786 resultados para Mattila, Mikko: Policy making in Finnish social and health care


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An individual faced with intergroup conflict chooses A from a vast array of possible actions, ranging from grumbling among ingroup friends to voting and demonstrating to rioting and revolution. The present paper conceptualises these intergroup choices as rationally shaped by perceptions of the benefits and costs associated with the action (expectancy-value processes). However, in presenting a model of agentic normative influence, it is argued that in intergroup contexts group-level costs and benefits play a critical role in individuals' decision-making. In the context of English-French conflict in Quebec, in Canada, four studies provide evidence that group-level costs and benef influence individuals' decision-making in intergro conflict; that the individual level of analysis need mediate the group level of analysis; that group-level co and benefits mediate the relationship between soc identity and intentions to engage in collective action; a that perceptions of outgroup and ingroup norms for inte group behaviours are relatively invariant and predictal related to perceptions of the group- and individual-le, benefits and costs associated with individualistic vers collective actions. By modelling the relationship betwe group norms and group-level costs and benefits, soc psychologists may begin to address the processes th underlie identity-behaviour relationships in collecti action and intergroup conflict.

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The first and main contribution of this article is its access to the decision-making processes which drive innovation in policy-making within central government. The article will present a detailed case history of how the innovation came about and conclude by highlighting analytic possibilities for future research. The policy in focus is the UK’s Traffic Management Act 2004, which passed responsibility for managing incidents on major roads from the police to the Highways Agency (HA), and has been interpreted as a world first in traffic management. The article tracks the Traffic Management Act 2004 from problem identification to a preliminary evaluation. It is then suggested that future research could explain organizational change more theoretically. By taking a longitudinal and multi-level approach, the research falls into a processual account of organizational change. The second contribution of the article is to highlight two novel ways in which this approach is being applied to policy-making, through an institutional processualist research programme on public management reform and empirical investigations using complex systems to explain policy change.

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When assembling self-managing work teams, the personalities of team members are often overlooked. One personality variable known to be critical for effective decision making in teams is cognitive style. This study sought to examine how differences and similarities in analytic/intuitive cognitive styles affected the behavior of team members on the task/emotionally expressive dimension identified by Bales. As hypothesized, intuitive individuals and homogeneous intuitive teams were found to initiate more social-emotional acts. Contrary to expectations, intuitive rather than analytic individuals and homogeneous intuitive rather than analytic teams engaged in more task-oriented behaviors. Teams also tended to select intuitive individuals as leaders. The possibility that different combinations of styles may be important for overall team effectiveness was subsequently discussed, and it was suggested that this may depend on whether the nature of the work environment is relatively well structured and mechanistic or relatively unstructured and organic.

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Ionising radiation hazards are perhaps the most documented and regulated occupational and environmental hazard. In the radiological protection field a single expert advisory organisation has had an unusually large influence on the international standard setting process. This is the International Commission on Radiological Protection (ICRP). Two common, and opposing views, exist over the formulation of protection recommendations by the ICRP. The first, and most widely accepted, is that its recommendations are scientifically determined. The second view, is that its recommendations are politically or socially determined. Neither of these analyses adequately accounts for the complex process in which protection recommendations are formulated. A third view, provided by studies of the origins of scientific controversy, suggests that both science and social factors are important in the assessment and limitation of risk. The aim of this thesis is not simply to examine the origin of controversy. Issues of equal, if not more, importance are the resolution of controversy, the formation of consensus and the maintenance of expert authority and influence. These issues form the central focus of this thesis. The aim is to assess the process through which the ICRP formulates its radiological protection recommendations and comment on the extent that these are influenced by the affiliations of its members. This thesis concludes that the ICRP's recommendations have been shaped by a complex relationship of scientific and social considerations, in which a socio-technical commitment to nuclear energy has played a key role. The Commission has responded to new scientific data by making complex changes to its philosophy and methods of describing risk. Where reductions in numerical limits have been applied they have been accompanied by practical measures designed to limit the impact of the change and provide continuity with the old limits and flexibility in the application of the new recommendations.

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As public policy issues increasingly have a technical aspect to them an interactive relationship has developed between science and policy. The aim of this thesis is to investigate the two aspects of this relationship: the influence of science on policy and the influence of policy implications on science. Most existing studies in this area treat only one or other of these aspects. Furthermore, they tend to provide interesting case study material but very little theoretical analysis. This thesis attempts to overcome these problems by dealing with both aspects of the interaction between science and policy and by providing theoretical models of this relationship. The thesis combines the theoretical development of these models with the analysis of three empirical case studies: the controversy in Britain over smoking and health; the application of educational psychology to the development of education policy in Britain; the controversy over the health effect of lead in the environment. The theoretical models are developed in Part 1. In Part 2 the empirical case studies are presented and in Part 3 the theoretical material is assessed in the light of these case studies. The main thesis of this study is that there is a fundamental mismatch between science and policy-making. Criticism is always essential in science. However, when science is involved in the policy process, either scientific claims are not subjected to a significant level of criticism or they are scrutinized so closely that no view achieves general consensus and conflicting advice results. In this situation, contrary to the traditional view, science can generate uncertainty. The role which science plays in the policy process is influenced by this level of criticism, by the context of political power and by the progress of an issue through the various stages of the policy process.

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This paper examines the 'ideological grip' of personalization. It does so empirically, tracking the trajectory of personalization through austerity budgeting in one English local authority. In this case, personalization continued to signify hope and liberation even though the most draconian cuts in the Council's history effectively rendered personalization a practical impossibility. This requires critical theorization. Two bodies of theory are interrogated. First Boltanski's sociology of critique, and, in particular, his notion of managerial domination illuminate the way in which change imperatives and crises come to cement ideological formations. Here it is argued that the articulation of personalization with transformation lends itself to managerial domination. It is further argued, though, that while institutional actors may be able to manipulate the symbolic to evade, what Boltanski terms, deconstructionist critique, this cannot entirely explain the hold of this particular discourse. Here, the Lacanian concept of enjoyment is deployed to interrogate its extra-symbolic function and fantasmatic form. Finally, the paper explores the political implications of such affective attachment and, in particular, the guarantee that personalization offers in a period of welfare state decline. © The Author(s) 2012.

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By contrast to major constitutional reforms elsewhere in the UK, in England's eight regions beyond London New Labour has favoured administrative decentralisation. This paper examines these institutional arrangements and assesses their capacity to develop a more integrated approach to territorial development. It confirms a growing awareness of the need to ensure greater coherence between policies to promote economic, social and environmental wellbeing. Nonetheless, a complex regional institutional architecture, inconsistent sector-based strategies, a lack of strategic leadership and blurred accountabilities hamper moves towards policy integration and the delivery of joint outcomes. Moreover, despite ongoing reforms, the absence of a clear regional agenda in a functionally designed Whitehall raises fundamental questions about the ability of sub-national bodies to work collectively to develop and implement a more coherent approach to regional policy.

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This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of 'knowledge structures' when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests.

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The question of how to organize and manage sustainable regional development has recently come to the fore in many places across the industrialized countries of Central and Western Europe, and especially within the European Union (EU).This book looks at the home-grown natural, economic and social, socio-political, political and administrative conditions which policy makers face, while also being subjected to numerous external influences. Political actors in less important EU regions The question of how to organize and manage sustainable regional development has recently come to the fore in many places across the industrialized countries of Central and Western Europe, and especially within the European Union (EU).This book looks at the home-grown natural, economic and social, socio-political, political and administrative conditions which policy makers face, while also being subjected to numerous external influences. Political actors in less important EU regions attempt to create and implement strategies of regional development in the context of regional policy-making by EU institutions, national governments and the globalization process

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In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However, what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this article illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

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The period 2010–2013 was a time of far-reaching structural reforms of the National Health Service in England. Of particular interest in this paper is the way in which radical critiques of the reform process were marginalised by pragmatic concerns about how to maintain the market-competition thrust of the reforms while avoiding potential fragmentation. We draw on the Essex school of political discourse theory and develop a ‘nodal’ analytical framework to argue that widespread and repeated appeals to a narrative of choice-based integrated care served to take the fragmentation ‘sting’ out of radical critiques of the pro-competition reform process. This served to marginalise alternative visions of health and social care, and to pre-empt the contestation of a key norm in the provision of health care that is closely associated with the notions of ‘any willing provider’ and ‘any qualified provider’: provider-blind provision.

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Significant growth in mobile media consumption has prompted a call to better understand the socio-cultural and policy dimensions of consumer choices. Contrary to industry and technology led analysis, this study argues that to guide consumer choice and innovation via regulatory policies requires an understanding of both ex-ante as well as in ex-post consumption conditions. This study examines mobile phone gaming to uncover how consumer anti-choice shapes decision-making as a framework for closely interrogating the ways in which policy concerns impact on consumers' behavior. Through eleven focus groups (n=62), the study empirically identifies voluntary, intentional, and positive consumer anti-choice behaviors all of which impact policy initiatives when consumers, both gamers and non-gamers, self-regulate their behaviors. Findings point to four types of policy implication: regulating the self-regulated, understanding anti-choice, boundary-setting and including the self-excluded. © 2012 Elsevier Ltd.

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In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this chapter illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.