Shifting logics of legitimation in the diffusion of complex innovations

Legitimation and competition are two major forces moulding organizational field and the diffusion of innovations. While discursive legitimation provides "rational justifications" for innovations, competition may incite organizations to acquire effective innovations preemptively. This paper draws on a case study of the legitimation and diffusion of a sophisticated medical technology to suggest that, in highly regulated environments, these two forces may interact, and that opposing legitimation strategies may be associated with competition. We argue that while convergent discursive legitimation strategies tend to speed up the diffusion process, divergent discursive legitimation strategies may have the opposite effect. The case suggests that the dominant logics of legitimation may shift, oscillating between convergence and divergence as an innovation diffuses. We also show how the resulting delays in diffusion may be pre-empted by a phenomenon we call institutional delinquency, that is when the moral and cognitive-cultural legitimacies of the technology among professionals and managers becomes sufficient to counteract regulatory forces.technology, legitimation, institution, innovation, PET scanner, theorization, competition

Status francuskih "novih općina"

French decentralisation reform includes a reduction in the number of communes (36,686 on January 1st, 2009), through the promotion of »new communes«. After the failures of 1959 and 1971, a new attempt started in 2010. The “new commune” is an example of a new, improved, and modernized system for merging communes. It is a simpler and more flexible than the earlier system enacted in the Marcellin Law of 1971. From a modern perspective, mostly inspired by the school of the New Public Management, the merger of communes should save money and improve local public management. Legal and institutional analysis shows certain advantages and some critical points in that regard. The maintenance of “delegated or associated” communes is not a measure of the efficiency of French administrative organisation; especially since the new communes do not have a mandate to eliminate the establishments for intercommunal cooperation (EPCIs) to which the communes concerned will belong. The absence of any financial incentive in case of merger does not add much to the attractiveness of territorial mergers.Decentralizacija u Francuskoj uključuje smanjivanje broja općina kojih je 1. siječnja 2009. bilo 36.686. Nakon neuspješnih pokušaja iz 1959. i 1971. novi pokušaj je započeo 2010. »Nova općina« je primjer novog, poboljšanog i moderniziranog sustava spajanja općina. Taj je sustav jednostavniji i fleksibilniji od ranijeg koji je bio utemeljen Marcellinovim zakonom iz 1971. Gledajući s moderne perspektive inspirirane školom novog javnog menadžmenta, spajanje općina trebalo bi dovesti do financijskih ušteda i poboljšanja u lokalnom javnom upravljanju. Pravna i institucionalna analiza pokazuje određene prednosti, ali i neke kritične točke u ostvarenju tih namjera. Zadržavanje delegiranih ili pridruženih općina nije mjera koja bi pridonijela efikasnosti francuske upravne organizacije, posebno budući da nove općine nemaju ovlast ukinuti oblike međuopćinske suradnje kojima će pripadati. Nepostojanje financijske motivacije u slučaju spajanja ne čini teritorijalno spajanje privlačnijim

Shifting logics of legitimation in the diffusion of complex innovations

Legitimation and competition are two major forces moulding organizational field and the diffusion of innovations. While discursive legitimation provides "rational justifications" for innovations, competition may incite organizations to acquire effective innovations preemptively. This paper draws on a case study of the legitimation and diffusion of a sophisticated medical technology to suggest that, in highly regulated environments, these two forces may interact, and that opposing legitimation strategies may be associated with competition. We argue that while convergent discursive legitimation strategies tend to speed up the diffusion process, divergent discursive legitimation strategies may have the opposite effect. The case suggests that the dominant logics of legitimation may shift, oscillating between convergence and divergence as an innovation diffuses. We also show how the resulting delays in diffusion may be pre-empted by a phenomenon we call institutional delinquency, that is when the moral and cognitive-cultural legitimacies of the technology among professionals and managers becomes sufficient to counteract regulatory forces. [Authors]]]> Technology, Medical ; Economic Competition eng https://serval.unil.ch/resource/serval:BIB_33CD090B88C8.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_33CD090B88C82 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_33CD090B88C82 info:eu-repo/semantics/submittedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_33CD45FA5C43 2022-05-07T01:14:48Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_33CD45FA5C43 Dysfunction of the redox-sensitive transcription factor Nrf2 in vulnerable animals. info:doi:10.1038/mp.2017.250 info:eu-repo/semantics/altIdentifier/doi/10.1038/mp.2017.250 info:eu-repo/semantics/altIdentifier/eissn/1476-5578 info:eu-repo/semantics/altIdentifier/pmid/29176622 Bouvier, E. Brouillard, F. Molet, J. Claverie, D. Cabungcal, J.H. Cresto, N. Doligez, N. Rivat, C. Do, K.Q. Bernard, C. Benoliel, J.J. Becker, C. info:eu-repo/semantics/other misc 2017-12 eng oai:serval.unil.ch:BIB_33CE68B39CE2 2022-05-07T01:14:48Z ehelvetica openaire documents phdthesis urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_33CE68B39CE2 E2F1 inhibits circulating cholesterol clearance by regulating PCSK9 expression in the liver (PhD) Lai, Q. Université de Lausanne, Faculté de biologie et médecine info:eu-repo/semantics/doctoralThesis phdthesis 2016 <![CDATA[The metabolic syndrome has become a worldwide epidemic. It includes obesity, dyslipidemia, diabetes and nonalcoholic fatty liver disease (NAFLD). The metabolic syndrome is caused, amongst others, by alterations in lipid metabolism, that lead to aberrant whole body energy homeostasis and thus disease development. Hence, understanding how cells regulate lipid homeostasis is key to treat lipid deregulation. Recently, novel regulators of metabolic processes, including cell cycle regulators like cell cycle dependent kinase 4 (CDK4) and E2F transcription factors 1 (E2F1) have been identified. Here, we show that E2F1 plays a crucial role in maintaining cellular cholesterol homeostasis through the regulation of cholesterol uptake via the proprotein convertase subtilisin/kexin type 9 (PCSK9); an enzyme that upon activation promotes low-density lipoprotein receptor (LDLR) degradation. We found that the E2F1-/- mice have reduced total plasma cholesterol and elevated cholesterol content in the liver, suggesting an increase of cholesterol uptake. Following these observations, we showed that E2F1 deletion leads to a marked decrease in PCSK9 expression and to an increase in LDLR expression. In addition to the upregulation of LDLR, we also demonstrated that E2F1-/- hepatocytes have increased LDL uptake. Moreover, ChIP-seq and PCSK9 reporter experiments confirmed that E2F1 binds and transactivates PCSK9 promoter. Consistent with this, E2F1-/- mice fed a high cholesterol diet (HCD) displayed a fatty liver phenotype, confirming our hypothesis that E2F1 controls cholesterol uptake. Collectively, our results suggest that E2F1 plays a physiological role in maintaining cholesterol balance via the control of PCSK9 expression, which in turn controls LDLR stability. The newly identified E2F1-PCSK9 axis is likely the first report to define the role of E2F1 in cholesterol metabolism and to improve therapeutic strategies to counteract dyslipidemia. -- Les maladies métaboliques constituent actuellement l'épidémie mondiale du 21ème siècle. L'altération du métabolisme lipidique peut conduire à des altérations de l'homéostasie du corps en entier, qui résultent dans le développement de maladies telles que le diabète, la stéatose hépatique et l'athérosclérose. Par conséquent, comprendre comment les cellules régulent l'homéostasie lipidique est clef pour fournir des connaissances pour lutter contre les dérégulations lipidiques. Au cours des années, la recherche à permis de mettre en évidence de nouveaux régulateurs des processus métaboliques, tels que des facteurs du cycle cellulaire comme CDK4 (Cell Cycle Dependent Kinase 4) et E2F1 (E2F transcription factor 1). Nous avons mis en évidence que le facteur de transcription E2F1 joue un rôle crucial dans le maintien de l'homéostasie cellulaire du cholestérol, via la régulation de son incorporation, par l'intermédiaire de PCSK9 (Proprotein convertase subtilisin/kexin type 9) ; une enzyme qui induit une dégradation des LDLR (Low density lipoprotein receptor). Les souris E2F1-/- ont un taux de cholestérol plasmatique diminué et une augmentation du contenu de cholestérol dans le foie, suggérant une augmentation de l'absorption du cholestérol. Suite à cette observation, nous avons démontré que l'inactivation du gène E2F1 entraîne une diminution marquée de l'expression de PCSK9, et une augmentation de l'expression du LDLR. Ainsi, les hépatocytes E2F1-/- sont caractérisés par une augmentation de l'absorption de LDL. De plus, des expériences de ChIP-seq, et l'utilisation de rapporteurs d'activité de promoteurs, démontrent que E2F1 se lie au promoteur de PCSK9 en activant ainsi l'expression de ce gène. De façon intéressante, les souris E2F1-/- ayant subi un régime riche en cholestérol (HCD-High cholesterol diet) développent une stéatose hépatique, confirmant notre hypothèse que E2F1 contrôle l'absorption du cholestérol. Dans l'ensemble, nos résultats suggèrent que E2F1 joue un rôle physiologique dans le maintien de l'homéostasie du cholestérol par le contrôle de l'expression de PCSK9, qui à son tour contrôle l'absorption optimale des stérols. Notre travail aura un impact important, car il identifie un nouveau rôle pour le facteur de transcription E2F1, connu pour son implication dans le cycle cellulaire et le cancer, dans le contrôle du métabolisme du cholestérol

La liberté religieuse dans les lieux publics

Introduction La liberté est un bien si précieux, disait Montesquieu, que chacun veut prendre celle des autres. A. Les notions de « liberté religieuse » et de « neutralité religieuse » « C’est la neutralité de l’espace public qui permet la coexistence harmonieuse des différentes religions ». Mais avant de cerner la notion de « neutralité religieuse » (2), il convient de définir la liberté religieuse (1). 1. La double « liberté religieuse » « La liberté religieuse revêt deux aspects distincts m..

L'acceptation définitive de la démission d'un maire

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Struggles in the diffusion of high-end medical technology in Switzerland and in Canada

This book examines the diffusion process for a complex medical technology, the PET scanner, in two different health care systems, one of which is more market-oriented (Switzerland) and the other more centrally managed by a public agency (the province of Quebec in Canada). More specifically, this research draws on institutional and socio-political theories of the diffusion of innovations to examine how institutional contexts affect processes of diffusion. The study finds that diffusion proceeds more rapidly in Switzerland than in Quebec, but that processes in both jurisdictions are characterized by intense struggles among providers and between providers and public agencies. This study shows that the institutional environment influences these processes by determining the patterns of material resources and authority available to actors in their struggles to strategically control the technology, and by constituting the discursive resources or institutional logics on which actors may legitimately draw in their struggles to give meaning to the technology in line with their interests and values. This book also illustrates how institutional structures and meanings manifest themselves in the context of specific decisions within an organizational field, and reveals the ways in which governance structures may be contested and realigned when they conflict with interests that are legitimized by dominant institutional logics. It is argued that this form of contestation and readjustment at the margins constitutes one mechanism by which institutional frameworks are tested, stretched and reproduced or redefined

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