What motivates adherence to medical recommendations? The procedural justice approach to gaining deference in the medical arena

Although it is within their long‐term interest, patients often fail to follow health care recommendations made by medical experts. This failure results in the widespread occurrence of preventable health problems and a significant increase in health care costs. Taking a new approach to confronting this issue, this paper examines whether the procedural justice model, which has been useful in explaining cooperation with legal and managerial authorities, can provide a basis for increasing patients' willingness to voluntarily adhere to health care recommendations. Three studies tested and supported this proposition. Study 1 experimentally manipulated physicians' procedural fairness or unfairness to explore its influence on patients' acceptance of doctors' recommendations. Study 2 used patients' reports about the fairness of their personal physicians and linked those evaluations to their willingness to follow their doctor's recommendations. Finally, study 3 explored the role of general procedural justice judgments in promoting willingness to accept health policies when they are advocated by private doctors and government health care authorities. The results of all three studies support the argument that when health care authorities use fair procedures, patients are more likely to accept their recommendations. Importantly, this procedural justice effect is distinct from, and in some cases stronger than, the influence of competence.     

Mending the “Unhinged Alliance” in the 1970S: Transatlantic Relations,Public Diplomacy,and the Origins of the European Union Visitors Program

This article examines in depth the foundation of the EU’s one explicit example of public diplomacy, the European Union Visitors Programme. The narrative covers the historical background to the EUVP, the main individuals involved, and its significance for the development of the EU as an international actor. Public diplomacy relies on personal contacts, and the intention here is to demonstrate the importance of this petit histoire. The contribution of the EUVP towards establishing a transatlantic “community of values,” as demonstrated by the support it received from the U.S. diplomatic representation in Brussels, is an important extra dimension. The article concludes that the EUVP, while offering a potential model for the EU to project its “soft power” and world-view internationally, remains limited in scope and unable to fulfill its potential.     

Part-time Work,Job Satisfaction and Well-being: Evidence from a Developing OECD Country

We estimate the effects of part-time work on job and life satisfaction using new data for Chile. While part-time work is being promoted to increase female labour participation in many countries, there are concerns about its quality and the overall effect on well-being of such policies. We estimate models for job and life satisfaction addressing for endogeneity and selectivity bias. We found that part-time work has a negative effect on job satisfaction and well-being for men; however, when looking at just women, the negative effect is reversed. This should be considered when designing public policies oriented at increasing female labour participation through part-time work.     

Aid as an encounter at the interface: the complexity of the global fight against poverty

International development discourse has recently shifted its focus from top‐down economic adjustment to participative anti‐poverty policy. This shift hints at an acknowledgement of the local complexities within the poverty process and at a need to listen to and develop actions with the ‘poor’. But, whereas the mainstream argument remains couched in a technical framework, we argue that the fight against poverty is inevitably political. Conceptualising the aid industry as a set of global–local interfaces, it follows that a closer look at ‘participation’ in anti‐poverty interventions is needed to come to grips with the political issues involved. Four issues are discussed: the complexity of local ‘participation’, given the ‘polycephalous’ character of third world societies; the power biases in the aid chain; the potential problem of ‘false consciousness’; and the ambiguities of the role of local development brokers. We conclude that anti‐poverty policy is in need of ‘interface experts’, who, through ‘provocation’ can beget ‘participation’.     

From the Executive Board to the Classroom. What Debt Relief Means for Education in the Democratic Republic of the Congo (DRC)

ABSTRACT

This analysis re-assesses the IMF’s decision to grant debt relief to the DRC in 2010 based on the country’s poverty reduction and growth performance: would the IMF come to the same conclusion given the current knowledge available about the impact of the debt relief process on public governance and service delivery? First, it shows that, whereas the direct resource effect of this aid modality was minimal, the indirect effect was more significant: the conditionalities attached to the process helped to stabilize the economy and increased the overall budget of the Congolese state. This increased resource availability also sustainably percolated to the education sector. Second, however, the impact on social development was minimal: school enrolment increased but was hardly accompanied by extra budget per pupil, whereas more complicated challenges like disparities in access or quality of schooling were left untouched. The government’s strategy was also partly short-circuited by the electoral process.     

A ‘Fruitless Obsession with Accuracy’: The Uses of Sensemaking in Public Sector Performance Management

Sensemaking provides a framework for understanding and interpreting managers' working lives, based on a thorough critique of rational choice models. It refutes rational choice, and aims not to predict, prove or control but simply to explain: the making of sense. This article, based on the author's original prizewinning MBA thesis, presents research undertaken in 2005–2006 on the uses of sensemaking in understanding local government organisations' contrasting experiences of performance management systems: an internal system in Canadian city government, and an externally-imposed system in the form of the now abandoned Comprehensive Performance Assessment (CPA) in British local government. Key literature utilised includes social and organisational psychologist Karl Weick, British complexity theorists such as Ralph Stacey, and a literature on the politics of organisational behaviour (such as Guy Peters et al.). A critique of rational choice and summary of sensemaking precedes an account of phenomenological case study research across two countries, undertaken using ethnographic field methods. The author argues that using sensemaking to understand performance management systems provides a further imperfect means of making sense of inherent organisational equivocality. These systems are radically interpreted as devices for making sense of experience in organisations in which human behaviour cannot be expected to be forever accurately predicted and controlled. Conclusions with enduring relevance for practising managers are presented on the personal, tactical, methodological and philosophical ‘uses’ of sensemaking in managers' working lives.     

A Prehistory of the Best Value Regime

Best Value was one of the central planks of New Labour's modernisation agenda for local government. This article uncovers the origins of the regime by unpicking the activities of two working groups responsible for its design. Licking its wounds in the aftermath of the 1987 General Election the Labour Party's leadership had come to see the party's record in local government as a source of increasing embarrassment. A series of policy initiatives, first emerging from the party's policy review, later given the Best Value tag, were intended to neutralise producer interests and improve the party's reputation for governing competence.