Technologies in caregiving: professionals’ strategies for engaging with new technology

This article explores the adoption of new technology in organisations that provide senior citizen care. Inspired by Niklas Luhmann’s systems theory, we study how technology reduces complexity by identifying client needs and ensuring predictability in service delivery. However, how technologies are adopted in practice is not determined by technology since it is also structured by care-workers' continuous decision-making. Against this backdrop, we explore how technologies alter the conditions for decision-making in two settings of elderly care, and we describe how care workers seek to adapt technologies to their practical needs as well as conception of care ethics. Developing a systems theory approach, the article eschews a priori assumptions of technological constraint on care-workers’ professional autonomy, offering a more open-ended exploration of diversified strategies for coping with new technology. Our case studies show that employees develop diversified strategies for technology adoption, including both non-usage, heated resistance, excessive embrace, and creative adaption.     

Macroeconomic consequences of state fragility in sub‐Saharan Africa

Are poor macroeconomic outcomes primarily the result of economic policies, or of deeper underlying state fragility problems in sub‐Saharan Africa? We attempt to answer this question by using carefully specified dynamic panel regression techniques to show how state fragility conditions help to explain the differences in the macroeconomic performance of sub‐Saharan African economies, and to identify the most plausible mechanisms of transmission. We find that countries with greater fragility suffer higher macroeconomic volatility and crisis; they also experience weaker growth. When we disaggregate state fragility into its various components, we find that it is the security and social components that have the strongest causal impact on macroeconomic outcomes, while the political component is, at best, weak. Therefore, we conclude that it is state fragility conditions, and not necessarily macroeconomic policies, that are of first‐order importance in explaining the differences in macroeconomic performance for African countries. The knock‐on effects are mostly mediated through the fiscal channel, the aid channel, and the finance channel. Accordingly, we recommend that interventions in fragile states should best focus on exploiting the potential for using fiscal policy, aid, and finance as instruments to improve macroeconomic outcomes in sub‐Saharan Africa.     

智慧居家养老服务协同供给的优化路径研究——以广西钦州市智慧居家养老项目的实践经验为例

智慧居家养老服务的协同供给可以形成社会联动效应，降低公共服务成本。运用公共服务协同供给分析框架，通过交叉分类方法从协同主体的利益与目标两个变量的耦合性出发分析广西钦州市智慧居家养老项目中养老服务主体间不同种类的协同关系，可以从加强政府领导、形成合作联盟、建立市场标准、创新扶持政策4个方面完善政府、企业、社会组织之间不同类型的协同供给，实现社会资源的高效利用以及向智慧居家养老服务的发展和转变。     

Effects of pro-growth policies on employment: evidence of regional disparities

The main objective of our research is to study the direct impact of pro-growth economic policies on employment creation globally and regionally, as evidence has countered policy-makers’ expectation that output growth leads automatically to job creation. We innovate by using the ratio of employment to the population above 25 years as dependent variable instead of the customary employment elasticity. We apply generalized methods of moments’ econometrics on dynamic panel data models and find that growth stimulates employment creation on average across 76 countries. The policies promoting private sector credit, investments, openness, services, education spending, tertiary enrollment, and a fixed exchange rate are the ones that create employment. Larger government size undermines job creation, while policies promoting FDI and industrial development fail to stimulate employment. However, we establish that the effect of pro-growth policies on employment varies significantly across regions, with evidence of weaker links between economic policies and employment in Sub-Saharan Africa and the Middle East.     

Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries

Healthcare reforms have long been advocated as a cure to the increasing healthcare expenditures in advanced economies. Nevertheless, it has not been established whether a market solution via private financing, rather than public financing, curb aggregate healthcare expenditures. To our knowledge, this paper is the first that quantifies the impact of reforms that significantly increases (decreases) the private (public) share of healthcare financing on total healthcare expenditures relative to income in 20 OECD countries. Our reform measure is based on structural break testing of the private share of total expenditures, and verification using evidence of policy reforms. To quantify the effect of these reforms we apply Propensity Score Matching and Inverse Probability Weighted regression analysis. Over a 5-year evaluation period the reforms lead to an accumulated cost saving 0.45 percentage points of GDP. The yearly effects of the reforms are largest in the first years in the post-reform period and decreases in size as a function of time since the reform. Our findings suggest that the investigated healthcare reforms have a relatively short-lived effect on aggregate health spending relative to GDP. The findings are robust to various sensitivity tests.     

“Going natural”: Black women’s identity project shifts in hair care practices

Hair care, a seemingly mundane consumption practice, is packed with sociocultural meanings and constitutes an important realm of identity work for consumers. Drawing upon existing literature on consumer identity projects, this paper investigates the experiences of urban, Black women in Kenya as they disengage from the normative practice of altering their natural hair texture using chemical straighteners (a practice that conforms to Eurocentric beauty ideals of straight, flowing hair), and adopt the non-normative hair care practice of “going natural,” in which they embrace their natural hair texture and hairstyles. This paper traces the historical, sociocultural, and political events that underpin the normative ideology associated with the identity marker of natural Black hair, and how this ideology influences the women’s “going natural” experience. Findings reveal tensions that emerge in the women’s identity project disengagement and reconstruction process, and how the women navigate their position as they reimagine their embodied identity quest.     

Goodwill—an Example of Puzzle-Solving in Accounting—a Reply

Grinyer and Russell's (G&R, 1992) contention that Ma and Hopkins (1988) have imposed the mutually exclusive rules of the valuation-based paradigm on the matching-based paradigm that underlies accounting practice is overly defensive and misguided. Our 1988 paper was an attempt to throw light on why there was so little agreement on the rules governing the treatment of goodwill. G&R's comment does not change our view that the only answer to the 'puzzle' lies in the lack of a full understanding of the nature of goodwill.     

战后日本经济发展中积极财政政策的研究

战后，在实现经济恢复和高速发展过程中，日本政府高度重视财政政策的宏观调控作用，在运用财政政策调节经济方面开辟了一条符合本国国情、突出本国特点的路子．对日本战后积极财政政策进行分析和评价，对我国经济发展具有重要的参考借鉴意义。     

Efficiency outcomes of market concentration and managed care

The paper examines how hospital cost efficiency has reacted to extensive horizontal integrations of hospitals and rapid growth of managed care in the US health care industry. Cost efficiency is estimated by using panel data approaches to relax the assumptions for the hospital effects imposed in earlier studies. The paper shows that higher managed care penetration over time is associated with greater hospital efficiency, and higher market concentration is positively associated with efficiency when markets are highly competitive or highly concentrated.     

Violations of Service Fairness and Legal Ramifications: The Case of the Managed Care Industry

Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with HMOs' service unfairness to enrollees, physicians, and hospitals is examined. A general synopsis of the ethical issues in the managed care industry is provided. The various lawsuits launched by each group: enrollees, physicians, and hospitals together with the key statutes used are discussed. This paper also highlights the provisions and ramifications of the 11 April 2000 landmark agreement that Aetna made with Texas Attorney General John Cornyn to settle the 1998 lawsuit brought against the company. Lastly, the current ethical issues in the managed care industry are further discussed. The value of this paper can be adapted to the study of organizations' service fairness violations in other industries or in the educational, governmental, and not-for-profit sectors both nationally and internationally.