Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales

The National Health Service (NHS) in England and Wales has embarked upon a radical and far–reaching programme of change and reform. However, to date the results of organizational quality and service improvement initiatives in the public sector have been mixed, if not to say disappointing, with anticipated gains often failing to materialize or to be sustained in the longer term. This paper draws on the authors' recent extensive research into one of the principal methodologies for bringing about the sought after step change in the quality of health care in England and Wales. It explores how private sector knowledge management (KM) concepts and practices might contribute to the further development of public sector quality improvement initiatives in general and to the reform of the NHS in particular. Our analysis suggests there have been a number of problems and challenges in practice, not least a considerable naïvety around the issue of knowledge transfer and 'knowledge into practice' within health care organizations. We suggest four broad areas for possible development which also have important implications for other public sector organizations.     

Periventricular fatty metamorphosis in neuroglia--a morphologic substrate in SIDS

In 7 of 15 cases of sudden infant death syndrome (SIDS), distinct periventricular fatty metamorphosis of the neuroglia could be demonstrated by a histological staining technique. None of the six children (under 1 year of age) used as a control group whose cause of death was not SIDS showed this morphological change. Thin-layer chromatographic analysis of the lipids accumulated in the glial cells in SIDS established a high amount of esterified cholesterol whereas the content of esterified cholesterol in the control group was low. We presume that fatty metamorphosis of the neuroglia represents the morphological substrate of a metabolic disorder of the sensitive, immature glia of the periventricular white cerebral matter caused by various kinds of damage.     

Policy analysis as discourse

The field of policy analysis encompasses a greater diversity of practices than is commonly appreciated. Many recent revisions agree with the postmodern dictum that analytic studies are socially constructed and propose some form of discourse for formulating policy. This article compares three theoretical perspectives on discourse: analytic discourse, which draws on multiple theories and data sources; critical discourse, which emphasizes critical reflection and links evidence to value discussions; and persuasive discourse, which focuses on the role of ideas and persuasion by policy entrepreneurs. Analytic discourse has had the most impact on the practice of analysis, but the other two literatures have had some influence and address important issues. Critical discourse is sensitive to the structural biases in policy research, and persuasive discourse links the practice of analysis to opportunities in the policy arena. The author seeks to make us more conscious of alternative theories, while emphasizing the role of discourse in all three models and the linkages between policy design and the policy process.     

Unwirksamkeit einer Hundesteuersatzung, die die Besteuerung gef?hrlicher Hunde von einem Stichtag abh?ngig macht

Keine Zusammenfassung     

Rebalancing the Global Economy

The United States accuses China of subsidizing its entire export economy through artificially undervaluing its currency. China accuses the United States of fiscal profligacy while flooding the world with easy credit to keep its economy afloat. This dispute reflects the reality that the world's two largest economies are built on opposite dynamics of production and savings vs. consumerism and debt. In Europe, the wages of unsustainable debt that financed the welfare state have also come due. Rebalancing the global economy in this context is not only a matter of fixing exchange or interest rates and extending the retirement age. It must also involve a recalibration of democracy in both East and West. Two Nobel economists, the Greek prime minister, a ranking Chinese economist and the former chief economist of the IMF address these issues.     

“We two will never twin”: Fundamentalism and the politics of security

Tell me your enemy and I will tell you who you are. This article takes issue with the significant but often disavowed symbiotic relation between two contemporary enemies: fundamentalism and the politics of security. We start with a metaphorical twinning, showing how these two enemies create, provoke, mimic and ultimately support each other. Then, by way of a discourse analysis, we show the way religion functions in Bush's and Bin Laden's discourses. Our claim is not (only) that the discourse of security is as religious as Bin Laden's but that politics of security as such is the religion of our times. We conclude by arguing that the dyadic interdependence between the two fundamentalisms—Islamic and securiticised—is dissolving the democratic habitus in a post-political condition, a condition devoid of self-reflexivity.