Exploring business transformation : the challenges of developing a benefits realization capability.

The successful management of change continues to be a major issue for organizations. This article draws on rich qualitative data to provide evidence of issues faced by organizations as they try to realize benefits from investments in IT-enabled change, and as they try to develop and enhance their benefits realization capability. Several of these issues are not effectively covered by previous research, for example managing the overall portfolio of change initiatives and how to develop the capacity of the organization for benefits realization. The research also provides empirical evidence that supports the theoretical propositions from dynamic capability theory that routines (practices) are often similar across different organizations, and that organizations go through a number of stages in developing competences. A further contribution of the research is to develop an enhanced model of an organizational competence, which has important implications for the action required to develop competences

Workforce development and effective evaluation of projects

Date of Acceptance: 01/05/2014The success of a project or programme is typically determined in relation to outputs. However, there is a commitment among UK public services to spending public funds efficiently and on activities that provide the greatest benefit to society. Skills for Health recognised the need for a tool to manage the complex process of evaluating project benefits. An integrated evaluation framework was developed to help practitioners identify, describe, measure and evaluate the benefits of workforce development projects. Practitioners tested the framework on projects within three NHS trusts and provided valuable feedback to support its development. The prospective approach taken to identify benefits and collect baseline data to support evaluation was positively received and the clarity and completeness of the framework, as well as the relevance of the questions, were commended. Users reported that the framework was difficult to complete; an online version could be developed, which might help to improve usability. Effective implementation of this approach will depend on the quality and usability of the framework, the willingness of organisations to implement it, and the presence or establishment of an effective change management culture.Peer reviewedFinal Accepted Versio

Vortex Reconnection as the Dissipative Scattering of Dipoles

We propose a phenomenological model of vortex tube reconnection at high Reynolds numbers. The basic picture is that squeezed vortex lines, formed by stretching in the region of closest approach between filaments, interact like dipoles (monopole-antimonopole pairs) of a confining electrostatic theory. The probability of dipole creation is found from a canonical ensemble spanned by foldings of the vortex tubes, with temperature parameter estimated from the typical energy variation taking place in the reconnection process. Vortex line reshuffling by viscous diffusion is described in terms of directional transitions of the dipoles. The model is used to fit with reasonable accuracy experimental data established long ago on the symmetric collision of vortex rings. We also study along similar lines the asymmetric case, related to the reconnection of non-parallel vortex tubes.Comment: 8 pages, 3 postscript figure

Oncology-led early identification of nutritional risk: a pragmatic, evidence-based protocol (PRONTO)

Simple Summary Early identification of patients on antineoplastic therapy who are at risk for or already malnourished is critical for optimizing treatment success. Malnourished patients are at increased risk for being unable to tolerate the most effective 'level' and 'duration' of treatment, with grave implications for both the short- (during treatment) and long-term outcomes. Herein, we provide a practical PROtocol for NuTritional risk in Oncology (PRONTO) to enable oncologists to identify patients with or at risk of malnutrition for further evaluation and follow-up with members of the multidisciplinary care team (MDT). Additional guidance is included on the oncologist-led provision of nutritional support if referral to a dietary service is not available. Nutritional issues, including malnutrition, low muscle mass, sarcopenia (i.e., low muscle mass and strength), and cachexia (i.e., weight loss characterized by a continuous decline in skeletal muscle mass, with or without fat loss), are commonly experienced by patients with cancer at all stages of disease. Cancer cachexia may be associated with poor nutritional status and can compromise a patient's ability to tolerate antineoplastic therapy, increase the likelihood of post-surgical complications, and impact long-term outcomes including survival, quality of life, and function. One of the primary nutritional problems these patients experience is malnutrition, of which muscle depletion represents a clinically relevant feature. There have been recent calls for nutritional screening, assessment, treatment, and monitoring as a consistent component of care for all patients diagnosed with cancer. To achieve this, there is a need for a standardized approach to enable oncologists to identify patients commencing and undergoing antineoplastic therapy who are or who may be at risk of malnutrition and/or muscle depletion. This approach should not replace existing tools used in the dietitian's role, but rather give the oncologist a simple nutritional protocol for optimization of the patient care pathway where this is needed. Given the considerable time constraints in day-to-day oncology practice, any such approach must be simple and quick to implement so that oncologists can flag individual patients for further evaluation and follow-up with appropriate members of the multidisciplinary care team. To enable the rapid and routine identification of patients with or at risk of malnutrition and/or muscle depletion, an expert panel of nutrition specialists and practicing oncologists developed the PROtocol for NuTritional risk in Oncology (PRONTO). The protocol enables the rapid identification of patients with or at risk of malnutrition and/or muscle depletion and provides guidance on next steps. The protocol is adaptable to multiple settings and countries, which makes implementation feasible by oncologists and may optimize patient outcomes. We advise the use of this protocol in countries/clinical scenarios where a specialized approach to nutrition assessment and care is not available

The Vertebrate Genome Annotation (Vega) database

The Vertebrate Genome Annotation (Vega) database (http://vega.sanger.ac.uk) has been designed to be a community resource for browsing manual annotation of finished sequences from a variety of vertebrate genomes. Its core database is based on an Ensembl-style schema, extended to incorporate curation-specific metadata. In collaboration with the genome sequencing centres, Vega attempts to present consistent high-quality annotation of the published human chromosome sequences. In addition, it is also possible to view various finished regions from other vertebrates, including mouse and zebrafish. Vega displays only manually annotated gene structures built using transcriptional evidence, which can be examined in the browser. Attempts have been made to standardize the annotation procedure across each vertebrate genome, which should aid comparative analysis of orthologues across the different finished regions

Flame front propagation IV: Random Noise and Pole-Dynamics in Unstable Front Propagation II

The current paper is a corrected version of our previous paper arXiv:adap-org/9608001. Similarly to previous version we investigate the problem of flame propagation. This problem is studied as an example of unstable fronts that wrinkle on many scales. The analytic tool of pole expansion in the complex plane is employed to address the interaction of the unstable growth process with random initial conditions and perturbations. We argue that the effect of random noise is immense and that it can never be neglected in sufficiently large systems. We present simulations that lead to scaling laws for the velocity and acceleration of the front as a function of the system size and the level of noise, and analytic arguments that explain these results in terms of the noisy pole dynamics.This version corrects some very critical errors made in arXiv:adap-org/9608001 and makes more detailed description of excess number of poles in system, number of poles that appear in the system in unit of time, life time of pole. It allows us to understand more correctly dependence of the system parameters on noise than in arXiv:adap-org/9608001Comment: 23 pages, 4 figures,revised, version accepted for publication in journal "Combustion, Explosion and Shock Waves". arXiv admin note: substantial text overlap with arXiv:nlin/0302021, arXiv:adap-org/9608001, arXiv:nlin/030201

Developing an online learning community for mental health professionals and service users: a discursive analysis

<p>Abstract</p> <p>Background</p> <p>There is increasing interest in online collaborative learning tools in health education, to reduce costs, and to offer alternative communication opportunities. Patients and students often have extensive experience of using the Internet for health information and support, and many health organisations are increasingly trying out online tools, while many healthcare professionals are unused to, and have reservations about, online interaction.</p> <p>Methods</p> <p>We ran three week-long collaborative learning courses, in which 19 mental health professionals (MHPs) and 12 mental health service users (MHSUs) participated. Data were analysed using a discursive approach to consider the ways in which participants interacted, and how this contributed to the goal of online learning about using Internet technologies for mental health practice.</p> <p>Results</p> <p>MHSUs and MHPs were able to discuss issues together, listening to the views of the other stakeholders. Discussions on synchronous format encouraged participation by service users while the MHPs showed a preference for an asynchronous format with longer, reasoned postings. Although participants regularly drew on their MHP or MHSU status in discussions, and participants typically drew on either a medical expert discourse or a "lived experience" discourse, there was a blurred boundary as participants shifted between these positions.</p> <p>Conclusions</p> <p>The anonymous format was successful in that it produced a "co-constructed asymmetry" which permitted the MHPs and MHSUs to discuss issues online, listening to the views of other stakeholders. Although anonymity was essential for this course to 'work' at all, the recourse to expert or lay discourses demonstrates that it did not eliminate the hierarchies between teacher and learner, or MHP and MHSU. The mix of synchronous and asynchronous formats helped MHSUs to contribute. Moderators might best facilitate service user experience by responding within an experiential discourse rather than an academic one.</p

High-Resolution Modeling of Multiscale Transient Phenomena in Turbulent Boundary Layers

High fidelity numerical simulation of wall-bounded turbulence requires physically sound representation of the small scale unsteady processes governing near-wall momentum, heat, and mass transfer. Conventional wall treatments do not capture the diverse multiphysics flow regimes relevant to engineering applications. To obtain a robust yet computationally affordable near-wall submodel for turbulent flow computations, the fine-grained spatial structure and time evolution of the near-wall flow is simulated using a model formulated on a 1D domain corresponding to the wall-normal direction. This approach captures the strong variation of flow properties in the wall-normal direction and the transient interactions between this highly inhomogeneous region and the more nearly homogeneous (at fine scales) flow farther from the wall. The 1D simulation utilizes the One Dimensional Turbulence (ODT) methodology, whose formulation for the present application is described in detail. Demonstrations of ODT performance with regard to aspects of flow physics relevant to near-wall flow modeling are presented. The coupling of ODT to a large eddy simulation (LES) of confined turbulent flow is described, and the performance of the coupled formulation is demonstrated. It is concluded that this formulation has the potential to provide the fidelity needed for engineering applications at an affordable computational cost

Diffusion in Stationary Flow from Mesoscopic Non-equilibrium Thermodynamics

We analyze the diffusion of a Brownian particle in a fluid under stationary flow. By using the scheme of non-equilibrium thermodynamics in phase space, we obtain the Fokker-Planck equation which is compared with others derived from kinetic theory and projector operator techniques. That equation exhibits violation of the fluctuation dissipation-theorem. By implementing the hydrodynamic regime described by the first moments of the non-equilibrium distribution, we find relaxation equations for the diffusion current and pressure tensor, allowing us to arrive at a complete description of the system in the inertial and diffusion regimes. The simplicity and generality of the method we propose, makes it applicable to more complex situations, often encountered in problems of soft condensed matter, in which not only one but more degrees of freedom are coupled to a non-equilibrium bath.Comment: 10 pages, accepted in Phys. Rev.