Productive resistance within the public sector: exploring organisational culture

The article examines how South Korean civil servants responded to the introduction of pay for performance. Drawing upon 31 in-depth interviews with career civil servants, it identifies what became known as 1/n, a form of ‘discreet resistance’ that emerged and evolved. The analytical framework allows productive resistance to be seen as ebbing and flowing during organisational change that sees institutionalisation, deinstitutionalisation and re-institutionalisation. In understanding the cultural context of organisational resistance the contribution is three-fold. First, a nuanced definition and understanding of productive resistance. Second, it argues that productive resistance must be seen as part of a process that does not simply reflect ‘offer and counter-offer’ within the change management process. Thirdly, it identifies differences within groups and sub-cultures concerning commitment towards resistance and how these fissures contribute towards change as new interpretive schemes and justifications are presented in light of policy reformulations

‘Curiouser and curiouser!’:organizations as wonderland – a metaphorical alternative to the rational model

The metaphors in Morgan’s (1986) Images of Organization largely imply order, rationality, stability and manageability. This reflects that the text is concerned with facilitating the design and management of organizations. This article draws on Lewis Carroll’s (1865) novel Alice’s Adventures in Wonderland to propose Wonderland as an alternative metaphor that places at centre stage issues such as absurdity, irrationality, uncertainty and disorder. Rather than a marginal or temporary aberration, it is argued that such conditions need to be understood as an everyday experience for many. This metaphor is important because those who are tasked with managing organizations may find it stressful and puzzling that they are so inept, when they compare their experiences and achievements with the rational model. In this sense, it offers both comfort and perhaps encouragement, but it should also foster humility and caution in terms of what those at the top can achieve. Likewise, those on the receiving end of irrational decisions or who reside in absurd worlds can gain solace from knowing that they are not alone, whilst those concerned with resisting such conditions can find strength in the knowledge that those in positions of authority are not omniscient/omnipotent

A Controversy That Has Been Tough to Swallow: Is the Treatment of Achalasia Now Digested?

Esophageal achalasia is a rare neurodegenerative disease of the esophagus and the lower esophageal sphincter that presents within a spectrum of disease severity related to progressive pathological changes, most commonly resulting in dysphagia. The pathophysiology of achalasia is still incompletely understood, but recent evidence suggests that degeneration of the postganglionic inhibitory nerves of the myenteric plexus could be due to an infectious or autoimmune mechanism, and nitric oxide is the neurotransmitter affected. Current treatment of achalasia is directed at palliation of symptoms. Therapies include pharmacological therapy, endoscopic injection of botulinum toxin, endoscopic dilation, and surgery. Until the late 1980s, endoscopic dilation was the first line of therapy. The advent of safe and effective minimally invasive surgical techniques in the early 1990s paved the way for the introduction of laparoscopic myotomy. This review will discuss the most up-to-date information regarding the pathophysiology, diagnosis, and treatment of achalasia, including a historical perspective. The laparoscopic Heller myotomy with partial fundoplication performed at an experienced center is currently the first line of therapy because it offers a low complication rate, the most durable symptom relief, and the lowest incidence of postoperative gastroesophageal reflux