As ever more women work outside the home, ever more families employ childcare workers. In the absence of government regulations or social models that clearly define the childcare provider’s role, mothers worry about the quality of care their children are getting. By connecting the personal level of mothers’ daily experiences to the larger political, economic, and ideological context of childcare, Lynet Uttal describes and explains how mothers rely on their relationship with the providers to monitor and influence the quality of care their children receive. Whereas other studies have emphasized how mothers undervalue and exploit providers, this book paints a more nuanced picture, arguing that the ties between adults who share in the care of children creates neither heroes nor victims. This ethnography reveals that mothers are often reluctant to discuss their concerns with their childcare providers. Uttal shows how mothers walk a fine line between wanting to believe in the quality of care they have chosen, and the fact that they might have made a mistake. Catalyzed by their worries about the quality of care, mothers develop complex relationships with the women—and most are women—who look after their children.
Throughout, Roe focuses on the global financial mess of 2008 and its ongoing aftermath, showing how mismanagement has allowed it to morph into other national and international messes. More effective management is still possible for this and many other policy messes but that requires better recognition of patterns and formulation of scenarios, as well as the ability to translate pattern and scenario into reliability. Developing networks of professionals who respond to messes is particularly important. Roe describes how these networks enable the avoidance of bad or worse messes, take advantage of opportunities resulting from messes, and address societal and professional challenges. In addition to finance, he draws from a wide range of case material in other policy arenas. Roe demonstrates that knowing how to manage policy messes is the best approach to preventing crises.
In Managing the Environmental Crisis William R. Mangun and Daniel H. Henning provide a balanced and comprehensive guide to the management of complex environmental and natural resource policy issues. Taking into account new developments, trends, and issues that have arisen in recent years, the authors begin with the recognition, often overlooked, that it is not the environment that needs to be managed but human action relating to the environment.
The authors review issues associated with a range of environmental policy concerns, including energy considerations, renewable and non renewable resource management, pollution control, wilderness management, and urban and regional policy. The history of these issues, recent actions pertaining to their management, difficulties associated with their continued presence, and the consequences of a failure to address these concerns are explored. Though focused on specific political issues, Mangun and Henning direct their attention to two large-scale trends—globalization and the political polarization of the environmental movement. At the level of the decision-making process, the incorporation of values—specifically addressed from multicultural and cross-disciplinary perspectives—is also discussed. International in scope, the book provides descriptions of the roles of both governmental and nongovernmental organizations in the formulations and implementation of national and global environmental policy.
This thoroughly revised second edition discusses various successes in the arenas of environmental cooperation and management strategy while pointing to the new challenges that have emerged in the last decade.
Mediated modeling is an innovative new approach that enhances the use of computer models as invaluable tools to guide policy and management decisions. Rather than having outside experts dispensing answers to local stakeholders, mediated modeling brings together diverse interests to raise the shared level of understanding and foster a broad and
deep consensus. It provides a structured process based on system dynamics thinking in which community members, government officials, industry representatives, and other stakeholders can work together to produce a coherent, simple but elegant simulation model.
Mediated Modeling by Marjan Van Den Belt is a practical guide to participatory modeling for both practitioners and students, one that is firmly theoretically grounded in the field of systems dynamics and environmental modeling. Five in-depth case studies describe the successful use of the technique in a variety of settings, and a final chapter synthesizes the lessons highlighted by the case studies.
Mediated Modeling's step-by-step description of the techniques and practical advice regarding implementation offer a real-world solution for all those seeking to make sound decisions about the environment.
How the politics of “medical necessity” complicates American health care
The definition of medical necessity has morphed over the years, from a singular physician’s determination to a complex and dynamic political contest involving patients, medical companies, insurance companies, and government agencies. In this book, Daniel Skinner constructs a comprehensive understanding of the politics of defining this concept, arguing that sustained political engagement with medical necessity is essential to developing a health care system that meets basic public health objectives.
From medical marijuana to mental health to reproductive politics, the concept of medical necessity underscores many of the most divisive and contentious debates in American health care. Skinner’s close reading of medical necessity’s production illuminates the divides between perceptions of medical need as well as how the gatekeeper concept of medical necessity tends to frame medical objectives. He questions the wisdom of continuing to use medical necessity when thinking critically about vexing health care challenges, exploring the possibility that contracts, rights, and technology may resolve the contentious politics of medical necessity.
Skinner ultimately contends that a major shift is needed, one in which health care administrators, doctors, and patients admit that medical necessity is, at its base, a contestable political concept.
Competent physicians make accurate diagnoses. How are accurate diagnoses made? This readable book gives some important answers to that question. Experienced physicians were presented with diagnostic problems and asked to solve them. Through the use of trained actors serving as “patients” and with a variety of supplementary techniques, the investigators were able to dissect the process by which diagnoses, right and wrong, are made.
Reporting on the most comprehensive investigation of clinical reasoning yet conducted, the authors present data and conclusions of importance not just to medical educators but to anyone interested in the psychology of problem solving. Rigorous attention to methods, thorough grounding in contemporary theories of problem solving, and a healthy respect for the complexity of real-life situations characterize this remarkable study.
A sampling of its salient findings only suggests the richness of this book. Successful diagnosticians begin to form hypotheses almost as soon as they encounter a patient. They entertain a limited number of hypotheses, but these are tested repeatedly during a workup. New findings are treated as confirming, refuting, or not contributing to the solution contemplated; more elaborate schemes based on a knowledge of probabilities are not used. A common error is to relate new information to a working hypothesis, although the information is, in fact, non-contributory. The performance of even an experienced physician varies markedly from case to case. Two of the most important determinants of competence are information and experience; problem-solving skills without a rich supply of facts are insufficient for diagnostic acumen.
Mobilizing Science theoretically and empirically explores the rise of a new kind of social movement—one that attempts to empower citizens through the use of expert scientific research. Sabrina Mccormick advances theories of social movements, development, and science and technology studies by examining how these fields intersect in cases around the globe.
Mccormick grounds her argument in two very different case studies: the anti-dam movement in Brazil and the environmental breast cancer prevention movement in the U.S. These, and many other cases, show that the scientization of society, where expert knowledge is inculcated in multiple institutions and lay people are marginalized, give rise to these new types of movements. While activists who consequently engage in science often instigate new methods that result in new findings and scientific tools, these movements still often fail due to superficial participatory institutions and tightly knit corporate/government relationships.
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