Panning for Gold: The Standardizing Work of Filling “Autistic” Shells – Using institutional ethnography to explore textually mediated health relations in the diagnostic process of autism.

Health reform practices in Canada and elsewhere have restructured the purpose and use of diagnostic labels and the processes of naming such labels. Diagnoses are no longer only a means to tell doctors and patients what may be wrong and indicate potential courses of treatment; some diagnoses activate specialized services and supports for persons with a disability and those who provide care for them. In British Columbia, a standardized process of diagnosis with the outcome of an autism spectrum disorder gives access to government provided health care and educational services and supports. Such processes enter individuals into a complex of text mediated relations, regulated by the principles of evidence-based medicine. However, the diagnosis of autism in children is notoriously uncertain. Because of this ambiguity, standardizing the diagnostic process creates a hurdle in gaining help and support for parents who have children with problems that could lead to a diagnosis on the autism spectrum. Such processes and their organizing relations are problematized, explored and explicated below. Grounded in the epistemological and ontological shift offered by Dorothy E. Smith (1987; 1990a; 1999; 2005), this article reports on the findings of an institutional ethnographic study that explored the diagnostic process of autism in British Columbia. More specifically, this article focuses on the processes involved in going from mothers talking from their experience about their childrens problems to the formalized and standardized, and thus “virtually” produced, diagnoses that may or may not give access to services and supports in different systems of care. Two psychologists, a developmental pediatrician, a social worker – members of a specialized multidisciplinary assessment team – and several mothers of children with a diagnosis on the autism spectrum were interviewed. The implications of standardizing the diagnosis process of a disability that is not clear-cut and has funding attached are discussed. This ethnography also provides a glimpse of the implications of current and ongoing reforms in the state-supported health care system in British Columbia, and more generally in Canada, for people’s everyday doings.

Going above and beyond: how sustainability culture and entrepreneurial orientation drive social sustainability supply chain practice adoption

Purpose
– This paper aims to examine what drives the adoption of different social sustainability supply chain practices. Research has shown that certain factors drive the adoption of environmental sustainability practices but few focus on social supply chain practices, delineate which practices are adopted or what drives their adoption.

Design/methodology/approach
– The authors examine the facilitative role of sustainability culture to explain the adoption of social sustainability supply chain practices: basic practices, consisting of monitoring and management systems and advanced practices, which are new product and process development and strategic redefinition. The authors then explore the role played by a firm’s entrepreneurial orientation in shaping and reinforcing the adoption of social sustainability supply chain practices. A survey of 156 supply chain managers in multiple industries in Ireland was conducted to test the relationship between the variables.

Findings
– The findings show that sustainability culture is positively related to all the practices, and entrepreneurial orientation impacts and moderates social sustainability culture in advanced social sustainability supply chain adoption.

Research limitations/implications
– As with any survey, this is a single point in time with a single respondent. Implications for managers include finding the right culture in the organisation to implement social sustainability supply chain management practices that go beyond monitoring to behavioural changes in the supply chain with implications beyond the dyad of buyer and supplier to lower tier suppliers and the community surrounding the supply chain.

Practical implications
– The implications for managers include developing and fostering cultural attributes in the organisation to implement social sustainability supply chain management practices that go beyond monitoring suppliers to behavioural changes in the supply chain with implications beyond the dyad of buyer and supplier to lower tier suppliers and the community surrounding the supply chain.

Originality/value
– This is the first time, to the authors’ knowledge, that cultural and entrepreneurial variables have been tested for social sustainability supply chain practices, giving them new insights into how and why social sustainability supply chain practices are adopted.

The role of complexity metrics in a multi-institutional dosimetry audit of VMAT

OBJECTIVE: To demonstrate the benefit of complexity metrics such as the modulation complexity score (MCS) and monitor units (MUs) in multi-institutional audits of volumetric-modulated arc therapy (VMAT) delivery.

METHODS: 39 VMAT treatment plans were analysed using MCS and MU. A virtual phantom planning exercise was planned and independently measured using the PTW Octavius(®) phantom and seven29(®) 2D array (PTW-Freiburg GmbH, Freiburg, Germany). MCS and MU were compared with the median gamma index pass rates (2%/2 and 3%/3 mm) and plan quality. The treatment planning systems (TPS) were grouped by VMAT modelling being specifically designed for the linear accelerator manufacturer's own treatment delivery system (Type 1) or independent of vendor for VMAT delivery (Type 2). Differences in plan complexity (MCS and MU) between TPS types were compared.

RESULTS: For Varian(®) linear accelerators (Varian(®) Medical Systems, Inc., Palo Alto, CA), MCS and MU were significantly correlated with gamma pass rates. Type 2 TPS created poorer quality, more complex plans with significantly higher MUs and MCS than Type 1 TPS. Plan quality was significantly correlated with MU for Type 2 plans. A statistically significant correlation was observed between MU and MCS for all plans (R = -0.84, p < 0.01).

CONCLUSION: MU and MCS have a role in assessing plan complexity in audits along with plan quality metrics. Plan complexity metrics give some indication of plan deliverability but should be analysed with plan quality.

ADVANCES IN KNOWLEDGE: Complexity metrics were investigated for a national rotational audit involving 34 institutions and they showed value. The metrics found that more complex plans were created for planning systems which were independent of vendor for VMAT delivery.

Parenthood and Open Adoption: an Interpretative Phenomenological Analysis

This book explores what it is like to be involved in contemporary open adoption, characterised by varying forms of contact with birth relatives, from an adoptive parent point of view.

The author’s fine-grained interpretative phenomenological analysis of adopters’ accounts reveals the complexity of kinship for those whose most significant relationships are made, unmade and permanently altered through adoption. MacDonald distinctively connects adoption to wider sociological theories of relatedness and personal life, and focuses on domestic non-kin adoption of children from state care, including compulsory adoption. The book also addresses current child welfare concerns, and suggestions are made for adoption practice. The book will be of interest to scholars and students with an interest in adoption, social work, child welfare, foster care, family and sociology.

Employing neo-Durkheimian institutional theory in crosscultural accounting research

Purpose
Neo-Durkheimian institutional theory, as developed by the anthropologist Mary Douglas, is proposed as a suitable theory base for undertaking cross-cultural accounting research. Her social theory provides a structure for examining within-country and cross-country actions and behaviours of different groups and communities. It avoids associating nations and cultures, instead contending any nation will comprise four different solidarities engaging in constant
dialogues. Further, it is a dynamic theory able to take account of cultural change.

Design/methodology/approach
The paper establishes a case for using neo-Durkheimian institutional theory in cross-cultural accounting research by specifying the key components of the theory and addressing common criticisms. To illustrate how the theory might be utilised in the domain of accounting and finance research, a comparative interpretation of the different experiences of financialization in Germany and the UK is provided drawing on Douglas’s grid-group schema.

Findings (mandatory)
Neo-Durkheimian institutional theory is deemed sufficiently capable of interpreting the
behaviours of different social groups and is not open to the same criticisms as Hofstede’s
work. Differences in Douglasian cultural dialogues in the post-1945 history of Germany and
the UK provide an explanation of the variations in the comparative experiences of
financialization.

Institutional Hybridity in Public Sector Reform: Replacement, Blending, or Layering of Administrative Paradigms

Despite an abundance of studies on hybridization and hybrid forms of organizing, scholarly work has failed to distinguish consistently between specific types of hybridity. As a consequence, the analytical category has become blurred and lacks conceptual clarity. Our paper discusses hybridity as the simultaneous appearance of institutional logics in organizational contexts, and differentiates the parallel co-existence of logics from transitional combinations (eventually leading to the replacement of a logic) and more robust combinations in the form of layering and blending. While blending refers to hybridity as an ‘amalgamate’ with original components that are no longer discernible, the notion of layering conceptualizes hybridity in a way that the various elements, or clusters thereof, are added on top of, or alongside, each other, similar to sediment layers in geology. We illustrate and substantiate such conceptual differentiation with an empirical study of the dynamics of public sector reform. In more detail, we examine the parliamentary discourse around two major reforms of the Austrian Federal Budget Law in 1986 and in 2007/2009 in order to trace administrative (reform) paradigms. Each of the three identified paradigms manifests a specific field-level logic with implications for the state and its administration: bureaucracy in Weberian-style Public Administration, market-capitalism in New Public Management, and democracy in New Public Governance. We find no indication of a parallel co-existence or transitional combination of logics, but hybridity in the form of robust combinations. We explore how new ideas fundamentally build on – and are made resonant with – the central bureaucratic logic in a way that suggests layering rather than blending. The conceptual findings presented in our article have implications for the literature on institutional analysis and institutional hybridity.

Adoption of farm-based irrigation water-saving techniques in the Guanzhong Plain, China

This article analyses adoption of farm-based irrigation water saving techniques, based on a cross-sectional data set of 357 farmers in the Guanzhong Plain, China. Approximately 83% of the farmers use at least one farm-based water-saving technique. However, the traditional, inefficient techniques border and furrow irrigation are still prevalent whereas the use of advanced, more efficient techniques is still rather rare. We develop and estimate an adoption model consisting of two stages: awareness of water scarcity and intensity of adoption. We find that awareness of water scarcity and financial status enhance adoption of more advanced techniques whereas access to better community-based irrigation infrastructure discourages it. We furthermore find both community-based irrigation infrastructure and farm-based irrigation water-saving techniques have mitigating effects on production risk. From the results it follows that adoption can be stimulated via financial support and via extension aimed at enhancing awareness of water scarcity.