DEveloping a Complex Intervention for DEteriorating Patients using Theoretical Modelling (DECIDE study): study protocol

AIM: To develop a theory-based complex intervention (targeting nursing staff), to enhance enablers and overcome barriers to enacting expected behaviour when monitoring patients and responding to abnormal vital signs that signal deterioration. DESIGN: A mixed method design including structured observations on hospital wards, field notes, brief, un-recorded interviews and semi-structured interviews to inform the development of an intervention to enhance practice. METHODS: Semi-structured interviews will be conducted with nursing staff using a topic guide informed by the Theoretical Domains Framework. Semi-structured interviews will be transcribed verbatim and coded deductively into the 14 Theoretical Domains Framework domains and then inductively into 'belief statements'. Priority domains will be identified and mapped to appropriate behaviour change techniques. Intervention content and mode of delivery (how behaviour change techniques are operationalised) will be developed using nominal groups, during which participants (clinicians) will rank behaviour change techniques /mode of delivery combinations according to acceptability and feasibility. Findings will be synthesised to develop an intervention manual. DISCUSSION: Despite being a priority for clinicians, researchers and policymakers for two decades, 'sub-optimal care' of the deteriorating ward patient persists. Existing interventions have been largely educational (i.e., targeting assumed knowledge deficits) with limited evidence that they change staff behaviour. Staff behaviour when monitoring and responding to abnormal vital signs is likely influenced by a range of mediators that includes barriers and enablers. IMPACT: Systematically applying theory and evidence-based methods, will result in the specification of an intervention which is more likely to result in behaviour change and can be tested empirically in future research. This article is protected by copyright. All rights reserved

Corporate governance, moral hazard and conflict of interest in Italian universal banking, 1914-1933

Universal banking is widely held to enjoy comparative advantages in corporate finance. Recent theories of financial intermediation argue that 'insider systems' are better suited to effectively deal with long-term growth and moral hazard problems. However, little attention (if any) is usually paid to corporate governance problems that are specific to universal banking. How can banks' ownership structure and agency problems influence their ability to address longterm growth and moral hazard problems? Under which institutional arrangements, incentives and constraints can universal banking effectively realize its potential? The paper looks at such issues through the experience of interwar Italy. The evolution of universal banking in the 1920s emerges as heavily exposed to potentially serious problems of moral hazard and conflicts of interest, due to inefficient corporate governance, lack of external controls and a moral-hazard-enhancing institutional set-up. These factors may distort bank managers' incentives, affect strategic trade-offs and lead to unsound banking. The findings are consistent with that part of corporate governance literature which points to the potential for moral hazard and conflicts of interest inherent to universal banking and emphasise the conditional and historically-specific nature of its alleged benefits

Dandelion Program Generic Project Management Plan

[Excerpt] There are significant benefits to clients in establishing an arrangement with Hewlett Packard Enterprise (HPE)/ Specialist People to access and acquire critical, skilled ICT resources by harnessing the talents and developing the skills of a capable, diverse segment of the workforce

An integrated approach to supply chain risk analysis

Despite the increasing attention that supply chain risk management is receiving by both researchers and practitioners, companies still lack a risk culture. Moreover, risk management approaches are either too general or require pieces of information not regularly recorded by organisations. This work develops a risk identification and analysis methodology that integrates widely adopted supply chain and risk management tools. In particular, process analysis is performed by means of the standard framework provided by the Supply Chain Operations Reference Model, the risk identification and analysis tasks are accomplished by applying the Risk Breakdown Structure and the Risk Breakdown Matrix, and the effects of risk occurrence on activities are assessed by indicators that are already measured by companies in order to monitor their performances. In such a way, the framework contributes to increase companies' awareness and communication about risk, which are essential components of the management of modern supply chains. A base case has been developed by applying the proposed approach to a hypothetical manufacturing supply chain. An in-depth validation will be carried out to improve the methodology and further demonstrate its benefits and limitations. Future research will extend the framework to include the understanding of the multiple effects of risky events on different processe

The European Union, Conflict Transformation and Civil Society: A Conceptual Framework

The European Union considers conflict resolution as a cardinal objective of its foreign policy. It makes use of a number of policy instruments to promote conflict transformation through ‘constructive engagement’, which cover a range of sectors affecting conditions and incentives at the micro level. The EU has recognised the importance of engaging with civil society in situations of violent conflict, but needs to engage more with local civil society to make its policies more effective. This paper provides a conceptual framework and discussion to analyse which local civil society actors play a role in conflict and conflict transformation, through which activities they impact on conflicts and how, what determines their effectiveness, and finally how EU neighbourhood policies can enhance their constructive impact in peacefully transforming conflicts in its near abroad by engaging with civil society.Civil society, European Union, European Neighbourhood Policy, violent conflict, conflict transformation

Governance of Offshore IT Outsourcing at Shell Global Functions IT-BAM Development and Application of a Governance Framework to Improve Outsourcing Relationships

The lack of effective IT governance is widely recognized as a key inhibitor to successful global IT outsourcing relationships. In this study we present the development and application of a governance framework to improve outsourcing relationships. The approach used to developing an IT governance framework includes a meta model and a customization process to fit the framework to the target organization. The IT governance framework consists of four different elements (1) organisational structures, (2) joint processes between in- and outsourcer, (3) responsibilities that link roles to processes and (4) a diverse set of control indicators to measure the success of the relationship. The IT governance framework is put in practice in Shell GFIT BAM, a part of Shell that concluded to have a lack of management control over at least one of their outsourcing relationships. In a workshop the governance framework was used to perform a gap analysis between the current and desired governance. Several gaps were identified in the way roles and responsibilities are assigned and joint processes are set-up. Moreover, this workshop also showed the usefulness and usability of the IT governance framework in structuring, providing input and managing stakeholders in the discussions around IT governance

Library project management in a collaborative web-based working environment

This paper discusses the emerging paradigm of project management performed in a web-based working environment. It highlights how project management and its associated features are strongly linked to fulfilling quality and value criteria for customers, and it examines how collaborative working environments can greatly reduce the administrative burden of managing large projects, especially and almost paradoxically, when resources are limited. Specifically, the paper examines the application of a project management methodology (PRINCE2) together with the use of a collaborative web-based working environment over a number of pilot projects at Leeds University Library. It describes the pilot phase of a library management decision to run a series of major Library projects using project management methodology, while continuing to run other projects through the existing locally developed planning mechanisms and describes the pitfalls of these latter alternatives, less sophisticated project management tools, and describes the main issues that this change in practice has brought to light. It draws preliminary conclusions about the effectiveness of this change in practice in one of the UK’s largest academic libraries