Formal planning rationality in public sector professional work: between discourse and practice

Although rational models of formal planning have been seriously criticized by strategy literature, they not only remain a widely used organizational practice in private firms, but they have increasingly been entering public, professional organizations too, as part of public sector managerial reforms. This research addresses this apparent paradox, exploring the meaning of formal planning in public sector professional work. Curiously, this is an issue that remains under-investigated in the literature: the long debate on formal planning in strategy research devoted scant attention to its diffusion in the public sector, and public sector studies have scrutinized the introduction of other management tools in professional work, but very limitedly formal planning itself. In fact, little is known on the actual meaning of formal planning in public, professional services. This research is based upon a case of adoption of formal planning tools in a public hospital. Embracing a discourse analytical lens, it examines which formal planning discourse entered professional work, to what extent, and how professionals interpret it and engage with it in their practice. The analysis uncovers dynamics of social construction of meaning where, eventually, a formal planning discourse both shapes and is shaped by professional practice. In particular, it is found that formal planning rationality largely penetrated professional work, but not to the detriment of professional values. Morevover, formal planning ‘fails’ as a tool for rational decision making, but it takes up a knowledge work and a social value in professional work, as a tool for explicitation of action courses and for dialogue between otherwise more disconnected parts of the organization.

Combined Evaluation of ST-segment Elevation in lead AVR and ST-segment Depression in other Leads Enhances Prediction of in-hospital Cardiovascular Death in Patients with Non ST-segment Elevation Acute Coronary Syndrome

Objective: To investigate the prognostic significance of ST-segment elevation (STE) in aVR associated with ST-segment depression (STD) in other leads in patients with non-STE acute coronary syndrome (NSTE-ACS). Background: In NSTE-ACS patients, STD has been extensively associated with severe coronary lesions and poor outcomes. The prognostic role of STE in aVR is uncertain. Methods: We enrolled 888 consecutive patients with NSTE-ACS. They were divided into two groups according to the presence or not on admission ECG of aVR STE≥ 1mm and STD (defined as high risk ECG pattern). The primary and secondary endpoints were: in-hospital cardiovascular (CV) death and the rate of culprit left main disease (LMD). Results: Patients with high risk ECG pattern (n=121) disclosed a worse clinical profile compared to patients (n=575) without [median GRACE (Global-Registry-of-Acute-Coronary-Events) risk score =142 vs. 182, respectively]. A total of 75% of patients underwent coronary angiography. The rate of in-hospital CV death was 3.9%. On multivariable analysis patients who had the high risk ECG pattern showed an increased risk of CV death (OR=2.88, 95%CI 1.05-7.88) and culprit LMD (OR=4.67,95%CI 1.86-11.74) compared to patients who had not. The prognostic significance of the high risk ECG pattern was maintained even after adjustment for the GRACE risk score (OR = 2.28, 95%CI:1.06-4.93 and OR = 4.13, 95%CI:2.13-8.01, for primary and secondary endpoint, respectively). Conclusions: STE in aVR associated with STD in other leads predicts in-hospital CV death and culprit LMD. This pattern may add prognostic information in patients with NSTE-ACS on top of recommended scoring system.

The Right to Voice: Its Realization by Estonian and American Parents in Public Schools

Investigating parents’ formal engagement opportunities in public schools serves well to characterize the relationship between states and societies. While the relationship between parental involvement and students’ academic success has been thoroughly investigated, rarely has it been seen to indicate countries’ governing regimes. The researcher was curious to see whether and how does parents’ voice differ in different democracies. The hypothesis was that in mature regimes, institutional opportunities for formal parental engagement are plenty and parents are actively involved; while in young democracies there are less opportunities and the engagement is lower. The assumption was also that parental deliberation in expressing their dissatisfaction with schools differs across democracies: where it is more intense, there it translates to higher engagement. Parents’ informedness on relevant regulations and agendas was assumed to be equally average, and their demographic background to have similar effects on engagement. The comparative, most different systems design was employed where public middle schools last graders’ parents in Tartu, Estonia and in Huntsville, Alabama the United States served as a sample. The multidimensional study includes the theoretical review, country and community analyses, institutional analysis in terms of formal parental involvement, and parents’ survey. The findings revealed sizeable differences between parents’ engagement levels in Huntsville and Tartu. The results indicate passivity in both communities, while in Tartu the engagement seems to be alarmingly low. Furthermore, Tartu parents have much less institutional opportunities to engage. In the United States, multilevel efforts to engage parents are visible from local to federal level, in Estonia similar intentions seem to be missing and meaningful parental organizations do not exist. In terms of civic education there is much room for development in both countries. The road will be longer for a young democracy Estonia in transforming its institutional systems from formally democratic to inherently inclusive.

Medical Malpractice in Public Healthcare Systems: An Empirical Investigation of Scheduled Damages

In the last decades, medical malpractice has been framed as one of the most critical issues for healthcare providers and health policy, holding a central role on both the policy agenda and public debate. The Law and Economics literature has devoted much attention to medical malpractice and to the investigation of the impact of malpractice reforms. Nonetheless, some reforms have been much less empirically studied as in the case of schedules, and their effects remain highly debated. The present work seeks to contribute to the study of medical malpractice and of schedules of noneconomic damages in a civil law country with a public national health system, using Italy as case study. Besides considering schedules and exploiting a quasi-experimental setting, the novelty of our contribution consists in the inclusion of the performance of the judiciary (measured as courts’ civil backlog) in the empirical analysis. The empirical analysis is twofold. First, it investigates how limiting compensations for pain and suffering through schedules impacts on the malpractice insurance market in terms of presence of private insurers and of premiums applied. Second, it examines whether, and to what extent, healthcare providers react to the implementation of this policy in terms of both levels and composition of the medical treatments offered. Our findings show that the introduction of schedules increases the presence of insurers only in inefficient courts, while it does not produce significant effects on paid premiums. Judicial inefficiency is attractive to insurers for average values of schedules penetration of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Moreover, the implementation of schedules tends to reduce the use of defensive practices on the part of clinicians, but the magnitude of this impact is ultimately determined by the actual degree of backlog of the court implementing schedules.

Power in public art spaces. F(r)ictions, performativity and the generation of counter-hegemonic narratives

Abstract This thesis applies queer theories to the examination of experiences which go beyond queerness. Queer, decolonial, antiracist and feminist new materialist concepts are implemented to the analysis of four case studies dealing with power and art in public spaces. By applying concepts as methodologies, autoethnographic reflections and f(r)ictions as research alternatives, the thesis brings up new diffractive readings from where to perform those scenarios differently. In doing so, the thesis disentangles the historical, material, philosophical, political and disruptive meanings which haunt the four case studies and triggers the artivist potential of their counter-hegemonic narratives.

Development discourse in Romania: from Socialism to EU Membership

With their accession to the European Union, twelve new countries - Romania among them - (re)entered the international community of international donors. In the history of development aid this can be seen as a unique event: it is for the first time in history that such a large number of countries become international donors, with such short notice and in such a particular context that sees some scholars announcing the ‘death’ of development. But in spite of what might be claimed regarding the ‘end’ of the development era, development discourse seems to be rather vigorous and in good health: it is able to extert an undeniable force of attraction over the twelve countries that, in a matter of years, have already convinced themselves of its validity and adhered to its main tenets. This thesis collects evidence for improving our understanding of this process that sees the co-optation of twelve new countries to the dominant theory and practice of development cooperation. The evidence collected seems to show that one of the tools employed by the promoters of this co-optation process is that of constructing the ‘new’ Member States as ‘new’, inexpert donors that need to learn from the ‘old’ ones. By taking a case-study approach, this thesis gathers data that suggests that conceiving of the ‘twelve’ as ‘new’ donors is both historically inaccurate and value-ladden. On one hand, Romania’s case-study illustrates how in the (socialist) past at least one in the group of the twelve was particularly conversant in the discourse of international development. On the other hand, the process of co-optation, while being presented as a knowledgeproducing process, can also be seen as an ignorance-producing procedure: Romania, along with its fellow new Member States, takes the opportunity of ‘building its capacity’ and ‘raising its awareness’ of development cooperation along the line drawn by the European Union, but at the same time it seems to un-learn and ‘lower’ its awareness of development experience in the (socialist) past. This is one possible reading of this thesis. At a different level, this thesis can also be seen as an attempt to account of almost five decades of international development discourse in one specific country – Romania – in three different socio-political contexts: the socialist years (up to the year 1989), the ‘transition years’ (from 1989 to the pre-accession years) and the membership to the European Union. In this second reading, the thesis seeks to illustrate how – contrary to widespread beliefs – before 1989 Romania’s international development discourse was particularly vivid: in the most varied national and international settings President Ceausescu unfolded an extensive discursive activity on issues pertaining to international development; generous media coverage of affairs concerning the developing countries and their fight for development was the rule rather than the exception; the political leadership wanted the Romanians not only to be familiarized with (or ‘aware of’ to use current terminology) matters of underdevelopment, but also to prove a sense of solidarity with these countries, as well as a sense of pride for the relations of ‘mutual help’ that were being built with them; finally, international development was object of academic attention and the Romanian scholars were able not only to reflect on major developments, but could also formulate critical positions towards the practices of development aid. Very little remains of all this during the transition years, while in the present those who are engaged in matters pertaining to international development do so with a view of building Romania as an EU-compliant donor.

L'a(rche)tipico Brian O'Nolan. Comico e riso dalla tradizione al post-

This study aims at analysing Brian O'Nolans literary production in the light of a reconsideration of the role played by his two most famous pseudonyms ,Flann Brien and Myles na Gopaleen, behind which he was active both as a novelist and as a journalist. We tried to establish a new kind of relationship between them and their empirical author following recent cultural and scientific surveys in the field of Humour Studies, Psychology, and Sociology: taking as a starting point the appreciation of the comic attitude in nature and in cultural history, we progressed through a short history of laughter and derision, followed by an overview on humour theories. After having established such a frame, we considered an integration of scientific studies in the field of laughter and humour as a base for our study scheme, in order to come to a definition of the comic author as a recognised, powerful and authoritative social figure who acts as a critic of conventions. The history of laughter and comic we briefly summarized, based on the one related by the French scholar Georges Minois in his work (Minois 2004), has been taken into account in the view that humorous attitude is one of man’s characteristic traits always present and witnessed throughout the ages, though subject in most cases to repression by cultural and political conservative power. This sort of Super-Ego notwithstanding, or perhaps because of that, comic impulse proved irreducible exactly in its influence on the current cultural debates. Basing mainly on Robert R. Provine’s (Provine 2001), Fabio Ceccarelli’s (Ceccarelli 1988), Arthur Koestler’s (Koestler 1975) and Peter L. Berger’s (Berger 1995) scientific essays on the actual occurrence of laughter and smile in complex social situations, we underlined the many evidences for how the use of comic, humour and wit (in a Freudian sense) could be best comprehended if seen as a common mind process designed for the improvement of knowledge, in which we traced a strict relation with the play-element the Dutch historian Huizinga highlighted in his famous essay, Homo Ludens (Huizinga 1955). We considered comic and humour/wit as different sides of the same coin, and showed how the demonstrations scientists provided on this particular subject are not conclusive, given that the mental processes could not still be irrefutably shown to be separated as regards graduations in comic expression and reception: in fact, different outputs in expressions might lead back to one and the same production process, following the general ‘Economy Rule’ of evolution; man is the only animal who lies, meaning with this that one feeling is not necessarily biuniquely associated with one and the same outward display, so human expressions are not validation proofs for feelings. Considering societies, we found that in nature they are all organized in more or less the same way, that is, in élites who govern over a community who, in turn, recognizes them as legitimate delegates for that task; we inferred from this the epistemological possibility for the existence of an added ruling figure alongside those political and religious: this figure being the comic, who is the person in charge of expressing true feelings towards given subjects of contention. Any community owns one, and his very peculiar status is validated by the fact that his place is within the community, living in it and speaking to it, but at the same time is outside it in the sense that his action focuses mainly on shedding light on ideas and objects placed out-side the boundaries of social convention: taboos, fears, sacred objects and finally culture are the favourite targets of the comic person’s arrow. This is the reason for the word a(rche)typical as applied to the comic figure in society: atypical in a sense, because unconventional and disrespectful of traditions, critical and never at ease with unblinkered respect of canons; archetypical, because the “village fool”, buffoon, jester or anyone in any kind of society who plays such roles, is an archetype in the Jungian sense, i.e. a personification of an irreducible side of human nature that everybody instinctively knows: a beginner of a tradition, the perfect type, what is most conventional of all and therefore the exact opposite of an atypical. There is an intrinsic necessity, we think, of such figures in societies, just like politicians and priests, who should play an elitist role in order to guide and rule not for their own benefit but for the good of the community. We are not naïve and do know that actual owners of power always tend to keep it indefinitely: the ‘social comic’ as a role of power has nonetheless the distinctive feature of being the only job whose tension is not towards stability. It has got in itself the rewarding permission of contradiction, for the very reason we exposed before that the comic must cast an eye both inside and outside society and his vision may be perforce not consistent, then it is satisfactory for the popularity that gives amongst readers and audience. Finally, the difference between governors, priests and comic figures is the seriousness of the first two (fundamentally monologic) and the merry contradiction of the third (essentially dialogic). MPs, mayors, bishops and pastors should always console, comfort and soothe popular mood in respect of the public convention; the comic has the opposite task of provoking, urging and irritating, accomplishing at the same time a sort of control of the soothing powers of society, keepers of the righteousness. In this view, the comic person assumes a paramount importance in the counterbalancing of power administration, whether in form of acting in public places or in written pieces which could circulate for private reading. At this point comes into question our Irish writer Brian O'Nolan(1911-1966), real name that stood behind the more famous masks of Flann O'Brien, novelist, author of At Swim-Two-Birds (1939), The Hard Life (1961), The Dalkey Archive (1964) and, posthumously, The Third Policeman (1967); and of Myles na Gopaleen, journalist, keeper for more than 25 years of the Cruiskeen Lawn column on The Irish Times (1940-1966), and author of the famous book-parody in Irish An Béal Bocht (1941), later translated in English as The Poor Mouth (1973). Brian O'Nolan, professional senior civil servant of the Republic, has never seen recognized his authorship in literary studies, since all of them concentrated on his alter egos Flann, Myles and some others he used for minor contributions. So far as we are concerned, we think this is the first study which places the real name in the title, this way acknowledging him an unity of intents that no-one before did. And this choice in titling is not a mere mark of distinction for the sake of it, but also a wilful sign of how his opus should now be reconsidered. In effect, the aim of this study is exactly that of demonstrating how the empirical author Brian O'Nolan was the real Deus in machina, the master of puppets who skilfully directed all of his identities in planned directions, so as to completely fulfil the role of the comic figure we explained before. Flann O'Brien and Myles na Gopaleen were personae and not persons, but the impression one gets from the critical studies on them is the exact opposite. Literary consideration, that came only after O'Nolans death, began with Anne Clissmann’s work, Flann O'Brien: A Critical Introduction to His Writings (Clissmann 1975), while the most recent book is Keith Donohue’s The Irish Anatomist: A Study of Flann O'Brien (Donohue 2002); passing through M.Keith Booker’s Flann O'Brien, Bakhtin and Menippean Satire (Booker 1995), Keith Hopper’s Flann O'Brien: A Portrait of the Artist as a Young Post-Modernist (Hopper 1995) and Monique Gallagher’s Flann O'Brien, Myles et les autres (Gallagher 1998). There have also been a couple of biographies, which incidentally somehow try to explain critical points his literary production, while many critical studies do the same on the opposite side, trying to found critical points of view on the author’s restless life and habits. At this stage, we attempted to merge into O'Nolan's corpus the journalistic articles he wrote, more than 4,200, for roughly two million words in the 26-year-old running of the column. To justify this, we appealed to several considerations about the figure O'Nolan used as writer: Myles na Gopaleen (later simplified in na Gopaleen), who was the equivalent of the street artist or storyteller, speaking to his imaginary public and trying to involve it in his stories, quarrels and debates of all kinds. First of all, he relied much on language for the reactions he would obtain, playing on, and with, words so as to ironically unmask untrue relationships between words and things. Secondly, he pushed to the limit the convention of addressing to spectators and listeners usually employed in live performing, stretching its role in the written discourse to come to a greater effect of involvement of readers. Lastly, he profited much from what we labelled his “specific weight”, i.e. the potential influence in society given by his recognised authority in determined matters, a position from which he could launch deeper attacks on conventional beliefs, so complying with the duty of a comic we hypothesised before: that of criticising society even in threat of losing the benefits the post guarantees. That seemingly masochistic tendency has its rationale. Every representative has many privileges on the assumption that he, or she, has great responsibilities in administrating. The higher those responsibilities are, the higher is the reward but also the severer is the punishment for the misfits done while in charge. But we all know that not everybody accepts the rules and many try to use their power for their personal benefit and do not want to undergo law’s penalties. The comic, showing in this case more civic sense than others, helped very much in this by the non-accessibility to the use of public force, finds in the role of the scapegoat the right accomplishment of his task, accepting the punishment when his breaking of the conventions is too stark to be forgiven. As Ceccarelli demonstrated, the role of the object of laughter (comic, ridicule) has its very own positive side: there is freedom of expression for the person, and at the same time integration in the society, even though at low levels. Then the banishment of a ‘social’ comic can never get to total extirpation from society, revealing how the scope of the comic lies on an entirely fictional layer, bearing no relation with facts, nor real consequences in terms of physical health. Myles na Gopaleen, mastering these three characteristics we postulated in the highest way, can be considered an author worth noting; and the oeuvre he wrote, the whole collection of Cruiskeen Lawn articles, is rightfully a novel because respects the canons of it especially regarding the authorial figure and his relationship with the readers. In addition, his work can be studied even if we cannot conduct our research on the whole of it, this proceeding being justified exactly because of the resemblances to the real figure of the storyteller: its ‘chapters’ —the daily articles— had a format that even the distracted reader could follow, even one who did not read each and every article before. So we can critically consider also a good part of them, as collected in the seven volumes published so far, with the addition of some others outside the collections, because completeness in this case is not at all a guarantee of a better precision in the assessment; on the contrary: examination of the totality of articles might let us consider him as a person and not a persona. Once cleared these points, we proceeded further in considering tout court the works of Brian O'Nolan as the works of a unique author, rather than complicating the references with many names which are none other than well-wrought sides of the same personality. By putting O'Nolan as the correct object of our research, empirical author of the works of the personae Flann O'Brien and Myles na Gopaleen, there comes out a clearer literary landscape: the comic author Brian O'Nolan, self-conscious of his paramount role in society as both a guide and a scourge, in a word as an a(rche)typical, intentionally chose to differentiate his personalities so as to create different perspectives in different fields of knowledge by using, in addition, different means of communication: novels and journalism. We finally compared the newly assessed author Brian O'Nolan with other great Irish comic writers in English, such as James Joyce (the one everybody named as the master in the field), Samuel Beckett, and Jonathan Swift. This comparison showed once more how O'Nolan is in no way inferior to these authors who, greatly celebrated by critics, have nonetheless failed to achieve that great public recognition O’Nolan received alias Myles, awarded by the daily audience he reached and influenced with his Cruiskeen Lawn column. For this reason, we believe him to be representative of the comic figure’s function as a social regulator and as a builder of solidarity, such as that Raymond Williams spoke of in his work (Williams 1982), with in mind the aim of building a ‘culture in common’. There is no way for a ‘culture in common’ to be acquired if we do not accept the fact that even the most functional society rests on conventions, and in a world more and more ‘connected’ we need someone to help everybody negotiate with different cultures and persons. The comic gives us a worldly perspective which is at the same time comfortable and distressing but in the end not harmful as the one furnished by politicians could be: he lets us peep into parallel worlds without moving too far from our armchair and, as a consequence, is the one who does his best for the improvement of our understanding of things.

Framing Death. La morte in diretta, tra cinema e media digitali

Come dimostrano i sempre più numerosi casi di cronaca riportati dai notiziari, la preoccupazione per la gestione delle immagini di morte si configura come un nodo centrale che coinvolge spettatori, produttori di contenuti e broadcaster, dato che la sua emersione nel panorama mediale in cui siamo immersi è sempre più evidente. Se la letteratura socio-antropologica è generalmente concorde nel ritenere che, rispetto al passato, oggi la morte si manifesti con meno evidenza nella vita comune delle persone, che tendono a rimuovere i segni della contiguità vivendo il lutto in forma privata, essa è però percepita in modo pervasivo perché disseminata nei (e dai) media. L'elaborato, concentrandosi in maniera specifica sulle produzioni audiovisive, e quindi sulla possibilità intrinseca al cinema – e alle sue forme derivate – di registrare un evento in diretta, tenta di mappare alcune dinamiche di produzione e fruizione considerando una particolare manifestazione della morte: quella che viene comunemente indicata come “morte in diretta”. Dopo una prima ricognizione dedicata alla tensione continua tra la spinta a considerare la morte come l'ultimo tabù e le manifestazioni che essa assume all'interno della “necrocultura”, appare chiaro che il paradigma pornografico risulta ormai inefficace a delineare compiutamente le emersioni della morte nei media, soggetta a opacità e interdizioni variabili, e necessita dunque di prospettive analitiche più articolate. Il fulcro dell'analisi è dunque la produzione e il consumo di precisi filoni quali snuff, cannibal e mondo movie e quelle declinazioni del gore che hanno ibridato reale e fittizio: il tentativo è tracciare un percorso che, a partire dal cinema muto, giunga al panorama contemporaneo e alle pratiche di remix rese possibili dai media digitali, toccando episodi controversi come i Video Nasties, le dinamiche di moral panic scatenate dagli snuff film e quelle di contagio derivanti dalla manipolazione e diffusione delle immagini di morte.

Il cambiamento climatico in Italia. Istituzioni scientifiche, politica e discorso pubblico (1988-2012)

La tesi di dottorato ivi presentata si pone come obbiettivo la ricostruzione come questo sapere scientifico (la scoperta del cambiamento climatico antropico sostanziata dalla comunità scientifica di 190 paesi) ha influenzato la ricerca, la politica e il discorso pubblico nel nostro paese, l'italia. Il titolo è indicativo quando riassuntivo: Il cambiamento climatico in Italia. Istituzioni scientifiche, politica e discorso pubblico (1988-2012). Esso definisce in maniera puntuale i temi che si tratteranno: una genealogia di fenomeni storici, politici, culturali nati in nuce alla scoperta di questo cambiamento che influenzerà in maniera determinante il modo in cui viviamo, l'ambiente intorno a noi, i modelli di sviluppo, la sicurezza del nostro abitare, la forma delle nostre città. In ogni paese questa complessa scoperta ha avuto impatti differenti, un portato differente sulla ricerca e sullo sviluppo economico. Quello che in queste pagine si tenta di analizzare è come l'Italia ha assimilato il discorso del cambiamento climatico , in continua evoluzione date le sue infinite ramificazioni, e come ha reagito a livello politico e di ricerca.