Simulation modelling and strategic change : creating the sustainable enterprise

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Biotechnological developments, socio-technical processes and materiality : the affordances and constraints of ‘social innovation'

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Organizational Change Stories and Management Research: Facts or Fiction

Company change stories are often constructed around a linear series of ‘successful’ events which serve to show the company in a positive light to any interested external party. These stories of company success sanitise this process and offer data for change experts to formulate neat linear prescriptions on how to best manage change. This position is criticised in this paper which draws on processual case study data to argue that change is a far more complex muddied political process consisting of competing histories and ongoing multiple change narratives which may vie for dominance in seeking to be the change story. A central aim is to demonstrate the analytical importance of identifying and unpacking frameworks of interpretation which are utilized in organizational struggles over change outcomes. Understanding how change stories are managed also highlights political process and draws attention to the ways in which power is exercised. As such, the paper calls for the more widespread use of the concept of ‘competing histories’ and ‘multiple change narratives’ in theories which seek to explain processes of organizational change

Choice and context in studying change, creativity and innovation at work: call off the search for excellence, question combinational perspectives, and loosen the straightjacket of polarised views

This article draws attention to debates on studying change, creativity and innovation at work. Attention is given to \u27stable\u27 and \u27process\u27 views of organizations and how these positions influence research objectives, methodological approach and findings. The paper is critical of those who seek to hold to a superior position - a one best approach for all; as well as those who seek the best from all worlds - a combinational approach that services both quantitative and qualitative research. In drawing on over 25 years of field research on change management, the paper also seeks to explore the broken links between good scholastic theory and more practical accounts of how to best manage change. These and other controversial concerns are raised and discussed but ultimately not resolved, as in many ways, the papers poses as many questions as answers to these ongoing concerns among research academics and business practitioners

Jigsaws and Jugglers: Disposition, Discourse, and Decision-making in the Assessment of Student Nurse Practice

This research is concerned with the assessment of student nurses' practice, implementation of which has been considered problematic since the move of initial training into higher education. It examines clinical nurses' accounts of assessment, and rejects an approach based on identification of competencies as too rationalistic for a situated practice. Insights from, in particular, Foucault, Deleuze, and Derrida were used to analyse practitioners' alternative discourse of practice, and the processes of self-constitution and decision-making. Eighteen practitioners from different settings were interviewed in depth about how they determine acceptable performance. Three participants were interviewed twice to develop ideas arising from the first round of conversations. Practitioners' accounts challenged the conventional understanding of assessment, and the construction of practice implicit in current policy. The analysis suggests a more fluid, un-predetermined understanding, characterised by hesitation and uncertainty, though without losing a concern with safe practice. Several implications for policy and practice are presented. These require a shift of authority towards practitioners' situated judgements and away from predetermined outcomes, both in respect of programme planning and policy guidelines on the specification of standards. A new alliance is proposed to encourage a more authentic engagement with the process from both clinical and educational practitioners

The way it really happened: competing narratives in the political process of technological change

Corporate narratives concerning technological change are often constructed around a linear series of events that show the organization in a positive light to internal and external observers. These narratives often sanitize the change process, and present data from which commentators can formulate neat linear prescriptions on how to implement new technology. In contrast, this paper draws on processual-contextual theoretical perspectives to argue that technological change is a more complex political process represented by multiple ongoing narratives which compete with each other for dominance as definitive change accounts. A central aim of this paper, therefore, is to demonstrate the analytical significance of identifying and unpacking the multiple frameworks of interpretation that are utilized in organizational struggles over technology and change at work. Understanding how change narratives are managed highlights political processes, and draws attention to the ways in which power is exercised through the construction of tacit explanations. The paper thus argues for the more widespread use of the concept of competing narratives in theories that seek to explain the process of technological change from contrasting perspectives

Temporal-Difference Learning to Assist Human Decision Making during the Control of an Artificial Limb

In this work we explore the use of reinforcement learning (RL) to help with human decision making, combining state-of-the-art RL algorithms with an application to prosthetics. Managing human-machine interaction is a problem of considerable scope, and the simplification of human-robot interfaces is especially important in the domains of biomedical technology and rehabilitation medicine. For example, amputees who control artificial limbs are often required to quickly switch between a number of control actions or modes of operation in order to operate their devices. We suggest that by learning to anticipate (predict) a user's behaviour, artificial limbs could take on an active role in a human's control decisions so as to reduce the burden on their users. Recently, we showed that RL in the form of general value functions (GVFs) could be used to accurately detect a user's control intent prior to their explicit control choices. In the present work, we explore the use of temporal-difference learning and GVFs to predict when users will switch their control influence between the different motor functions of a robot arm. Experiments were performed using a multi-function robot arm that was controlled by muscle signals from a user's body (similar to conventional artificial limb control). Our approach was able to acquire and maintain forecasts about a user's switching decisions in real time. It also provides an intuitive and reward-free way for users to correct or reinforce the decisions made by the machine learning system. We expect that when a system is certain enough about its predictions, it can begin to take over switching decisions from the user to streamline control and potentially decrease the time and effort needed to complete tasks. This preliminary study therefore suggests a way to naturally integrate human- and machine-based decision making systems.Comment: 5 pages, 4 figures, This version to appear at The 1st Multidisciplinary Conference on Reinforcement Learning and Decision Making, Princeton, NJ, USA, Oct. 25-27, 201

Understanding the Diversity of User Requirements for Interactive Online Health Services

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Renal replacement modality and stroke risk in end-stage renal disease—a national registry study

Background: The risk of stroke in end-stage renal disease (ESRD) on renal replacement therapy (RRT) is up to 10-fold greater than the general population. However, whether this increased risk differs by RRT modality is unclear. Methods: We used data contained in the Scottish Renal Registry and the Scottish Stroke Care Audit to identify stroke in all adult patients who commenced RRT for ESRD from 2005 to 2013. Incidence rate was calculated and regression analyses were performed to identify variables associated with stroke. We explored the effect of RRT modality at initiation and cumulative dialysis exposure by time-dependent regression analysis, using transplant recipients as the reference group. Results: A total of 4957 patients commenced RRT for ESRD. Median age was 64.5 years, 41.5% were female and 277 patients suffered a stroke (incidence rate was 18.6/1000 patient-years). Patients who had stroke were older, had higher blood pressure and were more likely to be female and have diabetes. On multivariable regression older age, female sex, diabetes and higher serum phosphate were associated with risk of stroke. RRT modality at initiation was not. On time-dependent analysis, haemodialysis (HD) exposure was independently associated with increased risk of stroke. Conclusions: In patients with ESRD who initiate RRT, HD use independently increases risk of stroke compared with transplantation. Use of peritoneal dialysis did not increase risk on adjusted analysis

Exploration of risk factors for weight loss in head and neck cancer patients

Introduction: Head and neck cancer patients receiving radiotherapy can experience a number of toxicities, including weight loss and malnutrition, which can impact upon the quality of treatment. The purpose of this retrospective cohort study is to evaluate weight loss and identify predictive factors for this patient group. Method and materials: 40 patients treated with radiotherapy since 2012 at the study centre were selected for analysis. Data was collected from patient records. The association between potential risk factors and weight loss was investigated. Results: Mean weight loss was 5 kg (6%). 24 patients lost >5% starting body weight. Age, Tstage,N-stage, chemotherapy and starting body weight were individually associated with significant differences in weight loss. On multiple linear regression analysis age and nodal status were predictive. Conclusion: Younger patients and those with nodal disease were most at risk of weight loss. Other studies have identified the same risk factors along with several other variables. The relative significance of each along with a number of other potential factors is yet to be fully understood. Further research is required to help identify patients most at risk of weight loss; and assess interventions aimed at preventing weight loss and malnutrition.</p