Organizational effectiveness. Primary care and the congruence model

The congruence model is a framework used to analyze organizational strengths and weaknesses and pinpoint specific areas for improving effectiveness. This article provides an overview of organizations as open systems, with examples in the primary care arena. It explains and applies the congruence model in the context of primary care issues and functions, including methods by which the model can be used to diagnose organizational problems and generate solutions. Changes needed in primary care due to the managed care environment, and areas of potential problems and sensitivities requiring organizational changes to meet market and regulatory demands now placed on PCOs are examined.     

Understanding child neglect in Aboriginal families and communities in the context of trauma

Child neglect is a significant concern for Aboriginal families and communities both in Australia and internationally. Service responses to child neglect are largely informed by child neglect theories, which explain the nature and causes of child neglect. However, child neglect is a problem that is worsening for Aboriginal children, suggesting that these theories are not appropriate. This paper argues that to meet the needs of Aboriginal families and communities where there is child neglect, policy and practice needs to acknowledge and address the impact of trauma in shaping the lived experiences of Aboriginal people. International literature discusses the impact and consequence of historical trauma within Indigenous families and communities, and separately, child maltreatment theorists have discussed the ecological nature of child neglect. However, the literature and evidence‐base linking the two, child neglect and historical trauma in Indigenous contexts, are very scant. This paper aims to fill this gap and emphasize the importance of addressing child neglect within Aboriginal families and communities in the context of historical trauma. Although this paper focuses on the post‐colonial experiences of Aboriginal people in Australia, the arguments can extend to many Indigenous cultures universally where child welfare interventions have resulted in significant and ongoing trauma.     

Who Reaps the Benefits,Who Bears the Risks? Comparative Optimism,Comparative Utility,and Regulatory Preferences for Mobile Phone Technology

Although the issue of risk target (e.g., self, others, children) is widely acknowledged in risk perception research, its importance appears underappreciated. To date, most research has been satisfied with demonstrating comparative optimism, i.e., lower perceived risk for the self than others, and exploring its moderators, such as perceived controllability and personal exposure. Much less research has investigated how the issue of target may affect benefit perceptions or key outcomes such as stated preferences for hazard regulation. The current research investigated these issues using data from a public survey of attitudes toward mobile phone technology (N= 1,320). First, results demonstrated comparative optimism for this hazard, and also found moderating effects of both controllability and personal exposure. Second, there was evidence of comparative utility, i.e., users believed that the benefits from mobile phone technology are greater for the self than others. Third, and most important for policy, preferences for handset regulation were best predicted by perceptions of the risks to others but perceived benefits for the self. Results suggest a closer awareness of target can improve prediction of stated preferences for hazard regulation and that it would be profitable for future research to pay more attention to the issue of target for both risk and benefit perceptions.     

Characterising the Perceived Risks and Benefits of Some Health Issues

Previous work on perceived risk, particularly a study by Fischhoff et al. (1978), is critically examined with reference to its applicability to specific health related issues. Judgments were obtained from 159 subjects of 15 health-related items in terms of perceived risk, benefit, and a number of risk characteristics based on the Fischhoff et al. research. In addition, demographic details concerning sex of respondent, seat belt usage, smoking status, and birth order were collected. Using regression analyses it was found that the direction of the risk-benefit relationship was dependent on the issue being judged. Risk was found to be better explained by ratings of likelihood of mishap and likelihood of death as a consequence of mishap. Benefit was poorly explained by the risk characteristics and demographic data. However, subject group characteristics were shown to be important influences on risk and benefit perception in certain situations. The implications of these results for understanding behavioral decisions involving risk in relation to specific activities are discussed.     

Awareness of Bad News, Environmental Attitudes, and Subjective Estimates of Coastal Pollution

Questionnaires distributed to 154 holiday-makers on beaches in Southwest England assessed awareness of local hazards or incidents associated with either the electricity supply industry or the water and sewage industry and examined the relationship between awareness and evaluations of the industry, current and future levels of pollution on the beach in question, and general levels of concern about environmental pollution. With respect to electricity, those respondents who were more aware of reports claiming a higher incidence of childhood leukemia in the vicinity of a nearby nuclear plant evaluated the electricity industry as less competent or trustworthy, showed higher levels of environmental concern, and were more pessimistic in their estimates of present and future levels of specific pollutants on their beach. With respect to the water industry, similar effects were associated with greater awareness of an accident at a water treatment plant and agricultural pollution of a nearby estuary. These findings are interpreted as suggesting a cyclical relationship between risk awareness and concern. On the one hand, reports about environmental hazards may lead to generalized concern across specific contexts; on the other hand, greater levels of concern may sensitize individuals to such reports.     

Marginal Trust in Risk Managers: Building and Losing Trust Following Decisions Under Uncertainty

Although a considerable amount of research has examined correlates of baseline public trust in risk managers, much less research has looked at marginal changes in public trust following specific events. Such research is important for identifying what kinds of events will lead to increases and decreases in public trust and thus for understanding how trust is built and lost. Using a taxonomy based upon signal detection theory (SDT), the current article presents two experimental studies examining marginal trust change following eight different types of events. Supporting predictions, cautious decisionmakers who accepted signs of danger (Hits and False Alarms) were more likely to be trusted than those who rejected them (All Clears and Misses). Moreover, transparency about an event was associated with higher levels of marginal trust than a lack of transparency in line with earlier findings. Contrary to predictions, however, trust was less affected by whether the decisions were correct (i.e., Hits and All Clears) or incorrect (i.e., False Alarms and Misses). This finding was primarily due to a "False Alarm Effect" whereby Open False Alarms led to positive increases in trust despite being incorrect assessments of risk. Results are explained in terms of a cue diagnosticity account of impression formation and suggest that a taxonomy of event types based on SDT may be useful in furthering our understanding of how public trust in risk managers is gained and lost.     

Risk Perceptions of Mobile Phone Use While Driving

Numerous governments have introduced regulations governing the use of mobile (cellular) telephones while driving. Despite significant research into the "objective" risks, there is relatively little research into risk perceptions either in relation to other in-car distractions or with respect to the factors underlying such perceptions. The current article reports on two studies addressing these issues. Study 1 ( N = 199) found that whereas the use of hand-held sets is seen as one of the riskiest activities to perform while driving, the risks of using a hands-free kit are perceived to be relatively small. Study 2 ( N = 1,320) found that nearly half of all drivers in the sample with a mobile phone reported having used it while driving and that, overall, the probability of having an accident was perceived to be less for oneself than for one's peers, indicating an optimistic bias. Two factors underpinned risk perceptions, "impact" including perceived severity and equitability, and "controllability" including immediacy, detectability, and probability. While higher "impact" scores were associated with increased preferences for restrictions on the use of hand-held mobiles while driving, the "controllability" scores moderated this relationship such that when perceived "controllability" was low, restriction preferences were high irrespective of perceived "impact." However, when "controllability" was high, restriction preferences remained high when "impact" was high but were low when "impact" was low. Given the growing number of in-car technological innovations, it is suggested that regulators act strategically, rather than finding themselves developing a series of "hazard-specific" regulations, which may ultimately lack coherence.     

SOCIAL DRINKING VERSUS ADMINISTERING ALCOHOL

Alcohol consumption tends to make some people (unwillingly) tell the truth, hence social drinking can serve as a signal in social contact games. We provide empirical evidence which shows that social drinking can serve as a trust facilitating mechanism. Liver cirrhosis mortality and the rate of abstainers are used to construct a novel index of moderate alcohol consumption, which correlates with trust levels in a cross‐country analysis.(JEL L14, D82, D71)     

"Trust me, I''m a scientist (not a developer)": perceived expertise and motives as predictors of trust in assessment of risk from contaminated land

Previous authors have argued that trust may be based on the extent to which risk communicators are seen as good at discriminating safety from danger, are unbiased in their assessments, and share their audience's values. Residents of two English urban regions rated their trust in six potential sources of information about the risk of contaminated land in their neighborhood (independent scientists; local council property developers; residents' groups; friends and family; local media), and how expert, open, accurate, or biased these sources were and how much they had residents' interests at heart. Overall, scientists were trusted most and developers least, but this was only partly due to their greater perceived expertise. Resident groups and friends/family were also trusted, despite being seen as relatively inexpert, since they scored highly on openness and shared interests, these latter two attributes being more important predictors of trust in individual sources than perceived expertise. We conclude that, where a source is seen as motivated to withhold, distort, or misinterpret information, this will undermine public trust even in apparently knowledgeable sources, hence supporting the view that trust depends on a combination of perceived expertise and perceived motives as complementary processes.     

Risk Perceptions and Trust Following the 2010 and 2011 Icelandic Volcanic Ash Crises

Eruptions at the Icelandic volcanoes of Eyjafjallajökull (2010) and Grimsvötn (2011) produced plumes of ash posing hazards to air traffic over northern Europe. In imposing restrictions on air traffic, regulators needed to balance the dangers of accidents or aircraft damage against the cost and inconvenience to travelers and industry. Two surveys examined how members of the public viewed the necessity of the imposed restrictions and their trust in different agencies as estimators of the level of risk. Study 1 was conducted with 213 British citizens (112 males, 101 females), who completed questionnaires while waiting for flights at London City Airport during May 2012. Study 2 involved an online survey of 301 Icelandic citizens (172 males, 127 females, 2 undeclared gender) during April 2012. In both samples, there was general support for the air traffic restrictions, especially among those who gave higher estimates of the likelihood of an air accident or mishap having otherwise happened. However, in both countries, the (minority of) respondents who had personally experienced travel disruption were less convinced that these restrictions were all necessary. Scientists, the International Civil Aviation Organization, and (in Iceland) the Icelandic Department of Civil Protection were all highly trusted, and seen as erring on the side of caution in their risk estimates. Airlines were seen as more likely to underestimate any risk. We conclude that perceptions of the balance between risk and caution in judgments under uncertainty are influenced by one's own motives and those attributed to others.