The UK Primary Health Care Reforms dating from 1990 have resulted in traumatic stress for General Practitioners (GPs) within the UK National Health Service (NHS). Previously, their first task had always been to provide care. Now the objectives are purely economic, focusing on cost-effectiveness and meeting Government targets. This article compares the Balint Model, set out by Michael and Edna Balint in the 1950s, to what is required in the current situation, and shows how group analysis can help GPs come to terms with their new professional identity and how they see their future.
Abstract. Extensions of Topological Spaces. An extension principle for T0-spaces is given which includes several well-known compactifications. Moreover, it is shown that the compact T2-spaces are exactly the T~-retracts of Stone spaces. All these results are derived from some general facts on semirings stated in the first part of the paper.Ist X ein Tychonoffraum und R ein Ring stetiger, reellwertiger Abbildungen auf X, so liefert die Menge der maximalcn Ideale yon R, versehen mit der Hfille--Kern Topologie, unter bestimmten Voraussetzungen eine Kompaktifizierung yon X. Bei den Wallman-Typ Kompaktifizierungen ffir T~-R/iume X kann formal ganz fihnlich verfahren werden (siehe [12; IV 2.4]). Man mul3 jetzt nur die maximalen (Verbands-)Ideale einer geeigneten Ringbasis nehmen. Wir zeigen im folgenden, dab sich diese beiden Kompaktifizierungsmethoden vereinheitlichen lassen. Dazu besch/iftigen wir uns vorab ausf/ihrlich mit gewissen Halbringen. Von entscheidender Bedeutung sind hier die sogenannten p m-Halbringe. Sie werden in Satz 1 charakterisiert. AnschlieBend diskutieren wir verschiedene Primidealr/iume von Halbringen. Einige diesbezfigliche Resultate wurden in der Literatur speziell ffir Ringe und Verb/inde bereits formuliert. Dennoch verzichten wir nicht auf Beweise, da wit mit Hilfe von Satz 1 hfiufig 6konomischer argumentieren k6nnen. Danach wenden wir uns dem eigentlichen Anliegen dieser Arbeit, den Erweiterungen topologischer R/iume, zu. Wir geben ein sehr einfaches und allgemeines Erweiterungsprinzip ffir T0-R/iume an, das neben den oben erw/ihnten Kompaktifizierungen noch andere Erweiterungen als Sonderffille mit enth/ilt. Aul3erdem wird sich u. a. herausstellen, dab die beliebig oft differenzierbaren Funktionen mit festem Definitionsbereich D grunds/itzlich p m-Ringe bilden und sie stets eine Stone--Qech Kompaktifizierung von D induzieren. Zum Schlui3 kennzeichnen wit die kompakten Hausdorffr/iume als T~-Retrakte der Stoner/iume und analog auch die Tz-Kompaktifizierungen.
Part 11, on 'Fellowship and Sharing', describes the deliberately minimal organizational structures of AA. Remarkably its principles are perpetuated more by a storytelling tradition (supported by written traditions) rather than any authoritative doctrines. How AA 'sharing' works is examined in chapter six, with O' Halloran drawing on dialogical theory. The case transcripts (which all derive from publicly available convention transcripts, thus avoiding confidentiality issues) are illuminating, as is the analysis offered-e.g. stories as a means of strengthening 'autobiographical commitment' and the promotion in AA of equal 'speaking rights'. Those unfamiliar with (e.g. 'open') AA meetings, will find a good introduction to what happens, the turn-taking convention, and the particular forms of 'speech act' that occur, to use a useful idea from linguistics.The final section of the book is entitled 'Entering the Dialogic'. I found the theory of story well set out, such as the ways in which stories are told and retold and how, in the telling, the 'interactive flow tends to be reiterative and circular, rather than linear' (p. 161). AA groups exemplify the reconstructive power of self-narration and identification, with interaction, so to speak, between the 'former self and the ' recovering self'; as O'Halloran argues, 'this engagement between present and past selves is probably the most central activity in AA storytelling, creating as it does the distance required for self-evaluation ' (p. 199). I particularly liked the author's notion of stories as 'working drafts' that are continually produced and revised over the course of time-how true of AA stories and how true of any other story of oneself in life.Elsewhere (Weegmann, 2004), I have argued that group analysts can learn much from fellowship groups. Their mode of being together and norms of 'sharing' differ markedly from group psychotherapy, but the two can, I am convinced, work well, side by side. Halloran's excellent research provides a text from which we can learn more.
In a context of rapid change, outbreaks of sibling rivalry in organizations act as a defence against the inability to mourn and feel remorse. When changes are imposed on work-teams, sibling preoccupations surface to prevent the working through of the breakdown of relations between the institutional parents and their dependants. Siblings also adopt envy-preventing strategies, engaging in collective self-idealization by forming sisterhoods or brotherhoods to protect themselves from disillusionment and individuation. Each succeeding generation has to face the fact that a primus inter pares will have to be chosen to inherit the mantle of power from the parental generation and restore the world to its `normal' state of inequality. In the context of recent structural changes in organizations the new managers have acted like borderline parents and fostered sibling rivalry. This dynamic has functioned to deny the guilt and the fear of retaliation associated with fratricide and matricide committed during the `re-engineering' process, when the youngsters sent their parents into early retirement. I want to explore the central importance of authority, disillusionment and mourning and show that the outbreak and suppression of sibling rivalry is connected with the problem of transition and succession in organizations.
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