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Purpose – Research on hospital system organization is dated and cross-sectional. We analyze trends in system structure during 2000–2010 to ascertain whether they have become more centralized or decentralized.

Design/Methodology/Approach – We test hypotheses drawn from organization theory and estimate empirical models to study the structural transitions that systems make between different “clusters” defined by the American Hospital Association.

Findings – There is a clear trend toward system fragmentation during most of this period, with a small recent shift to centralization in some systems. Systems decentralize as they increase their members and geographic dispersion. This is particularly true for systems that span multiple states; it is less true for smaller regional systems and local systems that adopt a hub-and-spoke configuration around a teaching hospital.

Research Limitations – Our time series ends in 2010 just as health care reform was implemented. We also rely on a single measure of system centralization.

Research Implications – Systems that appear to be able to centrally coordinate their services are those that operate in local or regional markets. Larger systems that span several states are likely to decentralize or fragment.

Practical Implications – System fragmentation may thwart policy aims pursued in health care reform. The potential of Accountable Care Organizations rests on their ability to coordinate multiple providers via centralized governance. Hospitals systems are likely to be central players in many ACOs, but may lack the necessary coherence to effectively play this governance role.

Originality/Value – Not all hospital systems act in a systemic manner. Those systems that are centralized (and presumably capable of acting in concerted fashion) are in the minority and have declined in prevalence over most of the past decade.

This paper furthers the analysis of patterns regulating capitalist accumulation based on a historical anthropology of economic activities revolving around and within the Mauritian Export Processing Zone (EPZ).

This paper uses fieldwork in Mauritius to interrogate and critique two important concepts in contemporary social theory – “embeddedness” and “the informal economy.” These are viewed in the wider frame of social anthropology’s engagement with (neoliberal) capitalism.

A process-oriented revision of Polanyi’s work on embeddedness and the “double movement” is proposed to help us situate EPZs within ongoing power struggles found throughout the history of capitalism. This helps us to challenge the notion of economic informality as supplied by Hart and others.

Scholars and policymakers have tended to see economic informality as a force from below, able to disrupt the legal-rational nature of capitalism as practiced from on high. Similarly, there is a view that a precapitalist embeddedness, a “human economy,” has many good things to offer. However, this paper shows that the practices of the state and multinational capitalism, in EPZs and elsewhere, exactly match the practices that are envisioned as the cure to the pitfalls of capitalism.

Setting aside the formal-informal distinction in favor of a process-oriented analysis of embeddedness allows us better to understand the shifting struggles among the state, capital, and labor.

The No Child Left Behind Act (2002) and Race to the Top (2009) led to the highest rate of standardized-state testing in the history of the United States of America. As a result, the Every Student Succeeds Act (2015) aims to reevaluate standardized-state testing. Previous research has assessed its impact on schools, educators, and students; yet, youth’s voices are almost absent. Therefore, this qualitative analysis examines how youth of color perceive and experience standardized-state testing.

Seventy-three youth participated in a semistructured interview during the summer of 2015. The sample consists of 34 girls and 39 boys, 13–18 years of age, of African American, Latino/a, Jamaican American, multiracial/ethnic, and other descent. It includes 6–12th graders who attended 61 inter-district and intra-district schools during the 2014–2015 academic year in a Northeastern metropolitan area in the United States that is undergoing a racial/ethnic integration reform.

Youth experienced testing overload under conflicting adult authorities and within an academically stratified peer culture on an ever-shifting policy terrain. While the parent-adult authority remained in the periphery, the state-adult authority intrusively interrupted the teacher-student power dynamics and the disempowered teacher-adult authority held youth accountable through the “attentiveness” rhetoric. However, youth’s perspectives and lived experiences varied across grade levels, school modalities, and school-geographical locations.

In this adult-dominated society, the market approach to education reform ultimately placed the burden of teacher and school evaluation on youth. Most importantly, youth received variegated messages from their conflicting adult authorities that threatened their academic journeys.

Purpose – Studies have described how migrants progressively transform extraneous spaces into familiar, meaningful environments, turning them into ‘homes’. However, in some contexts the opposite process occurs: what once felt like home becomes alien, unrecognizable and extraneous. Building on ethnographic vignettes on the everyday life of immobile young Eritreans, this chapter explores the paradox of ‘not feeling at home’ while being physically there.

Methodology – The chapter builds on three months’ ethnographic fieldwork in Eritrea and extended participant observation among Eritrean refugees in Ethiopia, Sudan and Italy from 2012 to 2014.

Findings – I show how the youth, in a pervasive context of migration culture, articulate a sense of belonging towards what they imagine as the ‘outside world’, while being unable to make sense of their lives in their own homeland. Using the notions of ‘estrangement’ and home-unmaking, it is possible to account for the feelings of those living in conditions of protracted crisis and explore the subjective worlds of prospective refugees.

Originality/Value – The chapter’s originality lies in the uniqueness of the ethnographic material and in the innovative approach to the debate on home-making and refugee studies. Instead of considering refugees’ home-making processes in other countries, this chapter analyses the experience of losing home without moving. By using the concept of estrangement, it investigates the manifold meanings of immobility while adding to the theoretical discussion on home-making/unmaking processes. Moreover, it contributes to the empirical investigation of determinants of asylum flows by investigating the case of Eritrea, a major refugee-producing country.

This chapter discusses the connection between authentic leadership and meta competence, examining whether authentic leadership can be developed or promoted in educational processes. The authors propose the concept of shaping orientation: problem-based learning without a fixed solution but with the generation of a solution-finding approach through the process of holistic action. They posit that training in authentic leadership can be embedded in curricula if learning is problem-based. This proposition poses important research and pedagogical questions for research. Is there evidence that problem-based learning generates the leadership qualities and attitudes that the authors claim? If so, how can this relationship be reliably tested over time?

The emergence of climate science denialism in the United States provides a challenge to STS theories of the relationship between scientific expertise and public policy because a situation of epistemic rift occurs: the capacity of scientific consensus to establish the grounds of political debate is broken, and the standard circulation of expertise from the scientists and funding from the state is interrupted. Three mechanisms for the containment of scientific expertise are studied: direct intellectual suppression of climate scientists, industry support of contrarian scientists and policymakers, and cutbacks on government research programs that support climate change. This situation politicizes climate scientists, who are drawn into the public sphere as a counterpublic to the effort to contain the circulation of their knowledge in the political field. Although the strategy of contained expertise has been effective in blocking climate legislation at the federal government level in the United States, it may be losing effectiveness, and an emergent alternative strategy based on adaptation may be coming to replace it. Factors that affect the reduction in the capacity to contain the circulation of scientific expertise are also analyzed.