The Iterative Process of Legitimacy-Building in Hybrid Organizations

Hybrid organizations face the fundamental challenge of building legitimacy. To deal with this challenge in administrative theory and practice, we apply an analytical framework following an organizational logic of legitimacy building to an exemplary case of hybridity — the Swiss Institute for Translational and Entrepreneurial Medicine. Our framework application illustrates that pragmatic legitimacy (i.e., establishing instrumental value) must be built before moral legitimacy (i.e., fostering normative evaluation) and cognitive legitimacy (i.e., creating comprehensibility), followed by an iterative process of mutual influence between the legitimacy forms. Originating in the management literature, the framework promises new insights for public administration research on hybrids

The Price of Progress: Funding and Financing Alzheimer\u27s Disease Drug Development

Introduction Advancing research and treatment for Alzheimer\u27s disease (AD) and the search for effective treatments depend on a complex financial ecosystem involving federal, state, industry, advocacy, venture capital, and philanthropy funding approaches. Methods We conducted an expert review of the literature pertaining to funding and financing of translational research and drug development for AD. Results The federal government is the largest public funder of research in AD. The National Institute on Aging, National Institute of Mental Health, National Institute of General Medical Sciences, and National Center for Advancing Translational Science all fund aspects of research in AD drug development. Non-National Institutes of Health federal funding comes from the National Science Foundation, Veterans Administration, Food and Drug Administration, and the Center for Medicare and Medicaid Services. Academic Medical Centers host much of the federally funded basic science research and are increasingly involved in drug development. Funding of the “Valley of Death” involves philanthropy and federal funding through small business programs and private equity from seed capital, angel investors, and venture capital companies. Advocacy groups fund both basic science and clinical trials. The Alzheimer Association is the advocacy organization with the largest research support portfolio relevant to AD drug development. Pharmaceutical companies are the largest supporters of biomedical research worldwide; companies are most interested in late stage de-risked drugs. Drugs progressing into phase II and III are candidates for pharmaceutical industry support through licensing, mergers and acquisitions, and co-development collaborations. Discussion Together, the funding and financing entities involved in supporting AD drug development comprise a complex, interactive, dynamic financial ecosystem. Funding source interaction is largely unstructured and available funding is insufficient to meet all demands for new therapies. Novel approaches to funding such as mega-funds have been proposed and more integration of component parts would assist in accelerating drug development

That was then but this is now

Current agricultural negotiations in the World Trade Organization are grappling on how to fully integrate agriculture within the general rules for trade in goods. The notion of multifunctionality of agriculture has been suggested as a reason to justify special treatment for that sector, including the continuation of its protection and subsidization. Many developing countries are still analyzing whether the idea has something to offer them in terms of their negotiating positions and policy framework. While multifunctionality has been invoked for supporting agriculture in developed countries, a similar idea, although not called so at the time, was clearly behind support for industry in developing countries. Again in this case, the policy implication was that government intervention was required (through trade protection, subsidies, and other special policies) to develop an industrial base that contributed to society more than what market valuations alone would suggest. The debate on industrialization in developing countries was part of a broader discussion regarding nation-building, economic development, and social modernization. The current arguments around multifunctionality are similarly embedded in a larger economic, political and social matrix. This paper, although it does not present a full account of either debate, discusses some of the intriguing parallelisms in their theoretical frameworks, policy implications and economic and social impacts. The main objective is to clarify current policy issues for the agricultural sector in developing countries, highlighting possible consequences for the negotiating position of developing countries in the WTO process.World Trade Organization. ,Trade policy. ,Agriculture Economic aspects ,Agricultural subsidies Developing countries. ,Industrialization Developing countries. ,Economic development Developing countries. ,Agricultural policy. ,Markets Economic policy. ,

Coordinating Care Between Behavioral Health and Primary Care Providers: Examining Agency Challenges, Capacity, and Patient Service Utilization

abstract: Health care in the United States has been undergoing significant changes since the 2010 passage of the Patient Protection and Affordable Care Act. One of the outcomes of this policy was an attempt to bring physical health care and behavioral health care together in an effort to provide more coordinated care for patients. This change created an opportunity to improve the quality of care for patients, and as a result reduce high cost emergency service that could be prevented through better maintenance of chronic conditions. Three studies were conducted to examine challenges behavioral health agencies face in implementing two models of coordinated care (co-located and fully integrated), staff and organization capacity and needs, and patient service utilization by model of care coordination. The first study used site visits and interviews to capture the challenges faced by agencies. Results from this study indicated that behavioral health agencies faced a number of challenges in providing coordinated care including financial barriers, regulations, information sharing, inadequate technology, and provider training needs. The second study used a staff survey to assess agency and staff capacity and needs in providing coordinated care. The results from this study found differences in capacity based on model of coordination in multiple dimensions related to inter-agency coordination and communication, role clarity, and team cohesion. The third study examined patient service utilization for outpatient visits, inpatient visits, and emergency visits. The results indicated that patients receiving care from co-located agencies were more likely to have at least one encounter in each of the three service utilization categories compared to patients at fully integrated agencies. Overall, the three studies suggest that agencies that have or will implement models of coordinated care face significant barriers that may impact the sustainability or feasibility of such care. Given the findings on patient service utilization, it seems that coordinated care has great potential for patient level outcomes which makes addressing agency barriers even more critical.Dissertation/ThesisDoctoral Dissertation Social Work 201

Prenatal hormones in first‐time expectant parents: Longitudinal changes and within‐couple correlations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111071/1/ajhb22670.pd

Community College President\u27s Health Habits: A Prescription for Job Performance in Rural Illinois

According to current reports, the experts are predicting a mass exodus of senior community college leaders, including presidents. News reports have indicated that some community college presidents have retired due to health problems. For whatever reason, it will cost the institutions to replace the presidents. The presidents are the decision makers of the community college. The presidents provide the guidance to the institution. In order to accomplish the duties of president, they need to have the physical and mental capacity to endure long hours required to complete these tasks. The purpose of the study was to explore the health and wellness initiative of rural Illinois community college presidents and the perceptions of their personal health and wellness initiatives affecting their job performance. This qualitative case study was situated in an interpretive paradigm. Four rural Illinois community college presidents described their perceptions on their health and wellness, wellness initiatives, health impact on their job performance, and factors that aid in wellness decisions making. Findings indicate the study participants believe that they are in good health and are able to complete their presidential duties. They believe there are health conditions that can impair job performance and there are measures that can be taken to aid in the prevention of these debilitating conditions. The participating presidents believe being healthy improves job performance. The presidents participate in wellness initiatives. Some initiatives are chosen at the discretion of the presidents and their physicians prescribe other initiatives. The wellness initiatives taken by the presidents only seem to meet their physical, mental, and spiritual needs. To have the most effective health and wellness program, consultation with physicians and other wellness practitioners needs to occur. Topics during consultation should include intellectual wellness, social wellness, and occupational wellness along with mental wellness, physical wellness, and spiritual wellness. Community college presidents need to be educated in all aspects of wellness and the consequences of poor health. Proper health knowledge is needed to make good decisions on wellness initiatives and ultimately to have healthy community college presidents