Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

Background A 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users’ experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items. Objectives Establish the construct and concurrent validity of GPPS items evaluating service users’ experience of GP out-of-hours care. Methods Cross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the ‘entry access’ (four items) and ‘consultation satisfaction’ (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions. Results The modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the ‘entry access’ scores (r=0.63) and 44.0% of variation in the ‘consultation satisfaction’ scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ. Conclusions Minor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users’ overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.

A Constitution of Social Governance for the European Union

his chapter considers the EU’s socio-economic constitution under the lens of humaneness. It argues that the EU’s unique socio-economic constitution demands equilibrium of socio-economic integration instead of widening the gap between economic integration at EU levels and social integration at national levels. While the EU lacks the legislative competences to achieve this equilibrium, the constitutional principle still prevails. Indeed, the EU competences reflect its own values as well as the socio-economic constitutions of its constituent Member States. These frequently do not allow for total state-governance of social spheres such as working life, education, care or other social services. Instead, societal actors are given scope to (co-)govern these spheres at national levels. Accordingly, the apparent tension between the EU’s socio-economic values and principles and its limited competences in the social policy field can be resolved through a dynamic interpretation of the EU Treaties towards a “constitution of social governance”. This interpretation reads the Treaties as authorising governance by societal actors. The chapter connects the idea of humanness to the ideals of social governance at EU level and proposes two options for practical application of the concept. These are rules for trans-national labour markets based on European collective labour agreements and a European higher education sector developed by agreements between universities.

'A Land Beyond the Wave': Transnational Perspectives on Easter 1916

Despite the appeal and significance of nationalism as a near universal political force, Irish historians – in common with the historians of most nationalist movements – have struggled to analyse nationalism from beyond the perspective of the nation state. The reasons for this are varied, arising both from practical aspects, such as the availability and accessibility of sources, to more conceptual issues such as the resilience of the national perspective in the framing of historiographical narratives. This paper considers the Easter Rising as a case study in assessing how a transnational framework complicates traditional historiographical perspectives. Accounts of the Easter Rising generally interpret the rebellion within local, national, or international (particularly Anglo-Irish or imperial) frameworks. Interpretations that adopt a broader framework have tended to focus on international rather than transnational dimensions: the First World War context, revolutionary links with Germany, and the role of the United States. This paper assesses the potential of a transnational approach by analysing four aspects of the Rising: the significance of the transnational movement of people prior to the event; the influence of the transnational circulation of political ideas; the impact of transnational cultural currents in shaping the framing of revolutionary ideals; and the impact of the Rising on Irish nationalist communities beyond Ireland.

Commemoration in the United Kingdom: A multitude of memories

In the United Kingdom (UK) the centenary commemoration of the First World War has been driven by a combination of central government direction (and funding) with a multitude of local and community initiatives, with a particular focus on 4 August 2014; 1 July 2016 (the beginning of the Battle of the Somme) and 11 November 2018. ‘National’ ceremonies on these dates have been and will be supplemented with projects commemorating micro-stories and government-funded opportunities for schoolchildren to visit Great War battlefields, the latter clearly aimed to reinforce a contemporary sense of civic and national obligation and service. This article explores the problematic nature of this approach, together with the issues raised by the multi-national nature of the UK state itself.

Examining Participatory Governance in a Devolving UK: insights from national parks policy development in Northern Ireland

This paper provides a contemporary examination of policy making and participatory practice in the context of devolving governance in the UK. The paper takes Northern Ireland as its focus and is particularly timely considering the context of devolved governance, the ongoing transition from conflict to relative peace and the potential for rejuvenating democracy through participatory
governance. The paper concentrates on one particular policy process, namely the attempted designation of a national park in the Mournes Area of Outstanding Natural Beauty. A thematic analysis of qualitative data is drawn upon to analyse the structural factors that framed the policymaking process, in particular the role of power in determining how consultation processes were 2 initiated, designed and undertaken. Using Lukes’ model) as an analytical framework, power is shown to manifest at multiple levels within the policy-making process to influence policy outcomes. The paper reveals how the persistence of a top-down approach to policy development combined with a highly parochial political outlook undermined attempts to designate a Mourne National Park. The paper concludes that, given the immaturity of recently devolved government in
Northern Ireland, in this instance, the democratising intentions of devolved governance have not been met. This has implications for Northern Ireland’s recent reform of public administration which devolves certain planning powers to local authority level and the management of the internationally significant Mournes landscape.

Colonial architectures, urban planning and the representation of Portuguese imperial history

This article proposes a critical analysis of recent interpretations made to the history of architecture and urban planning in the Portuguese colonial context in the twentieth century, particularly in the former African territories. More generally, it intends to explore how the internal history produced by specific fields of activity, such as architecture or urbanism, can reinforce the logic of a national and nationalized history. This effect is due partly to the fact that the legitimacy of these fields is largely dependent on the national identification in the context of activities that are internationalized. I will argue that the specific field of activity, while creating this internal discourse, can directly or indirectly produce representations of the nation, its history and its people on a larger scale, penetrating popular culture and influencing a shared common sense. In the case in question, the internal discourse on architectural and urbanistic works, on authors and styles, eventually reinforces an idealized and idyllic image of Portuguese colonialism.

The 2015 Portuguese Legislative Election: Widening the Coalitional Space and Bringing the Extreme Left in

This article provides an overview of the Portuguese legislative election held on 4 October 2015 by exploring the economic and political context in which the election took place, the opinion polls, party positions and campaign issues, the results and, finally, the process that led to the formation of the first Socialist minority government supported by far-left parties. Due to this outcome, despite the relative majority of the votes obtained by the incumbent centre-right coalition, we argue that this election result cannot be interpreted as a victory of austerity, but rather as the first step towards contract parliamentarism in Portugal.

The continuing popularity of the neighbourhood and neighbourhood governance in the transition from the 'big state' to the 'big society' paradigm

The neighbourhood in both the UK and Europe continues to dominate thinking about the quality of life in local communities, representation and empowerment, and how local services can be delivered most effectively. For several decades a series of centrally funded programmes in neighbour- hood governance have targeted localities suffering deprivation and social exclusion in England. From these much can be learnt about the strengths and limitations of a local approach to achieving multiple objectives.We review the findings of a case study of neighbourhood governance in the City of Westminster and draw on evaluations of two national programmes. In the conclusions we discuss the problems arising from multiple objectives and examine the prospects for neighbourhood governance as the national paradigm moves away from `big state' solutions towards the less-well-defined `big society' approach and the reinvention of `localism'. While the rationale for neighbourhood governance may change, the `neighbourhood' as a site for service delivery and planning remains as important now as in the past.

On the conservatism of post-Jungian criticism: competing concepts of the symbol in Freud, Jung and Walter Benjamin

The renewed interest in analytical psychology by academics working in the humanities has led to the emergence of a post-Jungian field of cultural criticism, at the theoretical core of which stands Jung's theory of symbolism. This article examines the centrality of symbolism to both Freud and Jung's psychology and explains how the differing concepts of the symbol lead to their divergent theories of interpretation in psychology and art criticism. Acknowledging the advantages of Jung's more expansive account of the symbol, it argues that Walter Benjamin's critical engagement with Jung nonetheless provides a useful correction to the problematic conservatism inherent to his concept of the symbol and its contemporary application.

Interrupting the courtroom organism: screaming bodies, material affects and the theatre of cruelty

This article offers a method of reading the courtroom which produces an alternative mapping of the space. My method combines a reading of Antonin Artaud’s Theatre of Cruelty with a Deleuzian theoretical analysis. I suggest that this is a useful method since it allows examination of the spatial praxes of the courtroom which pulsate with a power to organize, terrorize and to judge. This method is also able to conceptualize the presence of ‘‘screaming’’ bodies and living matter which are appropriated to build, as well as feed the presence and functioning of the courtroom space, or organism. By using a method that articulates the cry of these bodies in the shadow of the organism, it becomes clear that this cry is both unwelcome and suppressed by the courtroom. The howl of anxious bodies enduring the process and space of the law can be materialized through interruptions to the courtroom, such as when bodies stand when they should not and when they speak when they should be silent. These vociferous actualizations of the scream serve only to feed the organism they seek to disturb, yet if the scream is listened to before it disrupts, the interruption becomes-imperceptible to the courtroom. Through my Artaudian/Deleuzian reading, I give a voice to the corporeal gasp that lingers before the cry, which is embedded within the embodied multiplicity from which it is possible to draw a creative line of flight. The creative momentum of this line of flight produces a sustainable interruption to the courtroom process, which instead of being consumed by the system, has the potential to produce new courtroom alignments. My text therefore offers an alternative reading of the courtroom, and in doing so also offers a refined understanding of how to productively ‘‘interrupt’’ the courtroom process.

Defining the nation, defining public television: discourses of publics on public service television in post-communist Latvia

Institutional and political economy approaches have long dominated the study of post-Communist public broadcasting, as well as the entire body of post-Communist media transformations research, and the enquiry into publics of public broadcasting has traditionally been neglected. Though media scholars like to talk about a deep crisis in the relationship between public broadcasters and their publics in former Communist bloc countries across Central and Eastern Europe, little has been done to understand the relationship between public broadcasters and their publics in these societies drawing on qualitative audience research tradition. Building on Hirschman’s influential theory of ‘exit, voice and loyalty’, which made it possible to see viewing choices audiences make as an act of agency, in combination with theoretical tools developed within the framework of social constructionist approaches to national imagination and broadcasting, my study focuses on the investigation of responses publics of the Latvian public television LTV have developed vis-à-vis its role as contributing to the nation-building project in this ex-Soviet Baltic country. With the help of focus groups methodology and family ethnography, the thesis aims to explore the relationship between the way members of the ethno-linguistic majority of Latvian-speakers and the sizeable ethno-linguistic minority of Russian-speakers conceptualize the public broadcaster LTV, as well as understand the concept of public broadcasting more generally, and the way they define the national ‘we’. The study concludes that what I call publics of LTV employ Hirschman’s described exit mechanism as a voice-type response. Through their rejection of public television which, for a number of complex reasons they consider to be a state broadcaster serving the interests of those in power they voice their protest against the country’s political establishment and in the case of its Russian-speaking publics also against the government’s ethno-nationalistic conception of the national ‘we’. I also find that though having exited from the public broadcaster LTV, its publics have not abandoned the idea of public broadcasting as such. At least at a normative level the public broadcasting ideals are recognized, accepted and valued, though they are not necessarily associated with the country’s de jure institutional embodiment of public broadcasting LTV. Rejection of the public television has also not made its non-loyal publics ‘less citizens’. The commercial rivals of LTV, be they national or, in the case of Russian-speaking audiences, localized transnational Russian television, have allowed their viewers to exercise citizenship and be loyal nationals day in day out in a way that is more liberal and flexible than the hegemonic form of citizenship and national imagination of the public television LTV can offer.

Walter Benjamin and the Inhumanities: Towards a Pedagogical Anti-Nietzscheanism

The following discussion is intended as a critical intervention into recent debates about the “crisis of the humanities,” reading the symptomaticity of crisis in the medical sense of a turning point. It does so from the perspective of the work of Walter Benjamin, whose own transdisciplinary practice of thought has been characterized as a “philosophy directed against philosophy” and a “philosophizing beyond philosophy,” and stands as a model for the kind of intellectual and para-academic activity evoked here. Historically re-situating Benjamin’s famous allegory of the Angel of History from the twentieth-century context of the “crisis of culture” to the contemporary “crisis of education,” it attempts to reconstruct a dialectical understanding of pedagogization within Benjamin’s work, which is used to sketch out the contours of a critically reimagined pedagogy of the Inhumanities.

Multidimensional scaling analysis of the dynamics of a country economy

This paper analyzes the Portuguese short-run business cycles over the last 150 years and presents the multidimensional scaling (MDS) for visualizing the results. The analytical and numerical assessment of this long-run perspective reveals periods with close connections between the macroeconomic variables related to government accounts equilibrium, balance of payments equilibrium, and economic growth. The MDS method is adopted for a quantitative statistical analysis. In this way, similarity clusters of several historical periods emerge in the MDS maps, namely, in identifying similarities and dissimilarities that identify periods of prosperity and crises, growth, and stagnation. Such features are major aspects of collective national achievement, to which can be associated the impact of international problems such as the World Wars, the Great Depression, or the current global financial crisis, as well as national events in the context of broad political blueprints for the Portuguese society in the rising globalization process.

Resilience in organizations: The perspective of managers in Portugal and Germany

The concept of organizational resilience has become popular in Organizational Studies during the last decades - yet researchers have not been able to find one commonly accepted definition for what exactly it is. What are the drivers of resilience in organizations? Are there certain cultural factors and national differences regarding the perception of the concept? This paper aims to answer these questions from a perspective of within institutions. A group of managers from different corporations in Portugal and Germany has been interviewed in order to understand how managers experience and characterize organizational resilience. Based on qualitative inductive research the results show that organizational resilience is built on four main drivers: a sense of proximity, a sense of openness, a sense of challenge and a sense for structure.