Implications of Change Management

Date of Seminar: 2018.01.11 Supervisor: Devrim Göktepe-Hultén Key words: Change management, change process, Shape 2020, Shape & Share Purpose: The purpose of this thesis is to investigate how Cramo AB works with change management and if they succeed or not, by using Kotter’s model as an analytic tool and other theoretical perspectives of change management. Methodology: The research is conducted as a case study of explorative nature. Data was collected at two different semi-structured interviews. One for the managers at Cramo AB and another one for the employees further down in the organisational structure. Seven interviews were performed with respondents from Cramo AB’s top management group and four interviews were conducted with employees from the depots. The collected data was analysed with pattern coding. Theoretical perspectives: Previous research consists of numerous models for change management shows that it is a complex subject. This study will therefore aim to contribute to existing literature by investigating how Kotter’s eight step model for leading change and other selected theoretical perspectives can be analysed against a real case to clarify how and why a company works with changes. Empirical foundation: Cramo AB is an interesting company to investigate, since they currently are working extensively with a change program called Shape 2020. Throughout the years the company implemented many large change processes that have affected the whole organisation. However, employees express some issues today regarding the change processes. Conclusions: This study reached the conclusion that Cramo AB have both successful and failed with change processes. The success rate seems to heavily rely on how well the change and implementation has been communicated as well as how the good or bad the attitude towards change in general is. The comparison between literature and a real case also suggests that literature does not acknowledge the complexity of communication in a real case

Enhancing Classroom Instruction with Online News

Purpose Investigate how school teachers look for informational texts for their classrooms. Access to current, varied, and authentic informational texts improves learning outcomes for K-12 students, but many teachers lack resources to expand and update readings. The Web offers freely-available resources, but finding suitable ones is time-consuming. This research lays the groundwork for building tools to ease that burden. Methodology This paper reports qualitative findings from a study in two stages: (1) a set of semi-structured interviews, based on the Critical Incident Technique, eliciting teachers’ information-seeking practices and challenges; and (2) observations of teachers using a prototype teaching-oriented news search tool under a think-aloud protocol. Findings Teachers articulated different objectives and ways of using readings in their classrooms; goals and self-reported practices varied by experience level. Teachers struggled to formulate queries that are likely to return readings on specific course topics, instead searching directly for abstract topics. Experience differences did not translate into observable differences in search skill or success in the lab study. Originality and Value There is limited work on teachers’ information-seeking practices, particularly on how teachers look for texts for classroom use. This paper describes how teachers look for information in this context, setting the stage for future development and research on how to support this use case. Understanding and supporting teachers looking for information is a rich area for future research, due to the complexity of the information need and the fact that teachers are not looking for information for themselves

Retrieving and Recommending for the Classroom: Stakeholders, Objectives, Resources, and Users

In this paper, we consider the promise and challenges of deploying recommendation and information retrieval technology to help teachers locate resources for use in classroom instruction. The classroom setting is a complex environment presenting a number of challenges for recommendation, due to its inherent multi-stakeholder nature, the multiple objectives that quality educational resources and experiences must simultaneously satisfy, and potential disconnect between the direct user of the system and the end users of the resources it provides. In this paper, we outline these challenges, highlight opportunities for new research, and describe our work in progress in this area including insights from interviews with working teachers

HIV Stigma Reduction for Health Facility Staff: Development of a Blended- Learning Intervention

Introduction: The effect of stigma on health and health inequity is increasingly recognized. While many medical conditions trigger stigmatization, the negative effects of HIV stigma are particularly well documented. HIV stigma undermines access, uptake, and adherence to both HIV prevention and treatment. People living with HIV face stigma in all aspects of their daily lives; however, stigma in the health system is particularly detrimental. A key component for health facility stigma-reduction interventions is participatory training of staff, often through several days of in-person training. Though this approach shows promise, it is time intensive and poses challenges for busy health facilities. In response, the DriSti study has developed a brief blended-learning approach to stigma reduction in Karnataka State, India. This paper describes the process and final content of the intervention development. The intervention is currently being tested. Final evaluation results will be published upon study completion.Methods: Grounded in behavior change strategies based on social cognitive theory principles that stress the importance of combining interpersonal interactions with specific strategies that promote behavior change, we used a three-phase approach to intervention development: (1) content planning—review of existing participatory stigma-reduction training activities; (2) story boarding—script development and tablet content production; and (3) pilot testing of tablet and in-person session materials.Results: The final intervention curriculum consists of three sessions. Two initial self-administered tablet sessions focus on stigma awareness, attitudes, fears of HIV transmission, and use of standard precautions. The third small group session covers the same material but includes skill building through role-play and testimony by a person living with HIV. A study team member administers the tablet sessions, explains the process, and is present throughout to answer questions.Conclusion: This paper describes the theoretical underpinning and process of developing the blended-learning curriculum content, and practical lessons learned.The approach covers three key drivers of HIV stigma—stigma awareness, fear of HIV transmission, and attitudes. Developing video content for the self-directed learning is complex, requires a diverse set of people and skills, and presents unexpected opportunities for stigma reduction. Co-facilitation of the in-person session by someone living with HIV is a critical component

Identifying targets for increased biogas production through chemical and organic matter characterization of digestate from full-scale biogas plants: what remains and why?

Background This study examines the destiny of macromolecules in different full-scale biogas processes. From previous studies it is clear that the residual organic matter in outgoing digestates can have significant biogas potential, but the factors dictating the size and composition of this residual fraction and how they correlate with the residual methane potential (RMP) are not fully understood. The aim of this study was to generate additional knowledge of the composition of residual digestate fractions and to understand how they correlate with various operational and chemical parameters. The organic composition of both the substrates and digestates from nine biogas plants operating on food waste, sewage sludge, or agricultural waste was characterized and the residual organic fractions were linked to substrate type, trace metal content, ammonia concentration, operational parameters, RMP, and enzyme activity. Results Carbohydrates represented the largest fraction of the total VS (32-68%) in most substrates. However, in the digestates protein was instead the most abundant residual macromolecule in almost all plants (3-21 g/kg). The degradation efficiency of proteins generally lower (28-79%) compared to carbohydrates (67-94%) and fats (86-91%). High residual protein content was coupled to recalcitrant protein fractions and microbial biomass, either from the substrate or formed in the degradation process. Co-digesting sewage sludge with fat increased the protein degradation efficiency with 18%, possibly through a priming mechanism where addition of easily degradable substrates also triggers the degradation of more complex fractions. In this study, high residual methane production (> 140 L CH4/kg VS) was firstly coupled to operation at unstable process conditions caused mainly by ammonia inhibition (0.74 mg NH3-N/kg) and/or trace element deficiency and, secondly, to short hydraulic retention time (HRT) (55 days) relative to the slow digestion of agricultural waste and manure. Conclusions Operation at unstable conditions was one reason for the high residual macromolecule content and high RMP. The outgoing protein content was relatively high in all digesters and improving the degradation of proteins represents one important way to increase the VS reduction and methane production in biogas plants. Post-treatment or post-digestion of digestates, targeting microbial biomass or recalcitrant protein fractions, is a potential way to achieve increased protein degradation

How can climate change be incorporated in river basin management plans under the WFD? Report from the EurAqua conference 2008

This report is based on the EurAqua conference 2008: "How can climate change be incorporated in river basin management plans under the WFD?". The conference focused on recent development in relevant EU policy, on challenges for WFD-based water management, and on the science-to-policy interface regarding adaptations to climate change impacts. This report provides recommendations for incorporating climate change considerations into river basin management plans, and identifies relevant research needs with emphasis on ecology, modelling and uncertainty.NIV

High rates of adherence and treatment success in a public and public-private HIV clinic in India: potential benefits of standardized national care delivery systems

<p>Abstract</p> <p>Background</p> <p>The massive scale-up of antiretroviral treatment (ART) access worldwide has brought tremendous benefit to populations affected by HIV/AIDS. Optimising HIV care in countries with diverse medical systems is critical; however data on best practices for HIV healthcare delivery in resource-constrained settings are limited. This study aimed to understand patient characteristics and treatment outcomes from different HIV healthcare settings in Bangalore, India.</p> <p>Methods</p> <p>Participants from public, private and public-private HIV healthcare settings were recruited between 2007 and 2009 and were administered structured interviews by trained staff. Self-reported adherence was measured using the visual analogue scale to capture adherence over the past month, and a history of treatment interruptions (defined as having missed medications for more than 48 hours in the past three months). In addition, CD4 count and viral load (VL) were measured; genotyping for drug resistance-associated mutations was performed on those who were in virological failure (VL > 1000 copies/ml).</p> <p>Results</p> <p>A total of 471 individuals were included in the analysis (263 from the public facility, 149 from the public-private facility and 59 from the private center). Private facility patients were more likely to be male, with higher education levels and incomes. More participants reported ≥ 95% adherence among public and public-private groups compared to private participants (public 97%; private 88%; public-private 93%, p < 0.05). Treatment interruptions were lowest among public participants (1%, 10%, 5% respectively, p < 0.001). Although longer clinic waiting times were experienced by more public participants (48%, compared to private 27%, public-private 19%, p < 0.001), adherence barriers were highest among private (31%) compared with public (10%) and public-private (17%, p < 0.001) participants. Viral load was detectable in 13% public, 22% private and 9% public-private participants (p < 0.05) suggesting fewer treatment failures among public and public-private settings. Drug resistance mutations were found more frequently among private facility patients (20%) compared to those from the public (9%) or public-private facility (8%, p < 0.05).</p> <p>Conclusions</p> <p>Adherence and treatment success was significantly higher among patients from public and public-private settings compared with patients from private facilities. These results suggest a possible benefit of the standardized care delivery system established in public and public-private health facilities where counselling by a multi-disciplinary team of workers is integral to provision of ART. Strengthening and increasing public-private partnerships can enhance the success of national ART programs.</p

Human APOBEC3G-mediated hypermutation is associated with antiretroviral therapy failure in HIV-1 subtype C-infected individuals

Introduction: Human APOBEC3G/F (hA3G/F) restricts retroviral replication through G-to-A hypermutations, which can generate drug-resistant progenies in vitro. The clinical relevance is still inconclusive. To bridge this gap, we aim to study the role of these hypermutations in evolution of drug resistance; we characterised hA3G/F-mediated hypermutations in the RT region of the pol gene of patients with or without antiretroviral therapy (ART). Methods: In 88 HIV-1-positive individuals, drug resistance genotyping was carried out in plasma virus and provirus by population sequencing. Hypermutations were determined by three different approaches using Hypermut 2.0 software, cluster analysis and APOBEC3G-mediated defectives indices. Clinical and demographic characteristics of these individuals were studied in relation to these hypermutations. Results: hA3G/F-mediated hypermutated sequences in proviral DNA, but not in plasma virus, were identified in 11.4% (10/88) subjects. Proviral hypermutations were observed more frequently in patients with ART failure than in ART-na&#x00EF;ve individuals (p=0.03). In therapy failure patients, proviral hypermutation were associated with greater intra-compartmental genetic diversity (p&#60;0.001). In therapy-na&#x00EF;ve individuals, hypermutated proviral DNA with M184I and M230I mutations due to the editing of hA3G, had stop codons in the open reading frames and the same mutations were absent in the plasma virus. Only a limited concordance was found between the drug resistance mutations in plasma RNA and proviral DNA. Conclusions: hA3G lethal hypermutation was significantly associated with ART failure in Indian HIV-1 subtype C patients. It is unlikely that viral variants, which exhibit hypermutated sequences and M184I and/or M230I, will mature and expand in vivo

Maintenance of respiratory chain function in mouse hearts with severely impaired mtDNA transcription

The basal mitochondrial transcription machinery is essential for biogenesis of the respiratory chain and consists of mitochondrial RNA polymerase, mitochondrial transcription factor A (TFAM) and mitochondrial transcription factor B2. This triad of proteins is sufficient and necessary for mtDNA transcription initiation. Abolished mtDNA transcription caused by tissue-specific knockout of TFAM in the mouse heart leads to early onset of a severe mitochondrial cardiomyopathy with lethality within the first post-natal weeks. Here, we describe a mouse model expressing human TFAM instead of the endogenous mouse TFAM in heart. These rescue mice have severe reduction in mtDNA transcription initiation, but, surprisingly, are healthy at the age of 52 weeks with near-normal steady-state levels of transcripts. In addition, we demonstrate that heavy-strand mtDNA transcription normally terminates at the termination-associated sequence in the control region. This termination is abolished in rescue animals resulting in heavy (H)-strand transcription of the entire control region. In conclusion, we demonstrate here the existence of an unexpected mtDNA transcript stabilization mechanism that almost completely compensates for the severely reduced transcription initiation in rescue hearts. Future elucidation of the underlying molecular mechanism may provide a novel pathway to treat mitochondrial dysfunction in human pathology