Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

The role of the National Audit Office in Private Finance Initiative endurance

The Private Finance Initiative (PFI) has become one of the UK’s most contentious public policies. Despite New Labour’s advocacy of PFI as a means of achieving better value for money, criticisms of PFI have centred on key issues such as a lack of cost effectiveness, exaggerated pricing of risk transfers, excessive private sector profits, inflexibility and cumbersome administrative arrangements. Nevertheless, PFI has persisted as a key
infrastructure procurement method in the UK and has been supported as such by successive governments, as well as influencing policy in the Republic of Ireland and other European Nations. This paper explores this paradoxical outcome in relation to the role played in the UK by the National Audit Office (NAO). Under pressure to justify its support for PFI, the Blair government sought support for its policies by encouraging the NAO to investigate issues relating to PFI as well as specific PFI projects. It would have been expected that in fulfilling its role as independent auditor, the NAO would have examined whether PFI projects could have been delivered more efficiently, effectively or economically through other means. Yet, in line with earlier research, we find evidence that the NAO failed to comprehensively assess
key issues such as the value for money of PFI projects, and in so doing effectively acted as a legitimator of PFI policy. Using concepts relating to legitimacy theory and the idea of framing, our paper looks into 67 NAO private finance reports published between 1997 and 2011, with the goal of identifying the preferences, values and ideology underpinning the
NAO’s view on PFI during this period. Our analysis suggests that the NAO sought to legitimise existing PFI practices via a selective framing of problems and questions. Utilising a longitudinal approach, our analysis further suggests that this patterns of selective framing persisted over an extended time period during which fundamental parameters of the policy (such as contract length, to name one of the most important issues) were rarely addressed.
Overall the NAO’ supportive stance toward PFI seems to have relied on 1) a focused on positive aspects of PFI, such as on time delivery or lessons learned, and 2) positive comments on aspects of PFI that were criticised elsewhere, such as the lack of flexibility of underlying contractual arrangements. Our paper highlights the possibility that, rather than providing for a critical assessment of existing policies, national auditing bodies can
contribute to the creation of legitimatory environments. In terms of accounting research we would suggests that the objectivity and independence of accounting watchdogs should not be taken for granted, and that instead a critical investigation of the biases which can characterise these bodies can contribute to a deeper understanding of the nature of lobbying networks in the modern state.

Building public policy on shifting sands: the case of the National Asset Management Agency

Over the last thirty years, there has been an increased demand for better management of public sector organisations (PSOs). This requires that they are answerable for the inputs that they are given but also for what they achieve with these inputs (Hood 1991; Hood 1995). It is suggested that this will improve the management of the organisation through better planning and control, and the achievement of greater accountability (Smith 1995). However, such a rational approach with clear goals and the means to measure achievement can cause difficulties for many PSOs. These difficulties include the distinctive nature of the public sector due to the political environment within which the public sector manager operates (Stewart and Walsh 1992) and the fact that PSOs will have many stakeholders, each of whom will have their own specific objectives based on their own perspective (Boyle 1995). This can
result in goal ambiguity which means that there is leeway in interpreting the results of the PSO. The National Asset Management Agency (NAMA) was set up to bring stability to the financial system by buying loans from the banks (which were in most cases, non-performing loans). The intention was to cleanse the banks of these loans so that they could return to their normal business of taking deposits and making loans. However, the legislation, also gave NAMA a wide range of other responsibilities including responsibility for facilitating credit in the economy and protecting the interests of taxpayers. In more recent times, NAMA has been given responsibility for building social housing. This wide-range of activities is a clear example of a PSO being given multiple goals which may conflict and is therefore likely to lead to goal ambiguity. This makes it very difficult to evaluate NAMA’s performance as they are attempting to meet numerous goals at the same time and also highlights the complexity of policy making in the public sector. The purpose of this paper is to examine how NAMA dealt with goal ambiguity. This will be done through a thematic analysis of its annual reports over the last five years. The paper’s will contribute to the ongoing debate about the evaluation of PSOs and the complex environment within which they operate which makes evaluation difficult as they are
answerable to multiple stakeholders who have different objectives and different criteria for measuring success.

Renaissance Humanism and Ethnicity before Race:The Irish and the English in the Seventeenth Century

Inspired both by debates about the origins of the modern ideology of race and also by controversy over the place of Ireland and the Irish in theories of empire in the early modern Atlantic world, Renaissance Humanism and Ethnicity before Race argues that ethnic discourse among the elite in early modern Ireland was grounded firmly in the Renaissance Humanism and Aristotelianism which dominated all the European universities before the Enlightenment. Irish and English, Catholic and Protestant, all employed theories of human society based on Aristotle’s Politics and the natural law of the medieval universities to construct or dismantle the categories of civility and barbarism. The elites operating in Ireland also shared common resources, taught in the universities, for arguing about the human body and its ability to transmit hereditary characteristics. Both in Ireland and elsewhere in Europe, these theories of human society and the human body underwent violent changes in the late seventeenth century under the impact of the early Enlightenment. These changes were vital to the development of race as we know it.

Irish Credit Unions: Differential Regulation based on Business Model Complexity

This study examines the business model complexity of Irish credit unions using a latent class approach to measure structural performance over the period 2002 to 2013. The latent class approach allows the endogenous identification of a multi-class framework for business models based on credit union specific characteristics. The analysis finds a three class system to be appropriate with the multi-class model dependent on three financial viability characteristics. This finding is consistent with the deliberations of the Irish Commission on Credit Unions (2012) which identified complexity and diversity in the business models of Irish credit unions and recommended that such complexity and diversity could not be accommodated within a one size fits all regulatory framework. The analysis also highlights that two of the classes are subject to diseconomies of scale. This may suggest credit unions would benefit from a reduction in scale or perhaps that there is an imbalance in the present change process. Finally, relative performance differences are identified for each class in terms of technical efficiency. This suggests that there is an opportunity for credit unions to improve their performance by using within-class best practice or alternatively by switching to another class.

Measuring the sustainability of a national economy. The application of three measures of sustainability to Ireland

An assessment of the sustainability of the Irish economy has been carried out using three methodologies, enabling comparison and evaluation of the advantages and disadvantages of each, and potential synergies among them. The three measures chosen were economy-wide Material Flow Analysis (MFA), environmentally extended input-output (EE-IO) analysis and the Ecological Footprint (EF). The research aims to assess the sustainability of the Irish economy using these methods and to draw conclusions on their effectiveness in policy making both individually and in combination. A theoretical description discusses the methods and their respective advantages and disadvantages and sets out a rationale for their combined application. The application of the methods in combination has provided insights into measuring the sustainability of a national economy and generated new knowledge on the collective application of these methods. The limitations of the research are acknowledged and opportunities to address these and build on and extend the research are identified. Building on previous research, it is concluded that a complete picture of sustainability cannot be provided by a single method and/or indicator.

Narratively framing emergent identities in post-agreement societies: patterns of the Northern Irish identity within the provincial media

The research analyses ‘Northern Irish��� identity narratives post-agreement, and examines the configuration of frame agendas in terms of individual narrative components. A content analysis utilised news published through 1997–2014 within Northern Ireland daily newspapers – the Belfast Telegraph, the Irish News and the News Letter. A process of manifest coding produced an emergent coding scheme displaying the relative stability of media frames surrounding the Northern Irish identity as broadly partisan; however, there is also a subtle narrative shift of Northern Irish identity across the time periods; and findings of a dominant framing paradigm of political and social conceptions of identification post-agreement.

Catalysing the Irish Energy Transition: Capacities and Challenges

The transition to a “low carbon, climate resilient and environmentally sustainable economy by the end of the 
year 2050” has been conceptualised as the “national transition objective” in the Irish Climate Action and Low Carbon Development Bill, passed in late 2015. This has raised a myriad of questions over how this can be operationalised and resourced and whether it can maintain political momentum. This paper assesses the utility of framings informed by the transitions (MLP) and technological innovation systems perspectives in contributing to transformative societal processes, by examining their application in an Irish case study on policy and technology. Through a qualitative exploration of the broader societal and policy context of the energy sector and a more detailed examination of the innovation systems of selected niche technologies (bioenergy and electric vehicles), the Irish case study sought to identify potential catalysts for a sustainability transition in the energy sector in Ireland: where these exist, how these are being built or enabled, and barriers to change. Following a discussion on the theoretical approaches used, a description will be given of how these were applied in the conducting of the research on transition in Ireland case study and the key findings which emerged. A critical reflection will then be made on the utility of these perspectives (as applied) to contribute to broader processes of societal transformation in Ireland.

‘Do you want to see my hornpipe?’: the traditional Irish dancing body at play in the work of Jean Butler and Colin Dunne’, in Anthony Shay and Barbara Sellers-Young (eds.), The Oxford Handbook of Dance and Ethnicity, Oxford: Oxford University Press, 2016, pp.41-65.

This chapter considers the radical reimaginings of traditional Irish step dance in the recent works of Jean Butler and Colin Dunne, in which the Irish step-dancing body is separated from its historical roots in nationalism, from the exhibitionism required by the competitive form, and from the spectacularization of the commercialized theatrical format. In these works the traditional form undergoes a critical interrogation in which the dancers attempt to depart from the determinacy of the traditional technique, while acknowledging its formation of their corporealities; the Irish step-dance technique becomes a springboard for creative experimentation. To consider the importance of the creative potential revealed by these works, this chapter contextualizes them within the dance background from which they emerged, outlining the history of competitive step dancing in Ireland, the “modernization” of traditional Irish dance with the emergence of Riverdance (1994), and the experiments of Ireland’s national folk theater, Siamsa Tíre.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

PURPOSE Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. METHODS Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. RESULTS The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. CONCLUSIONS Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.

School-Based Referrals to the Juvenile Courts: Prevalence and Characteristics in Several States

Effective school discipline practices are essential to keeping schools safe and creating an optimal learning environment. However, the overreliance of exclusionary discipline often removes students from the school setting and deprives them of the opportunity to learn. Previous research has suggested that students are being introduced to the juvenile justice system through the use of school-based juvenile court referrals. In 2011, approximately 1.2 million delinquency cases were referred to the juvenile courts in the United States. Preliminary evidence suggests that an increasing number of these referrals have originated in the schools. This study investigated school-based referrals to the juvenile courts as an element of the School-to-Prison Pipeline (StPP). The likelihood of school-based juvenile court referrals and rate of dismissal of these referrals was examined in several states using data from the National Juvenile Court Data Archives. In addition, the study examined race and special education status as predictors of school-based juvenile court referrals. Descriptive statistics, logistic regression and odds ratio, were used to analyze the data, make conclusions based on the findings and recommend appropriate school discipline practices.

Primary prevention of neural tube defects: data from the portuguese national registry of congenital anomalies (RENAC)

Background: In Portugal folic acid supplementation is recommended to start at least 2-3 months before conception for primary prevention of Neural Tube Defects. The aim of this study was to evaluate, within gestations with at least one congenital anomaly, possible association between maternal socio-demographic factors and the use of folic acid. Methods: Using data from the Portuguese national registry of congenital anomalies, for the 2004-2013 period, the association between folic acid use during pregnancy and maternal characteristics was studied using the chi-square test. Results: Considering all reported cases with congenital anomaly, the use of folic acid before conception was reported by 12.7% (n = 1233) of the women; 47.8% (n = 4623) started supplementation during the 1st trimester, 7% (n = 680) did not take folic acid and 32.5% (3143) of the records had no information on folic acid use. Women with professions that require higher academic differentiation started the use of supplements before pregnancy (p <0.001); women under 19 years old and with Arab ethnicity (p <0.001) did not take folic acid. Mothers with a previous pregnancy reported less use of folic acid (11.5% versus 14.7%) than mothers without a previous pregnancy (p <0.001). Conclusions: The results suggest some degree of association between maternal characteristics and use of folic acid. To increase the consumption of folic acid before pregnancy new measures are need to promote this primary prevention, among couples and health professionals. This study highlights some maternal characteristics and subgroups of mothers for who the measures should be reinforced.

FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

UPDATE NEEDS OF PROFESSIONAL LIBRARY: Diagnosis of teachers and graduate degree from the School of Library, Documentation and Information (EBDI), National University of Costa Rica

This project is a diagnosis of update needs and training for professionals in bibliotecology and its results will be used for the design of a Program of Permanent training in bibliotecology, which will be implemented in Bibliotecology School, Documentation and Information of the National University.The studied population is composed by all the teachers of Bibliotecology School, Documentation and Information of the National University, in October, 2007, and all the graduated students of licentiate of the EBDI from 2000 to 2007.The results of this investigation were obtained by means of a questionnaire that was filled by each one of the members of these two populations, who corresponded to 25 teachers of the EBDI and 18 graduates of licentiate. This one also presents the information that was obtained in interviews realized to the managers of the principal institutions who are professionals contracted in bibliotecology.The results obtained of this diagnosis will allow the elaboration of the Program of Permanent training in bibliotecology, considering the formative needs of the professionals in bibliotecology of the EBDI. This project includes the following products:a) Description of the social and demographic characteristics of teachers and of graduated of licentiate of the EBDI.b) Diagnosis of needs to update and training of bibliotecology professional teachers and of graduated of licentiate of the EBDI.c) Determination of the knowledge and skills that the needs to satisfy what big employers ask for.d) Recommendations for the program. Implementation.

Energy efficiency and appliance’s characteristics considered prior to purchase: Differences and similarities between the United Kingdom, Germany, Portugal, Greece, Poland, Spain and Italy

This article reports country differences in the consumer’s most considered characteristics when choosing electrical appliances, including but not restricted to the energy efficiency aspect. A survey was performed to store customers from 7 countries: the United Kingdom; Germany; Portugal; Greece; Poland; Spain; Italy. Results showed consistency between countries in the top three characteristics considered: cost; quality; and a balance between price and quality. Differences were found for reported environmental attitudes and behaviours, purchase motives, and store employees evaluation. The results may support national policies and store level energy efficiency interventions. Specifically, they can provide input for store employee’s training, in persuading customers towards the purchase of energy efficient appliances.