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"A manager in the minds of doctors" : a comparison of new modes of control in European hospitals
(2013)
Background: Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals.
Methods: The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources.
Results: The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management.
Conclusions: Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective.
German Expressionist cinema is a movement that began in 1919. Expressionist film is marked by distinct visual features and performance styles that rebel against prior realist art movements. More than 20 years prior to the Expressionist movement, Sigmund Frued published "The Interpretation of Dreams" in 1899, a ground breaking study that links dreams to unconcious impulses. This thesis argues that the unexplained dream - like imagery found in two Expressionist films, The Cabinet of Dr. Caligari (Robert Wiene, 1920) and Dr. Mabus, the Gambler (Fritz Lang, 1922) - can be seen in terms of Freud's model of dreaming.
From New Corbuzon to UnLondon, China Miéville's works show a preoccupation with the city which transcends the function of setting and serves as a subtext to the plot. As one of the most prominent representatives of weird fiction Miéville constructs cityscapes that fascinate the reader with their eccentricity and strangeness, but also with their social, historical and architectural complexity. In "Perdido Street Station" the eponymous landmark in New Corbuzon is essential for the denouement of the plot rather than merely a backdrop. The city is a character in its own right. This is also and especially true for Miéville's 2009 novel "The City and the City". Here, the city seems at first normal, then alien and in conclusion utterly quotidian. The way the literary space and place is built permeates everything in the novel: the way the characters act, the crime plot, the philosophy and mood. At the core, "The City and the City" captures the everyday creation and maintenance of social space and illustrates the human capacity to deal with conflicting, layered realities of communal life and the human condition.
The "City and the City" is set in the twin city states of Besźel and Ul Qoma that occupy much of the same geographical space, but are perceived as two very different cities. The borders between the cities are invisible and intangible, but reinforced by citizens by "unseeing" and "unsensing" the other one. Meaning: someone in Besźel must ignore everything Ul Qoman even what is right next to them. Some parts of the cityscape are totally in one city but quite a few are "cross-hatched", meaning in either city depending on what is unseen. Unsight is an acquired habit, but one that is performed unconsciously. To unsee the other city is an integral part of being a citizen and important in the socialiation of children. Acknowledging the other city even accidentally is a serious crime called breaching punished by an all-seeing, all-powerful agency named Breach. Why and how the state of separation between the cities came to pass is unknown: an event ambiguously called "cleavage" split or united the cities.
"The City and the City" won several awards for fantasy writing, although it is fantastic only in one aspect and – plotwise – the novel is crime fiction: a police procedural with noir and hard-boiled touches – genres that lay claim on gritty realism. It is precisely this uncertainty of genre that allows a subversive reading of the text and contributes to the social criticism therein. In the novel Inspector Tyador Borlú from Besźel investigates the murder of foreign student Mahalia Greary across the cities and uncovers a conspiracy to exploit the cities' cultural heritage for profit.
The concept of length, the concept is synonymous, the concept is nothing more than, the proper definition of a concept ... Forget programs and visions; the operational approach refers specifically to concepts, and in a very specific way: it describes the process whereby concepts are transformed into a series of operations—which, in their turn, allow to measure all sorts of objects. Operationalizing means building a bridge from concepts to measurement, and then to the world. In our case: from the concepts of literary theory, through some form of quantification, to literary texts.
"PULS." – a blog-based online-magazine for students of medicine of the Goethe University Frankfurt
(2013)
In the context of nationwide protests 2009 also students of the faculty of medicine/dentistry at Goethe-University in Frankfurt demanded more transparency and communication. To satisfy these demands, a web 2.0-tool offered an innovative solution: A blog-based online-magazine for students and other faculty-members. The online-magazine "PULS." is realized with the share-ware blog-software (wordpress version 3.1.3) and is conceived and written by an online-journalist. "PULS." is available from https://newsmagazin.puls.med.uni-frankfurt.de/wp/. The articles are generated from own investigations and from ideas of different groups of the faculty– deanship, students and lecturers. A user-analysis is conducted with the open-source software Piwik and considers the data security. Additionally, every year an anonymous online-user-survey (Survey Monkey) is conducted. "PULS." is continuously online since 14.02.2010 and has published 806 articles (state: 27.11.2012) and has about 2400 readers monthly. The content focuses on the needs of Frankfurt medical students. The close cooperation with different groups of the faculty - deanship, students and lecturers - furthermore guarantees themes relevant to the academic faculty. "PULS." flanks complex projects and decisions with background-information and communicates them understandable. The user-evaluation shows a growing number of readers and a high acceptance for the online-magazine, its themes and its style. The web 2.0-tool "Blog" and the web-specific language comply with media habits of the main target group, the students of the faculty medicine/dentistry. Thus, "PULS." has proven as a suitable and strategic instrument. It pushes towards a higher transparency, more communication and a stronger identification of the students with their faculty.
"Shades" of postmortem personal identity : ψυχή καὶ εἴδωλον in the dream passage (Il. 23.103-104)
(2013)
The ALICE detector is ideally suited to study the production of anti- and hyper-matter due to its excellent particle identification capabilities. The measurement of the He¯4-nucleus in Pb–Pb collisons at sNN=2.76TeV is presented. We further show the performance for the reconstruction of the (anti-)hypertriton in the decay to He3+π− (He¯3+π+). In addition to this, two searches have been performed, one for the H-Dibaryon →Λpπ− and one for the Λn bound state (Λn¯→d¯π+). No signals are observed for these exotic states and upper limits have been determined.
Out of the first series of public lectures titled (Re) membering Kenya organised by the Volume editors together with Twaweza Communications and supported by the Goethe Institut Kenya, The Ford Foundation and the Institute for International Education, and whose key outcome was the publication of Remembering Kenya Vol.1 (2010) grew a second round of lecture series. The second series took cognisance of the fact that the problems that bedevil Kenya as a nation go far beyond questions of culture and identity that Volume 1 dealt with. Thus, the second presentations revolved mainly around issues of economics, governance and power. The awareness of the role and/or lack of equity and social justice in causing Kenya?s persistent problems informed all these presentations. Issues of how to bring marginalised groups into the mainstream were discussed. This Volume, in part, arises from the second presentations. The authors of chapters attempt to provide answers to the question: what entails (re)membering in post-conflict Kenya? From their work, it is clear that there is a lot to (re)member in Kenya, and many ways in which to reconfigure project Kenya. (Re)membering is re-thinking and re organising our ways of doing things. It entails a juggling of priorities; between peace and reconciliation, peace and justice, and seeking justice and reconciliation without undermining peace, all of which are arduous exercises. Reconciling misconceptions about places, issues and people is part of this reconstitution too. New pathways require being embraced, past mistakes (individual and collective) acknowledged and giving earnest meaning to the vow ?never again!? Yet, as observed in this Volume, Kenyans must be vigilant against individuals and groups that have often resisted change. There are also material constraints to the achievement of the various economic activities that come with reconfiguring the Kenyan nation. Worse still there exist certain cultural underpinnings that continue to have a debilitating effect on efforts to forge a sustainable peace after conflict. These aspects require deep reflection and honest work. In part, the contributors to this Volume suggest how it can be done. There is a hint in these chapters that we need to find new organizing spaces and principles on which a ?new? Kenya can move forward. Equally, debating the very meanings of social justice and reconciliation against the background of potential conflict should be a project of this endeavor. Questioning and identifying where impunity begun is key to this process. In doing so, we begin liberating ourselves from Kenyan society?s deep-rooted impunity. (Re)membering Kenya, after all, calls for a reconstruction of ?the journey to the conflict? in order to find the right balance between the right of remembrance and the duty of forgetfulness.