Re: Download Italian Movie Through The Time Barrier
Harriet Wehrenberg
Aside from its Old Norse heritage and its prehistoric sites, Orkney is known for its role in 20th-century military history. The islands of Orkney create a natural harbor, called Scapa Flow, that was the base for the British Royal Navy during both World Wars.
During World War I, to more completely seal off the harbor, the navy requisitioned and intentionally sank hundreds of ships in the narrow straits between islets. A century later, you can still see their rusting hulls poking up above the surf.
In the early days of World War II, a Nazi submarine discovered a gap in the sunken-ship barriers, and managed to enter Scapa Flow and sink the HMS Royal Oak. First Lord of the Admiralty Winston Churchill (just weeks before becoming prime minister) hatched a plan to build sturdy barriers between the islets. These were finally completed just a few days after V-E Day, and today tourists use them to link the WWII sights.
The POWs decorated the chapel in their free time, using whatever materials they could scavenge. The ethereal Madonna e Bambino over the main altar is based on a small votive one prisoner had brought with him to war. They used scrap metal from sunken WWI ships to create the gate and chandeliers.
Seeing the many sights on Orkney is doable on your own, but much more satisfying with a good local guide. I was treated to a great guide named Kinlay, whose company Orkney Uncovered runs tours that efficiently tie together both the prehistoric and the World War sights on this eclectic island. Thanks, Kinlay!
Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted.
To investigate this topic, we undertook a single case study - a longitudinal project (Place4Carers (Graffigna et al., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process.
Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together.
The case study investigated in this paper focuses on the possible barriers that may arise during co-production between family carers of elderly people living in rural and remote areas and health and social care experts for the planning of a new service. Co-production requires a substantial contribution of citizens in designing and implementing a new service. In line with recent open debate of co-production research, our inquiry critically reflects on the experience of carer involvement. This study supports practitioners and researchers in preventing barriers before, during and after co-production with vulnerable citizens. It also illustrates possible service solutions to support family carers in looking after their elderly relatives at home, highlighting the importance of this informal category in the health and social care system.
Researchers and practitioners have adopted co-production for years by highlighting its effectiveness. However, there has been a considerable number of negative empirical examples of co-production, especially involving vulnerable citizens. Although the involvement of vulnerable citizens may be more challenging than usual, their involvement has paramount importance as their voices are rarely heard and their needs are not satisfied by existing service systems. This study is a first attempt to identify ways to prevent failure when involving vulnerable citizens.
Unfortunately, the reasons that may inhibit co-production are not easy to identify [14]. For instance, an interactional process between citizens and providers may fail because citizens do not have enough information about the topic of discussion [15]. In contrast, it may fail because the organisation does not want to share some information with citizens [14] or because the local rules and regulations do not allow organisations to share that information [16]. Finally, the failure may be caused by all three reasons, demonstrating the complexity of this field.
Understanding how to identify and interpret barriers in co-production has both practical and theoretical benefits [7]. On the one hand, organisations may succeed in preventing or limiting barriers that can generate negative effects during co-production. On the other hand, scholars may be able to critically analyse co-production and its effects, opening the way to improvements in the application of co-production [8].
On the basis of these considerations, this paper investigates the barriers that arose during the co-production of a social and community service with family carers of elderly people living in remote and rural areas and studies how they can be identified and interpreted by using co-destruction.
Finally, co-production may have negative effects on citizens, providers/researchers and the system. In the first case, it may make citizens feel compelled [22, 42] and may risk harming their privacy and rights [27]. Second, the adoption of co-production in research may have several costs and risks for researchers given its complexity and time consumption [27]. Finally, it may require considerable time and resources without guaranteeing clear and unambiguous results [24, 27], compromising the health and/or research system.
Co-destruction is an interactional process [19] that aims to explain how the direct or indirect interactions between participants belonging to the same service system may reduce the well-being of at least one of the parties [14]. Since co-production captures a wide variety of activities in which citizens and other service system stakeholders interact [44], it can be considered an interactional process, and the co-destruction theoretical framework can support the identification and explanation of how barriers can generate negative effects [18].
Given the scarce health literature investigating co-destruction [20], to understand this concept, we should examine the private and public service literature. Two authors have investigated co-destruction empirically: Jarvi et al. [17] and Engen et al. [14].
To investigate the barriers to the co-production process, we used a case study methodology, which facilitates the understanding of current phenomena before, during and after co-production, making the phenomena inseparable from the context [48, 49]. More precisely, we investigated the barriers to co-production by using co-destruction as the theoretical lens to understand and reveal them. The adoption of this particular lens of analysis overcomes at least two existing limitations of the health and social care literature. First, as a process, it highlights when barriers arise and how they generate negative effects [17]. Second, from a system view, it collects the perspectives of all participants of the networks, including citizens, providers and researchers.
This research is part of a larger study intended to make a substantial contribution to the debate on the involvement of vulnerable citizens in co-production activities [52]. This research was performed in the latest phase of the study, in which we considered the implementation of the project to similar remote and rural areas. To reflect on the lessons learned during the development of the overall project, we adopted a distinctive perspective that helped us to identify the possible barriers arising from the co-production of the new social and community service with family carers, ATSP and researchers of the project team. In the co-production process, family carers were involved as users, while ATSP and researchers as providers of the new service. Moreover, given the fragility of family carers caused by medium-high level of stress and a high number of hours of caregiving [52] and the limited accessibility of local health and social care facilities in remote and rural areas, we can consider this case study a useful example of how to investigate co-production with vulnerable citizens.
the training programme, we collected the participation rate, the level of understanding of the content (by asking participants before and after each meeting to answer three questions about the content of the course) [53] and the level of satisfaction with the course (by asking participants at the end of each course to complete a satisfaction survey of 13 items used 3-point scale of de Lima) [54, 55];
On the basis of these considerations, we deem this project suitable for investigating our research questions for three main reasons. First, it reflects on the adoption of co-production with vulnerable citizens in the health and social care sector. Second, the time horizon of analysis is medium-long, facilitating the evaluation of co-production activities during execution and beyond as suggested by co-destruction framework of Jarvi et al. Third, the involvement of family carers in the co-designed service yields both positive and negative effects, making the investigation of the barriers that arose during co-production interesting and important.
7fc3f7cf58