Salient Reasons Research Articles

Opportunities to Improve Antibiotic Appropriateness in U.S. ICUs: A Multicenter Evaluation.

To use a standardized tool for a multicenter assessment of antibiotic appropriateness in ICUs and identify local antibiotic stewardship improvement opportunities. Pilot point prevalence conducted on October 5, 2016; point prevalence survey conducted on March 1, 2017. ICUs in 12 U.S. acute care hospitals with median bed size 563. Receiving antibiotics on participating units on March 1, 2017. The Centers for Disease Control and Prevention tool for the Assessment of Appropriateness of Inpatient Antibiotics was made actionable by an expert antibiotic stewardship panel and implemented across hospitals. Data were collected by antibiotic stewardship program personnel at each hospital, deidentified and submitted in aggregate for benchmarking. hospital personnel identified most salient reasons for inappropriate use by category and agent. Forty-seven ICUs participated. Most hospitals (83%) identified as teaching with median licensed ICU beds of 70. On March 1, 2017, 362 (54%) of 667 ICU patients were on antibiotics (range, 8-81 patients); of these, 112 (31%) were identified as inappropriate and administered greater than 72 hours among all 12 hospitals (range, 9-82%). Prophylactic antibiotic regimens and PICU patients demonstrated a statistically significant risk ratio of 1.76 and 1.90 for inappropriate treatment, respectively. Reasons for inappropriate use included unnecessarily broad spectrum (29%), no infection or nonbacterial syndrome (22%), and duration longer than necessary (21%). Of patients on inappropriate antibiotic therapy in surgical ICUs, a statistically significant risk ratio of 2.59 was calculated for noninfectious or nonbacterial reasons for inappropriate therapy. In this multicenter point prevalence study, 31% of ICU antibiotic regimens were inappropriate; prophylactic regimens were often inappropriate across different ICU types, particularly in surgical ICUs. Engaging intensivists in antibiotic stewardship program efforts is crucial to sustain the efficacy of antibiotics and quality of infectious diseases care in critical care settings. This study underscores the value of standardized assessment tools and benchmarking to be shared with local leaders for targeted antibiotic stewardship program interventions.

Prevalence of catastrophic health expenditure and its associated factors, due to out-of-pocket health care expenses among households with and without chronic illness in Bangalore, India: a longitudinal study.

SummaryBackgroundIndia, one of the economic powerhouses of the world, is lacking in health development.Moreover, it is facing ‘Triple burden of disease’. Indians have one of highest proportion of out-of-pocket (OOP) health expenses. Salient reasons are poor quality public health care, costly private care and lack of health insurance. This has led to catastrophic health expenditure (CHE). Another contributor to this CHE is the chronic illness, which require long-term follow-up. It is estimated that catastrophic health expenditure impoverishes 3.3% of Indians every year. This study was undertaken with an aim to estimate the prevalence of catastrophic health expenditure and its associated factors.MethodsA longitudinal study with one-year follow-up period was conducted among 350 households of an urban area in Bangalore city. Simple random sampling method was used to select the study sample. Data collection done using pre-tested, semi-structured questionnaire by interview method.ResultsChronic illness mean health expenditure was 1155.67 INR (56.09% of the direct cost was spent on drugs). In acute illness, mean health expenditure was 567.45 INR (59.54% of the direct cost was spent on drugs). Fourty eight (14.86%) of the households experienced CHE in the one year Statistically significant association was found between socio-economic status and catastrophic health expenditure. Eighty-five 42% of the households who experienced CHE had a member with chronic illness in it.ConclusionReducing the financial burden of high health care expenses is possible by improving the government health care system, free quality regular supply of medications to chronic disease patients and to improve the beneficiaries under insurance schemes.

A Patient-Centered Information System (myED) for Emergency Care Journeys: Design, Development, and Initial Adoption.

BackgroundMedical care is highly complex in that it addresses patient-centered health goals that require the coordination of multiple care providers. Emergency department (ED) patients currently lack a sense of predictability about ED procedures. This increases frustration and aggression. Herein, we describe a system for providing real-time information to ED patients regarding the procedures in their ED medical journey.ObjectiveThis study aimed to develop a system that provides patients with dynamically updated information about the specific procedures and expected waiting times in their personal ED journey, and to report initial evaluations of this system.MethodsTo develop the myED system, we extracted information from hospital databases and translated it using process mining and user interface design into a language that is accessible and comprehensible to patients. We evaluated the system using a mixed methods approach that combined observations, interviews, and online records.ResultsInterviews with patients, accompanying family members, and health care providers (HCPs) confirmed patients’ needs for information about their personal ED journey. The system developed enables patients to access this information on their personal mobile phones through a responsive website. In the third month after deployment, 492 of 1614 (30.48%) patients used myED. Patients’ understanding of their ED journey improved significantly (F8,299=2.519; P=.01), and patients showed positive reactions to the system. We identified future challenges, including achieving quick engagement without delaying medical care. Salient reasons for poor system adoption were patients’ medical state and technological illiteracy. HCPs confirmed the potential of myED and identified means that could improve patient experience and staff cooperation.ConclusionsOur iterative work with ED patients, HCPs, and a multidisciplinary team of developers yielded a system that provides personal information to patients about their ED journey in a secure, effective, and user-friendly way. MyED communicates this information through mobile technology. This improves health care by addressing patients’ psychological needs for information and understanding, which are often overlooked. We continue to test and refine the system and expect to find positive effects of myED on patients’ ED experience and hospital operations.

The Crown Prince Court’s Training and Career Development section: managing training for its employees

Learning outcomes This case study focuses on change management and employee resistance when implementing a new initiative. The case may be helpful to students to clarify their understanding of the following: the importance of employee involvement in the change management process in the government sector. Understand how to help employees to deal with change more effectively, maintaining their commitment and bringing them successfully through the change. Understand the importance of communication during the change process. Successful approaches used when implementing change, such as the Lewin model and Kotter 8. The obstacles to change, including resistance and adverse reactions to change and connecting employees, as well as the causes of resistance when implementing a change. Case overview/synopsis The Crown Prince’s Court is an independent government entity established in 1971, providing support to the Crown Prince of Abu Dhabi with the help of almost 300 employees. The Training and Career Development subsection headed by Sumaya Al Saedi decided to initiate an online training and development program for employees. Given that national service, maternity leave and emergency leave had led to working pressure and less training and development for the employees, Sumaya and her team realized that few employees were registering for the course and few of those that did register actually completed their course. Several causes were identified that had led to employees avoiding the online courses. Work pressure and technical issues were among the most salient reasons that kept registered employees from completing the course. The lack of policies at an institutional level to aid changes in training structures reduced the number of employees who felt that they could register for the courses. Therefore, Sumaya and her team had to decide how to attract their employees to online courses and how to support them. Complexity academic level This case study was written for Change Management courses in Bachelor of Business Administration programs. This case examines employee resistance to change when implementing a new system. It can, therefore, be used for undergraduate-level courses. As it concerns employees during the implementation of changes, this case study can be used to help students develop their planning and implementation skills. By focusing on internal departmental challenges, students are introduced to the change process of implementing an initiative and how to deal with employees in the organization. Supplementary materials Teaching Notes are available for educators only. Subject code CSS 6: Human Resource Management.

Alcohol Use Behaviors and Reasons to Abstain From or Limit Drinking Among Medically Vulnerable Youth.

Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, we sought to identify clusters of RALD and test associations with use behaviors. Eligible YCMC (ages 9-18) recruited from outpatient clinics reported their use behaviors and importance of potential RALD. Cluster analysis was used to discern RALD patterns, which were examined as predictors of alcohol use using multivariate regression. Among 398 participants, 30.9% reported past year alcohol use. Concerns about impacts on medications, school, and disease status were the most frequently endorsed RALD; prior negative experiences with alcohol and family history were the least frequently endorsed. Five RALD clusters were identified for all YCMC and 2 for recent drinkers. Compared to the cluster with high endorsement of multiple general and health-related RALD, those predominantly citing concerns about addiction and those not strongly endorsing any RALD consistently reported greater alcohol use. Among recent drinkers, the cluster characterized by low concern across multiple RALD also consistently reported greater alcohol use compared to their counterparts expressing moderate concern. For YCMC, RALD are complex but endorsement of multiple general and health-related RALD is associated with less use, and health concerns are especially prevalent. More research is needed to understand how salient RALD can inform tailored interventions that aim to delay and reduce substance use and improve health outcomes for YCMC.

Resolutions, salient reasons, and weakness of will

Traditionally, weakness of will (WOW) has been identified with an agent acting contrary to her better judgment, or akrasia. Recent empirical findings, however, have led many to conclude that the folk concept of WOW is not amenable to necessary and sufficient conditions. To this end, it has been argued that WOW attributions point to a cluster concept (May and Holton in Philos Stud 157(3):341–360, 2012), a disjunctive account of WOW as either judgment or resolution violation (Mele in Philos Stud 150(3):391–404, 2010), and a two-tiered account including both failures to adhere to commitments as well as failures to commit (Doucet and Turri in Synthese 191(16):3935–3954, 2014). Contrary to these views, I argue that there is indeed an underlying unifying feature of the folk concept of WOW. In particular, I argue that WOW is a matter of violating one’s salient reasons for action. I develop and defend this account in three stages. First, I introduce the theory philosophically, by critiquing the traditional view, i.e. judgment violation, as well as its initial competitor, Holton’s (J Philos 96(5):241–262, 1999; Willing, wanting, waiting, Oxford University Press, New York, 2009) view of resolution violation. I then turn to the empirical case for Salient Reasons Violation, arguing that the view best fits the data concerning folk attributions of WOW. Importantly, I argue that folk attributions unsurprisingly include violations of reasons that the attributor finds salient, even when the agent in the case may not. Finally, I turn to an explanatory account of Salient Reasons Violation, which moves beyond establishing the contours of our concept, by providing an explanation as to why the concept functions as it does.

Measuring food and nutritional losses through value stream mapping along the dairy value chain in Uganda

The growing burden of food losses has intensified the need for reliable and comparable data. This study extends the application of lean manufacturing practices and uses Value Stream Mapping (VSM) analysis with the Food Loss and Waste (FLW) Accounting and Reporting Standard to identify hotspots and analyze the magnitude of both food and nutritional losses in the food value chain. A case study on the dairy value chain in Uganda is utilized to understand the production configuration (primary production, processing and distribution). Through linking hotspots where food loss in milk production takes place to specific salient reasons, this case provides an estimation of the magnitude of losses occurring in yogurt and UHT milk production lines. Findings reaffirm the processing stage as a principle hotspot for discarding yogurt as well as UHT milk products. Throughout processing, from start to finish, food losses at chain level are estimated to be in the magnitude of up to 14%. This also translates to a substantial nutritional value disappearing from the food system, which compromises the ability of people to meet their nutrient recommendations. The case study represents a pragmatic assessment that combines the mapping advantages of VSM with accounting and reporting guidelines of FLW Accounting and Reporting Standard to contribute to a detailed assessment of food and nutritional losses. Thereby, reinforcing initiation of evidence-based and targeted reduction strategies along food supply chains.

Knowledge, attitude and practice among non-ophthalmic health care providers regarding eye management of diabetics in private sector of Riyadh, Saudi Arabia

BackgroundThe levels of knowledge, attitude and practice among primary physicians concerning both diabetic retinopathy screening and treatment of sight threatening diabetic retinopathy have been studied by different groups, such as medical students, pharmacists, Primary Health Care staff and opticians. In some studies, the levels were very high, while in others it was noted to be less than desired.AimThis study’s intent is to estimate and improve level of Knowledge (K), Attitude (A) and Practice (P) among non-ophthalmic health care providers regarding eye management of diabetes and barriers that people with diabetes face in Saudi Arabia.MethodsThis cross-sectional survey targeted medical doctors (except ophthalmologists) working at private sector institutions in Riyadh. They were interviewed using closed-ended questions for knowledge (8), attitude (5), practice (5), and reasons for their current KAP status comprised of 8 questions. The level of Knowledge was assessed as good if its score was (> 50%); positive attitude (> 50%) and excellent practice (> 75%) were estimated and associated to the risk factors.ResultsOut of the 355 participants that were interviewed, the percentages of good knowledge, positive attitude and excellent practice concerning diabetic retinopathy (DR)were 193 [54.3% (95% CI 49.2–59.5)], 111 [31.3% (95% CI 26.4–36.1)], and 145 [40.8% (95% CI 35.7–46.0) participants, respectively. Gender, place of work and type of doctor were not significantly associated with the level of KAP. Salient reasons for low KAP status included a busy schedule (54.6%), less resources (75.2%), inadequate periodic training in eye care (69%), and absence of retinal evaluation training (49.6%).ConclusionsImproving KAP level is urgently needed. Addressing underlying causes of low KAP could enhance eye care of people with diabetes. Additionally, training for primary health care providers for early detection of DR and timely management of sight threatening diabetic retinopathy (STDR) is necessary.

Toward Increased Professionalism in Teaching English as a Second or Other Language through Pre-service Trainee Teacher Mentoring in the United Arab Emirates

For a variety of reasons, both historical and sociological, the feasibility – as well as the very desirability – of mainstream teaching securing the status of a profession (in the sense of established professions such as law, medicine, architecture, and engineering) has long been questioned (e.g., Burbules and Densmore, 1991). If this is the case as regard regular, mainstream education, what then is the situation in relation to the subfield of teaching that is teaching English as a second or other language (TESOL)? Sadly, few if any would likely doubt that the field has so far failed to achieve the status of a recognized profession. There are numerous causes of this failure, though some especially salient reasons – less than stellar public perceptions of the fields of English as a second language/English as a foreign language, employment standards of the private sector, that is, the (in) famous English language teaching industry, the initial training and qualifications of those in the field, and discriminatory practices – will be highlighted in the following discussion. In addition, the second half of this paper draws and reflects on a trainee teacher mentoring scheme at a federally-sponsored institution of higher education in the United Arab Emirates – now sadly discontinued – which the author participated in for 3 years between 2011 and 2015, and which, it is argued, exemplified programs which can go some not inconsiderable way toward combatting a number of the obstacles currently preventing the field of TESOL achieving the status of a legitimate profession.

Self-Reported Reasons for Abstinence from Illicit Drugs

Objective: To provide a more balanced understanding of the initiation and restraint of substance use, educators, clinicians, and researchers would benefit from a review of research assessing the reasons nonusers report for having abstained from drugs. Method: Based on searches of computerized databases and the reference sections of relevant articles, we identified 15 relevant studies that assessed and quantified participants’ expressed reasons for having abstained from (a) one or more named substances or (b) drugs (or alcohol and drugs) with little or no further specification. We defined as more salient those 25% of reasons in each study that were endorsed most frequently, ranked highest, or rated most influential. Results: Five reasons – concerns about physical health, lack of interest, harmful psychological consequences, personal beliefs/morals, and peer/family disapproval – were most frequently identified as salient across studies and substances. Conclusion: These salient reasons are consistent with outcome expectancy and social learning models that have been proposed to explain drug initiation. To enhance the value of future research, we recommend testing whether importance ratings differ across contexts; repeatedly assessing within-subject variability of reasons across time; evaluating the association of psychological characteristics with reasons for abstaining; and continuing to evaluate which reasons for abstaining vary by type of drug, gender, ethnicity, and religiosity. We also recommend additional research comparing which reasons predict continued abstinence and which predict initiation of use during follow-up.

Culture Shock and Job Expectations Adjustment among Nigerian Self-Initiated Expatriates in the United Kingdom

Purpose: A great number of people in the world today, live and work outside the shores of their nations of origin. It is imperative to investigate how they are faring in the face of job satisfaction/dissatisfaction and the divergent cultural environment of their sojourn in order to correctly harness their inter-cultural usefulness across the globe. This research investigated the factors that influenced the relocation of Nigerians to the United Kingdom and sustained them there, in spite of their job experiences and culture shock.Methodology/Approach: Methodology triangulation of both questionnaire survey on seventy-six participants and six in-depth interviews was employed. Reflexivity, thick description and grounded theory were the approaches engaged in the data analysis and Interpretation of results.Findings: The findings revealed that multiple reasons like education, economic, socio-political and personal, are ‘pushing’ Nigerians from home and ‘pulling’ them to the United Kingdom. It was also discovered that the Nigerians in the United Kingdom, are experiencing different forms of job dissatisfaction and culture shock but for some salient reasons, they adjust fairly well to the environment.Keywords: Self-initiated expatriates, job expectations, culture shock, and socio-cultural adjustment.

Selecting anti-speeding messages for roadside application

PurposeAnalyze qualitative and quantitative data to determine the relative effectiveness of theoretically-developed anti-speeding messages, as judged by relatively inexperienced and experienced drivers, both for themselves as a driver, and for drivers in general. MethodEight focus groups and three individual interviews were conducted. Participants initially completed a questionnaire, ranking sets of three anti-speeding messages representing each of the six components of protection motivation theory (PMT). Participants were encouraged to write down the reasons for their rankings. During group and individual facilitation sessions, the rankings and reasons for them were discussed to identify salient reasons for participants’ judgments. The ranking data were analyzed quantitatively, with individual and group-based comments being analyzed thematically. ResultsQuantitative analyses of message pairs revealed five third-person effects (TPEs). Three messages were perceived as more relevant to drivers in general than to the participant-as-driver while two were associated with reverse TPEs, which participants perceived as more relevant to themselves-as-driver than for drivers in general. For four PMT components (rewards, self-efficacy, response efficacy, response costs), one or more messages received significantly higher rankings than one or more other messages representing the same component. Substantial variation was found within the individual and group discussion comments in respect of nearly all the messages, reflecting different driver perspectives and demographics. DiscussionA general preference for shorter messages was evident, leading to a revision of most of the messages comprising the stimuli for this study. On the basis of the focus group and interview responses, consideration was given as to which messages would be recommended for a pilot field study.

Overcommunication Strategies of Violating Grice’s Cooperative Principle in Ground Service

Based on four maxims of Grice’s cooperative principle framework, a small scale study is conducted to examine the communication strategies employed by experienced ground service staff. Data have been collected from questionnaires and in –depth interviews with Chinese domestic airlines’ ground staff. This study identifies that the communicative challenges usually happen in service failure and service recovery. And it finds out violation of four maxims of Grice’s cooperative principle is taken as sub-strategies of overinformativeness, telling a white lie, irrelevance, and ambiguity or prolixity. These strategies lead to overcommunication which could be routinely employed for the specific professional purposes of saving the passenger’s face, gaining the passenger’s understanding, reducing conflicts, avoiding complaints, or even establishing a harmonious relationship with passengers. This study moreover exploits that in the ground service communication context, two salient reasons stimulate the overcommunication strategies. Firstly it is to improve the service quality and secondly to enhance the passenger’s satisfaction which are the determining factors to the sustainable development of the airlines. This study is ambitious to seek a new means of understanding and investigating the ground service communication from the perspective of pragmatics. By integrating business communication in ESP context to the classical theory of pragmatics, this study attempts to offer practical suggestions to the frontline communicators.

Psychological and demographic predictors of undergraduate non-attendance at university lectures and seminars

Absenteeism from university teaching sessions is increasingly becoming a common phenomenon and remains a major concern to universities. Poor attendance has significant and detrimental effects on students themselves, their peers and teaching staff. There is, however, a lack of previous research investigating demographic and psychological predictors of non-attendance alongside salient reasons students offer for their absence; it is this ‘gap’ that the present study attempts to fill. We approached 618 undergraduate university students from a single UK university studying various courses to complete a bespoke questionnaire assessing their estimated percentage attendance at lectures and seminars over the academic year. Students answered demographic questions, completed psychometric tests of perceived confidence (Perceived Confidence for Learning) and university belongingness (Psychological Sense of School Membership), and rated the degree to which possible reasons for non-attendance applied to themselves. Multiple regression analyses were carried out separately for estimated attendance at lectures and seminars. Results demonstrated that significant predictors of poorer attendance for both scenarios were experiencing a lower sense of belongingness to university; working more hours in paid employment; having more social life commitments; facing coursework deadlines; and experiencing mental health issues. Improving a sense of belonging to university and targeting interventions at students working in paid employment may be effective means of increasing attendance. Providing support for students with mental health issues, structuring courses around coursework deadlines and helping students to organise their attendance around social activities could also be advantageous.

The imperviance of conceptual systems: cognitive and moral aspects

Purpose The complexity of the modern world calls for the increasingly complex (i.e. containing more concepts) and systemic (i.e. containing more causal connections between the concepts) conceptual systems, such as theories and mental models which may exist at varying levels of complexity and systemicity. Yet, these systems are often found to be impervious to data and counter-arguments. Examples of such disputes are found in arguments over global warming and in the many debates between political groups. The purpose of this paper is to review the reasons behind this imperviance and identify ways to move forward. Design/methodology/approach The paper brings together the insights from the burgeoning science of conceptual systems as well as selected ideas from the moral philosophies of Niklas Luhmann and Jürgen Habermas. The science of conceptual systems is utilized to unearth the cognitive reasons for the imperviance of conceptual systems, while the work of Luhmann and Habermas is brought to bear on the moral reasons. Findings The most salient cognitive reasons for this imperviance are shown to be related to the questionable validity of data, the situational inappropriateness of conceptual systems, as well as their low complexity and systemicity. The effect of the moral content of conceptual systems on their imperviance is ambivalent. For Luhmann, moral communication may enhance imperviance and induce conflicts. In contrast, the Habermasian discourse ethics may counteract imperviance by stimulating the rational moral argumentation. Originality/value The science of conceptual systems is uniquely positioned to analyze the pervasive problem of their imperviance, especially if this problem is aggravated by moral reasons.

Akrasia and conflict in the Nicomachean Ethics

ABSTRACTIn Nicomachean Ethics VII, Aristotle offers an account of akrasia that purports to salvage the kernel of truth in the Socratic paradox that people act against what is best only through ignorance. Despite Aristotle’s apparent confidence in having identified the sense in which Socrates was right about akrasia, we are left puzzling over Aristotle’s own account, and the extent to which he agrees with Socrates. The most fundamental interpretive question concerns the sense in which Aristotle takes the akratic to be ignorant. The received view in the literature has been the intellectualist interpretation, which takes akratic agents to be so ignorant of the wrongness of what they do as to be unaware of it. In recent decades, many scholars have identified serious problems in this interpretation and have moved towards the non-intellectualist reading, the strong version of which takes clearheaded akrasia to be possible. There is, however, a glaring shortage of discussion of the difficulties facing the strong non-intellectualist reading. In this paper, I present what I take to be the most salient reasons for rejecting strong non-intellectualism, and argue that Aristotle’s text supports a moderate non-intellectualism, according to which clearheaded akrasia is impossible.

Why do you feel stressed in a “smile factory”?

Purpose– This study aims to theoretically construct the role of hospitality job characteristics (HJCs), conceptually identify specific HJCs and empirically examine the relationships of these to work–family conflict and job stress. Hospitality employees work in a “smile factory” – often under stress.Design/methodology/approach– Data were collected from 346 hotel employees in China and analyzed using structural equation modeling (SEM) and a series of hierarchical regression analyses (HRA).Findings– The SEM results confirmed the general role of HJCs as a job stressor, and the HRA findings differentiated the specific impacts of the characteristics on work–family conflict and job stress.Research limitations/implications– The survey was cross-sectional and correlational in nature. Furthermore, the results were also from selected hotels, and the respondents do not fully represent all hotel employees. Finally, the measures of hospitality job uniqueness were employees’ subjective agreement on the given statements.Practical implications– The study offers a systematic framework of specific job characteristics in the hospitality context for the reconciliation of previously inconsistent research findings. The findings may also be useful to hospitality managers as they attempt to analyze and understand the specific job characteristics that are the most salient reasons for withdrawal attitudes and behaviors.Originality/value– The present study identified the list of HJCs by summarizing previous studies and examining the roles of HJCs in work attitudes among hospitality employees. These efforts could be helpful both for scholars by constructing a consistent base for future research and for managers by precisely analyzing the specific job attributes.

The nasal vestibular body: anatomy, clinical features, and treatment considerations.

Nasal obstruction is a common presenting complaint, with many possible etiologies. Herein, we provide an introductory anatomic description, clinical relevance, and proposed nomenclature for an underappreciated soft tissue focus in the nasal vestibule-the nasal vestibular body (NVB)-that can contribute to nasal obstruction in a subset of patients. This is a small mound of dynamic soft tissue in the lateral aspect of the internal nasal valve, situated inferior and anterior to the head of the inferior turbinate that can be missed on routine examination for many salient reasons. In well-selected patients, whose symptoms of nasal obstruction may in part be secondary to the presence of this soft tissue focus, directed testing and tissue reduction can be performed.

Nonsuicidal self-injury: a rapidly evolving global field.

Nonsuicidal self-injury: a rapidly evolving global field.

Managerialism Meets Regime: A Distinctively Singaporean Marriage?

Managerial reforms were once assumed to be apolitical, and hence universally applied to various political settings. This assumption has been widely contested; some argue that managerial reforms are not applicable to countries outside what are termed Western liberal democracies, due to differing political contexts. The case of Singapore offers a counter-argument to these claims—managerial reforms were well-received in the state and its bureaucracy; both of which were vastly different from those of liberal democracies. The article further argues that this was not a coincidence; there seem to be salient reasons why managerial reforms were able to ‘marry’ Singapore's regime. This case study offers insights vis-à-vis a broader question: whether and how managerial reforms can be justified within and received in differing political contexts. It seems imperative to address this question, given the implications for future scholarship and how managerialism is a significant matter of concern to many governments worldwide.