O institucionalismo, que passa por uma fase de renovação em todas as ciências sociais, distingue-se de outros paradigmas intelectuais, especialmente as ortodoxias do individualismo metodológico, ao apontar para a necessidade de se levar em conta, a fim de se compreender a ação dos indivíduos e suas manifestações coletivas, as mediações entre as estruturas sociais e os comportamentos individuais. Essas mediações são precisamente as instituições.Por outro lado, se seguíssemos Paul DiMaggio e Walter Powell, acreditaríamos que "o institucionalismo tem sentidos variados dependendo das disciplinas", sendo difícil de defini-lo positivamente, na medida em que "os acadêmicos que trabalham sobre instituições geralmente concederam pouca atenção à sua definição". Isso em razão que os "diversos institucionalismos -em Economia, teoria das organizações, Ciência Política, public choice, História e Sociologia -(...) aproximam-se apenas pelo mesmo ceticismo que revelam a respeito das concepções atomísticas dos processos sociais e pela crença difusa de que os dispositivos institucionais e os processos sociais são importantes".Um ponto de vista como esse deve ser fortemente nuançado. Com efeito, pode-se encontrar definições precisas de instituições, e teremos a oportunidade de fornecê-las ao longo do texto, tanto entre economistas como entre sociólogos, tanto entre antigos como entre novos institucionalistas. É mesmo baseada nessas definições que se estabelecem

Objective To assess the impact of antenatal corticosteroids (ACS) on neonatal mortality, cerebral lesions and 5-year neurodevelopmental outcome of infants born at 24-27 and 28-32 weeks of gestational age (GA).Design Observational population-based study including all births at GAs between 22 and 32 weeks in 1997 in nine regions of France. Survivors were assessed at the age of 5 years.Sample and methods The population enrolled in the follow up comprised 2323 infants; there were 23 deaths before age 5 years and outcome at 5 years was available for up to 1781 subjects. Two GA subgroups (24-27 and 28-32 weeks of GA) were analysed separately. Propensity scores were used to reduce bias in the estimation of the association between ACS treatment and outcomes. ConclusionThe study shows that ACS therapy greatly increases the survival of very preterm infants, including the most immature, but there is little evidence that ACS affects long-term neurodevelopmental and behavioural outcome in 28-to 32-week survivors, and none in <28-week survivors.Keywords Antenatal corticosteroids, behavioural difficulties, cerebral palsy, neurodevelopmental outcome, population-based study, very preterm infants, white matter injury.Please cite this paper as: Foix-L'Hélias L, Marret S, Ancel P, Marchand L, Arnaud C, Fresson J, Picaud J, Rozé J, Theret B, Burguet A, Larroque B, Kaminski M and the EPIPAGE Study Group. Impact of the use of antenatal corticosteroids on mortality, cerebral lesions and 5-year neurodevelopmental outcomes of very preterm infants: the EPIPAGE cohort study . BJOG 2008;115:275-282.

Regionalization is a contradictory process meaning both subnational "fragmentation" of territorial states and their supranational "integration" at a larger scale. In this paper federalism, as a division of sovereignty between several orders of government within the same political system, is conceived as an institution designed to regulate regionalization. But federal pacts are subject to two symmetrical risks: either, a risk of a centralizing drift towards a unitary state; or a risk of disintegrating into as many sovereign states as previous federated units. Thus, in the first section of the paper, we define a 'true'federal system as a political order where an institutional device permanently tackles the problem of self-conservation of the federal principle. Then, in the second section, we show that self-conservation of a federal system or its evolution towards centralization or dissolution, are not first order dependent on economic issues, but on specific institutional forms that rule the game of political and social actors. To demonstrate this we take a comparative view of equalization programmes for tax revenues which distinguish Canadian federalism from its US counterpart. For these programmes channel competition between governments on political grounds and participate in the self-reproduction of the federal covenant. On the contrary, a lack of equalization liberates economic competition between federal states - tax war, social dumping - and leaves the ground free for centralization or dissolution of the federation. Copyright Joint Editors and Blackwell Publishers Ltd 1999.

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