Strategy Workshops and Strategic Change

Despite the attention that strategic change as a topic of research has received, there remain considerable difficulties in conceptualizing the actual sources of strategic change. Strategy workshops represent one obvious and explicit research site since organizations often use such events as a means of effecting or initiating strategic change. This paper examines empirical data from ninety-nine strategy workshops in ten separate organizations to address the research question: Do strategy workshops produce strategic change? The paper concludes that workshops can produce change but that one-off workshops are much less effective than a series of workshops. The data presented indicates that the elapsed duration of the entire series of workshops, the frequency of workshops, the scope and autonomy of the unit concerned, and the seniority of participants have an impact on the success or failure of the venture

Strategy Workshops and Strategic Change

Despite the attention that strategic change as a topic of research has received, there remain considerable difficulties in conceptualizing the actual sources of strategic change. Strategy workshops represent one obvious and explicit research site since organizations often use such events as a means of effecting or initiating strategic change. This paper examines empirical data from ninety-nine strategy workshops in ten separate organizations to address the research question: Do strategy workshops produce strategic change? The paper concludes that workshops can produce change but that one-off workshops are much less effective than a series of workshops. The data presented indicates that the elapsed duration of the entire series of workshops, the frequency of workshops, the scope and autonomy of the unit concerned, and the seniority of participants have an impact on the success or failure of the venture.Co-production of Knowledge; Engaged Scholarship; Strategic Change; Strategy as Practice; Strategy Workshops

Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial.

Aim Human factors are essential for high-quality resuscitation team collaboration and are, therefore, taught in international advanced life support courses, but their assessment differs widely. In Europe, the summative life support course assessment tests mainly adhere to guidelines but few human factors. This randomized controlled simulation trial investigated instructors' and course participants' perceptions of human factors assessment after two different summative assessments. Methods All 5th/6th-year medical students who attended 19 advanced life support courses according to the 2015 European Resuscitation Council guidelines during one study year were invited to participate. Each course was randomized to either: (1) Simulated team assessment (one instructor simulates a team, and the assessed person leads this "team" through a cardiac-arrest scenario test); (2) Real team assessment (4 students form a team, one of them is assessed as the team leader; team members are not assessed and act only on team leader's commands). After the summative assessments, instructors, and students rated the tests' ability to assess human factors using a visual analog scale (VAS, 0 = no agreement, 10 = total agreement). Results A total of 227 students participated in the 1-day Immediate Life Support courses, 196 students in the 2-day Advanced Life Support courses, additionally 54 instructors were included. Instructors judged all human factors significantly better in real team assessments; students rated leadership and situational awareness comparable between both assessments. Assessment pass rates were comparable between groups. Conclusion Summative assessment in real teams was perceived significantly better to assess human factors. These results might influence current summative assessment practices in advanced life support courses

Modeling Social-Ecological Feedback Effects in the Implementation of Payments for Environmental Services in Pasture-Woodlands

International audienceAn effective implementation of payment for environmental services (PES) must allow for complex interactions of coupled social-ecological systems. We present an integrative study of the pasture-woodland landscape of the Swiss Jura Mountains combining methods from natural and social sciences to explore feedback between vegetation dynamics on paddock level, farm-based decision making, and policy decisions on the national political level. Our modeling results show that concomitant climatic and socioeconomic changes advance the loss of open grassland in silvopastoral landscapes. This would, in the longer term, deteriorate the historical wooded pastures in the region, which fulfill important functions for biodiversity and are widely considered as landscapes that deserve protection. Payment for environmental services could counteract this development while respecting historical land-use and ecological boundary conditions. The assessed policy feedback process reveals that current policy processes may hinder the implementation of PES, even though a payment for the upkeep of wooded pasture would generally enjoy the backing of the relevant policy network. To effectively support the upkeep of the wooded pastures in the Jura, concomitant policy changes, such as market deregulation, must also be taken into account

The Prevalence and Clinical Implications of Comorbid Back Pain in Shoulder Instability: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study.

Background:Understanding predictors of pain is critical, as recent literature shows that comorbid back pain is an independent risk factor for worse functional and patient-reported outcomes (PROs) as well as increased opioid dependence after total joint arthroplasty. Purpose/Hypothesis:The purpose of this study was to evaluate whether comorbid back pain would be predictive of pain or self-reported instability symptoms at the time of stabilization surgery. We hypothesized that comorbid back pain will correlate with increased pain at the time of surgery as well as with worse scores on shoulder-related PRO measures. Study Design:Cross-sectional study; Level of evidence, 3. Methods:As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients consented to participate in pre- and intraoperative data collection. Demographic characteristics, injury history, preoperative PRO scores, and radiologic and intraoperative findings were recorded for patients undergoing surgical shoulder stabilization. Patients were also asked, whether they had any back pain. Results:The study cohort consisted of 1001 patients (81% male; mean age, 24.1 years). Patients with comorbid back pain (158 patients; 15.8%) were significantly older (28.1 vs 23.4 years; P < .001) and were more likely to be female (25.3% vs 17.4%; P = .02) but did not differ in terms of either preoperative imaging or intraoperative findings. Patients with self-reported back pain had significantly worse preoperative pain and shoulder-related PRO scores (American Shoulder and Elbow Surgeons score, Western Ontario Shoulder Instability Index) (P < .001), more frequent depression (22.2% vs 8.3%; P < .001), poorer mental health status (worse scores for the RAND 36-Item Health Survey Mental Component Score, Iowa Quick Screen, and Personality Assessment Screener) (P < .01), and worse preoperative expectations (P < .01). Conclusion:Despite having similar physical findings, patients with comorbid back pain had more severe preoperative pain and self-reported symptoms of instability as well as more frequent depression and lower mental health scores. The combination of disproportionate shoulder pain, comorbid back pain and mental health conditions, and inferior preoperative expectations may affect not only the patient's preoperative state but also postoperative pain control and/or postoperative outcomes

Transformation of the cyclo ‐P 5 Middle Deck in [(Cp*Fe)(Cp’’’Co)(μ,η 5 :η 4 ‐P 5 )] upon Functionalization – A Comprehensive Study of Reactivity

The heterobimetallic triple-decker complex [(Cp*Fe)(Cp’’’Co)(μ,η5 : η4-P5)] (1) was functionalized by main group nucleophiles and subsequently electrophilically quenched or oxidized. Reacting 1 with group 14 nucleophiles revealed different organo-substituted P5R middle-decks depending on the steric and electronic effects of the used alkali metal organyls (2: R=tBu; 3: R=Me). Further, with group 15 nucleophiles, the first structural characterized monosubstituted complexes with phosphanides could be obtained as P5 ligands containing exocyclic {PR2} units (4: R=Cy, H; 5: R=Ph). These monoanionic complexes 2–5 were isolated and subsequent electrophilic quenching revealed novel types of neutral functionalized polyphosphorus complexes. These complexes bear formal chains of P5R'R’’ (6: R’=tBu, R’=Me) in a 1,3-disubstitution pattern or P6R'R’’R’’’ units (7: R’=Cy, R’’=H, R’’’=Me; 8: R’=Me, R’’=Ph, R’’’=Me) in a 1,1,3-substitution as middle-decks stabilized by one {Cp’’’Co} and one {Cp*Fe} fragment. One-electron oxidation of 2, 3 or 5 by AgBF4 gave access to paramagnetic triple-decker complexes bearing P5R middle-decks in various coordination fashions (R=tBu (10), R=PPh2 (12)). Interestingly, for R=Me (11), a dimerization is observed revealing a diamagnetic tetranuclear cluster containing a unique dihydrofulvalene-type P10R2 ligand. All complexes were characterized by crystallographic and spectroscopic methods (EPR, multinuclear NMR and mass spectrometry) and their electronic structures were elucidated by DFT calculations