243 research outputs found

    Transformation Paradox: A Framework for the Analysis of Politics in Enterprise Transformations

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    The purpose of this research is to develop a theoretical framework for the analysis of politics in enterprise transformations using a dialectical analysis approach (Hegel, 1989; Heraclitus, 1979; Pinkard, 1988; Skinner, 1978a, 1978b) and conduct an evaluation of the framework validity. The framework is constructed using a dialectical analysis of concepts stemming from the work of Alford and Friedland (1992) and considers four theoretical perspectives: autocratic, bureaucratic, pluralistic, and cognitive. The framework is then validated by means of qualitative metrics and adherence to critical ideology. This research addresses the problem that there is no holistic theoretical framework for the analysis of politics across the systemic, situational, and structural contexts found in enterprise transformations. Politics occurs at multiple levels in the enterprise making it difficult to identify the salient issues that need to be addressed in support of transformation. Transformations can be paradoxical as enterprises revert to the dominant paradigm that affirms present realities rather than developing a critical posture to break the constraining paradigm. The dialectical approach used embraces the power of multiple theoretical perspectives in the transformation process, asserting that theories have power over actions, behaviors, and language. The theoretical framework allows for the simultaneous existence of shifting states of cooperation, frustration, and paradigmatic hegemony over systemic, situational, and structural contexts that embody politics in enterprise transformations. Rough set theory is used to demonstrate the ability of the framework to be adaptive and to evolve based on the inclusion of new data. I conclude that the deployment of an evolving framework of this magnitude may have a significant impact on the management of transformation efforts and suggest new areas of research to further the work

    Burst mitofusin activation reverses neuromuscular dysfunction in murine CMT2A

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    Charcot-Marie-Tooth disease type 2A (CMT2A) is an untreatable childhood peripheral neuropathy caused by mutations of the mitochondrial fusion protein, mitofusin (MFN) 2. Here, pharmacological activation of endogenous normal mitofusins overcame dominant inhibitory effects of CMT2A mutants in reprogrammed human patient motor neurons, reversing hallmark mitochondrial stasis and fragmentation independent of causa

    A randomised controlled trial and cost-effectiveness evaluation of "booster" interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

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    Background: Systematic reviews have identified a range of brief interventions which increase physical activity in previously sedentary people. There is an absence of evidence about whether follow up beyond three months can maintain long term physical activity. This study assesses whether it is worth providing motivational interviews, three months after giving initial advice, to those who have become more active. Methods/Design: Study candidates (n = 1500) will initially be given an interactive DVD and receive two telephone follow ups at monthly intervals checking on receipt and use of the DVD. Only those that have increased their physical activity after three months (n = 600) will be randomised into the study. These participants will receive either a "mini booster" (n = 200), "full booster" (n = 200) or no booster (n = 200). The "mini booster" consists of two telephone calls one month apart to discuss physical activity and maintenance strategies. The "full booster" consists of a face-to-face meeting with the facilitator at the same intervals. The purpose of these booster sessions is to help the individual maintain their increase in physical activity. Differences in physical activity, quality of life and costs associated with the booster interventions, will be measured three and nine months from randomisation. The research will be conducted in 20 of the most deprived neighbourhoods in Sheffield, which have large, ethnically diverse populations, high levels of economic deprivation, low levels of physical activity, poorer health and shorter life expectancy. Participants will be recruited through general practices and community groups, as well as by postal invitation, to ensure the participation of minority ethnic groups and those with lower levels of literacy. Sheffield City Council and Primary Care Trust fund a range of facilities and activities to promote physical activity and variations in access to these between neighbourhoods will make it possible to examine whether the effectiveness of the intervention is modified by access to community facilities. A one-year integrated feasibility study will confirm that recruitment targets are achievable based on a 10% sample.Discussion: The choice of study population, study interventions, brief intervention preceding the study, and outcome measure are discussed

    Investigating Biotic Interactions in Deep Time

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    Recent renewed interest in using fossil data to understand how biotic interactions have shaped the evolution of life is challenging the widely held assumption that long-term climate changes are the primary drivers of biodiversity change. New approaches go beyond traditional richness and co-occurrence studies to explicitly model biotic interactions using data on fossil and modern biodiversity. Important developments in three primary areas of research include analysis of (i) macroevolutionary rates, (ii) the impacts of and recovery from extinction events, and (iii) how humans (Homo sapiens) affected interactions among non-human species. We present multiple lines of evidence for an important and measurable role of biotic interactions in shaping the evolution of communities and lineages on long timescales.Peer reviewe

    Variation in antibiotic treatment for diabetic patients with serious foot infections: A retrospective observational study

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    <p>Abstract</p> <p>Background</p> <p>Diabetic foot infections are common, serious, and diverse. There is uncertainty about optimal antibiotic treatment, and probably substantial variation in practice. Our aim was to document whether this is the case: A finding that would raise questions about the comparative cost-effectiveness of different regimens and also open the possibility of examining costs and outcomes to determine which should be preferred.</p> <p>Methods</p> <p>We used the Veterans Health Administration (VA) Diabetes Epidemiology Cohorts (DEpiC) database to conduct a retrospective observational study of hospitalized patients with diabetic foot infections. DEpiC contains computerized VA and Medicare patient-level data for VA patients with diabetes since 1998, including demographics, ICD-9-CM diagnostic codes, antibiotics prescribed, and VA facility. We identified all patients with ICD-9-CM codes for cellulitis/abscess of the foot and then sub-grouped them according to whether they had cellulitis/abscess plus codes for gangrene, osteomyelitis, skin ulcer, or none of these. For each facility, we determined: 1) The proportion of patients treated with an antibiotic and the initial route of administration; 2) The first antibiotic regimen prescribed for each patient, defined as treatment with the same antibiotic, or combination of antibiotics, for at least 5 continuous days; and 3) The antibacterial spectrum of the first regimen.</p> <p>Results</p> <p>We identified 3,792 patients with cellulitis/abscess of the foot either alone (16.4%), or with ulcer (32.6%), osteomyelitis (19.0%) or gangrene (32.0%). Antibiotics were prescribed for 98.9%. At least 5 continuous days of treatment with an unchanged regimen of one or more antibiotics was prescribed for 59.3%. The means and (ranges) across facilities of the three most common regimens were: 16.4%, (22.8%); 15.7%, (36.1%); and 10.8%, (50.5%). The range of variation across facilities proved substantially greater than that across the different categories of foot infection. We found similar variation in the spectrum of the antibiotic regimen.</p> <p>Conclusions</p> <p>The large variations in regimen appear to reflect differences in facility practice styles rather than case mix. It is unlikely that all regimens are equally cost-effective. Our methods make possible evaluation of many regimens across many facilities, and can be applied in further studies to determine which antibiotic regimens should be preferred.</p

    Late quaternary biotic homogenization of North American mammalian faunas

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    Biotic homogenization-increasing similarity of species composition among ecological communities-has been linked to anthropogenic processes operating over the last century. Fossil evidence, however, suggests that humans have had impacts on ecosystems for millennia. We quantify biotic homogenization of North American mammalian assemblages during the late Pleistocene through Holocene (similar to 30,000 ybp to recent), a timespan encompassing increased evidence of humans on the landscape (similar to 20,000-14,000 ybp). From similar to 10,000 ybp to recent, assemblages became significantly more homogenous (>100% increase in Jaccard similarity), a pattern that cannot be explained by changes in fossil record sampling. Homogenization was most pronounced among mammals larger than 1 kg and occurred in two phases. The first followed the megafaunal extinction at similar to 10,000 ybp. The second, more rapid phase began during human population growth and early agricultural intensification (similar to 2,000-1,000 ybp). We show that North American ecosystems were homogenizing for millennia, extending human impacts back similar to 10,000 years.Peer reviewe

    Late quaternary biotic homogenization of North American mammalian faunas

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    Biotic homogenization-increasing similarity of species composition among ecological communities-has been linked to anthropogenic processes operating over the last century. Fossil evidence, however, suggests that humans have had impacts on ecosystems for millennia. We quantify biotic homogenization of North American mammalian assemblages during the late Pleistocene through Holocene (similar to 30,000 ybp to recent), a timespan encompassing increased evidence of humans on the landscape (similar to 20,000-14,000 ybp). From similar to 10,000 ybp to recent, assemblages became significantly more homogenous (>100% increase in Jaccard similarity), a pattern that cannot be explained by changes in fossil record sampling. Homogenization was most pronounced among mammals larger than 1 kg and occurred in two phases. The first followed the megafaunal extinction at similar to 10,000 ybp. The second, more rapid phase began during human population growth and early agricultural intensification (similar to 2,000-1,000 ybp). We show that North American ecosystems were homogenizing for millennia, extending human impacts back similar to 10,000 years.Peer reviewe
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