Change Requests Research Articles

The differential association between change request qualities and resistance, problem resolution, and relationship satisfaction.

Although research supports the negative sequelae of the "demand/withdrawal" pattern, research is scant on the impact of "nondemanding" change requests (e.g., specific, increasing, "we" requests). We hypothesize that such change requests will be associated with less partner withdrawal/resistance, better problem resolution, and greater relationship satisfaction. Seventy-two conversations between couples who were recruited through random digit dialing were coded for change request qualities. Results indicate that wife specific and "we" requests led to less husband resistance, and husband increasing and "we" requests led to less wife resistance. Greater percentages of wife and husband specific and "we" requests were related to better problem resolution in the conversation, and greater percentages of wife specific and "we" requests were related to greater wife satisfaction. Research and clinical implications are detailed.

Supplemental Material for The Differential Association Between Change Request Qualities and Resistance, Problem Resolution, and Relationship Satisfaction

Supplemental Material for The Differential Association Between Change Request Qualities and Resistance, Problem Resolution, and Relationship Satisfaction

Competing Through Cooperation: The Organization of Standard Setting in Wireless Telecommunications

This study examines cooperative standard setting in wireless telecommunications. Focusing on the competition among firms to influence formal standardization, the roles of standard-setting committees, private alliances, and industry consortia are highlighted. The empirical context is Third Generation Partnership Project (3GPP), an international standards-development organization in the wireless telecommunication industry. Panel data analyses exploiting natural experiments caused by a consortium merger and entry of Asian firms suggest that participation in industry consortia increases firms' contributions to the development of new technical specifications in 3GPP committees. Moreover, connections to standard-setting peers formed in consortia facilitate change requests to ongoing specifications. These results suggest that if firms in network technology industries want to influence the evolution of their industry, they should identify both formal standard-setting committees and industry consortia in which they can discuss, negotiate, and align positions on technical features with their peers. For policymakers, these results suggest that it is important to ensure that technical consortia remain open for all industry actors and that membership fees do not become prohibitive to small and resource-constrained players.

Commentary] IMPROVING NRT LABELING AND CORRECTING PUBLIC MISPERCEPTIONS

Commentary] IMPROVING NRT LABELING AND CORRECTING PUBLIC MISPERCEPTIONS

Evaluating usability of a commercial electronic health record: A case study

Electronic health records (EHR) are increasingly being implemented by care providers in order to streamline processes and improve quality of care. Due to EHRs’ complexity, the usability of these systems is crucial to ensure safety and to enable clinicians (users) to focus on their patients rather than the technology. This case study presents experiences from the implementation of a commercial EHR in a large pediatric hospital system. This case discusses how a predictive evaluation method, Heuristic Walkthrough, was used to evaluate and improve the usability of the EHR system. Outcomes from the evaluation resulted in immediate changes in the system configuration and training materials, which helped to avoid usability problems at rollout, as well as change requests to the vendor to improve overall system usability in the long term. Design trade-offs and lessons learned for future EHR implementations and other healthcare applications are discussed.

The Erythropoiesis-Stimulating Agents: Reimbursement Challenges and More

t a H r C 1 he aftershock of the national coverage determination (NCD) changes for erythropoiesis-stimulating agents (ESAs) has created a great deal of onsternation in our daily practices. It appears that the CD has prompted Medicare carriers, Medicare interediaries, and private payors to evaluate their policies n ESA injectibles. The policy revisions are related to overage indications, dosing requirements, frequency f use, authorization, and requirements; in some cases, hey outline the mode of acquiring these injectibles specialty pharmacy). To date, the Center for Medicare and Medicaid Serices (CMS) has not issued a final request for change to he Medicare carriers related to the NCD Final Decision emorandum of July 30, 2007. However, it is not only rudent, but imperative, to follow the NCD Decision emorandum guidelines. The important components o the policy that you should know are outlined below. emember these policies apply and it has been deterined that ESA treatment of anemia secondary to mylosuppressive anticancer chemotherapy in solid tuors, multiple myeloma, lymphoma, and lymphocytic eukemia is only reasonable and necessary under the ollowing conditions:

A Hybrid Agent — Genetic Algorithm Approach to General Arrangements

The continuing development of an agent-genetic algorithm hybrid optimization kernel for the allocation of spaces to Zone-decks in a preliminary ship general arrangements design system is presented. In this system, design agents representing the interests of the spaces and the Zone-decks arc utilized to propose possible improvements to a population of candidate solutions. Their design change requests arc accepted or denied by a domain agent if they will improve the overall ship space allocation design. In parallel, a design judge agent monitors the population and reseeds dominated or infeasible solutions and a genetic algorithm agent provides periodic stochastic manipulation of the population to improve the algorithm’s global search capabilities. The algorithm is used to optimize the Zone-deck allocation of spaces for a Notional Corvette-sized vessel.

CPT®: An Open System That Describes All That You Do

The American Medical Association, with the cooperation of multiple major medical specialty societies, including the ACR, responded in 1966 to the need for a complete coding system for describing medical procedures and services with the first publication of Current Procedural Terminology (CPT). This system, now CPT IV, forms the basis of reporting of virtually all inpatient and outpatient services performed by physicians and nonphysician health care providers as well as facilities. This coding system and its maintenance process have evolved in complexity and sophistication, particularly in the past decade, such that it is now integral to all facets of health care, including tracking new and investigational procedures and reporting and monitoring performance measures (read "pay for performance"), in addition to its long-standing use for reporting for reimbursement. To paraphrase a recent automobile commercial, "This is not your father's CPT." The author describes the development of CPT as it exists today, examining the forces that molded its current form, the input opportunities available to medical specialty societies and others, the ever increasing transparency of the CPT maintenance process, and the availability of resources allowing all to stay current. Understanding this system, critical to the practice of all of medicine, including radiology, will aid all health care providers in maintaining the quality, efficiency, and accuracy of their practices' business operations as well as assist them in a world of increasingly complex reporting requirements.

Hedge Fund Activism: Findings and Recommendations for Corporations and Investors

The Conference Board Working Group on Hedge Fund Activism released a set of recommendations for public companies and institutional investors that might find themselves involved in an activism campaign mounted by hedge funds. The proposed recommendations are supported by a research report discussing the Working Group's findings, including recent notable cases of activism such as those at Yahoo, CSX, Motorola, and The New York Times.The recommendations were formulated by a heterogeneous group of high-level corporate and investor representatives, instituted under the auspices of The Conference Board Governance Center. They include guidelines on monitoring securities holdings, responding to requests for change, ensuring voting integrity, and overseeing hedge fund management. Working Group members include:- Major pension funds and asset management firms, including TIAA-CREF, Florida State Board of Administration, and Barclays;- Corporations at the forefront of corporate governance developments, including Pfizer, American Express, and The Coca-Cola Company; and- Industry associations and service providers such as Managed Funds Association, the National Investor Relations Institute, ISS-RiskMetrics Group, Standard & Poor's, and Weil, Gotshal & Manges, LLP.The group is co-chaired by Stephen Davis, director of the Millstein Center for Corporate Governance and Performance at Yale School of Management and chairman of the board of Hermes Equity Ownership Service, and Jon Lukomnik, managing director of Sinclair Capital and recently-named director of the Investor Responsibility Research Center Institute for Corporate Responsibility (IRRCi) in Washington, D.C. Matteo Tonello, Associate Director, Corporate Governance at The Conference Board serves as research director and authored the final paper.The Conference Board Working Group recommends actions which can be taken voluntarily by corporations and investors. Due to the non-advocacy policy adopted by The Conference Board, no recommendations to legislative bodies or regulatory agencies were issued. The Working Group focused on the following major areas:(1) What corporations can do to better monitor securities holdings and learn about those accumulations of stock or extraordinary trading patterns that may reveal a hedge fund's activism tactic.(2) What measures corporations can adopt to avoid becoming a target.(3) How boards and senior executives can react to an activism campaign and how they should respond to requests for change made by hedge funds.(4) How companies and large institutional investors can ensure the integrity of the voting process in those situations where hedge funds borrow shares for the sole purpose of influencing a shareholders' vote; and(5) What considerations institutional investors should be mindful of when allocating some of their assets to hedge funds pursuing activism strategies.The recommendations were formally endorsed by the National Investor Relations Institute (NIRI). NIRI is the largest U.S. association of investor relation officers with 4,400 members representing nearly 2,100 publicly held companies and $5.4 trillion in stock market capitalization.

Family Responsibilities Discrimination in Queensland Workplaces: Where Business and Caring Collide

Although a large body of literature has addressed many of the issues relating to flexible working from both a supply and demand perspective, less attention has focused on situations where these two positions conflict. This research explores a secondary, qualitative data set consisting of over 200 cases of alleged family responsibilities discrimination reported to a community advocacy organization in Brisbane, Australia. Findings indicate that discord in the work environment occurs in relation to (1) requests for part-time work; (2) altered duties during or after maternity leave; (3) requests for changes to rostered work hours; (4) having to take leave to care for sick children; and (5) opportunities for recruitment or promotion. Direct family responsibilities discrimination was evident in only six cases, while the remainder were indirect. A small number of cases were formally lodged for redress although financial compensation was limited. Economic factors such as a shrinking labour force highlight the importance of finding solutions to situations where business imperatives and the well-being of families collide.

Software engineering within a dynamic digital business ecosystem

The goal of fast adaptations and modifications according to continuous change requests is common to all software engineering methodologies. In most cases, sooner or later this results in a mismatch between the software specification and the actual implementation with related disadvantages such as the impossibility of performing validations of related models. We present here an aspect of the digital business ecosystem concept that gives incentives for more responsible software engineering approaches in general by offering a platform for automatic composition of services and re-adaptation of the specifications based on actual changes. The main innovation is a natural language based modelling notation that enables ecosystems of companies to use software described in a high-level language that can also be understood by non-technical users.

A Version Control Tool for Framework-based Applications


 
 
 Framework based application development is increasingly being adopted by software organizations. Frameworks provide reuse of both software design and code, and supply more trustable applications, as the components used to implement them have been previously tested. However, version control is more problematic than in conventional software development, as it is necessary to control both the framework versions and the versions of the applications created with it. Furthermore, aiming to minimize the impact of system requirement changes, framework based software development and reengineering processes adopt the incremental approach, which is a “must” in agile methodologies. This approach makes easier to fulfill requests for system requirements change at any time during the process application. In that context, there is a lack of tools that support version control of applications created with frameworks. This paper presents a tool that aims to aid in the fulfillment of that need, contributing to quality assurance of the products that result from software development or reengineering.
 
 

Patient choice in forensic settings: managing requests for change of consultant

The National Health Service (NHS) is undergoing extensive modernisation. Central to this process is the move away from a professional-led health service to a patient-centred system, which offers patients the ‘power’ to make decisions about their healthcare. In 2003, the government announced their plans for ‘patient choice’ within the NHS (Department of Health, 2003).

Design Reuse and Buffers in High-Tech Infrastructure Development: A Stakeholder Perspective

This study investigates the implementation of design reuse and buffers in developing the infrastructure of high-tech production facilities Design reuse entails using the same systems architecture from one project to the next. Design buffers involve building slack into a proven systems architecture to absorb foreseeable change requests. Choosing the appropriate amounts of reuse and slack is dependent on the uncertainty in the manufacturing technology over the infrastructure life cycle. While proven infrastructure designs can economically accommodate incremental changes in technology, adaptation costs escalate when sufficient buffers are not built-in and changes are radical. We uncover opposing stakeholder interests in determining the extent to which reuse or buffers are used. Design reuse is attractive to the client to reduce the risk that a facility fails to perform, but limits the designer's job to tedious customization work. Design buffers are attractive to the designer to do original problem-solving and limit the risks of being unresponsive to uncertainty, but not to the client who is not guaranteed that the investments will pay off. We find that inequalities between the two stakeholders in the governing power on design decision-making compound the difficulties in assessing and implementing the reuse versus buffers tradeoff.

Distributed personnel scheduling—negotiation among scheduling agents

This paper introduces a model for Distributed Employee Timetabling Problems (DisETPs) and proposes a general architecture for solving DisETPs by using a Multi Agent System (MAS) paradigm. The architecture is composed of a set of autonomous software Scheduling Agents (SAs) that solve the Employee Timetabling Problems (ETP) for each department. Each agent has its own local ETP problem and its own goals. The Scheduling Agents must coordinate their local solution with the other agents in order to achieve a global solution for the whole organization that yields a better result with respect to the organization’s global targets. To achieve a coherent and consistent global solution, the SAs make use of a sophisticated negotiation protocol among scheduling agents that always ends in an agreement (not ensured to be optimal). The main functionalities of this protocol are agent to agent relation definition, a mechanism to approve a chain of Request for Changes and an electronic marketplace for bidding on preferred common time slots.

Assessing hybrid incremental processes for SISOS development

AbstractNew processes are being assessed to address modern challenges for Software‐Intensive Systems of Systems (SISOS), such as coping with rapid change while simultaneously assuring high dependability. A hybrid agile and plan‐driven process based on the spiral lifecycle has been outlined to address these conflicting challenges with the need to rapidly field incremental capabilities in a value‐based framework. A system dynamics model has been developed to assess the incremental hybrid process and support project decision making. It estimates cost and schedule for multiple increments of a hybrid process that uses three specialized teams, and also considers the mission value of software capabilities. It considers changes due to external volatility and feedback from user‐driven change requests, and dynamically reestimates and allocates resources in response to the volatility. Deferral policies and team sizes can be experimented with, and it includes trade off functions between cost and the timing of changes within and across increments, length of deferral delays, and others. We illustrate how the model can be used to determine optimal agile team size to handle changes. Both the hybrid process and simulation model are being evolved on a very large scale incremental SISOS project and other potential pilots. Copyright © 2007 John Wiley & Sons, Ltd.

Teachers’ reflections of professional change during a literacy-reform initiative

Policymakers recently have targeted teacher quality, and school systems have increased their attention to instructional reform through professional development. The purpose of this study was to examine teachers’ views about the change process and professional development that supports change. Semi-structured focus-group data were gathered from 41 primary-grades teachers (students ages 5–9) across five schools in a high-poverty urban district that participated in a 2-year literacy-reform initiative. Results indicated that teachers viewed the change process from two stances: as learners and as change agents. Three conditions supported their professional growth: professional development embedded in school and classroom contexts, professional development focused on limited and clearly defined learning goals, and on-demand access to time and resources. Changes that occurred did so in three phases: movement from curriculum-centered to student-centered practices, increased collaboration, and requests for policy changes via teacher autonomy and advocacy for students.

Nutrition recommendations and their implementation

Nutrition recommendations are – and should be – under continuous debate. New findings challenge old concepts. The media have a preference for news, and rightly so. The increasing interest in diet and health issues among lay people merges with a continuously increasing importance for universities and individual scientists to be visible in the media. Thus, there are many reasons for the often contradictory messages on nutrition and health provided to the general public, leaving the impression of frequent rapid and drastic changes in the science base behind the nutrition recommendations, and therefore requests for changes in these recommendations. In this context it is important to consider the fact that official nutrition recommendations have been quite stable during the almost 40 years that have passed since the first recommendations appeared. The Scandinavian countries issued such recommendations in the late 1960s. At that time, there was already evidence that reduction in fat intake, particularly saturated fat, would help to decrease risk factors for cardiovascular disease. Developments within the field of dietary fibre in the 1970s and 1980s provided a basis for recommendations regarding intake. The 10 energy per cent limit of added sugars was included in the Nordic recommendations from the beginning. There is, in general, very strong agreement between the most recent Nordic recommendations (NNR 2004) and recommendations in other countries and internationally, e.g. as expressed in the WHO TRS 916 report from 2003 and recent recommendations issued by the Institute of Medicine/Food and Nutrition Board in the USA. An overview of the scientific basis of current nutrition recommendations was given at a recent symposium in Uppsala, reported in this issue, as a basis for examples and discussions on how to implement these recommendations in practice. Food-based simple messages were highlighted as important and found to be similar in the different Nordic countries in many respects. Such messages should be given and marketed to utilize the potential for health improvements, or avoidance of health deterioration, even during emerging science, and adjusted when there is enough evidence to do so. Evidently, every new significant correlation in observational/epidemiological studies cannot, and should not, lead to changes in recommendations. Health claims in the marketing of food products may be one way of highlighting nutritional benefits of food products and making them visible to consumers. When used properly and responsibly, such claims may also contribute to consumer education. The new EU regulation of nutrition and health claims became effective on 19 January 2007, almost 4 years after the first draft regulation. The regulation is an important step forward both for producers, who will now have a harmonized European market for their products, and for consumers, who will receive well-founded information and increased protection against false claims. The regulation is summarized and commented on in this issue. The three original articles in this issue cover quite different, but most relevant fields of nutrition: A study on Nutrition support in hospitalized elderly patients, showing the importance of weight increase or maintenance through proper nutrition; Carboxyl acids in the large bowel as affected by prebiotics and probiotics – there are increasing possibilities to stimulate and regulate carboxyl acid formation through both prebiotics and probiotics, with potential benefits for both colonic and systemic health; and Variability in folic acid content in different varieties of lettuce, showing a potential of increasing considerably the intake of this vitamin by the choice of folate-rich varieties of this popular vegetable.

Working together towards a common goal

Working together towards a common goal

Correlation of physician and patient rated quality of life during antipsychotic treatment in outpatients with schizophrenia

Perception of quality of life (QOL) may differ depending on the perspective. This 12-month, prospective, naturalistic study compared QOL ratings in outpatients on antipsychotic treatment for schizophrenia both from a “subjective” patient rated and an “objective” physician rated perspective. Included were 1462 patients. Two scales were used to assess patient and physician perspectives: the Subjective Well-being on Neuroleptics (SWN) scale and the Quality of Life Scale (QLS). Linear correlation was found between both ratings: 10 points on the SWN corresponded to 9.35 points on the QLS. Spearman's correlation coefficients increased over time up to r = 0.71 at Month 12. Patients were grouped into four cohorts depending on the degree of concordance between SWN and QLS ratings. Several factors affecting the concordance of both ratings were identified. Compared to the cohort with QLS = SWN, higher QOL ratings by the physician (QLS ≫ SWN) were more likely in females than in males (OR = 1.36; 95% CI 1.00 – 1.85) and in older than in younger patients (≤ 30 years vs. > 50 years: OR = 0.58, 95% CI 0.34 – 0.998), but less likely in patients with high baseline CGI-severity (CGI > 4; OR = 0.63; 95% CI 0.47 – 0.86) or treatment with oral typicals before baseline (OR = 0.53; 95% CI 0.31 – 0.91). Higher QOL ratings by the patient (SWN ≫ QLS) were less likely in patients with psychotherapy before baseline (OR = 0.54; 95% CI 0.36 – 0.81), medication intolerability before baseline (OR = 0.53; 95% CI 0.36 – 0.78) or patient request of treatment change at baseline (OR = 0.64; 95% CI 0.42 – 0.96). The combination of several factors predicted concordant ratings, including male sex, young age, high CGI at baseline, and psychotherapy prior to the study.