Managing diabetes in people with dementia: protocol for a realist review

Background Worldwide, the prevalences of diabetes and dementia are both increasing, particularly in older people. Rates of diabetes in people with dementia are between 13 and 20 %. Diabetes management and diabetic self-care may be adversely affected by the presence of dementia. There is a need to know what interventions work best in the management of diabetes in people living with dementia (PLWD) in different settings and at different stages of the dementia trajectory. The overall aim is to develop an explanatory account or programme theory about ‘what works’ in the management of diabetes in people in what context and to identify promising interventions that merit further evaluation. Methods/design This study uses a realist approach including studies on the management of diabetes in older people, medication management, diabetes-related self-care, workforce issues and assessment and treatment. We will use an iterative, stakeholder driven, four-stage approach. Phase 1: development of initial programme theory/ies through a first scoping of the literature and consultation with key stakeholder groups (user/patient representatives, dementia-care providers, clinicians, diabetes and dementia researchers and diabetes specialists). Phase 2: systematic searches of the evidence to test and develop the theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. Phase 4: actionable recommendations for the management of diabetes in PLWD. Discussion A realist synthesis of the evidence will provide a theoretical framework (i.e. an explanation of how interventions work, for whom, in what context and why) for practice and future research work that articulates the barriers and facilitators to effective management of diabetes in people with dementia. By providing possible explanations for the way in which interventions are thought to work and how change is achieved, it will demonstrate how to tailor an intervention to the setting and patient group. The propositions arising from the review will also inform the design of future intervention studies. Systematic review registration PROSPERO registration number CRD42015020625

Translating clinicians' beliefs into implementation interventions (TRACII) : a protocol for an intervention modeling experiment to change clinicians' intentions to implement evidence-based practice

Background: Biomedical research constantly produces new findings, but these are not routinely incorporated into health care practice. Currently, a range of interventions to promote the uptake of emerging evidence are available. While their effectiveness has been tested in pragmatic trials, these do not form a basis from which to generalise to routine care settings. Implementation research is the scientific study of methods to promote the uptake of research findings, and hence to reduce inappropriate care. As clinical practice is a form of human behaviour, theories of human behaviour that have proved to be useful in other settings offer a basis for developing a scientific rationale for the choice of interventions. Aims: The aims of this protocol are 1) to develop interventions to change beliefs that have already been identified as antecedents to antibiotic prescribing for sore throats, and 2) to experimentally evaluate these interventions to identify those that have the largest impact on behavioural intention and behavioural simulation. Design: The clinical focus for this work will be the management of uncomplicated sore throat in general practice. Symptoms of upper respiratory tract infections are common presenting features in primary care. They are frequently treated with antibiotics, and research evidence is clear that antibiotic treatment offers little or no benefit to otherwise healthy adult patients. Reducing antibiotic prescribing in the community by the "prudent" use of antibiotics is seen as one way to slow the rise in antibiotic resistance, and appears safe, at least in children. However, our understanding of how to do this is limited. Participants will be general medical practitioners. Two theory-based interventions will be designed to address the discriminant beliefs in the prescribing of antibiotics for sore throat, using empirically derived resources. The interventions will be evaluated in a 2 × 2 factorial randomised controlled trial delivered in a postal questionnaire survey. Two outcome measures will be assessed: behavioural intention and behavioural simulation.This study is funded by the European Commission Research Directorate as part of a multi-partner program: Research Based Education and Quality Improvement (ReBEQI): A Framework and tools to develop effective quality improvement programs in European healthcare. (Proposal No: QLRT-2001-00657)

Theories in sustainable supply chain management: a structured literature review

Purpose – The purpose of this paper is to investigate theoretical perspectives in sustainable supply chain management (SSCM) and contributes to understanding the current state of research in the field and its future development. Design/methodology/approach – This paper conducts a structured literature review and aims at mapping the use of theories in the field. The authors assess the current state of research, looking in more details at popular theories, and propose possible future avenues for the field to develop. Findings – Theory-building efforts in SSCM remain scarce, with the predominance of a few popular imported macro theories (resource-based view (RBV), stakeholder theory and institutional theory) having implications on the conceptualisation of SSCM and the topics researched to date. More theoretical contributions can potentially emerge from the adoption of original methodologies, the investigation of under-explored aspects of SSCM and the testing of recently developed frameworks. Research limitations/implications – Drawing on the analysis the authors propose an overarching map of popular theories in SSCM and define potential avenues towards the maturation of the discipline. A number of propositions are offered to guide future research. This study constitutes a first step towards understanding how theories in SSCM are developing and how SSCM has been conceptualised. Originality/value – The originality of this paper lies in its analytical focus on theories in SSCM, which have not been mapped to date

Relational Perspectives on Brand Logics and Design Innovation Strategies and Implementation

With the primary ambition to contribute to the brand orientation literature this thesis explores relationships between corporate brand identities and the management of design innovation. The thesis is based partly on a prolonged empirical case study of Bang & Olufsen and partly on a multiple case study of small and medium sized design-oriented firms – all characterised by a strategic focus on managing market-driving innovation. Grounded in an interpretive analytical approach the thesis examines how corporate brand identity as a strategic logic of the firm affects flows of management decisions and the structuring of design innovation strategies and implementation hereof. The thesis’ theoretical foundation is anchored in the competence-based view on firm competitiveness. This foundation is complemented by institutional and organisational culture theories to the purpose of uncovering how organisational decision-makers are affected by corporate brand logics in relation to the management of design innovation processes and capabilities. The thesis presents four papers, which contribute conceptually and empirically to advance the brand orientation literature from a competence-based perspective focused on design and innovation management. Overall, findings suggest that corporate brand identity as a competitive logic in brand- and design-oriented firms can guide innovation strategy and decisions for coordinating management processes and the use of resources to develop brandsupportive innovation capabilities. However, it is also suggested that such brand logics should be complemented by market logics in a dynamic interplay. In this way a more pragmatic approach is achieved to the sustainment of innovation capabilities, which in an integrative manner support firm corporate brand identity and market adaptability as complementary management foci for customer value creation and sustained competitive advantages

International projects and political risk management by multinational enterprises : insights from multiple emerging markets

Purpose This study investigates an under-researched yet fundamental question of how a developed country multinational enterprises (DMNE) perceives and manages political risks when undertaking infrastructure projects in the emerging markets (EMs). Design/methodology/approach The authors use an abduction-based qualitative research approach to analyze six international project operations of a multinational enterprise originating from Finland in five EMs. Findings The findings suggest that the overall nature of political risks in EMs is not the same, except few political risk factors that are visible in most EMs. Consequently, the applied risk management mechanisms vary between EMs, except with few common mechanisms. The authors develop an integrative analytical framework of political risk management based on the findings. Originality/value This paper is one of the first studies to identify political risk factors for western MNEs while undertaking international project operations and link them to reduction mechanisms used by them. The authors go beyond the notion of risk being conceptualized at a general level and evaluate 20 specific political risk factors referred to in extant literature. The authors further link these political risk factors with both social exchange and transaction cost theories conceptually as well as empirically. Finally, the authors develop a relatively comprehensive analytical framework of political risk management based on the case projects' findings that combine several strands of literature, including the social exchange theory, transaction cost theory, international market entry, project management and finance literature streams.© Tahir Ali, Aurangzeab Butt, Ahmad Arslan, Shlomo Yedidia Tarba, Sniazhana Ana Sniazhko and Minnie Kontkanen. Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen athttp://creativecommons.org/licences/by/4.0/legalcodefi=vertaisarvioitu|en=peerReviewed

Customer Relationship Management (CRM) In Small And Medium Tourism Enterprises: A Dynamic Capabilities Perspective

Purpose – The objective of this study is to develop an integrated framework incorporating Customer Relationship Management (CRM) and Dynamic capabilities (DC) together for Tourism Small and Medium Enterprises (SMEs). Design – We reconcile theories from strategic management and marketing literatures to form an unifying framework of sources of performance differentials as the theoretical background. Successful factors for the framework including specific CRM processes, two different approaches in DC and specific business processes are defined. Methodology – The framework is tested on data collected from 111 SMEs in tourism industry in Vietnam using Partial Least Square Structural Equation Modeling (PLS SEM). Approach – This study approaches CRM processes at the customer facing level and attempts to discover its effects to performance at firm-level analysis. Findings – The results show that the interrelationships suggested by the framework are supported. Especially, the mechanisms of how CRM processes can influence the customer value and financial performance are explored. Originality of the research - The different effects of different DC approaches also suggested useful insights how to develop use them for tourism SMEs. There also has been an emerging urgency for the framework in the practice given the fact that there hasn’t been any of it in previous researches yet

Machines like us? An occupational health perspective on machine learning (artificial intelligence)

Summary Aim Focusing on management theories and occupational health and safety (OSH) principles, the use of machine learning (AI) may give benefits within risk management, economical costs, as well as prevent sickness absence and work-related illness. The purpose of this thesis was to develop an industry standard in the form of concrete advice for management and OSH services on how to avoid sickness absence related to the introduction and application of machine learning (AI). Method This thesis is a literature-based monography set in the Norwegian work-life context. An explorative, qualitative research design was chosen with a phenomenological approach. Three main theoretical perspectives were explored, namely the psychological, sociological and cognitive perspectives. In addition, a literature review was performed, and white spots on the theoretical map were defined. This set the theoretical framework for the empirical part of the study, consisting of two focus group interviews from two of Norway’s largest companies. Both companies were data driven and front runners in their fields and were chosen from a vendor (Kongsberg) and buyer (Equinor) perspective. This data was then triangulated against an in-depth interview from SINTEF, one of Europe’s largest research institutes. For external validity, thick description was added. Limitations may be the sample size in data collection and bias due to the companies chosen. Additionally, there may be researcher’s bias as a company doctor and leading advisor of a multi-disciplinary occupational health team for one of the companies interviewed. Contributions to state-of-the-art To the researcher’s knowledge, this may be the first study of its kind where international OSH advice and research findings from review articles (and a workshop summary) is combined with experience transfer from managers and employees in this phase of machine learning (AI). Findings show that to prevent machine learning (AI) related sickness absence, the decision makers will need to acquire related OSH competence, perform dynamic virtual task analyses and from the outset integrate OSH measures in early phase developments of machine learning (AI) by utilizing human centered design. The OSH services will need to work more cross-disciplinary again, develop one common language based on Human Factors and perform dynamic evaluations of occupational health risk. The tripartite dialogue with the safety delegates will need to be strengthened with the same competence

Risk management in intelligent agents

University of Technology, Sydney. Faculty of Engineering and Information Technology.This thesis presents the development of a generalised risk analysis, modelling and management framework for intelligent agents based on the state-of-art techniques from knowledge representation and uncertainty management in the field of Artificial Intelligence (AI). Assessment and management of risk are well established common practices in human society. However, formal recognition and treatment of risk are not usually considered in the design and implementation of (most existing) intelligent agents and information systems. This thesis aims to fill this gap and improve the overall performance of an intelligent agent. By providing a formal framework that can be easily implemented in practice, my work enables an agent to assess and manage relevant domain risks in a consistent, systematic and intelligent manner. In this thesis, I canvas a wide range of theories and techniques in AI research that deal with uncertainty representation and management. I formulated a generalised concept of risk for intelligent agents and developed formal qualitative and quantitative representations of risk based on the Possible Worlds paradigm. By adapting a selection of mature knowledge modelling and reasoning techniques, I develop a qualitative and a quantitative approach of modelling domains for risk assessment and management. Both approaches are developed under the same theoretical assumptions and use the same domain analysis procedure; both share a similar iterative process to maintain and improve domain knowledge base continuously over time. Most importantly, the knowledge modelling and reasoning techniques used in both approaches share the same underlying paradigm of Possible Worlds. The close connection between the two risk modelling and reasoning approaches leads us to combine them into a hybrid, multi-level, iterative risk modelling and management framework for intelligent agents, or HiRMA, that is generalised for risk modelling and management in many disparate problem domains and environments. Finally, I provide a top-level guide on how HiRMA can be implemented in a practical domain and a software architecture for such an implementation. My work lays a solid foundation for building better decision support tools (with respect to risk management) that can be integrated into existing or future intelligent agents

River basin planning project: social learning (Science Report SC050037/SR1)

This report documents the findings of a 12-month Environment Agency science project on social learning for river basin planning. Our aim was to use social learning approaches and soft system methods to inform the development of the River Basin Planning Strategy and improve the effectiveness of the Environment Agency's Water Framework Directive (WFD) Programm