34 research outputs found

    Targeting histone deacetyalses in the treatment of B- and T-cell malignancies

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    HDAC inhibitors (HDACI) are now emerging as one of the most promising new classes of drugs for the treatment of select forms of non-Hodgkin’s lymphoma (NHL). They are particularly active in T-cell lymphomas, possibly hodgkin’s lymphoma and indolent B cell lymphomas. Presently, two of these agents, vorinostat and romidepsin, have been approved in the US for the treatment of relapsed and refractory cutaneous T cell lymphomas (CTCL). Initially, these agents were developed with the idea that they affected transcriptional activation and thus gene expression, by modulating chromatin condensation and decondensation. It is now clear that their effects go beyond chromatin and by affecting the acetylation status of histones and other intra-cellular proteins, they modify gene expression and cellular function via multiple pathways. Gene expression profiles and functional genetic analysis has led to further understanding of the various molecular pathways that are affected by these agents including cell cycle regulation, pathways of cellular proliferation, apoptosis and angiogenesis all important in lymphomagenesis. There is also increasing data to support the effects of these agents on T cell receptor and immune function which may explain the high level of activity of these agents in T cell lymphomas and hodgkin’s lymphoma. There is ample evidence of epigenetic dysregulation in lymphomas which may underlie the mechanisms of action of these agents but how these agents work is still not clear. Current HDAC inhibitors can be divided into at least four classes based on their chemical structure. At present several of these HDAC inhibitors are in clinical trials both as single agents and in combination with chemotherapy or other biological agents. They are easy to administer and are generally well tolerated with minimal side effects. Different dosing levels and schedules and the use of isospecific HDAC inhibitors are some of the strategies that are being employed to increase the therapeutic effect of these agents in the treatment of lymphomas. There may also be class differences that translate into specific activity against different lymphoma. HDAC inhibitors will likely be incorporated into combinations of targeted therapies both in the upfront and relapsed setting for lymphomas

    Proactive change management framework: A systematic review of the literature

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    This dissertation is designed to explore steps that organizations could take to adopt proactive change management that increases organizational performance. Despite scholarly developed change management tools and the concerted efforts of leaders in carrying out effective change management, many organizations fail to achieve their desired objectives. The preponderance of change models and frameworks seem to be inherently reactive,forthey were designed to aid organizations to respond to changes that had already occurred. Change is inevitable. Therefore, for organizations to remain viable, one must ask: Could proactive change management be an effective solution for organizations to overcome challenges that come with the traditional, reactive response to changes? Method: An evidence-based research framework was used to address the research question, including an electronic literature search of the UMGC library for change management. Screening articles for relevancy and applying a critical appraisal process, which yielded 40articlesthatwere included in the coding and thematic analysis. Results: The coding and thematic analysis converged into five overarching themes that were related to successful organizational proactive change management: (a) role of leadership; (b) communication and employee engagement; (c) organizational culture; (d) operational procedures; and (e) proactive change management. Themes 1–4 reflect a well-established scholarly body of work in the literature on change management in general. However, Theme 5 brings to bear additional information on approaches by which potential changes might be identified, evaluated, and implemented proactively. Specifically, organizations could take six steps for proactive change management: (a) identify and evaluate potential changes proactively; (b) develop a shared assessment and value; (c) evaluate options and solutions; (d) develop specific plans to incorporate changes; (e) implement changes; and (f) evaluate results.Conclusions: Practitioners in private and public organizations could use the proactive change management framework to overcome challenges associated with the inherently reactive approach to change management and ultimately enhance organizational performance. Limitations: Additional research to validate (ground truth) the framework in different organizational environments and settings is necessary to verify its effectiveness. Implications: This dissertation will influence management practice on change management, thereby,increasing organizational performance, survival, and thrive in an ever-changing environment.Abstract Title of Dissertation: PROACTIVE CHANGE MANAGEMENT FRAMEWORK: A SYSTEMATIC REVIEW OF THE LITERATURE Osama El-Lissy, Doctor of Management, 2020 This dissertation is designed to explore steps that organizations could take to adopt proactive change management that increases organizational performance. Despite scholarly developed change management tools and the concerted efforts of leaders in carrying out effective change management, many organizations fail to achieve their desired objectives. The preponderance of change models and frameworks seem to be inherently reactive, for they were designed to aid organizations to respond to changes that had already occurred. Change is inevitable. Therefore, for organizations to remain viable, one must ask: Could proactive change management be an effective solution for organizations to overcome challenges that come with the traditional, reactive response to changes? Method: An evidence-based research framework was used to address the research question, including an electronic literature search of the UMGC library for change management. Screening articles for relevancy and applying a critical appraisal process, which yielded 40 articles that were included in the coding and thematic analysis. Results: The coding and thematic analysis converged into five overarching themes that were related to successful organizational proactive change management: (a) role of leadership; (b) communication and employee engagement; (c) organizational culture; (d) operational procedures; and (e) proactive change management. Themes 1–4 reflect a well-established scholarly body of work in the literature on change management in general. However, Theme 5 brings to bear additional information on approaches by which potential changes might be identified, evaluated, and implemented proactively. Specifically, organizations could take six steps for proactive change management: (a) identify and evaluate potential changes proactively; (b) develop a shared assessment and value; (c) evaluate options and solutions; (d) develop specific plans to incorporate changes; (e) implement changes; and (f) evaluate results. Conclusions: Practitioners in private and public organizations could use the proactive change management framework to overcome challenges associated with the inherently reactive approach to change management and ultimately enhance organizational performance. Limitations: Additional research to validate (ground truth) the framework in different organizational environments and settings is necessary to verify its effectiveness. Implications: This dissertation will influence management practice on change management, thereby, increasing organizational performance, survival, and thrive in an ever-changing environment. Keywords: proactive change management, leadership, organizational culture, organizational performance PROACTIVE CHANGE MANAGEMENT FRAMEWORK: A SYSTEMATIC REVIEW OF THE LITERATURE By Osama El-Lissy Dissertation submitted to the Faculty of the Graduate School of the University of Maryland Global Campus, in partial fulfillment of the requirements for the degree of Doctor of Management 2020 © Copyright by [Osama El-Lissy] 2020 ii Preface This dissertation was prepared to fulfill the requirement of the Doctor of Management program at the University of Maryland Global Campus. The purpose of this dissertation was to identify a potential solution for an ongoing organizational management problem. The primary focus of this research was to investigate whether a proactive approach to change management could be a more effective alternative to the traditional, reactive response to change. The motivation for this research stems from the desire to identify effective solutions designed to aid organizations in both public and private sectors to overcome challenges posed by the ever-changing environment, including economic, social, and political structures around the world. Organizations that are able to cope effectively with internal and external changes are able not only to survive, but also to thrive in today’s fierce competitive environment. The main source of data used in this research was collected through a systematic literature review of scholarly published journals related to change management. iii Dedication This dissertation is dedicated to the memory of my mother, Ferial. Although she was my inspiration to continue learning, she was unable to see my graduation. This doctoral degree is for her. iv Acknowledgements Firstly, I would like to express my sincere gratitude to my mentor, Dr. James Gelatt, for his astute insights and expert knowledge throughout the entire dissertation process. With his guidance, consistent encouragement, and emotional support, I was able to complete this dissertation. I could not have imagined a better advisor and mentor for my dissertation. I also thank Dr. Denise Breckon for her insightful comments, encouragement, and for the hard questions that prompted me to adjust the scope of my research. I’m grateful to Dr. Walter McCullum for sharing his personal experience in overcoming some of the most complex and seemingly insurmountable challenges, for it was such an up-lifting and inspiration for me to persist in this journey. Ultimately, I am indebted to Dr. Gelatt, Dr. Breckon, and Dr. McCullum for their invaluable input and guidance as members of the dissertation committee. I also give my sincere thanks to Ms. Cynthia Thomes for providing me with insights and instruction for critical search of the University of Maryland Global Campus library in support of my research. Her consistent, thorough, and timely response was invaluable, especially when faced with extreme time constraints. I am grateful to our academic program coordinator, Ms. Marina Caminis, for her tireless commitment and enthusiastic support throughout the entire program, particularly during residencies. I also want to thank all the professors and my colleagues in this cohort who inspired my drive, expanded my thinking, and enriched my experience throughout the entire journey. Last, but not least, cheers go to my wife, Wendy, and son, Ramy, for their understanding and steadfast support throughout the entire doctoral program. Their constant encouragement has been unmatched. v Table of Contents Preface............................................................................................................................................ ii Dedication ..................................................................................................................................... iii Acknowledgements ........................................................................................................................ iv Table of Contents ............................................................................................................................ v List of Tables ............................................................................................................................... vii List of Figures .............................................................................................................................. viii Chapter 1: Introduction and Overview of the Management Problem ............................................. 1 Background and Overview ......................................................................................................... 1 Problem Statement and Significance of the Problem ................................................................. 3 Research Question ...................................................................................................................... 5 Definitions and Terminology ...................................................................................................... 6 Organization of the Dissertation ................................................................................................. 6 Chapter Summary ....................................................................................................................... 7 Chapter 2: Scoping Literature Review and Theoretical Framework .............................................. 8 The Literature Landscape ........................................................................................................... 8 Change and Change Management .......................................................................................... 8 Leadership ............................................................................................................................... 9 Organizational Culture ............................................................................................................ 9 Proactive Change Management ............................................................................................ 10 Theoretical Background ............................................................................................................ 11 Theoretical Framework ............................................................................................................. 13 Chapter Summary ..................................................................................................................... 15 Chapter 3: Method ........................................................................................................................ 16 Search Strategy and Inclusion/Exclusion Criteria .................................................................... 16 Study Selection ......................................................................................................................... 18 Critical Appraisal ...................................................................................................................... 18 Data Extraction ......................................................................................................................... 19 Analysis and Coding ................................................................................................................. 22 Chapter Summary ..................................................................................................................... 22 Chapter 4: Analysis and Findings ................................................................................................. 23 Selected Articles ....................................................................................................................... 23 Coding and Thematic Analysis Results .................................................................................... 24 Theme One – Role of Leadership ......................................................................................... 27 Theme Two – Importance of Employee Engagement and Communication ......................... 28 Theme Three – Organizational Culture ................................................................................ 29 Theme Four – Operational Procedures and Systems ............................................................ 30 Theme Five – Proactive Change Management ..................................................................... 31 Summary .................................................................................................................................. 34 Chapter 5: Conclusions and Implications ..................................................................................... 35 Role of Leadership .................................................................................................................... 36 Employee and Stakeholder Engagement .................................................................................. 36 Organizational Culture .............................................................................................................. 37 Operational Procedures and Systems ........................................................................................ 38 vi Proactive Change Management ................................................................................................ 38 Identify and Evaluate Potential Changes Proactively ........................................................... 38 Develop a Shared Assessment and Value: Engage Employees and Stakeholders................ 39 Evaluate Options and Solutions ............................................................................................ 39 Develop Specific Plans to Incorporate Changes ................................................................... 40 Implement Changes (Kotter Model) ..................................................................................... 40 Evaluate Results of Changes ................................................................................................. 41 Case Studies .............................................................................................................................. 42 Case Study 1 – Customer Shopping Preference ................................................................... 42 Case Study 2 – COVID-19 Pandemic ................................................................................... 45 Conclusion and Recommendations ........................................................................................... 48 Limitations and Future Research .............................................................................................. 49 Final Summary .......................................................................................................................... 50 References .................................................................................................................................... 52 Appendix A. Number of Retrieved Articles from Databases using Prescribed Search Statements .............................................................................................................. 75 Appendix B. List of Eligible Articles .......................................................................................... 77 Appendix C. TAPUPAS and Weight of Evidence Framework Scoring Scale ............................ 89 Appendix D. Data Extraction and Six Levels of Appropriateness Analysis ............................. 104 Appendix E. Coding and Thematic Analysis ............................................................................. 129 vii List of Tables Table 1 Kotter’s Eight Steps Change Management Model and Modified Model for Proactive Change Management ..................................................................................... 41 viii List of Figures Figure 1. Proactive Change Management Framework ................................................................ 14 Figure 2. PRISMA Chart Indicating the Screening Processes and Resulting Number of Articles Included in the Synthesis ................................................................................ 21 Figure 3. Number of Articles Grouped by Publication Year ....................................................... 24 Figure 4. Five Themes Extracted From the Selected Articles ..................................................... 26 Figure 5. Number of Articles Directly Reporting on Proactive Change Management, 2000–2020 .............................................................................................................................. 27 Figure 6. Depiction of the Five Change Management Themes That Were Positively Related to Organizational Performance ..................................................................................... 33 Figure 7. Diagram Listing the Six Steps That Organizations Can Take to Successfully Adopt and Implement Proactive Change Management ................................................ 34 Figure 8. Proactive Change Management Framework ................................................................ 49 1 Chapter 1: Introduction and Overview of the Management Problem Background and Overview Organizations have been faced with globalization, exponential advancements in technology, rapid increase in knowledge and access to information, and integration of economic, social, and political structures around the world (Burke, 2008; Cawsey & Deszca, 2007; Manzo et al., 2012). To cope with these changes, scholars and practitioners have long recognized the need for change management. Lewin’s (1947) seminal field theory work provided the basis for the Lewin model of change, which offers a guide for successful transformation, both for individuals and organizations (DK, 2012, p. 220). Lewin’s (1947) model of change consists of three phases: (a) unfreezing—behavior that increases the receptivity to a possible change in the distribution and balance of social forces; (b) moving—altering the magnitude, direction, or number of driving and resisting forces, consequently shifting the equilibrium to a new level; and (c) freezing—reinforcing the new distribution of forces, thereby maintaining and stabilizing the new social equilibrium. Building on Lewin’s (1947) model of change, hands-on guides and frameworks have been developed to aid organizations with change management; among them are those by Hall (1991), Judson (1991), Burke and Litwin (1992), Kanter et al. (1992), Thomas and Robertshaw (1999), Bridges (2003), and Schein (2004). Each of the frameworks underscored specific aspects of change management. For example, Hall (1991) emphasized the importance of employee engagement and evaluation of the change plan; Judson (1991), employee communication and institutionalizing new changes; Burke and Litwin (1992), the role of leadership and top managers as central to successful change management; Kanter et al. (1992), leadership and creating an enabling structure to successfully implement changes; Thomas and Robertshaw (1999), 2 leadership and ongoing evaluation of change plans and the flexibility to making adjustments during the implementation phase; Bridges (2003), managing employees’ emotions during change; and Schein (2004), organizational culture as a support system of change management. Burnes (2004) and Paton and McCalman (2008) emphasized in their frameworks change management at the organizational strategic level; explaining the importance of mapping changes within specific organizations and incorporating potential intervention in the organizational strategic plans. Another framework that has been used to institute change is Enterprise Change Management (Miller & Proctor, 2016), which was designed to bridge the gap between what organizations would like to deliver and their capabilities. The Six Sigma framework provides a set of steps—define, measure, analyze, improve, and control—to facilitate change through process improvement (Pande et al., 2000). McKinsey’s 7S framework (strategy, structure, systems, shared values, style, staff and skills) has also been used in assessing and analyzing internal changes of organizations (as cited in Waterman et al., 1980; Peters & Waterman, 1982). The ADKAR (awareness, desire, knowledge, ability, and reinforcement) is another model designed to guide individual and organizational change (Hiatt, 2006). These change management fram
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