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In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity.

A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used.

Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union–management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies.

Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.

The purpose of this study is to provide new insights into the relationship between fiscal policy and total factor productivity (TFP) while accounting for several economic and econometric issues of the phenomenon like non-stationarity, fiscal feedback effects, persistence in productivity, country heterogeneity and unobserved global shocks and local spillovers affecting heterogeneously the countries in the sample.

The paper is empirical. It builds an Error Correction Model (ECM) specification within a dynamic heterogeneous framework with common correlated effects and models both reverse causality and feedback effects.

The results of this study highlight some new findings relative to the existing related literature. The outcomes suggest some relevant evidence at both the academic and policy levels: (1) the causal effects going from fiscal deficit/surplus to TFP are heterogeneous across countries; (2) the effects depend on the time horizon considered; (3) the long-run dynamics of TFP are positively impacted by improvements in fiscal budget, but only if the austerity measures do not exert slowdowns in aggregate growth.

The main originality of this study is methodological, with possible extensions to related phenomena. Relative to the existing literature, the gains of this study rely on the way econometric techniques, recently proposed in the literature, are adapted to the economic relationship of interest. The endogeneity due to the existence of reverse causality is modelled without implying relevant performance losses of the models. Moreover, this is the first article that questions whether the effects of fiscal budget on productivity depend on the impact of the former on aggregate output growth, thus emphasising the importance of the quality of fiscal adjustments.

The purpose of this study is to empirically test the intelligent career framework in a public sector setting in a country with a clientelistic culture to inform human resource management strategies.

Based on a qualitative methodology and an interpretivist paradigm, 33 in-depth interviews were conducted with Greek civil servants before the COVID-19 pandemic. The interview recordings were subsequently transcribed and coded via a blend of inductive and deductive approaches.

Outcomes of the study indicate that in a public sector setting in a country with a clientelistic culture, the three dimensions of knowing-whom, knowing-how and knowing-why are less balanced than those reported by findings from private sector settings in countries with an individualistic culture. Instead, knowing-whom is a critical dimension and a necessary condition for career development that affects knowing-how and knowing-why.

The theoretical contribution comes from providing evidence of the dark side of careers and how imbalances between the three dimensions of the intelligent career framework reduce work satisfaction, hinder career success and affect organisational performance. The practical contribution offers recommendations for human resource management practices in the public sector, including training, mentoring, transparency in performance evaluations and fostering trust.

The concept of personal recovery is now a key pillar of service delivery. It aims to support individuals to flourish and establish a new identity following an acute episode or diagnosis. This view of recovery is unique to each person on that journey. However, there has been a significant focus on measuring these experiences. This paper aims to explore the influence of social constructionism on the concept of recovery within an Irish context, seeking to understand the influence of language, discourse and power on service users’ experiences.

A qualitative, interpretivist methodology was adopted for this case study design. Semi-structured interviews were conducted with 12 service users. Thematic analysis was chosen as the method of analysis.

Personalising recovery did not always lead to the removal of biological symptoms, but with the appropriate supports, individual’s recovery journey was greatly enhanced. On the contrary, personal recovery places overwhelmingly responsibility on the individual to succeed, largely driven by neoliberal discourse. This focus on individualism and the pressure to succeed was further experienced when people sought to re-integrate into society and participate in normalised social order. Ultimately, for many service users, they viewed personal recovery as an unfulfilled promise.

It is not a representative sample of service users within an Irish context.

To the best of the authors’ knowledge, this is the first study to explore influence of social constructionism on the concept of personal recovery within a mental health service context.

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Trade relations between China and the USA have been marked by conflict, especially since China’s membership in the World Trade Organization (WTO). These conflicts have been analyzed from a variety of perspectives, including the loss of jobs in the USA due to Chinese imports, competition in high technology sectors and the balance of trade. Conceptual frameworks have employed models of domestic differences as well as models of international power distribution. Among domestic differences examined are the existence of state-owned enterprises in China compared to the domination of the USA economy by private firms, the large role of the Communist Party in China and the influence of labor and environmental and labor groups in the USA. Power distribution theories focus on the systemic effects of the distribution of power on trade openness and on the pattern of intra-bloc versus between-bloc trade. This paper aims to examine the role of macroeconomic policy factors in China and the USA, in particular, the role of national patterns of savings, investment and consumption (both private and government). The paper concludes that insofar as the balance of trade is an important component of the trade conflict, domestic macroeconomic factors continue to be important. The resolution of the conflict will have to take into account the respective macroeconomic policies of China and the USA.

The design is an analytic case study of US–China trade relations with a particular focus on the balance of trade. The conceptual framework employed involves an analysis of macroeconomic policy categories, especially the overall pattern of savings (household, firm and government), investment and consumption. Process tracing over time since China's membership in the WTO is carried out with an eye toward the relationship between the balance of trade and macroeconomic policy.

The main findings are that there is a strong relation between the respective macroeconomic policies of the USA and China and their trade relations. The domestic political economy of the USA encourages consumption and a low rate of savings. The opposite is true of China where household income is low by design and national savings are high. China depends on the USA to consume what is not consumed domestically. The USA depends on Chinese imports for additional consumption encouraged by its low rate of savings. The two economies are locked in a mutual dependence.

Key research implications are that there should be more focus on domestic macroeconomic policies since these are the root causes of the trade imbalance. This is not to say that trade frictions centering on jobs, subsidies and competition in high technology are unimportant. However, without the resolution of differences in the management of macroeconomic policies, trade conflicts between the USA and China will continue.

Practical implications are huge, in some ways much more important than the academic implications. Macroeconomic policy differences in savings, investment, government spending, taxation and infrastructure are important. Furthermore, there are available tools in both China and the USA to manage the macroeconomy, particularly, monetary and fiscal policy.

One implication of this paper is that satisfaction or dissatisfaction of workers is dependent on income distribution which in turn affects trade. Treatment of people in different socioeconomic categories, such as the elderly, the young, and those at working age are a function of macroeconomic policies.

Many people have written about macroeconomics. It is a conventional subfield of economics. The originality of this paper lies in its advocacy of a shift of focus and attention and in the argument that traditional macroeconomics is related to trade. Despite its importance, macroeconomics has not been the center of attention for most political scientists, though economists have made it more central.

The purpose of this paper is to investigate the adjustment of government redistributive policies in Scandinavian and Mediterranean countries following changes in income inequality over the period 1980–2021.

The authors first modelled the time-varying dynamics between income inequality and redistribution and then used a non-linear framework to test for the existence of asymmetries and cointegration in their long-run relationship. The authors used two complementary measures of inequality – the share of total income accruing to top percentile income holders and the ratio of the share of total income accruing to top decile income holders divided by that accumulated by the bottom 50% – and computed redistribution as the difference between the two inequality indicators before and after taxes and transfers.

The authors found that the sign of the relationship between income inequality and redistribution is mostly positive and time-varying. Overall, the authors also found evidence that the impact of increases in inequality on redistributive measures is higher than that of decreases. Finally, the authors obtained a significant long-run relationship between both variables in all countries except Denmark and Spain. These results hold for both Scandinavian and Mediterranean countries.

To the best of the authors’ knowledge, this is the first paper to account for the potential existence of non-linearities and to examine the asymmetries in the adjustment of redistributive policies to increases in income inequality using alternative income inequality metrics.

The purpose of this study is shed light on the underlying forces behind entrepreneurship within a regional innovation system (RIS) in a remote rural region. The authors examine the following questions: Which are the main underlying forces behind the entrepreneurial process in a rural RIS characterized by traditionally low-tech, small-scale businesses? How can the development of a low-tech regional innovation system be conceptualized?

The design of the study is based on entrepreneurship theory. Data analysis followed practices used in phenomenography, a research approach used to analyse and identify commonalities and variations in populations' perceptions of a certain phenomenon. Data are composed using semi-structured interviews and a database composed of company information of all firms in the population.

A proactive mobilization of regional stakeholders and resources can be an important driving force behind the entrepreneurial process and generation of a rural RIS. Innovation can be generated within low-tech industries turning the rural context into an asset. An RIS in a remote rural context can be initiated and orchestrated by regional authorities, but knowledge brokering and orchestration can also be managed by networks of small-scale businesses brought together by mutual benefit and common interests.

Regional innovation systems theory is most often used to study high-tech industries. But by combining regional innovation systems with rural entrepreneurship and entrepreneurship context theory is a fruitful avenue to understand the role of rural entrepreneurship in regional development, even in remote and peripheral regions. Innovation does not need to entail high-tech international environments; it can appear as the result of efforts in low-tech industries in rural and remote environments. The authors’ findings need to be scrutinized; therefore, the authors call for more research on regional innovation systems in rural environments.

It is possible for regional authorities to orchestrate a development process through the actions of a strong regional agent but also by supporting the creation of networks of small businesses that are built on trust and common interests.

This study contributes to the literature with a new perspective to the study of entrepreneurship and of regional innovation systems. Entrepreneurship research with focus on rural contexts most often highlight limits to entrepreneurship and see entrepreneurship as “just running a business”. A perspective that starts from innovation and innovative behaviour, despite the rural context and embedded resources, helps to generate new knowledge that can enrich the understanding of entrepreneurship and also be the foundation for more precise business development policies in rural settings.

This study aims to explore to what extent stakeholder engagement affects the sustainability reporting (SR) process and if it succeeds in facilitating the encounter between demand and supply of accountability, as well as the main challenges of this practice, by focusing on a crucial and under-investigated public sector area, the judicial system.

The study adopts an action research (AR) approach. Specifically, it focuses on a specific phase (i.e. stakeholder engagement) of the broader project that was carried on from 2019 in an Italian Public Prosecutor’s Office. Data were collected from multiple sources, i.e. written notes and reports gathered during meetings, the survey administered to stakeholders and the published sustainability reports.

Stakeholder engagement may be a valuable and effective tool for improving the level of accountability, as it increases the responsiveness of SR to the informative needs of stakeholders. However, the study also highlights some critical points that must be addressed to exploit this fully. Among these is the need to act upstream of the process by working on an accounting system that goes beyond the economic dynamics and can effectively answer the accountability demand.

The study contributes to theoretical and empirical knowledge by exploring a topic and a public sphere still limited investigated, i.e. the stakeholder engagement in sustainability in the judicial sector. The AR approach also presents some originality points, as it is low widespread in management and accounting literature.