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The purpose of this paper is to present a case study of the World Health Organization’s Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH).

Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders. Sampling was purposive and at a senior level, focusing on board members, executive directors, funders, and academics. Data were analyzed thematically with reference to systems theory and Shiffman’s theory of network development.

Five key lessons emerged: effective management and leadership are critical; networks need to balance “tight” and “loose” approaches to their structure and processes; an active communication strategy is key to create and maintain support; the goals, priorities, and membership must be carefully focused; and the network needs to support shared measurement of progress on agreed-upon goals. Shiffman’s middle-range network theory is a useful tool when guided by the principles of complex systems that illuminate dynamic situations and shifting interests as global alliances evolve.

This study was implemented at the end of the ten-year funding cycle. A more continuous evaluation throughout the term would have provided richer understanding of issues. Experience and perspectives at the country level were not assessed.

Design and management of large, complex networks requires ongoing attention to key issues like leadership, and flexible structures and processes to accommodate the dynamic reality of these networks.

This case study builds on growing interest in the role of networks to foster large-scale change. The particular value rests on the longitudinal perspective on the evolution of a large, complex global network, and the use of theory to guide understanding.

WENT TO Brittany in July for a week's holiday with my dear wife, and found it agreeaby empty of both tourists and the flood of crude oil which had enveloped the coast a few months ago when the tanker Amoco Cadiz broke up. Plenty of rain, though, so we spent the week perambulating between restaurants, and returned lighter of pocket and heavier of tum, to find a charming letter from a librarian in Hong Kong, who said he had met my sister there recently and she had expressed great admiration for me. I replied that in that case it couldn't have been my sister and would he please send a photo of the lady.

Purpose – Movements typically have great difficulty using the mass media to spread their messages to the public, given the media's greater power to impose their frames on movement activities and goals. In this paper, we look at the impact of the political context and media strategies of protesters against the 2009 G-20 meetings in Pittsburgh on media coverage of the protests.

Methodology – We employ field observations, interviews with activists and reporters, and a content analysis of print coverage of the demonstrations by the two local daily newspapers, the Pittsburgh Post-Gazette and the Pittsburgh Tribune-Review.

Findings – We find that protesters were relatively successful in influencing how they were portrayed in local newspaper stories and in developing a sympathetic image of their groups’ members. Specifically, we find that activist frames were present in newspaper coverage and activists were quoted as frequently as city officials.

Research implications – We argue that events such as the G-20 meetings provide protesters with opportunities to gain temporary “standing” with the media. During such times, activists can use tactics and frames to alter the balance of power in relations with the media and the state and to attract positive media coverage, particularly when activists develop strategies that are not exclusively focused on the media. We argue that a combination of political opportunities and activist media strategies enabled protest organizers to position themselves as central figures in the G-20 news story and leverage that position to build media interest, develop relationships with reporters, and influence newspaper coverage.

To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and stigma.

I conducted 33 semi-structured interviews with the hearing parents or parent of children with cochlear implants. In all but two families I interviewed the primary caretaker which in all cases was a mother. In the remaining two interviews, I interviewed both parents together. Because of the relative scarcity of families with children with cochlear implants, and the difficulty in connecting with these families, I used a convenience sample, and I did not stratify it in any way. The only requirement for parents to be interviewed is that they had at least one deaf child who had been implanted with at least one cochlear implant. Although this is a small sample, the findings are transferable to other families with the same sociodemographic characteristics as those in my study.

Parents in the study focused on three key concepts: normality, risk analysis, and being a good parent. Dispositional factors such as the need to be “normal” and the desire for material success for one's children appeared to moderate the cost-benefit calculus.

This interview project concentrated on hearing families who had implanted their deaf children with cochlear implants; it does not include culturally Deaf parents who choose to use American Sign Language (ASL) with their Deaf children. Understanding how Deaf families understand the concepts of normality, medicalization, and stigma would shed light on how a distinctly “abnormal” group (by a statistical conception of normal) – ASL-using Deaf people-explain normality in the face of using a non-typical communication method. One can learn a lot by studying the absence of a phenomena, in this case, not implanting children with cochlear implants. It is possible that the existential threat felt by some Deaf people, specifically the demographic problem presented by cochlear implants, led Deaf educators or parents to resist being the subject of research.

Overwhelmingly the sample was female, and white. Only two participants were male, and none of the participants were non-white. The lack of diversity in the sample does not necessarily reflect a lack of diversity of children receiving cochlear implants. Medicaid, which disproportionately covers families of color, covers cochlear implants in most cases, so low SES/racial intersectionality should not have affected the lack of diversity in the sample. However, the oral schools are all private pay, with few scholarships available, so low SES/racial intersectionality in the sampling universe (all children who attend oral schools), may have played a part in the lack of racial diversity within the sample.

Parents in this study were very specific about the fact that they believed cochlear implants would lead to academic, professional, and personal success. They weaved narratives of normality, medicalization, and stigma through their stories. Normality is an important lens from which to see stories about disability and ability, as well as medical correction. As medical science continues to advance, more and more conditions will become medicalized, leading to more and more people taking advanced medical treatments to address problems that were previously considered “problems with living” that are now considered “medical problems” that can be treated with advanced science.

This chapter's contribution to the sociological cochlear implant literature is it's weaving of narratives about normality, stigma, and medicalization into parental stories about the cochlear implant decision-making process. Most literature about the cochlear implant decision-making process focus on cost-benefit analysis, and logical decision-making processes, whereas this paper focuses on decision-making factors stemming from bias, emotions, and values.

Scholars have shown many ways that social movements and democracy are deeply connected. Here, we demonstrate a previously unexplored process by which social movements alter democratic practice. Democratic movements are often experienced as insufficiently democratic by the very activists who participate in them, impelling new practices. We present examples from recent research on democratic movements and then contend that this is a common occurrence. Building on Hirschman's analysis of organizational change, we develop a theoretical account of why activists find movements for democracy disappointing and try to correct this, either by transforming the organizations they are in or creating new ones. Hirschman categorized responses to organizational challenges as Voice and Exit; we define a combination of these we call Semi-Exit as a useful extension. We then show in some detail how both disappointment and creativity have been generated in two major movement arenas: transnational activism that links social justice with environmental concerns and the Occupy Movement.

A VERY interesting winter lies ahead for all students and other librarians; for, we suppose, almost immediately attempts will be made to harmonize the practice of the Library Association with the expressed wishes of its last Annual Meeting. We publish some notes in Letters on Our Affairs on the crisis, if it may be so called, but we would add such voice as we have to that of those who plead for moderation. Violent changes are rarely justified, and violent expressions still less rarely, and as there appears to be now a disposition to bury hatchets and to get to work we hope that every advantage will be taken of it.

In most restaurants or dining facilities, even though a set of condiments such as salt, black pepper, ketchup, and mustard, is placed on the tables, and such condiments are a staple of many cuisines, they have been largely ignored with respect to understanding their effects on food choice. The purpose of this study is to determine whether condiments placed on tables at dining facilities can affect consumers’ cuisine selection.

Four individual booths were set up with four different condiment configurations: 1) branded ketchup and mustard, 2) unbranded ketchup and mustard, 3) unbranded soy sauce and chili-garlic sauce, and 4) no condiment. In all, 68 participants were assigned in random sequence to all booths, with each given a menu listing nine different cuisines (three North American, three Asian, and three Hispanic cuisines) in a random order, and asked to identify their top three preferred cuisines at each booth.

Participants chose Asian cuisines with higher priority than Mexican and North American selections when Asian condiments were placed on the table. Interestingly, this effect occurred only when the participants had noticed the condiment setting, but not when they had unnoticed it. Such Asian condiment availability-induced cuisine selection was also more pronounced for external eaters.

Food service professionals and business owners, especially in food courts comprised of a variety of ethnic food vendors, should perhaps consider placing a set of condiments associated with their target cuisines at visible table spaces at dining facilities, thereby leading customers to select their cuisine items.

This study provides new empirical evidence that consumers are more likely to select cuisines congruent to the choice of condiment setting placed on their dining table.

Numbers of worthy people are no doubt nursing themselves in the fond and foolish belief that when the Food Bill has received the Royal assent, and becomes law, the manufacture and sale of adulterated and sophisticated products will, to all intents and purposes, be suppressed, and that the Public Analyst and the Inspector will be able to report the existence of almost universal purity and virtue. This optimistic feeling will not be shared by the traders and manufacturers who have suffered from the effects of unfair and dishonest competition, nor by those whose knowledge and experience of the existing law enables them to gauge the probable value of the new one with some approach to accuracy. The measure has satisfied nobody, and can satisfy nobody but those whose nefarious practices it is intended to check, and who can fully appreciate the value, to them, of patchwork and superficial legislation. We have repeatedly pointed out that repressive legislation, however stringent and however well applied, can never give the public that which the public, in theory, should receive—namely, complete protection and adequate guarantee,—nor to the honest trader the full support and encouragement to which he is entitled. But, in spite of the defects and ineffectualities necessarily attaching to legislation of this nature, a strong Government could without much difficulty have produced a far more effective, and therefore more valuable law than that which, after so long an incubation, is to be added to the statute‐book.

A point repeatedly brought forward for the defence, or at all events for the purpose of mitigating the fine, in adulteration cases, is the statement that defendant's goods have been analysed on former occasions and have been found genuine. As illustrating the slight value of analyses of previous samples may be taken the average laudatory analyses on patent or proprietary foods, drinks, or medicine. The manufacturer calculates—and calculates rightly—that the general public will believe that the published analysis of a particular specimen which had been submitted to the analytical expert by the manufacturer himself, guarantees all the samples on the market to be equally pure. History has repeatedly proved that in 99 cases out of 100 the goods found on the market fall below the quality indicated by the published analyses. Not long ago a case bearing on this matter was tried in court, where samples of cocoa supplied by the wholesale firm were distributed; but, when the retailer tried to sell the bulk of the consignment, he had repeated complaints from his customers that the samples were a very much better article than what he was then supplying. He summoned the wholesale dealer and won his case. But what guarantee have the general public of the quality of any manufacturer's goods—unless the Control System as instituted in Great Britain is accepted and applied ? Inasmuch as any manufacturer who joins the firms under the British Analytical Control thereby undertakes to keep all his samples up to the requisite standard; as his goods thenceforth bear the Control stamp; and as any purchaser can at any time submit a sample bought on the open market to the analytical experts of the British Analytical Control, free of any charge, to ascertain if the sample is up to the published and requisite standard, it is plain that a condition of things is created which not only protects the public from being cheated, but also acts most beneficially for these firms which are not afraid to supply a genuine article. The public are much more willing to buy an absolutely guaranteed article, of which each sample must be kept up to the previous high quality, rather than one which was good while it was being introduced, but as soon as it became well known fell off in quality and continued to live on its reputation alone.

ELSEWHERE in this number we list libraries which have Esent us copies of their annual reports which we are glad to have. Now and again we are able to elaborate on these, but in the present issue that has not been possible. We would say, however, that these reports are deserving of the attention of librarians generally, and of students at the library schools. They are records of work in progress, and they do suggest the development of library policy. The best of them are of textbook value.