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Although network governance has become increasingly popular in both research and practice, its anticipated benefits do not always materialize. Although literature on network governance acknowledges the challenges that result from its introduction, scholars tend to assume these challenges can be managed and rarely analyze how the different participating actors (strategically) react to the tensions surrounding its establishment. As such, the process of how “networking” actors establish, maintain, and negotiate a network remains understudied. In light of these shortcomings, this article zooms in on how actors, in their collaboration efforts with network partners, navigate the tensions between (a) their discretionary space and the parameters set by a central policymaker, and (b) their pursuit of both integration and differentiation. This ethnographic case analysis contributes by, first, revealing how local actors demonstrate agency in maneuvering between these tensions in everyday practice by adopting three strategies—that is, overwhelmed deflection, situational segmentation, and strategic reappropriation—and, second, by revealing how these tensions interact and subsequently affect the implementation of policies in networks.

Frailty management focuses on optimizing the physical and psychological functioning of older people with frail health through early risk identification and intervention in primary care. Such care programs demand a joint effort by primary care professionals and older persons, one in which professionals are expected to promote or facilitate self-management practices and older persons are expected to adhere to the professional advice. It is known that patients and professionals hold different perspectives on frailty, but we know little about how this may affect their cooperation in frailty management. In this article, we therefore study how different perspectives of older persons and their primary care professionals play a role frailty management in practice. Nine cases of frailty management were reconstructed through semi-structured interviews with older persons, their family doctor and practice nurse. Drawing from literature on managing complex problems, we analyzed how “factual” and “normative” orientations played a role in their perspectives. We observe that the perspectives of care professionals and older persons on frailty management were substantially different. Both actors “manage” frailty, but they focus on different aspects of frailty and interestingly, care professionals' rationale is future-oriented whereas older person's rationale past-oriented. Primary care professionals employed practices to manage the medical and social factors of frailty in order to prevent future loss. Older persons employed practices to deal with the psychological, emotional and social aspects of the different types of loss they already experienced, in order to reconcile with loss from the past in the present. These findings raise fundamental questions regarding the different perceptions of and priorities around not only care for frail older people in general, but also implied professional-patient relations and the value of a risk-management approach to care for older people with frail health. The distinction between these perspectives could help care professionals to better respond to older patients' preferences and it could empower older persons to voice preferences and priorities that might not fit within the proposed care program.

In this article, the authors argue that there is no such thing as the knowledge society. Like many others authors, they claim that the fundamental transformations of our time can be typified as the end of the national ‘industrial society’ and the move towards some kind of global society dominated by the production and use of knowledge. They argue, however, that these transformations not necessarily produce a convergence of national and regional socio-economic structures. In industrial society two types of knowledge were dominant: ‘technical knowledge’ and ‘social knowledge’. In our time, the growing diverseness of individual and group identities produced by reflexivisation, globalisation and the advancement of information technologies calls for the development and application of a new type of knowledge: ‘cultural knowledge’. They analyse the consequences of the increased significance of cultural knowledge in the economic sphere in terms of the division of labour, and subsequently conceptualise three different types of knowledge societies: ‘the techno-cultural’, ‘the socio-cultural’ and the ‘socio-technical knowledge society’. Finally, they will portray three ‘categories’ of trailblazers of the knowledge societies, new professionals that perform ‘meta business functions’. These trailblazers directly or indirectly create new value chains by linking or destroying existing ones, and breaking up others in to pieces in order to create new combinations. These professionals, in other words, actively manage value chains.