New Course Of Action Research Articles

Prioritizing Factors to Foster Improvement of Sales Operations in Small- and Medium-Sized Industrial Organizations

Small- and medium-sized companies depend heavily on their internal configuration to achieve their goals, generate profit, and remain competitive. The performance of the sales department is often crucial for this. Decision-makers need to understand how to coordinate the sales force’s operations while considering team members’ communication and commitment. This article presents an approach to prioritize factors that will improve the operations of the sales department in small- and medium-sized companies in the industrial sector. To achieve this, we adopted the soft modeling approach by (1) outlining a conceptual model that identifies the factors that can lead to improvements based on the literature and (2) using the analytical hierarchy process to validate a construct and prioritize the factors. This study is focused on the organizational domain and involves the participation of sixty employees from medium-sized Mexican companies with at least five years of experience. The results indicate that the factors that foster improvement in sales department operations are communication improvement, failure prevention, workload alignment, and adequate integration of human efforts with technology without neglecting coordination and management mechanisms. This article could encourage academics and practitioners to adopt the soft modeling approach to adopt new courses of action based on continuous learning and improve organizational cohesion.

Gezamenlijke reflectie over ethische twijfel met CURA: een laagdrempelig instrument voor moreel beraad

Joint reflection on moral doubts with CURA: a low-threshold clinical ethics support instrument Healthcare providers frequently encounter morally challenging situations. Clinical ethics support helps them to navigate in these complex situations by fostering reflection and generating new insights and courses of action. CURA is an instrument developed to provide low-threshold support in situations that evoke moral doubt. This article presents a case study to illustrate how CURA works and to underline the benefits it can bring to healthcare providers. The case involves a woman with Alzheimer’s disease exhibiting restlessness at night, disrupting the sleep of other clients of the residential care center. The night shift nurses want the situation to be resolved, for instance through measures such as fixation. The dementia case manager, however, advocates for an approach that meets her values and the needs of all participants. This case discussion highlights the significance of joint reflection with clinical ethics support: provide good care through generating new courses of action together and reduce moral distress by sharing moral doubts. CURA is one of the methods that can be used to achieve these goals.

Finding Creativity in Predictability: Seizing Kairos in Chronos Through Temporal Work in Complex Innovation Processes

Managing temporal complexity is a fundamental challenge in complex innovation processes, yet the temporal work whereby actors seize opportune moments (kairos) in an environment dominated by clock-time structures (chronos) remains elusive. Temporal tensions can partly be resolved through entrainment, that is, by aligning activities with dominant temporal structures. However, although entrainment ensures the exploitation of a predefined path, it is unable to harness unexpected developments as opportunities for exploration. Thus, navigating the competing temporal demands of chronos and kairos requires not just ambidextrous but also ambitemporal organizing. Collecting and analyzing in-depth interview and observational data from pharmaceutical drug discovery and development, we find that actors sometimes resolve temporal tensions through entrainment to ensure coordination and predictability. In other instances, however, actors abductively transform temporal tensions into novel interpretations and new courses of action. As such, temporal tensions become more than a bothersome deviation from the planned schedule, but an opportunity for creative agency. This understanding of kairos—as a process unfolding through temporal work—relies not only on detraining from chronos (i.e., momentarily detaching from the dominant temporal structure to question underlying assumptions), but also on its reframing and reconfiguration. We contribute to the literature on complex innovation and temporality by theorizing a transformative perspective on ambitemporal organizing, which relies less on paradoxical notions and instead emphasizes how kairos is enacted and seized within and from chronos. Funding: This work was supported by German Research Foundation (DFG) funding for the Research Unit “Organized Creativity” [Grant FOR 2161] as well as by the Austrian Science Fund (FWF) [10.55776/I4884].

The Fight Against Islamophobia in Madrid, Paris and London. A Comparative and Qualitative Analysis on Muslim Activism in Three Cities

1 This research focuses on new courses of action taken by Muslims in their fight against Islamophobia in global cities like London, Paris, and Madrid. Employing Putnam’s Social Capital Theory, this article demonstrates that the most effective actions against Islamophobia are those carried out by organizations deploying both bonding and bridging 2 social capital. Bonding social capital reinforces primary solidarity, which allows Muslim movements to survive in hostile contexts, while bridging social capital generates links outside the group and adds diversity to the movement. Using qualitative methods such as specific observations, biographical interviews and focus groups, this comparative research identifies a typology of anti-Islamophobia actions in each city. In addition, it shows the ideological and generational tensions that can arise from the myriad ways Muslim leaders incorporate religion into their activism, and the types of alliances they build inside and outside the primary group. This research also shows how both youth and women’s groups are trying to break away from these ideological confrontations by proposing new spaces of mobilization where it might be possible to turn a particular interest (the fight against Islamophobia) into a general one (the fight against extremist ideas and the defense of individual and collective rights).

How student healthcare providers in a communication skills course respond to standardized patient resistance

Encountering and responding to patient resistance can be especially challenging for student healthcare providers. Navigating who ultimately holds the authority to know and understand a health concern, make recommendations for a course of action, and accept or resist these recommendations are all part of how epistemic authority is negotiated in medical settings.The purpose of this paper is to systematically examine how student providers enrolled in a communication skills course at an American university responded to standardized patient resistance. The data for this study were 121 video-recorded and transcribed final objective structured clinical examinations from the fall 2019 course. We used discourse analysis informed by principles of conversation analysis to identify several discursive strategies used by the students, including: 1) asking for clarification; 2) expressing uncertainty and offering to gather additional resources; 3) aligning with and offering an account for the resistance; 4) recommending a new course of action; and 5) confronting the resistance. Our findings point to the value of including instruction for both student healthcare providers and standardized patients on how to respond to resistance they encounter in ways that may help improve healthcare outcomes.

SAT184 Improving Access To Osteoporosis Specialists Using Electronic Consultations

Abstract Disclosure: C. Sethuram: None. W. Brown: None. G. Gill: None. C. Liddy: None. A. Afkham: None. E. Keely: None. Background: Timely access to osteoporosis specialists remains a challenge in Canada, where patients face long wait times for specialist care. Electronic consultations (eConsults) help address this issue by allowing primary care providers (PCPs) to pose clinical questions to specialists using a secure online platform. This study identifies the types of osteoporosis-related questions being asked by PCPs and describes the impact of the advice provided by osteoporosis specialists using eConsult. Methods: We performed a cross-sectional study of osteoporosis-related eConsults submitted to endocrinologists between January 2018 and December 2020 on the Champlain BASE™ eConsult Service in Ontario, Canada. Each eConsult was coded according to clinical question and answer type through consensus between two authors, based on pre-determined taxonomies established by the reviewers. We analyzed eConsult utilization data, including response times, PCP satisfaction, and referral outcomes, which were collected via PCP surveys following completion of the eConsult. Results: Of the 2534 eConsults sent to endocrinologists during the study period, 408 (16%) were specific to osteoporosis. The most common questions asked by PCPs were regarding whether or not to start treatment (18%), the initial therapy choice (13%), and how often to complete bone mineral density scans (8%). The most common responses from specialists included recommendations for bone mineral density scanning (13%), recommendation to start therapy (9%), and recommendation to treat using a bisphosphonate without the dose specified (9%). The median response interval was 3.1 days, and the median time spent by endocrinologists responding to the eConsult was 10.0 minutes. Eighty-four percent of cases were resolved without requiring an in-person referral. A course of action that PCPs already had in mind was confirmed in 42% of cases. Clear advice for a new course of action for PCPs to implement was provided in 54% of cases. Conclusion: Osteoporosis eConsults provide timely access to valuable specialist advice while avoiding unnecessary face-to-face clinic visits. Further, we identified commonly recurring osteoporosis questions asked by PCPs, which can be used to inform planning of future continuing professional development events. Presentation: Saturday, June 17, 2023

JEDAN PRIMER UPOTREBE AKTIVNOG GEOKOMPOZITA ZA SANACIJU DEPONIJE

The ''Chalk landfill Bruck I/II'', a former industrial landfill is located in Austria. The landfill was filled from 1926-1981 with calcium carbide, CHC and mercury contaminated wastes. The total amount of HCH is estimated to 100-1000 t. Since 1995 different remedial actions took place as well as continuous securing measures. In 2000 the site was put on the list of contaminated sites that need remediation and got codename K20. Additional tests in 2003 gave the site highest priority level one. In 2009 decision is made to remove all stored material and treat or safely store in state-of-the-art landfill. After observation of Hexachlorobenzene in food in the area around the thermal treatment plant works were stopped. The new course of action was to secure the waste on site. The new physical safeguard measures included an innovative, multifunctional surface sealing system consisting of calcium bentonite geosynthetic clay liner, an activated carbon mat, a LDPE membrane with integrated aluminium sheet and a drainage element. This system creates a strong barrier for volatile CHC. There are soil vapor extraction pipes below and above the sealing system to ensure a monitoring. Minimal interference with existing landfill body was requirement. To enable long term stability of the whole sealing system geogrids are used. The construction work was executed in 2016.

Improving Access to Osteoporosis Specialists Using Electronic Consultations

ObjectiveTo identify the types of osteoporosis-related questions being asked by primary care providers (PCPs) and describe the impact of the advice provided by osteoporosis specialists using eConsult. MethodsWe performed a cross-sectional study of osteoporosis-related eConsults submitted to endocrinologists between January 2018 and December 2020 on the Champlain eConsult BASE™ Service in Ontario, Canada. Each eConsult was coded according to clinical question and answer type through consensus between 2 authors, based on predetermined taxonomies. We analyzed eConsult utilization data, including response times, PCP satisfaction, and referral outcomes (collected via PCP surveys). ResultsOf the 2,528 eConsults sent to endocrinologists during the study period, 408 (16%) were specific to osteoporosis. The most common questions asked by PCPs were regarding whether or not to start treatment (35%), the initial therapy choice (25%), and how often to complete bone mineral density scans (15%). The most common responses from specialists included recommendations for bone mineral density scanning (34%), recommendation to start therapy (24%), and recommendation to treat using a bisphosphonate without the dose specified (23%). The median response interval was 3.1 days. Most cases (84%) were resolved without requiring an in-person referral. Clear advice for a new course of action for PCPs to implement was provided in 54% of cases. ConclusionOsteoporosis eConsults provide timely access to valuable specialist advice while avoiding unnecessary face-to-face clinic visits. We identified commonly recurring osteoporosis questions asked by PCPs, which can be used to inform planning of future continuing professional development events.

New Formula for Conjugate Gradient Method to Unconstrained Optimization

This study presents a new conjugate gradient formula (CGM), which is obtained by fulfilling two conditions, firstly the conjugate property and secondly the descent property, in order to address the issue of unconstrained optimization. The gradient, which is the initial derivative of the objective function, is a continuous Lipchitz work and the objective function is differentiable. Using a new variable that serves as the gradient for the objective coefficient function, to create a new course of action based on the old variable and to validate the effectiveness of the new CDM, the table with total iterations and job evaluation was used to display the results of our new methodology using the MATLAB application

« Sarà primavera dai ». L’uso della particella dai in italiano e in dialetto trevigiano

This conversation analytic study aims to describe the actions performed by speakers of Italian and Trevigiano – a northern Italian dialect – by using the particle dai in everyday conversations. Our analyses draw on a corpus of formal and informal phone calls, where dai appears as preface and at the end of turns that initiate new courses of action, at the end of some responsive turns (or Turn-Constructional Units) and in post-expansions (that is, turns in third position). The actions embodied by these turns – requests, proposals and assessments – have in common the momentary deontic imbalance in favor of the speaker, who tells, asks or proposes to the coparticipant to do something. The particle also accompanies assessments of events to which the speaker has no direct experience (thus from an epistemically subordinate position). This study highlights the fuzziness of the boundaries between deontic and epistemic rights in everyday talk.

Countering antibiotic resistance: a new course of action is needed.

Antibiotic resistance does not seem to be stopping despite international policies that have been aiming to combat this phenomenon for more than 10 years. The World health organization (Who) seeing the relentless growth of the issue has reiterated its recommendations that have been implemented at the national level. In fact, in Italy the new National plan against antibiotic-resistance 2022-2025 (Pncar 2022-2025) is in full operation. At Asl Napoli 3 Sud, which boasts a population of more than 1 million people, an analysis was carried out regarding antibiotic consumption in the first six months of 2022. The results showed consumption deviating from the regional and national average, thus suggesting that swift actions are needed to curb overprescription by physicians as much as possible. This work also aims to raise awareness among physicians and health care professionals of compliance with the requirements of regulatory agencies and scientific societies, so that a virtuous path toward a decisive change of pace can be taken.

Importing implementation methods in clinical dementia research

AbstractBackgroundBringing clinical innovation from dementia research to health‐care requires implementing new courses of action. Implementation science methods can help bridge the gap between biomedical research and clinical practice. We imported implementation methods to perform a feasibility analysis for implementing the clinician’s Uniform Dataset‐cUDS as a standard cognitive assessment in two contexts: European academic memory clinics and Italian academic and non‐academic memory clinics.Method33 questions, addressing centers' contextual factors, mechanisms of impact, acceptability, hurdles and facilitators were posed to academic and non‐academic memory clinics. The Process Evaluation framework was used as a guidance to evaluate implementation feasibility. Mixed‐methods analyses were performed with SPSS and MAXQDA. We labelled open answers into categories and performed proportion tests for each hurdle and facilitator in both contexts.Result46 EADC (European Alzheimer’s' Disease Consortium) academic and 62 SINDem (Italian Society of Neurology on Dementia)(30 academic, 32 non‐academic) clinicians answered the survey. Acceptability towards implementation of cUDS was 65% among EADC and 95% among SINDem responders (p = .134,ɑ = .05). A statistically significant (p = .01) proportion of SINDem clinicians (47%) reported to envision no barrier to the implementation, as compared to EADC clinicians (11%). 59% of EADC centers reported to receive full reimbursement for cognitive assessment versus only 10% in Italian academic centers(p = .58). Qualitative analysis showed similar barriers as the unavailability of material (e.g., local norms) and finances (e.g., insurance, salary) in both EADC‐SINDem centers. Despite non‐statistical significant differences, compared to EADC, SINDem clinicians showed a trend towards greater need of neuropsychologists/specialized staff (EADC: 6%; SINDem: 14‐25%),in particular among non‐academic centers. On the other hand, EADC clinicians seemed more concerned with logistics (EADC: 15%; SINDem: 3%).ConclusionOur analysis revealed a good level of feasibility and acceptability for cUDS in Europe, especially in Italy which has no prior local standard as compared to other European countries (e.g., Germany, Netherlands). Similar barriers were identified among Europe and Italy, however, facilitators seemed to be more specific of the country and setting of implementation. This data also revealed structural hurdles, like heterogeneous reimbursement levels for cognitive assessment. Overall, country‐based feasibility analysis are necessary before proceeding into implementation.

Use of eConsult to enhance genetics service delivery in primary care: A multimethod study.

Electronic consultation (eConsult) is a freely-available secure online platform connecting primary care providers (PCPs) to geneticists. Our purpose was to determine whether eConsult is effective in improving genetics service delivery in primary care. PCP questionnaires regarding eConsult's utility, geneticists' tracking form assessments of eConsult type and appropriateness, and geneticists' interviews on implementing eConsult were carried out. In 2 regions of Ontario, Canada, from January 2019 to June 2020, there were 305 genetics eConsults. For 169 (55%), PCPs indicated receiving good advice for a new course of action; for 110 (36%), referral was now avoided; and for 261 (86%), eConsult was perceived valuable for patient management. Of the 131 geneticist-completed tracking forms, cancer questions were most common (68, 52%). For 63 (48%), geneticists disagreed/strongly disagreed PCPs should know the answer to the referral question. From the interview data, it was observed that geneticists described eConsult positively and suggested how it might improve access and efficiencies if integrated into genetic service delivery. Dealing with eConsults virtually could reduce waitlists, and suggesting appropriate investigations for PCPs could improve efficiencies. eConsult offers a potential solution for receiving timely genetics advice and avoiding unnecessary patient referrals, however, greater effect on access and wait times will need systematic integration into PCP and geneticist practice.

South African Economic Reconstruction and Recovery Plan as a response to South African economic crisis

The impact of the current Covid-19 pandemic on the economy presents an opportunity for an economic reset in South Africa. The economic reset will provide a chance for structural transformation that will underpin economic growth and sustainable development. The Covid-19 pandemic has entrenched and exposed South Africa’s inequality. Unemployment is at an all-time high and over half of South Africans, the majority which is African live in extreme poverty. This inequality has created a conducive environment for the recent instabilities that led to mass looting and property destruction. In response to the economic crisis and the Covid-19 pandemic, the South African government adopted the South African Economic Reconstruction and Recovery Plan to reconstruct and reset the economy. However, the South African Economic Reconstruction and Recovery Plan do not present an opportunity for the economic reset but it’s a perpetuation of neoliberalism. Therefore, the call “to build a new, inclusive economy that benefits all South Africans” is nothing but buzzwords without any meaning. The plan mimics rhetorical calls for job creation and industrialization made by previous policies i.e. National Development Plan (NDP) and New Growth Path (NGP) without any operational plan and a new course of action. In addition, the plan is intended for South Africa to move towards the target set in the NDP, vision 2030. This paper analyzes the South African Economic Reconstruction and Recovery Plan as a response to the economic crisis. Moreover, the paper seeks to determine whether the plan will lead to desired results of economic reconstruction. In conclusion, the paper determines whether neoliberalism is the correct trajectory for South African development or is there a need for a developmental state.

The Role of Organizational Myth in Institutional Persistence: The Case of Magnum Photos

Institutionalized organizations are pervaded by myths, that is, loosely factual historical narratives expressing organizational values. Yet, we scarcely understand how such organizations cohere around their myths over time, thus maintaining their distinctive characters and demonstrating institutional persistence. In this study, we explore how organizational myth fosters institutional persistence over a long period of time, even in the face of potentially disintegrating crises. We examine the case of Magnum Photos, a legendary photo agency founded in 1947. Our analysis of rich manually collected archival data covering more than half a century of Magnum’s existence allows us to unpack a mechanism that we term mastering the art of crisis. In mastering the art of crisis, any organizational crisis is transformed into an existential one and organizational myth is invoked for charting a course of action that would ensure the continuous organizational cohesion around the values expressed in the myth. As a new course of action is bounded by the logic of the myth, it does not disrupt the distinctive character and historic legacy of the organization. As organizational myth, by virtue of its symbolic nature, affords multiple frames of reference, it allows for reprioritization and reinterpretation of the values constituting it, thereby providing a room for successful adaptation to new circumstances. Our findings contribute to the historical turn and revival of old institutionalism in organization studies.

Chiral Porous Carbon Surfaces for Enantiospecific Synthesis.

Chiral surfaces, developed in the last decade, serve as media for enantioselective chemical reactions. Until today, they have been based mostly on developments in silica templating, and are made mainly from imprints of silicate materials developed a long time ago. Here, a chiral porous activated carbon surface was developed based on a chiral ionic liquid, and the surface chemistry and pore structure were studied to lay a new course of action in the field. The enantioselectivities of surfaces are examined by using variety of methods such as circular dichroism, linear sweep voltammetry and catalysis. These techniques revealed a 28.1% preference for the D enantiomer of the amino acid proline, and linear sweep voltammetry confirmed chirality recognition by another probe. An aldol surface chiral catalytic reaction was devised and allowed to determine the root of the enantiomeric excess. These results affirm the path toward a new type of chiral surface.

Mass assembly history of dark matter haloes in the light of H0 tension

ABSTRACT The Hubble tension may introduce a new course of action to revise the standard Lambda cold dark matter (ΛCDM) model to unravel dark energy and dark matter physics. The Hubble parameter can be reconstructed by late-time observations of the background evolution model independently. We relate the reconstructed Hubble parameter to the structure formation and large-scale structure observables in this work. We use excursion set theory to calculate the number density of dark matter haloes and the mass function of progenitors. We obtain results for both the Markov and non-Markov extensions of excursion set theory in the context of spherical and ellipsoidal collapse. We show that the number density of dark matter haloes in the reconstructed model has ∼2σ difference in comparison with the Planck 2018 ΛCDM in the mass range M ≳ 1012 M⊙. We also compare the dark matter halo progenitor mass function with the pair-galaxy statistics and their mass assembly history from observational data of the Hubble Space Telescope Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey. Due to complications in distinguishing the ratio of accretion and merger in mass assembly, our result on the pair fraction is for illustration only. However, the ∼5 times more accurate observations will be promising for distinguishing the reconstructed model and the Planck 2018 ΛCDM.

A language-based approach to measuring creative exploration

• Using textual analysis, we develop a new language-based indicator of firm exploration. • The exploration indicator covers all firms in all industries and spans a wide range of exploratory activities. • The exploration indicator predicts future R&D spending and patent and trademark applications and grants. • Exploration declines after periods of high R&D spending and as the firm matures. • Exploration correlates positively with firm risk. • Exploration exhibits a distinct positive impact on firm value. We propose a new measure of the exploratory activities of companies based on the idea that experimentation with new courses of action and the need to describe them entails the adoption of new words in firm regulatory disclosures. Unlike traditional indicators, such as R&D spending, the proposed exploration indicator is available for all publicly traded firms across all industries. The exploration indicator predicts firm knowledge accumulation, as measured by future patenting and trademarking activities. It further shows that firm exploration declines after periods of high R&D spending and over time. The exploration indicator correlates positively with firm risk and exhibits a distinct positive impact on firm value unexplained by traditional innovation indicators. Our language-based approach can be applied to measure creative contributions in other domains, such as government grant applications and academic publications.

How tax incentives slow down positive change in social impact ecosystems and what can we do about it

To advance positive change within social impact ecosystems, policy makers offer tax incentives in return for social value. Some social enterprises are exempt from paying taxes, with an expectation that they will create positive change in society. Yet, studies have highlighted that there are a growing number of value-detracting issues with tax exemptions, which detract from ecosystems of positive social change. Therefore, spotting and rectifying situations of potential value detraction is paramount. In this paper we offer a two-sided framework called SCAM/MEND, to identify and act upon the ‘dark side’ of tax exemptions in social impact ecosystems. The SCAM side of our framework allows ecosystem actors to spot situations in which negative outcomes are likely to emerge from tax exemptions. The MEND side of our framework offers policy makers and ecosystem actors a new course of action to redirect positive change efforts.

I saw you like this now I wanna know

In this paper, we focus on how interactants accomplish different forms of participation in the “one-to-many” context of social media interactions, where single users frequently have a wide audience of potential recipients to their posts. How do social media users ascertain who might be a relevant recipient to these posts, and how do other users who interact with these posts position themselves within a relevant participation framework? We explore these questions by examining how participants on Twitter orient to the act of “liking” a post as a resource for moving into the participation framework of the talk, and we show how this orientation allows likes to serve as possible pathways for launching new actions and activities. We examine these practices using the framework of conversation analysis (CA), showing how participants use public noticings of another user’s likes as a preface to, and justification for, a subsequent invitation sequence or complaint sequence. We additionally show how the specific media affordances of Twitter, which render likes publicly visible to others, facilitates the noticing of likes as a device for inciting new courses of action.