A social capital dimensional approach to Business-IT alignment

This paper examines the role that social capital plays in organisations in order to create alignment between the IT and business communities. Business and IT communities seem often to have little in common with each other and experience difficulties sharing objectives, deliverables and even communicating with each other. The heart of the problem lies in the fact that the business and IT organisations do not perceive themselves as part of a common, unified organisation. Beginning with the premise the absence of social capital is destroyer of alignment, the paper suggests that where social capital is built across the boundaries of the business and IT organisations, this leads to collective efficacy or superior performance. This is elaborated in a dimensional framework comprising the dimensions and attributes of social capital. Collective efficacy and superior performance are seen when the IT and business organisations are aligned through social capital

FRESH AIR:An implementation research project funded through Horizon 2020 exploring the prevention, diagnosis and treatment of chronic respiratory diseases in low-resource settings

This protocol describes FRESH AIR, an implementation science project exploring how to improve the prevention, diagnosis and treatment of chronic lung diseases in contexts with limited healthcare resources. It consists of inter-related studies that take place in four countries that are part of the International Primary Care Respiratory Group's (IPCRG) global network: Uganda, the Kyrgyz Republic, Vietnam and Greece. The project has been funded by the European Commission Horizon 2020 research programme and runs from October 2015 until September 2018

The IPCRG's teach the teacher programme: an educational initiative to promote improved management of difficult to manage asthma

The IPCRG is a network of organisations committed to improving primary care assessment and treatment of chronic respiratory disease. We developed an evidence-based resource, SIMPLES (Ryan D, et al. Prim Care Respir J 2013;22:365-73) to aid structured asthma review for difficult to manage asthma. An educational initiative was introduced to disseminate research findings from U-BIOPRED and promote improved primary care management. We aimed to support participants from seven European countries to design and plan local programmes of education:teaching clinical colleagues key messages about difficult to manage asthma, encouraging local adaptation of existing IPCRG resources. These took place in autumn 2015 involving over 230 health professionals - including early career and GPs with a special interest in asthma/COPD, specialist nurses and others. We proposed an evaluation framework(Guskey,T.Teachers&Teaching 2002;8:3, 381-391) which includes - i) participant reaction, ii) learning, iii) organisational changes, iv) use of new knowledge and v) impact on practice and service users. Programmes were well received by participants. There were many challenges encountered: in assessing local learning needs, setting up education programmes and supporting clinical practice change. The impact on participants' clinical practice and service users is more challenging to demonstrate and will require more time to evaluate. We reflect on the challenge of meaningful evaluation of practice change. These insights are important in thinking about the design, implementation and evaluation of clinical educational programmes globally.info:eu-repo/semantics/publishedVersio

BREATHLEssness in INDIA (BREATHE-INDIA)–Study protocol for the co-design of a community breathlessness intervention in India using realist methods and intervention mapping

Background Breathlessness that persists despite treatment of causal disease(s) is disabling, associated with high therapy-related costs and poor socioeconomic outcomes. Low resource countries bear a disproportionate burden of respiratory problems, often characterised by disabling breathlessness. Low-cost self-management breathlessness-targeted interventions are effective and deliverable in community settings but have been developed in high-income countries. We aim to understand how breathlessness self-management works in ‘real life’ populations and cultural contexts, to develop programme theory and co-design a prototype intervention to improve persistent breathlessness management in India. Methods and analysis Using a Realist approach, Intervention Mapping and the Medical Research Council Complex Intervention Framework we will undertake two phases of work supported by our Expert Group (of respiratory, primary, palliative care physicians) and key stakeholder groups (opinion leader clinicians, community health workers and people with lived experiences of breathlessness). 1) Realist review and evaluation to identify and refine evidence and theory for breathlessness self-management, producing intervention and implementation programme theory. We will identify literature through our Expert Group, scoping searches and systematic searches (Medline, Ebscohost, CINAHL, Scopus, Psychinfo). We will map intervention components to ‘what works, for whom, and where.’ 2) Intervention development using Intervention Mapping to map intervention and implementation programme theory to intervention components, develop materials to support intervention delivery, and co-design a prototype educational intervention ready for early acceptability and delivery-feasibility testing and evaluation planning in India. Use of stakeholder groups is to allow people with experience of breathlessness and/or its management to contribute their views on content developed by our team based upon review of secondary data sources. Experts and Stakeholders are therefore not research subjects but are included as extended members of the study team and will not follow informed consent procedures. Experts and stakeholders will be acknowledge in outputs arising from our project if they wish to be. Our review conduct will be consistent with RAMESES quality standards. Discussion At the conclusion of our study, we will have co-designed a breathlessness intervention for use in the community setting in India ready for further evaluation of: effectiveness, socioeconomic outcomes, acceptability and transferability to other low resource settings

Managing asthma in primary healthcare

Asthma brings considerable challenges for family doctors because of its variety of shapes, different levels of severity, a wide age range, and the fact that in the last decades clinicians are able to offer much better treatment options with a better level of disease control and a higher quality of life. The objectives of the current review article are to provide an up-to-date review by primary care respiratory leaders from different countries of the most significant challenges regarding asthma diagnosis and management, the importance of team work and the problems in recognizing and dealing with difficult-to-manage and severe asthma in primary care. The article provides a short review of the main challenges faced by family physicians and other primary health care professionals in supporting their patients in the management of asthma, such as asthma diagnosis, promoting access to spirometry, the importance of a multiprofessional team for the management of asthma, how to organize an asthma review, the promotion of patient autonomy and shared decision-making, improving the use of inhalers, the importance of the personalized asthma action plan, dealing with difficult-to-manage and severe asthma in primary care and choosing when, where and how to refer patients with severe asthma. The article also discusses the development of an integrated approach to asthma care in the community and the promotion of Asthma Right Care