – human beings prefer to face risks than uncertainties because we can (attempt at least) to act rationally in response to measurable risks. Consequently, giving preparedness a central role in science policy would counter-balance and address shortcomings in current science and innovation policy frameworks. Such a shift in emphasis would also make it easier to defend spending on capacity building in public science. In an uncertain world, the ability to respond quickly and effectively to the unforeseen is critical. Indeed, preparedness capacity is critical to setting the innovation objectives that allow us to respond to unforeseen threats. The paper recommends five complementary principles for giving preparedness a more central role in science and innovation policy. (1) Being more realistic and honest about limitations to forecasts and predictions, particularly in complex systems environments where simple Newtonian dynamics of linear cause and effect do not apply. (2) Making a more explicit distinction between risk and uncertainty, and doing more to understand the 'fuzzy' grey area between the two, again giving due recognition to the inherent unpredictability of complex systems. (3) Putting more effort into demonstrating how science translates uncertainty into risk and in so doing increases our levels of preparedness. (4) Adopting 'preparedness friendly' guidelines for research funding and performance evaluation that utilise 'risk-facilitating' portfolio-based investment methods. (5) Doing more to specify how preparedness outcomes are reflected (in the short term) in greater accuracy in the estimated Net Present Value of economic assets and also (in the very long term) the challenge of being fairer to future generations.

Over the last few decades public policy and public management methods have been very much concerned with the management of risk. Risk by definition is quantifiable, or if not quantifiable, something that can be 'managed'. In contrast, the preparedness perspective places far more emphasis on the need to deal with uncertainty – challenges that cannot be easily quantified, accurately forecasted or managed. Although the distinction between risk and uncertainty is not clear-cut (and is often the troubled area where policy-makers find themselves working), a strong bias towards framing the challenge as 'manageable' risk can, in practice, be distinguished from the more important challenge of handling substantive uncertainty. The preparedness perspective stresses the key role of governments in managing the economic, social, environmental and national security consequences of this substantive uncertainty. Preparedness also clarifies why government funding for basic research is so important: basic research, in essence, translates ignorance into risk. We explore the unknown because we want to find out more about it – human beings prefer to face risks than uncertainties because we can (attempt at least) to act rationally in response to measurable risks. Consequently, giving preparedness a central role in science policy would counter-balance and address shortcomings in current science and innovation policy frameworks. Such a shift in emphasis would also make it easier to defend spending on capacity building in public science. In an uncertain world, the ability to respond quickly and effectively to the unforeseen is critical. Indeed, preparedness capacity is critical to setting the innovation objectives that allow us to respond to unforeseen threats. The paper recommends five complementary principles for giving preparedness a more central role in science and innovation policy. (1) Being more realistic and honest about limitations to forecasts and predictions, particularly in complex systems environments where simple Newtonian dynamics of linear cause and effect do not apply. (2) Making a more explicit distinction between risk and uncertainty, and doing more to understand the 'fuzzy' grey area between the two, again giving due recognition to the inherent unpredictability of complex systems. (3) Putting more effort into demonstrating how science translates uncertainty into risk and in so doing increases our levels of preparedness. (4) Adopting 'preparedness friendly' guidelines for research funding and performance evaluation that utilise 'risk-facilitating' portfolio-based investment methods. (5) Doing more to specify how preparedness outcomes are reflected (in the short term) in greater accuracy in the estimated Net Present Value of economic assets and also (in the very long term) the challenge of being fairer to future generations.

The sector-wide approach (SWAp) was introduced to increase the impact of donor funds and local management of resources in developing countries. It gained progressively the support of major bilateral donors. In June 1998, the Tanzanian Ministry of Health and a group of donors adopted a SWAp in order to support health sector reforms and to increase coordination between donors and government. In fine, the main aim of the health reforms was to improve availability and quality of essential health service delivery through one comprehensive and coherent health sector programme. Despite increased attention during the past few years to explore the gaps between policies and results/outcomes at operational level, scarce evidence has been produced. Our multiple-case study design used mixed methods for data collection and analyses. It intended to evaluate and understand how the health sector reforms supported by a SWAp were implemented, and how they were eventually associated with health system improvements and a better health service delivery to the Tanzanian population. To fulfil that objective, we explored the conditions for success and/or failure of the national policy implementation through an analytical framework with functional links between the national and operational level. Our evaluation supported the fact that the adoption of a health SWAp in Tanzania played a major role in the implementing the health sector reforms. This was particularly true for the decentralisation process and the application of new policy on health financing sources. In addition, the different mechanisms under the framework of the SWAp contributed to strengthen the national health system, analyzed through six building blocks (finance, human resource, information, service, drug and equipment, and governance). At operational level, despite some improvements in the planning, supervision, finance, training, salary, and infrastructures, the overall results remained modest. Several components essential to quality health services, like referral system, working and living conditions, and reliable supplying system did not really improve, and policy implementation of community health fund mechanism failed. Incoherence between policies, lack of preparedness and human capacity buildings, absence of synergy between programmes, and shortcomings in having firm grip on context-reality are some of the policy-implementation gaps pointed out. Those gaps inhibit the success of strategies implementation and threaten the slight progresses already obtained. The more recent aid effectiveness policy, including Paris Declaration and International Health Partnership are more challenging than ever. Our validated method and analytical framework could, hopefully, guide further research on policy transfer, implementation and effectiveness at operational level. ; (MED 3) -- UCL, 2010

Presentation made at Latinos in the Heartland (8th : 2010 : St. Louis, Mo.) and published in the annual conference proceedings. ; Migration patterns of Hispanics changed dramatically in the 1990s from large metropolis to rural towns (Lazos and Jeanetta 2002). Migration patterns have also changed, from temporary and male to permanent male and female settlement, in rural areas of the south and the Midwest (Hernandez 2005). The heartland of rural America is experiencing demographic changes that are unprecedented in both their fast pace and diversity they bring to otherwise uniform areas. According to the 2000 Census, Hispanic?s earnings are low, and Hispanics live in homes in which multiple adults work full time and have low skills and limited English proficiency (Hernandez 2005; NCLR 2004; Gibbs, Kusmin and Cromartie 2005). For change to be beneficial and sustainable for every community today and for future generations, the integration process must be based on sound research. Although the challenges faced by education, health care and other service delivery systems are well-documented (Gozdziak & Martin 2005), our attention turns to the assets or capital Latinos bring with them as they settle. Recent developments in the cultural identity literature view culture as a resource from which individuals draw to create strategies to function in various domains of society (Berry 2003). This new orientation shifts us away from a deficit model for thinking about how individuals of different cultures gain and lose in the process of integration to recognizing the multiple ways individuals can adapt in new and ever-changing environments without suffering loss of identity in the process. We focus on what the newcomers offer and how we can engage them in the future development and prosperity of the new settlement communities. A model of capital, capabilities and strategies is developed informed by the sustainable livelihoods framework. The sustainable livelihood strategies model incorporates social and cultural capital into an examination of strategies newcomers employ to accumulate assets, minimize their vulnerability to risk exposure and become part of their new communities. The model accounts for the community climate as a proxy for context of reception in new settlement regions and identifies how it impacts strategies? outcome. Output from focus groups of men and women and photovoice, our qualitative research techniques, informs social and cultural capital constructs in three distinct regions of a Midwestern state. Income impacts of acculturation strategies, social capital, cultural capital and human capital are measured through their regression on income earnings of native and foreign born Latinos. Results provide lessons for policy.

Purpose – The paper aims to explore the consequences of new public management (NPM) inspired reforms in general and outsourcing of traditional public sector responsibilities in Sweden to private organizations in particular. At centre stage are the roles of entrepreneurs, women-owned small and medium enterprises (SMEs) and socially constructed paradigms of gender in this process. The paper's aim is to explore, through a local-level case study, the currently ongoing process of gendering and regendering in a female-dominated sector. This is done by a qualitative real-time study of the introduction of a customer-choice system in elder care in a Swedish municipality. Design/methodology/approach – The formal decision in Spring 2008 to introduce a "customer-choice model" into home-based elderly care in the municipality is the formal starting point of the research. The authors are given full access to all relevant information and informants including all questions and suggestions from the potential suppliers who were applying to be "authorized and certified suppliers". Interviews are the main method but also written material like applications and newspaper articles and "letters to the editor" are studied. Findings – The outcome of the changes are, from the decision-makers point of view, disappointing. The consequences so far of the customer-choice system, that have been examined here, can be labelled increased masculinism or even a masculinization of the elderly care sector. Whether the polarization is a presage of the process to come is too early to tell. If so, the masculinization observed in this paper extends along three dimensions: governing logic, leadership and ownership. These gender consequences are not those expected or intended by the leading local actors. Research limitations/implications – The study is made in an ongoing process. The politicians are making changes aiming at making better working conditions for SMEs and former employees especially women. It is therefore important to follow up what is going to happen in the future. Comparisons with other municipalities and other regimes, nationally and internationally, would also be valuable. Practical implications – In this case, the practical implications are, almost, the same as the research implications. Originality/value – The real-time research design is used focusing on what is happening in practise at the lower organizational levels of an organizational "experiment" of this kind make this paper unusual and valuable both for researchers and practioners. ; Institutional Perspectives on Gender and Entrepreneurship. Guest editors: Helene Ahl and Terese Nelson.