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This paper analyses how neighbourhood governance of social care affects the scope for frontline workers to address health inequities of older ethnic minorities. We critically discuss how an area-based, generic approach to service provision limits and enables frontline workers' efforts to reach out to ethnic minority elders, using a relational approach to place. This approach emphasises social and cultural distances to social care and understands efforts to bridge these distances as “relational work”.

The authors conducted a two-year multiple case study of the cities of Nijmegen and The Hague, the Netherlands, following the development of policies and practices relevant to ethnic minority elders. They conducted 44 semi-structured interviews with managers, policy officers and frontline workers as well as 295 h of participant observation at network events and meeting activities.

Relational work was open-ended and consisted of a continuous reorientation of goals and means. In some cases, frontline workers spanned neighbourhood boundaries to connect with professional networks, key figures and places meaningful to ethnic minority elders. While neighbourhood governance is attuned to equality, relational work practice fosters possibilities for achieving equity.

Further research on achieving equity in relational work practice and more explicit policy support of relational work is needed.

The paper contributes empirical knowledge about how neighbourhood governance of social care affects ethnic minority elders. It translates a relational view of place into a “situational” social justice approach.

Literature suggests that the poor often face a myriad of health care constraints and health problems. This study uses bivariate and multivariate analyses to examine the effects of systemic factors such as the availability of health care providers and neighborhood poverty on individual health decisions for a sample of African Americans, Whites, Mexicans, and Puerto Ricans in poor Chicago neighborhoods. Results show that Medicaid usage and having a regular physician increase the number of days home ill and days hospitalized, while frequenting clinics decreases such activity. Additionally, residents in more impoverished urban areas are less likely to stay home ill. Differences in health profiles and providers are also evident based on race/ethnicity. These findings illustrate the important relationship between macro-level factors and specific health choices many residents in poor urban areas make at the micro-level.

In healthcare, organizational boundaries are often viewed as barriers to change. The purpose of this paper is to show how middle managers create inter-organizational change by doing boundary work: the dual act of redrawing boundaries and coordinating work in new ways.

Theoretically, the paper draws on the concept of boundary work from Science and Technology Studies. Empirically, the paper is based on an ethnographic investigation of middle managers that participate in a Dutch reform program across health, social care, and housing.

The findings show how middle managers create a sense of urgency for inter-organizational change by emphasizing “fragmented” service provision due to professional, sectoral, financial, and geographical boundaries. Rather than eradicating these boundaries, middle managers change the status quo gradually by redrawing composite boundaries. They use boundary objects and a boundary-transcending vocabulary emphasizing the need for societal gains that go beyond production targets of individual organizations. As a result, work is coordinated in new ways in neighborhood teams and professional expertise is being reconfigured.

Since boundary workers create incremental change, it is necessary to follow their work for a longer period to assess whether boundary work contributes to paradigm change.

Organizations should pay attention to conditions for boundary work, such as legitimacy of boundary workers and the availability of boundary spaces that function as communities of practice.

By shifting the focus from boundaries to boundary work, this paper gives valuable insights into “how” boundaries are redrawn and embodied in objects and language.

Evidence is accumulating to suggest that positive youth development may be an effective approach to preventing teen pregnancy. Studies show that selected protective factors or “youth assets” are associated with lower levels of adolescent sexual risk behavior. This paper describes the development of “Healthy, empowered and responsible teens of Oklahoma City” (HEART of OKC), one of 13 CDC‐funded demonstration projects designed to mobilize community resources to prevent teen pregnancy. During a two‐year planning phase, HEART of OKC conducted needs and assets assessments in five, very diverse, inner‐city neighborhoods. Data collection methods included geocoding and mapping of teen birth rates and census data, over 100 key informant interviews, and 23 focus groups with 168 teens from the priority neighborhoods. Focus group findings suggested numerous opportunities for asset‐based interventions. Assessment findings were used to develop a conceptual model that served as the foundation of the project. Assessment findings were also helpful in the development of a survey instrument used in a major research project to provide baseline data for HEART of OKC and to examine the relationship between specific “youth assets” and several adolescent risk behaviors, including sexual activity.

The Veterans Healthcare Administration (VHA) has promoted Specialty Care Neighborhoods (SCN) to enhance the coordination of services between primary and specialty care. Care coordination agreements (CCAs) were included as a critical element in the SCN program. The purpose of this paper is to examine the role of these documents in the successful implementation of SCNs.

Content, quality, and perceived usefulness of CCAs from 19 SCN sites were evaluated. CCA content was defined as the presence or absence of eight key components: contact information, process for urgent consults, process for e-consults, content of consults, primary and specialty care responsibilities, expected response time, discharge criteria, and review criteria. CCA quality was based on a qualitative assessment of CCA content; and perceived usefulness was based on a qualitative assessment of interview responses from CCA users. CCA characteristics were compared to SCN implementation levels using descriptive statistics. SCN implementation level was defined and measured by VHA Specialty Care Services.

Participating sites with medium-high or high SCN implementation levels had CCAs with more key components and of higher quality than sites with medium-low to medium SCN implementation levels. Perceived usefulness of CCAs was not associated with implementation level.

Since this study built on a quality improvement effort to facilitate care coordination, a rigorous research approach was not used. Specific CCA components could not be examined nor could specific hypotheses be tested due to the small and diverse sample. Findings presented are only preliminary.

The examination of CCAs suggests that these documents may be helpful to improve communication among primary and specialty care providers by explicitly stating agreed upon processes, mechanisms and criteria for referrals, roles and responsibilities for the co-management of patients, and timelines for review of CCAs.

This small study suggests that high-quality CCAs, which include a number of key components, can facilitate the implementation of coordinated care. Key characteristics of CCAs are identified in this study, including measures of CCA content, quality, and usefulness, which can be used in future efforts to develop and evaluate efforts to improve care coordination.

Working to improve organizations is the mainstay of organization development (OD) practice and includes figuring out the sources of workplace disruptions and dysfunctions. Casting aside the focus of most change-management initiatives, the organization, organizing intelligence (OQ) relies on paying attention to what people actually do, making meaning of complex, messy human-social organizing activities, in the interests of fostering productive workplaces. Resting on dialog with and among participants “feeling their way” as they organize their work, OQ is an exercise in synthesis rather than analysis. A holistic understanding of organizing activities is helped by exploring the roles of a triad of closely interwoven factors – organizing structures, work-practices, and relationships – in how people get things done, while understanding how these are interconnected. This chapter examines why the capacity for OQ matters, why and how OQ differs from widely practiced, technically framed, organizational analysis, and what distinguishes people with OQ from those with a more conventional interest in organizational change. A case study of the Dutch home-nursing organization, Buurtzorg, illustrates OQ in practice. With small groups of nurses who self-organize, this is a structure that changes both the way people work and their relationships, to the benefit of nurses and the quality of life and care of their patients, while reducing costs; clearly an example of a more productive workplace.

Hong Kong entered an ultra-low fertility regime nearly two decades ago (Census and Statistics Department, 2013). The causes of ultra-low fertility in Hong Kong are the same as those in other developed economies (Tu and Lam, 2009). The phenomenon, in most of the western world and East Asian societies, is attributed to the incongruence between individual-oriented and family-oriented institutions (McDonald, 2000), or simply role incompatibility between work and motherhood (Stycos and Weller, 1967). One viable solution to alleviate role incompatibility is to introduce family-work reconciliation policies, including maternal and paternal leaves, subsidized child care and health care and work facilities that allow for breastfeeding (Lappegard, 2010). The purpose of this paper is to assess the family-friendly measures for enhancing fertility.

The paper analyzes the current demographic conundrum and makes recommendations.

Subsidized child care is an effective measure if it satisfies the five main criteria, namely, availability, accessibility, acceptability, cost, and quality, suggested by Rindfuss et al. (2003). Other family-friendly measures are inadequate in absolute terms and inferior to those of Asian countries such as Japan, Singapore, and South Korea (Ministry of Manpower, 2014; OECD, 2013). The possibility of shifting away from the ultra-low fertility regime remains doubtful, especially because low fertility is a combined effect of an increasing prevalence of single older women (Census and Statistics Department, 2014), a shift of the utility function of children toward other consumable goods (Inglehart, 1982) and a desire for achieving upward intragenerational and intergenerational social mobility (Ariès, 1980).

Since Hong Kong still subsides in the regime of the lowest-low fertility, an evaluation of the related family-friendly measures will provide constructive insights to the Hong Kong Special Administrative Region Government how to provide incentives to citizens to consider making childbearing decisions.

Because the introduction of family-friendly measures and gender ideologies are intractably linked (Brewster and Rindfuss, 2000), Hong Kong stays in the middle of nations of families and nations of individuals, influenced by western ideas and traditional family values. It is hence worthwhile to examine the effectiveness of different family-friendly measures.

The purpose of this paper was to investigate housing satisfaction in a traditional neighborhood of Izmit, Turkey. According to this purpose, it was investigated whether the perceived living conditions (PLC) were mediating the effect on participants’ general housing satisfaction caused by satisfaction with the perceived quality of facilities (FQP), satisfaction with performance of local authorities (LA), satisfaction with social relations (SR) and satisfaction with physical surrounding (PS) in the Topçular neighborhood of Izmit District in Kocaeli, Turkey.

According to the hypotheses developed within the framework of the theoretical model, by using structural equation modeling (SEM), first, the direct relations between the variables were tested (PLC → overall housing satisfaction (OHS); PS, SR, LA → PLC; FQP → LA), then the indirect relationships between the variables were analyzed with the mediated role of OHS (PS, SR, LA → OHS → PLC).

The results show that all factors affected the OHS through the PLC. In conclusion, as the living conditions of the individual living in the neighborhood improve, the conditions take an active role in the relationship between the OHS and the satisfaction with the other relevant factors in the neighborhood, namely, PS, SR and performance of LA. In this relationship, it is seen that the satisfaction with PS has a negative effect, while the satisfaction with SR and satisfaction with the performance of LA have positive effects.

The study was applied only to Turkey’s Izmit Province. Research may also be applied to other cities apart from those in Turkey. A small sample was also used in the study. Reaching a wider sampling for SEM can lead to different results.

Planners and designers should consider satisfaction – including various factors involved in planning, designing and refurbishing the neighborhoods – as the most important design data.

The results of this study show that living conditions had an active role in the relationship between OHS and certain factors in the neighborhood: satisfaction with PS, SR and performance of LA. This study offers a framework to LA such as policymakers and urban planners to develop relevant and effective strategies and to improve dissatisfactory conditions in new and peripheral areas.

The originality of the paper is based on revealing the factors affecting the housing satisfaction of people living in the province of Izmit. This study offers a framework to LA such as policymakers and urban planners to develop relevant and effective strategies and to improve dissatisfactory conditions in new and peripheral areas.

This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes.

A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR “NUD*IST” (version “N6”) was used as a technical tool, in order to facilitate the data analysis.

The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a “quest” by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state.

It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named “stakeholder management model”.

The transition to adulthood involves risk. In the 90s, sociologists have focused on the question of understanding and managing this risk. Much of this research has tried to go beyond family characteristics and examine the possible role of community or neighborhood. Furstenberg (2000) concludes, however, that the research “on adolescent behaviors has not shown a strong impact of the quality of neighborhoods, independent of the demographic characteristics of the resident families” (p. 902). The exploratory research reported in this paper on suburban neighborhoods, however, suggests that the neighborhood may have effects that have not yet been fully examined. Two problems with the previous research are highlighted. First is the problem of the definition of neighborhood in contrast to community, a continuing problem in neighborhood research. The second is that this research has largely focused on urban neighborhoods; the success of adolescents in suburban neighborhood contexts has not been highlighted. The result is that the focus of these studies has been more on poverty; this paper, however, will focus on inequality in contrasting the situation of adolescents in white suburban neighborhoods to that found in the inner city.