Emotions in institutional work:a discursive perspective

This paper focuses on the dynamics and interplay of meaning, emotions, and power in institutional work. Based on an empirical study, we explore and elaborate on the rhetorical strategies of emotion work that institutional actors employ to mobilize emotions for discursive institutional work. In an empirical context where a powerful institutional actor is tasked with creating support and acceptance for a new political and economic institution, we identify three rhetorical strategies of emotion work: eclipsing, diverting and evoking emotions. These strategies are employed to arouse, regulate, and organize emotions that underpin legitimacy judgments and drive resistance among field constituents. We find that actors exercise influence and engage in overt forms of emotion work by evoking shame and pride to sanction and reward particular expedient ways of thinking and feeling about the new institutional arrangements. More importantly, however, the study shows that they also engage in strategies of discursive institutional work that seek to exert power—force and influence—in more subtle ways by eclipsing and diverting the collective fears, anxieties, and moral indignation that drive resistance and breed negative legitimacy evaluations. Overall, the study suggests that emotions play an important role in institutional work associated with creating institutions, not only via “pathos appeals” but also as tools of discursive, cultural-cognitive meaning work and in the exercise of power in the field

Exercise as effective as surgery in improving quality of life, disability, and pain for large to massive rotator cuff tears: A systematic review & meta-analysis

Questions: To report the characteristics of exercise interventions and ascertain their effectiveness compared to surgery on quality of life, disability, and pain for people with large to massive rotator cuff tendon tears (L-MRCTTs). Design: Systematic review with meta-analysis of randomised controlled trials (RCTs). Participants: Adults with L-MRCTTs defined as; >5 cm, 2 or more tendons. Intervention: Exercise as an intervention for L-MRCTTs. Outcome measures: Primary: quality of life, disability, and pain. Secondary: range of motion (ROM). The Consensus on Exercise Reporting Template (CERT) was used to extract data on the individual characteristics of each exercise intervention. The Cochrane Risk of Bias Tool V2 was used to assess study quality with the certainty of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Results: Five trials (n = 297 participants, average age 66.7 years, 55% male) were included in analysis. Three trials compared exercise to another non-surgical intervention and 2 trials compared exercise to surgery. At 12 months a significant improvement in pain of 0.47 (95% CI 0.07–0.88, I2 = 53%, REM) favoured the surgical group and a significant improvement in shoulder external rotation ROM of 9° (95% CI 2.16–16.22, I2 = 0%, FEM) favoured the exercise group. The median CERT score was 7/19 (range 4–12). The certainty of evidence was low or very low across all outcomes. Conclusion: A paucity of high-quality research on the role of exercise in the management of L-MRCTTs exists with substantial discrepancies in the reporting of the exercise interventions in the published research. 2022 The Author

The interplay between HQ legitimation and subsidiary legitimacy judgments in HQ relocation : a social psychological approach

This paper marks a departure from the focus on external stakeholders in much research on legitimacy and multinational corporations, adopting a social psychological approach to study how MNCs build internal legitimacy for controversial decisions with their subsidiaries. We explore this through a longitudinal, real-time qualitative case study of a regional office relocation, since office relocations represent rare yet significant strategic decisions. We analyze the interplay between the legitimation strategies of senior managers and subsidiary legitimacy judgments, based in instrumental, relational, and moral considerations, and how the relationship between the two develops over time. From this analysis, we derive inductively a process model that reveals the dynamics of building internal legitimacy with subsidiaries, and how an MNC moves on even in the absence of full legitimacy, when dealing with controversial MNC decisions. The model highlights two important dynamics. The first is a dynamic between legitimation strategies and legitimacy judgments and how this is influenced by local subsidiary contexts. The second is a temporal dynamic in how both the legitimation strategies and legitimacy judgments evolve over time. Our model contributes to research on legitimacy in MNCs, what we know about tensions that characterize MNC–subunit relationships, and research on headquarters relocation

Developing a treatment algorithm for people presenting to primary care with symptomatic large to massive rotator cuff tendon tears: the CALMeR cuff pathway

Background: Shoulder pain is highly prevalent accounting for one-third of all musculoskeletal presentations managed in primary care. Full-thickness rotator cuff tears account for almost 1 in 4 of these presentations with the incidence and size of the tear positively correlated with increasing age. Patients can often present with pain, especially at night, significant muscle weakness, and loss of function. The prognosis is highly uncertain with 50% of patients reporting persistent pain and disability that lasts >6 months. Some of this uncertainty is created due to the high variability in first-line treatment which is often based on age, tear morphology and characteristics, and patient expectations. Managing shoulder pain at the primary care level is challenged further when a lack of clinician confidence is combined with many shoulder disorders exhibiting similar clinical features, and a lack of consensus on diagnostic criteria and concordance in clinical assessment. As a result, a great debate exists within the current literature around the prognostic outcomes of non-surgical versus surgical repair for large to massive rotator cuff tears (LMRCTTs). To address these evidence-practice gaps, the overarching aim of this thesis is to develop a treatment algorithm to assist in the provision of care for people presenting with LMRCTTs. The overall aim is achieved through the conduct of four objectives, underpinned by the Medical Research Council Framework for the Development and Evaluation of Complex Interventions. </p