The new production theory for health care through clinical reengineering: a study of clinical guidelines--Part II

In Part I of this two-part article, in the December 1994 issue of the journal, the author discussed the manufacturing theories of Peter Drucker in terms of their applicability for the health care field. He concluded that Drucker's four principles and practices of manufacturing--statistical quality control, manufacturing accounting, modular organization, and systems approach--do have application to the health care system. Clinical guidelines, a variation on the Drucker theory, are a specific example of the manufacturing process in health. The performance to date of some guidelines and their implications for the health care reform debate are discussed in Part II of the article.     

Coping with Compassion: Role Transformation Amongst Oregon Food Pantry Directors

In stark contrast to the robust social safety nets found in many developed nations around the world, the modern American welfare state is increasingly operated by a variety of non-governmental actors and voluntary organizations. The operation of this welfare regime depends on the discretionary decisions of street-level bureaucrats. As street-level bureaucrats confront new circumstances, their discretionary decisions change. Normative institutionalism and the concept of bricolage are used to explore how discretionary decisions change within an organizational role in the context of a voluntary organization. Understanding this process of bricolage sheds light on the decision-making processes of street-level bureaucrats, explains how behavior in an organizational role shifts over time, and points to the dynamic nature of institutions. We present an in-depth qualitative study of the emergency food network in Oregon as a critical case to illustrate this argument.     

Monotheistic Theodicy as Imaginary Face‐Work

In this article, I outline the cognitive process involved in accomplishing monotheistic theodicy, or the act of reconciling the belief in an omnipotent and morally perfect God with personal experiences of suffering. Based on in‐depth interviews with intimate partner violence victims, I argue that believers accomplish monotheistic theodicy by performing imaginary face‐work—or protective face‐work on the behalf of significant imagined others—that saves God's face as a morally perfect being. Believers perform this imaginary face‐work by constructing accounts that portray God as morally innocent of their suffering. These accounts fall into three main types: (1) fidelity to a higher principle, (2) ultimate benefit, and (3) shifting blame. These accounts serve as new cognitions that resolve the cognitive dissonance and concomitant negative emotions believers experience because of their suffering. Overall, the findings and analysis contribute to sociological theory by further extending the concepts of face and face‐work to imagined others.     

Production planning and control improvements in a small UK garment manufacturer; a case study

Through the medium of a case study, this paper highlights problems typical of a small manufacturer whose business operates in a turbulent environment, yet who lacks adequate planning and scheduling software needed to provide some visibility and control. This paper reveals how improvement options were evaluated, a system selected, and appropriate procedures and management disciplines installed to underpin the electronic solution. Finally, the paper closes with some cogent insights into the usefulness of finite capacity scheduling tools, and their successful operation.     

Reviews

Emmanuel Le Roy Ladurie, Montaillou: Cathars and Catholics in a French Village, 1294–1324, translated by Barbara Bray (1978), xvii+383 (The Scolar Press, £12.50).

Alan Macfarlane, The Origins of English Individualism. The Family, Property and Social Transition (Oxford, 1978), xvi+216 (Basil Blackwell. £8.50).

Thomas A. Brady, Jr., Ruling Class, Régime and Reformation at Strasbourg 1520–1555 (1978), xxi+458 (Brill, Leiden, 124 guilders).

Andrew B. Appleby, Famine in Tudor and Stuart England (1978) x+250 (Liverpool University Press, Liverpool, £10.75). Victor Skipp, Crisis and Development. An ecological case study of the Forest of Arden, 1570–1674 (1978) xii+132 (Cambridge University Press, Cambridge, £6.50).

Patricia Branca, Women in Europe since 1750 (1978), 233 (Croom Helm, £8.95, paperback £3.95).

John W. Blassingame (ed.), Slave Testimony: Two Centuries of Letters, Speeches, Interviews, and Autobiographies (1977), lxv+777 (Louisiana State University Press, Baton Rouge, paperback £7.50).

Jonas Frykman, Horaa i bondesamhället (1977), 230 (Liber Läromedel, Lund, 24 Sw. cr.). (The Whore in Peasant Society)

Helmut Bleiber (ed.), Bourgeoisie uad bürgerliche Umwälzuagin Deutschland 1789–1871 (Akademie der Wissenschaften der DDR: Schriften des Institute für Geschichte, 50, 1977) xii+525 (Akademie‐Verlag, East Berlin, 48M). (Bourgeoisie and Bourgeois Upheaval in Germany 1789–1871)

A. P. Donajgrodzki (ed.), Social Control in Nineteenth‐Century Britain (1977)! 258 (Croom Helm, £8.50).

Anthony S. Wohl (ed.), The Victorian Family (1978), 224 (Croom Helm, £7.95).

M. J. Daunton, Coal Metropolis Cardiff 1870–1914 (1977), 260 (Leicester University Press, Leicester, £12.00).

W. A. Speck, Stability and Strife: England 1714–1760 (1977), viii+311 (Edward Arnold, £9.95, paperback £3.50).

Howard Newby, The Deferential Worker: a study of farm workers in East Anglia (1977), 462 (Allen Lane, £9.00).

John Stevenson and Chris Cook, The Slump: Society and Politics during the Depression (1977), 348 (Jonathan Cape, £8.95).     

The geography of British exports: Country-level versus firm-level evidence

This study investigates the degree of regionalization of UK exporters. The firm-level findings, based on an original set of primary data of 356 UK exporters, are contrasted with the UK national trade flows as well as with the geographic spread of the UK, European and the world’s largest MNEs. The analysis produced consistent findings of regionalization regardless of the classification thresholds or sales matrices employed. The findings also imply that country-level data supports the firm-level findings of regionalization. While the analysis presents relatively strong corroborating evidence of regionalization of UK exports, it also indicates that UK exporters might be more multi-regional and global oriented than previously thought.     

The Intersection of Neglected Ideas: Durkheim,Mead, and the Postmodernists*

In this article, the author examines pragmatic philosophy as a tool to open a richer dialogue between modern and postmodern depictions of reality. Exploring the pragmatic influences in the thoughts of G. H. Mead and Emile Durkheim (as well as C. Wright Mills and others), the author argues that ideas found in these theorist's writings, as they are informed by American Pragmatism, can act as a metaphorical bridge in linking modern and postmodern thought. In this context, the author shows that the functionalists and structuralists wrongly depict Durkheim and Mead as disciples of and inheritors of the Enlightenment project. Conversely, the postmodernists simply ignore them because they are wrongly perceived to be part of the totalizing, “enemy” camp of the Enlightenment tradition. The author asserts that a more accurate read of Durkheim and Mead finds a nuanced, middle ground in regards to opposition to versus submission to the Enlightenment project, and hence Durkheim and Mead (due in large part to American Pragmatism's influence in their writings) offer a way for modern and postmodern theory to enter into more fruitful dialogue with each other.     

Relocation and the problem of survival in Qwaqwa: A report from the field

Few specifically anthropological studies have been made of the consequences of mass relocation into South Africa's Bantustans. This preliminary paper examines some of the factors which influence the chances of survival open to people relocated into Qwaqwa in the north‐east Orange Free State. It attempts also to relate the various conditions people experience in Qwaqwa to changes in the Free State region over the past twenty years. It is argued that an important aim of contemporary anthropological research in areas such as Qwaqwa should be to integrate the detailed micro‐level information produced by field work techniques with an appreciation of trends at a regional level.