Revolution or evolution:the challenges of conceptualizing patient and public involvement in a consumerist world

Background Changing the relationship between citizens and the state is at the heart of current policy reforms. Across England and the developed world, from Oslo to Ontario, Newcastle to Newquay, giving the public a more direct say in shaping the organization and delivery of healthcare services is central to the current health reform agenda. Realigning public services around those they serve, based on evidence from service user's experiences, and designed with and by the people rather than simply on their behalf, is challenging the dominance of managerialism, marketization and bureaucratic expertise. Despite this attention there is limited conceptual and theoretical work to underpin policy and practice. Objective This article proposes a conceptual framework for patient and public involvement (PPI) and goes on to explore the different justifications for involvement and the implications of a rights-based rather than a regulatory approach. These issues are highlighted through exploring the particular evolution of English health policy in relation to PPI on the one hand and patient choice on the other before turning to similar patterns apparent in the United States and more broadly. Conclusions A framework for conceptualizing PPI is presented that differentiates between the different types and aims of involvement and their potential impact. Approaches to involvement are different in those countries that adopt a rights-based rather than a regulatory approach. I conclude with a discussion of the tension and interaction apparent in the globalization of both involvement and patient choice in both policy and practice. © 2009 Blackwell Publishing Ltd.

A statistical analysis of the structure of language found in the essay writing of a sample of technical college students and public school boys

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Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However, what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this article illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this chapter illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Firm-level productivity growth in Northern Ireland:the impact of exporting, innovation and public financial assistance

Motivated by the historically poor productivity performance of Northern Ireland firms and the longstanding productivity gap with the UK, the aim of this thesis is to examine, through the use of firm-level data, how exporting, innovation and public financial assistance impact on firm productivity growth. These particular activities are investigated due to the continued policy focus on their link to productivity growth and the theoretical claims of a direct positive relationship. In order to undertake these analyses a newly constructed dataset is used which links together cross-sectional and longitudinal data over the 1998-2008 period from the Annual Business Survey, the Manufacturing Sales and Export Survey; the Community Innovation Survey and Invest NI Selective Financial Assistance (SFA) payment data. Econometric methodologies are employed to estimate each of the relationships with regards to productivity growth, making use in particular of Heckman selection techniques and propensity score matching to take account of critical issues of endogeneity and selection bias. The results show that more productive firms self-select into exporting but there is no resulting productivity effect from starting to export; contesting the argument for learning-by-exporting. Product innovation is also found to have no impact on productivity growth over a four year period but there is evidence of a negative process innovation impact, likely to reflect temporary learning effects. Finally SFA assistance, including the amount of the payment, is found to have no short term impact on productivity growth suggesting substantial deadweight effects and/or targeting of inefficient firms. The results provide partial evidence as to why Northern Ireland has failed to narrow the productivity gap with the rest of the UK. The analyses further highlight the need for access to comprehensive firm-level data for research purposes, not least to underpin robust evidence-based policymaking.

Co-ordination and public administration in a global economy — A Hungarian point of view

The purpose of social co-ordination mechanisms is to co-ordinate the activities of individuals and organisations specialised in the distribution of work. The paper reviews five basic types of mechanisms: market, bureaucratic, ethical, aggressive and co-operative co-ordination. Today’s world operates on the basis of a duality: international cooperation is based on nation states, in which the public administrations work according to bureaucratic coordination. However, the increasingly globalised market responds to the logic of market coordination. The article argues that in terms of understanding the working of public administration, the various coordination mechanisms are of crucial importance, especially where various mechanisms meet, such as the relationship between nation states and multinational corporations.

Versenyképesség és civil szerepvállalás a közigazgatás és a közszolgáltatások fejlesztésében (Competitiveness and civil contribution to the development of public administration and public services)

Az utóbbi évtizedek nemzetközi trendjei azt mutatják, hogy a civil szervezetek és a nonprofit szolgáltatók számottevő hatást gyakorolnak a versenyképesség alakulására. Ez a tanulmány azokat a formális és informális mechanizmusokat tekinti át, amelyeken keresztül a civil társadalom befolyásolja a közintézményi döntéseket és azok gyakorlati megvalósítását, hozzájárul a „government”-tôl a „governance” irányába való elmozduláshoz. Szintén képet ad arról az átalakulási folyamatról, amely a közszolgáltatások területén zajlik, s amelyből egyre markánsabban rajzolódik ki a közösségi kezdeményezésen alapuló, társadalmi ellenőrzés alatt működő nonprofit szolgáltatók és az állami szereplők közötti partneri viszony kialakulásának tendenciája. ____________ The international trends of the last decades have revealed that civil society organisations and nonprofit service providers have a significant impact on competitiveness. This paper gives an overview of the formal and informal mechanisms operated by civil society in order to keep public administration accountable, to influence public decisions and their implementation, thus moving from “government” towards “governance”. It also analyses the transition of public services, the more and more noticeable signs of an emerging partnership between the grassroots, community controlled service providing nonprofit organisations and the government actors.

Media presentation and public understanding of stem cells and stem cell research in Hungary

This paper reports on a research project which examined media coverage and audience perceptions of stem cells and stem cell research in Hungary, using focus groups and a media analysis. A background study was also conducted on the Hungarian legal, social and political situation linked to stem cell research, treatment and storage. Our data shows how stem cell research/treatments were framed by the focus group members in terms of medical results/cures and human interest stories – mirroring the dominant frames utilized by the Hungarian press. The spontaneous discourse on stem cells in the groups involved a non-political and non-controversial understanding – also echoing the dominant presentation of the media. Comparing our results with those of a UK study, we found that although there are some similarities, UK and Hungarian focus group participants framed the issue of stem cell research differently in many respects – and these differences often echoed the divergences of the media coverage in the two countries. We conclude by arguing against approaches which attribute only negligible influence to the media – especially in the case of complex scientific topics and when the dominant information source for the public is the media.

Identity formation and public perception in the history of American Mormonism

This study inquires into the institutional identity of the Church of Jesus Christ of Latter-day Saints since its founding in 1830. The study takes a historical stance in discussing the relationship between American public perceptions and the Church's developing internal identity, tracing these changes through three distinct historical stages. Building on the works of historians and sociologists such as Jan Shipps, Armand Mauss, and Terryl Givens, this study hopes to contribute to the understanding of new religious movements and the progression from sect to church. The study finds that Mormon identity and American perceptions of Mormons have had an inter-influential relationship, each responding and re-forming in turn. The LDS Church has progressed from sect to church as tensions with the host society have lessened. Currently, the Church is at an optimum level of tension with the host society, maintaining a distinct identity while enjoying conventional acceptance.

Characteristics of entrepreneurs and public support for NTBFs

This paper studies the role of the characteristics of entrepreneurs as determinants of public financial support for New Technology Based Firms (NTBFs). Using a single database about the profile of Spanish technology entrepreneurs from 2001 to 2009, we analyze the relationship between NTBF participation in the NEOTEC program run by the main Spanish public agency for R&D and four dimensions of the entrepreneurial team: its human capital, its links to the public system of R&D, its motivation at the time the company was created and the extent of its planning to initiate the business activity. Our results show that NTBFs founded by entrepreneurs who have less experience in management, have planned less, are more oriented toward growth and have closer ties to the public system of R&D are more likely to participate in the public aid program.

Political parties and trade unions in the post-communist Poland:class politics that have never a chance to happen

Trade unions in Poland have not built the stable and long-term relations with political parties as are observed in Western democracies. By analysing the historical and symbolic background of the transformation to a democratic civil society and free market economy, political preferences of working class, trade union membership rates, and public opinion polls, we argue that, in case of Poland, the initial links between political parties and trade unions weakened over time. Polish trade unions never had a chance to become a long-term intermediary between society and political parties, making the Polish case study a double exception from the traditional models.