What does it take for organizations to change themselves? The influences on the internal dynamics of organizational routines undergoing planned change

Accomplishing desired benefits from investments in planned change is problematical for organizations, their leaders and the change agents charged with delivery. This is despite a well-developed literature, replete with advice on how change should be achieved. Examination of this literature shows the primary focus on change agents and their practices. This research widens the focus by observing the influence of change agents, change recipients and line managers on organizational routines undergoing planned change. It examines the interplay between stability and change in organizational routines, adopting a social practice perspective, and the routine intended to change as the unit of analysis (Feldman and Pentland, 2003, 2005). The research builds on claims that to understand the patterns of action within routines requires the internal dynamics – the claimed duality between ostensive (in principle) and performative (in practice) aspects - to be examined. A research method to operationalize the study of this claimed duality was devised following the principles of Strong Structuration (Stones, 2005). This method enabled a unique conceptualization of the study of routine dynamics, focused on planned change from the perspective of multiple, interdependent actors. Two cases of change agents following the advice in the planned change literature were explored. In one case, stability of the routine persisted when change was intended. In the other, change was relatively easy to achieve irrespective of change agent actions. The primary contribution is the demonstration of how the attitudes to change of change recipients, line managers and change agents influence the internal dynamics of routines undergoing planned change. Other contributions pertain to the method of ‘unpacking’ organizational routines and its potential for shaping future practice. This research does not offer new ‘normative’ advice but instead sensitizes planned change practitioners to the level of analysis they need to carry out to ensure that their interventions are suitably designed

CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis.

As scientific techniques for the detection of cytomegalovirus (CMV) improve, we are able to detect small amounts of CMV in the mucosal wall. As clinicians, we are unsure how to interpret the results of this novel test. There is controversy in the literature as to the significance of the detection of CMV in the gut. Whilst the importance of CMV and reactivation of the virus is clear in those patients such as allograft recipients with established immune compromise, the role is less clear in patients with less damaged immune systems. We explore whether the detection of CMV in such cases influences outcome and how it should be optimally managed. We discuss the optimal management of such cases, according to current guidelines, with a review of the literature

Risk management reconceived: reconciling economic rationality with behavioural tendencies

Risk management practices as described in many leading texts feel counterintuitive to many practitioners and are frequently ignored, despite their being evidently logical and potentially valuable. Such practices are often conceived as a remedial post-planning, audit activity. This paper proposes an approach for dealing with project uncertainty and risk, grounded in economics and taking into account behavioural biases and heuristics. The proposed approach is argued to be an enhancement to conventional risk management practices and one that can serve organisations better while also aligning to experienced practitioners’ intuitive approaches. In particular, we argue: that the focus should be on adding economic value rather than reducing risk per se; that opportunity gain/loss is a superior metric for gauging potential impacts of risky events; and that creation of real options should be emphasised as part of the repertoire of generic response actions to risk. The approach also supports the integration and handling of uncertainty and risk as part of holistic project planning and control

Kinetics of acute hepatitis B virus infection in humans

Using patient data from a unique single source outbreak of hepatitis B virus (HBV) infection, we have characterized the kinetics of acute HBV infection by monitoring viral turnover in the serum during the late incubation and clinical phases of the disease in humans. HBV replicates rapidly with minimally estimated doubling times ranging between 2.2 and 5.8 d (mean 3.7 ± 1.5 d). After a peak viral load in serum of nearly 1010 HBV DNA copies/ml is attained, clearance of HBV DNA follows a two or three phase decay pattern with an initial rapid decline characterized by mean half-life (t1/2) of 3.7 ± 1.2 d, similar to the t1/2 observed in the noncytolytic clearance of covalently closed circular DNA for other hepadnaviruses. The final phase of virion clearance occurs at a variable rate (t1/2 of 4.8 to 284 d) and may relate to the rate of loss of infected hepatocytes. Free virus has a mean t1/2 of at most 1.2 ± 0.6 d. We estimate a peak HBV production rate of at least 1013 virions/day and a maximum production rate of an infected hepatocyte of 200–1,000 virions/day, on average. At this peak rate of virion production we estimate that every possible single and most double mutations would be created each day

The Men’s Safer Sex Trial: a feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men

OBJECTIVE: We aimed to determine the feasibility of an online randomised controlled trial (RCT) of the Men’s Safer Sex website, measuring condom use and sexually transmitted infection (STI). METHODS: For this study 159 men aged ≥16 with female sexual partners and recent condomless sex or suspected STI were recruited from three UK sexual health clinics. Participants were randomised to the intervention website plus usual clinic care (n = 84), or usual clinic care only (n = 75). Online outcome data were solicited at 3, 6, and 12 months. RESULTS: Men were enrolled via tablet computers in clinic waiting rooms. Software errors and clinic Wi-Fi access presented significant challenges, and online questionnaire response rates were poor (36% at 3 months with a £10 voucher; 50% at 12 months with £30). Clinical records (for STI diagnoses) were located for 94% of participants. Some 37% of the intervention group did not see the intervention website (n = 31/84), and (as expected) there was no detectable difference in condomless sex with female partners (IRR = 1.01, 95% CI 0.52 to 1.96). New acute STI diagnoses were recorded for 8.8% (7/80) of the intervention group, and 13.0% (9/69) of the control group over 12 months (IRR = 0.75, 95% CI 0.29 to 1.90). CONCLUSIONS: It is likely to be feasible to conduct a future large-scale RCT to assess the impact of an online intervention using clinic STI diagnoses as a primary outcome. However, practical and technical challenges need to be addressed before the potential of digital media interventions can be realised in sexual health settings

Structural, thermal, and magnetic properties of Ni[sub 2]MnGa

The two main effects underlying the magnetic shape memory effect in Ni2MnGa are martensitic transformations and magnetic anisotropy energies. Both issues are addressed here with first-principles calculations. First, we examine how the tetragonality in the martensitic phase varies with the composition. Then, the actual transformation is investigated by comparing the free energies of different phases. The transition from the cubic structure to the tetragonal structure with c/a=1.27 is driven by the vibrational free energy and occurs at a temperature of 200 K which is in the experimental range. Finally, we focus on the magnetic anisotropy energy for the tetragonal structure with c/a=0.94. It is shown to be a magnetically nearly ideal uniaxial system determined by the first-order anisotropy constant. However, it is estimated that the twinned microstructure can cause higher-order anisotropies to show up in the measured anisotropy.Peer reviewe

Diarrhetic shellfish toxin monitoring in commercial wild harvest bivalve shellfish in new south wales, Australia

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. An end-product market survey on biotoxins in commercial wild harvest shellfish (Plebidonax deltoides, Katelysia spp., Anadara granosa, Notocallista kingii) during three harvest seasons (2015–2017) from the coast of New South Wales, Australia found 99.38% of samples were within regulatory limits. Diarrhetic shellfish toxins (DSTs) were present in 34.27% of 321 samples but only in pipis (P. deltoides), with two samples above the regulatory limit. Comparison of these market survey data to samples (phytoplankton in water and biotoxins in shellfish tissue) collected during the same period at wild harvest beaches demonstrated that, while elevated concentrations of Dinophysis were detected, a lag in detecting bloom events on two occasions meant that wild harvest shellfish with DSTs above the regulatory limit entered the marketplace. Concurrently, data (phytoplankton and biotoxin) from Sydney rock oyster (Saccostrea glomerata) harvest areas in estuaries adjacent to wild harvest beaches impacted by DSTs frequently showed elevated Dinophysis concentrations, but DSTs were not detected in oyster samples. These results highlighted a need for distinct management strategies for different shellfish species, particularly during Dinophysis bloom events. DSTs above the regulatory limit in pipis sampled from the marketplace suggested there is merit in looking at options to strengthen the current wild harvest biotoxin management strategies