The dynamics of professions and development of new roles in public services organizations: the case of modern matrons in the English NHS

This study contributes to research examining how professional autonomy and hierarchy impacts upon the implementation of policy designed to improve the quality of public services delivery through the introduction of new managerial roles. It is based on an empirical examination of a new role for nurses – modern matrons – who are expected by policy-makers to drive organizational change aimed at tackling health care acquired infections (HCAI) in the National Health Service (NHS) within England. First, we show that the changing role of nurses associated with their ongoing professionalization limits the influence of modern matrons over their own ranks in tackling HCAI. Second, the influence of modern matrons over doctors is limited. Third, government policy itself appears inconsistent in its support for the role of modern matrons. The attempts of modern matrons to tackle HCAI appear more effective where infection control activity is situated in professional practice and where modern matrons integrate aspirations for improved infection control within mainstream audit mechanisms in a health care organization.

A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico

Introduction: Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure. Objective: To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico. Methods: A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans. Results: Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis. Conclusion: two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

Hospital Staff Perceptions of Health Promotion Activities in Public Hospitals

The aim of this study was to determine the level of staff support for health promotion activities in Queensland public hospitals.

Barriers to health promotion activities in public hospitals

Despite the central role hospitals have in the health care system, relatively few health promotion activities are conducted in Australian public hospitals. This study investigated the types of obstacles that were perceived to inhibit health promotion activities in hospitals. A questionnaire for self-completion was sent to medical superintendents in all public hospitals in Queensland and 112 questionnaires were returned (92.6 per cent response rate). The results indicated that lack of finance, lack of interest by relevant others, and needs (for appropriate programs, training and patient receptivity) were the barriers reported by superintendents. The barriers of 'interest' and 'needs' were related to a lack of written policies in some areas, but not directly to levels of other health promotion activities being conducted in the hospitals. Success in facilitating health promotion programs in hospitals will need to include a change in the environment, in particular the views of medical superintendents. The combination of attitude change and the availability of a motivated person (such as a health promotion officer) to lead the activities may be needed in order to produce an increase in the level of health promotion in public hospitals. Article in Australian and New Zealand Journal of Public Health 20(5):500-4 · November 1996

Public service motivation in public and nonprofit service providers: The cases of Belarus and Poland

The work motivation construct is central to the theory and practice of many social science disciplines. Yet, due to the novelty of validated measures appropriate for a deep cross-national comparison, studies that contrast different administrative regimes remain scarce. This study represents an initial empirical effort to validate the Public Service Motivation (PSM) instrument proposed by Kim and colleagues (2013) in a previously unstudied context. The two former communist countries analyzed in this dissertation—Belarus and Poland—followed diametrically opposite development strategies: a fully decentralized administrative regime in Poland and a highly centralized regime in Belarus. The employees (n = 677) of public and nonprofit organizations in the border regions of Podlaskie Wojewodstwo (Poland) and Hrodna Voblasc (Belarus) are the subjects of study. ^ Confirmatory factor analysis revealed three dimensions of public service motivation in the two regions: compassion, self-sacrifice, and attraction to public service. The statistical models tested in this dissertation suggest that nonprofit sector employees exhibit higher levels of PSM than their public sector counterparts. Nonprofit sector employees also reveal a similar set of values and work attitudes across the countries. Thus, the study concludes that in terms of PSM, employees of nonprofit organizations constitute a homogenous group that exists atop the administrative regimes. ^ However, the findings propose significant differences between public sector agencies across the two countries. Contrary to expectations, data suggest that organization centralization in Poland is equal to—or for some items even higher than—that of Belarus. We can conclude that the absence of administrative decentralization of service provision in a country does not necessarily undermine decentralized practices within organizations. Further analysis reveals strong correlations between organization centralization and PSM for the Polish sample. Meanwhile, in Belarus, correlations between organization centralization items and PSM are weak and mostly insignificant. ^ The analysis indicates other factors beyond organization centralization that significantly impact PSM in both sectors. PSM of the employees in the studied region is highly correlated with their participation in religious practices, political parties, or labor unions as well as location of their organization in a capital and type of social service provided.^

Urinary osteopontin predicts incident chronic kidney disease, while plasma osteopontin predicts cardiovascular death in elderly men

Background and objectives The matricellular protein osteopontin is involved in the pathogenesis of both kidney and cardiovascular disease. However, whether circulating and urinary osteopontin levels are associated with the risk of these diseases is less studied. Design, setting, participants and measurements A community-based cohort of elderly (Uppsala Longitudinal Study of Adult Men [ULSAM; n=741; mean age: 77 years]) was used to study the associations between plasma and urinary osteopontin, incident chronic kidney disease, and the risk of cardiovascular death during a median of 8 years of follow-up. Results There was no significant cross-sectional correlation between plasma and urinary osteopontin (Spearman rho=0.07, p=0.13). Higher urinary, but not plasma osteopontin, was associated with incident chronic kidney disease in multivariable models adjusted for age, cardiovascular risk factors, baseline glomerular filtration rate (GFR), urinary albumin/creatinine ratio, and inflammatory markers interleukin 6 and high sensitivity C-reactive protein (Odds ratio for 1-standard deviation (SD) of urinary osteopontin, 1.42, 95% CI (1.00-2.02), p=0.048). Conversely, plasma osteopontin, but not urinary osteopontin, was independently associated with cardiovascular death (multivariable hazard ratio per SD increase, 1.35, 95% CI (1.14-1.58), p<0.001, and 1.00, 95% CI (0.79-1.26), p=0.99, respectively). The addition of plasma osteopontin to a model with established cardiovascular risk factors significantly increased the C-statistics for the prediction of cardiovascular death (p<0.002). Conclusions Higher urinary osteopontin specifically predicts incident chronic kidney disease while plasma osteopontin specifically predicts cardiovascular death. Our data put forward osteopontin as an important factor in the detrimental interplay between the kidney and the cardiovascular system. The clinical implications, and why plasma and urinary osteopontin mirror different pathologies, remains to be established.

Re-imagining the theology of human sexuality in the Methodist Church: the use of narrative in theological methodology

This thesis proposes the development of a narrative methodology in the British Methodist Church. Such a methodology embraces and communicates both felt experience and critical theological thinking, thus producing and presenting a theology that might have a constructive transformative impact on wider society. In chapter one I explore the ways in which the Church speaks in public, identify some of the challenges it faces, and consider four models of engagement. If the Church is to engage in public discourses then I argue that its words need to be relevant and connect with people’s experiences. To ground the thinking I focus on the context of the British Methodist Church and explore how the Church engages in theological reflection through the lens of its thinking on issues of human sexuality. Chapter two reviews how theological reflection is undertaken in the British Methodist Church. I describe how the Methodist Quadrilateral of Scripture, tradition, reason and experience remains a foundational framework for theological reflection within the Methodist Church and consider the impact of institutional processes and the ways in which the Methodist people actually engage with theological thinking. The third and fourth chapters focus on how the British Methodist Church has produced its theology of human sexuality, giving particular attention to the use of personal and sexual stories in this process. I find that whilst there has been a desire to listen to the stories of the Methodist people, there has not been a corresponding interrogation or analysis of their stories so as to enable robust and constructive theological reflection on these experiences. Using resources from Foucauldian approaches to discourse analysis, I critique key statements and the processes involved in their production, offering an analysis of this body of theological thinking and indicating where possibilities for alternative ways of thinking and acting arise. The proposed methodology draws upon resources from social science methodologies, and in chapter five I look at the use of personal experience and relevant strategies of inquiry that prompt reflection on the hermeneutical process and employ narrative approaches in undertaking, analysing and presenting research. The exploration shows that qualitative research methodologies offer resources and methods of inquiry that could help the Church to engage with personal stories in its theological thinking in a robust, interrogative and imaginative way. In chapter six an examination of story and narrative is undertaken, to show how they have been understood as ways of knowing and how they relate to theological inquiry. Whilst acknowledging some of the limitations of narrative, I indicate how it offers constructive possibilities for theological reflection and could be a means for the British Methodist Church to engage in public discourse. This is explored further in chapter seven, which looks in more detail at how the British Methodist Church has used narrative in its theological thinking, and outlines areas requiring further attention in order for a narrative theological methodology to be developed, namely: attention to the question ‘whose experience?’; investigation of issues of power and the dynamics involved in the process of the production of theological thought; how personal stories and experiences are interrogated and how narrative is constructed; and how narrative might be employed within the Methodist Quadrilateral. The final chapter considers the advantages and limitations of such an approach, whether the development of such a method is possible in the Methodist Church today and its potential for helping the Church to engage in public discourse more effectively. I argue that this methodology can provoke new theological insights and enable new ways of being in the world

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.

Cultural differences in nonverbal communication and their implications in public service interpreting

This paper intends to underline the importance of nonverbal cues in intercultural communication and especially in the profession of the interpreter in the public services. The first chapter focuses on giving an overview on the different components of nonverbal communication by providing a definition and examples. The chapter then analyses the different functions carried out by nonverbal language. The second chapter addresses cultural differences related to nonverbal language and provides examples for every component of nonverbal language. It also explains the distinction between high context cultures and low context cultures. Lastly, the third chapter first gives an overview on Public Service Interpreting (PSI), explaining the main features and characteristics. It then provides real examples of cultural misunderstandings related to nonverbal language which occurred in public services and gives the techniques used by interpreters to solve them. This chapter includes examples of various nonverbal cues including eye contact, touch, silence, and hand gestures.

20 Year Strategy for the Irish Language 2010-2030

The objective of Government policy in relation to Irish is to increase on an incremental basis the use and knowledge of Irish as a community language. Specifically, the Government’s aim is to ensure that as many citizens as possible are bilingual in both Irish and English. It is an integral component of the Government’s Irish language policy that close attention be given to its place in the Gaeltacht, particularly in light of research which indicates that the language’s viability as a household and community language in the Gaeltacht is under threat. The aim of Government policy is also to: increase the number of families throughout the country who use Irish as the daily language of communication; provide linguistic support for the Gaeltacht as an Irish-speaking community and to recognise the issues which arise in areas where Irish is the household and community language; ensure that in public discourse and in public services the use of Irish or English will be, as far as practical, a choice for the citizen to make and that over time more and more people throughout the State will choose to do their business in Irish; and ensure that Irish becomes more visible in our society, both as a spoken language by our citizens and also in areas such as signage and literature

ePortfolio as a tool for reflexivity and skills' communication : learn how to communicate skills

This paper aims to present an ePortfolio project led for two years in a multilingual and interdisciplinary Master's program in public discourse and communication analysis offered by the Faculty of Arts of the University of Lausanne (Switzerland). Globally, the project - named Learn to communicate skills - offers a reflection about academic skills and their transferability to the professional world. More precisely, the aim of the project is to make students aware of the importance of reflexive learning to make their skills transferable to other contexts.

Faire confiance au gouvernement? : évaluation des caractéristiques individuelles, étatiques et sociales qui sont liées à la confiance envers le gouvernement

La confiance envers le gouvernement est une notion fréquemment évoquée dans le discours public et dans la littérature, mais il s’agit d’une notion imprécise, malgré des innovations depuis sa première spécification par David Easton en tant que support systémique. Cette revue de littérature propose de faire le point sur la question de la confiance envers les gouvernements démocratiques. Je définis d’abord la confiance envers le gouvernement comme un concept relationnel et relativement stable dans le temps. Ce mémoire se penche sur 26 facteurs qui sont liés à la confiance envers le gouvernement dans trois grandes catégories : les caractéristiques individuelles, étatiques et sociales. Je démontre que les explications culturelles de la confiance sont nettement supérieures aux explications économiques, et ce à toutes les échelles. Cependant, les jeunes démocraties présentent un profil un peu différent des démocraties plus anciennes : l’économie y joue un rôle un peu plus important.

Konsensus och personifierade konflikter : problembeskrivningar av äldreomsorg i svensk dagspress

Consensus and personified conflicts: representations of elderly care issues in Swedish newspapers Elderly care issues are commonly framed in public discourse. In mass media the representations of such issues are influenced by media logic. The purpose of this paper is to describe and analyse how elderly care issues were represented in three Swedish newspapers during the first half of 2007. How were the problems characterized? How were different actors characterized and which roles were they assigned? How are conflicts of interests described? Finally, we aim to discuss how media contribute to an understanding of the complexity of elderly care as a whole. Taken together, the articles do not provide a coherent picture. However, costs, quality of care and demographic issues were common themes. The elderly were commonly represented in personal narratives about problems that occurred when they needed elderly care. The elderly in the future are projected as more active and demanding than the elderly today. The care workers were active voices in discussions about working conditions, but absent in discussions about their education and professional identity, which was an issue commonly advocated by politicians. Many issues were represented as conflicts between the individual elderly and the care system or between care workers and their employers. More elaborated discussions about how to prioritize between different needs and demands were rare. This can be seen as examples of how the media tends to use personification, simplification and polarization as means to tell interesting stories.

One country, two societies? Germany twenty years after reunification. OSW Study 35/2011

3 October 2010 marked the twentieth anniversary of the reunification of the two German states. This is an occasion for summing up and evaluating the changes which have taken place in Germany since 1990. Germany became reunited through the incorporation of the East German federal states to the then Federal Republic of Germany. The West German point of view is predominant in public discourse regarding this issue, which is manifested through grading the new federal states for their progress in assimilation to the western part of Germany. However, this way the positive changes which have taken place in the social, political and economic areas in the eastern federal states over the past two decades are often disregarded. This paper is an attempt to show the changes which have taken place in Germany, involving areas in which new federal states have outperformed the western part of the country.