Successful Change Research Articles

Collaborative implementation of an evidence-based package of integrated primary mental healthcare using quality improvement within a learning health systems approach: Lessons from the Mental health INTegration programme in South Africa.

The treatment gap for mental health disorders persists in low- and middle-income countries despite overwhelming evidence of the efficacy of task-sharing mental health interventions. Key barriers in the uptake of these innovations include the absence of policy to support implementation and diverting of staff from usual routines in health systems that are already overstretched. South Africa enjoys a conducive policy environment; however, strategies for operationalizing the policy ideals are lacking. This paper describes the Mental health INTegration Programme (MhINT), which adopted a health system strengthening approach to embed an evidence-based task-sharing care package for depression to integrate mental health care into chronic care at primary health care (PHC). The MhINT care package consisting of psycho-education talks, nurse-led mental health assessment, and a structured psychosocial counselling intervention provided by lay counsellors was implemented in Amajuba district in KwaZulu-Natal over a 2-year period. A learning health systems approach was adopted, using continuous quality improvement (CQI) strategies to facilitate embedding of the intervention.MhINT was implemented along five phases: the project phase wherein teams to drive implementation were formed; the diagnostic phase where routinely collected data were used to identify system barriers to integrated mental health care; the intervention phase consisting of capacity building and using Plan-Do-Study-Act cycles to address implementation barriers and the impact and sustaining improvement phases entailed assessing the impact of the program and initiation of system-level interventions to sustain and institutionalize successful change ideas. Integrated planning and monitoring were enabled by including key mental health service indicators in weekly meetings designed to track the performance of noncommunicable diseases and human immunovirus clinical programmes. Lack of standardization in mental health screening prompted the validation of a mental health screening tool and testing feasibility of its use in centralized screening stations. A culture of collaborative problem-solving was promoted through CQI data-driven learning sessions. The province-level screening rate increased by 10%, whilst the district screening rate increased by 7% and new patients initiated to mental health treatment increased by 16%. The CQI approach holds promise in facilitating the attainment of integrated mental health care in resource-scarce contexts. A collaborative relationship between researchers and health system stakeholders is an important strategy for facilitating the uptake of evidence-based innovations. However, the lack of interventions to address healthcare workers' own mental health poses a threat to integrated mental health care at PHC.

Strategy for confronting intellectual challenges from an Islamic perspective

"Society today faces great challenges and dangerous phenomena that have often led to the loss of its cohesion and the dispersion and loss of its children on several levels, including the faith, psychological, intellectual and scientific levels, including those related to values and morals..., especially as the world is witnessing successive changes, carrying multi-directional ideas. Its owners are willing to publish it in light of the digital transformation that depends on advanced media such as the Internet and satellite channels, especially since the Islamic community is at the forefront of those targeted.

UX and Machine Learning – Preprocessing of Audiovisual Data Using Computer Vision to Recognize UI Elements

This study explores the convergence of user experience (UX) and machine learning, particularly employing computer vision techniques to preprocess audiovisual data to detect user interface (UI) elements. With an emphasis on usability testing, the study introduces a novel approach for recognizing changes in UI screens within video recordings. The methodology involves a sequence of steps, including form prototype creation, laboratory experiments, data analysis, and computer vision tasks. The future aim is to automate the evaluation of user behavior during UX testing. This innovative approach is relevant to the agricultural domain, where specialized applications for precision agriculture, subsidy requests, and production reporting demand streamlined usability. The research introduces a frame extraction algorithm that identifies screen changes by analyzing pixel differences between consecutive frames. Additionally, the study employs YOLOv7, an efficient object detection model, to identify UI elements within the video frames. Results showcase successful screen change detection with minimal false negatives and acceptable false positives, showcasing the potential for enhanced automation in UX testing. The study’s implications lie in simplifying analysis processes, enhancing insights for design decisions, and fostering user-centric advancements in diverse sectors, including precision agriculture.

Adapting Global Administrative Reforms to Local Contexts within Developing Countries: Insights into the Blue Ocean Strategy

As a subfield of Public Administration that is primarily concerned with improving performance within state institutions, administrative reform fails to fulfill its goals in developing countries due to the ethnocentricity of ready-made and replicable global strategies. Administrative reforms as top-down models of development marginalize local implementers who neither understand nor support the full adoption of the assigned models. Drawing on the significance of an all-inclusive synergy among local stakeholders for successful change, this study introduces the Blue Ocean strategy as an innovative managerial approach reflecting the temporal and spatial particularities of developing countries’ operational contexts. This study builds a conceptual framework for reforming public and non-profit sectors in developing countries in light of the guidelines of the Blue Ocean strategy as the expression of local stakeholders’ goal of improving organizational performance in compliance with existing opportunities and challenges. In doing so, it examines how the managers and employees of an Egyptian non-profit organization have benefited from the Blue Ocean strategy in improving their NGO’s performance through the adoption of effective strategic planning that restructured human resources functions and boosted employees’ productivity. The author conducted seven open-ended and semi-structured expert interviews with a selection of the NGO’s working staff and two managers in order to depict how the Blue Ocean strategy has enabled them to formulate and implement human resources strategic management as a customized administrative reform conforming to contextual exigencies.

Breaking Barriers and Bridging Gaps: Advancing Diversity, Equity, and Inclusion in Kidney Transplant Care for Black and Hispanic Patients in the United States.

Kidney transplantation offers better mortality and quality of life outcomes to patients with end-stage renal failure compared to dialysis. Specifically, living donor kidney transplantation is the best treatment for end-stage renal disease, since it offers the greatest survival benefit compared to deceased donor kidney transplant or dialysis. However, not all patients from all racial/ethnic backgrounds enjoy these benefits. While black and Hispanic patients bear the predominant disease burden within the United States, they represent less than half of all kidney transplants in the country. Other factors such as cultural barriers that proliferate myths about transplant, financial costs that impede altruistic donation, and even biological predispositions create a complex maze and can also perpetuate care inaccessibility. Therefore, blanket efforts to increase the overall donation pool may not extend access to vulnerable populations, who may require more targeted attention and interventions. This review uses US kidney transplantation data to substantiate accessibility differences amongst racial minorities as well as provides examples of successful institutional and national systemic level changes that have improved transplantation outcomes for all.

Microbial Succession and Flavor Changes During Fermentation of Semi-Dried Sea Bass (Lateolabrax maculatus)

ABSTRACT The Chinese traditional food, fermented semi-dried sea bass (FSSB), is famous for its unique flavor. The microbiota succession and flavor formation during fermentation remain unknown. This study utilized high-throughput sequencing to investigate the evolving microbiota and chemical determination to explore volatile compounds. The relevant abundance of microorganisms in the middle-fermented stage was significantly (p <.05) higher than that of the post-fermented stage. In addition, the main microbial phyla during fermentation were Firmicutes and Proteobacteria. In conclusion, this study contributes to understanding the changes in flavor substances during fermentation and the varying patterns of change among different floras.

Minority-group incubators and majority-group reservoirs support the diffusion of climate change adaptations.

Successful climate change adaptation depends on the spread and maintenance of adaptive behaviours. Current theory suggests that the heterogeneity of metapopulation structure can help adaptations diffuse throughout a population. In this paper, we develop an agent-based model of the spread of adaptations in populations with minority-majority metapopulation structure, where subpopulations learn more or less frequently from their own group compared to the other group. In our simulations, minority-majority-structured populations with moderate degrees of in-group preference better spread and maintained an adaptation compared to populations with more equal-sized groups and weak homophily. Minority groups act as incubators for an adaptation, while majority groups act as reservoirs for an adaptation once it has spread widely. This means that adaptations diffuse throughout populations better when minority groups start out knowing an adaptation, as Indigenous populations often do, while cohesion among majority groups further promotes adaptation diffusion. Our work advances the goal of this theme issue by developing new theoretical insights and demonstrating the utility of cultural evolutionary theory and methods as important tools in the nascent science of culture that climate change adaptation needs. This article is part of the theme issue 'Climate change adaptation needs a science of culture'.

Correlation between microbial communities and volatile flavor compounds in the fermentation of new pickle fermentation broth

The correlation between microbial community succession and volatile flavor substance changes in the fermentation of new pickle fermentation broth was revealed in this study via high-throughput sequencing and gas chromatography-mass spectrometry (GC-MS). Microbiological analysis demonstrated that Lactobacillus (relative abundance ≥93.98%) was the dominant bacterial genus in the broth, whereas Enterobacter was richest only in the first sampling. E-nose and GC-MS inspections revealed that the types and contents of volatile flavor compounds increased continuously with fermentation, rising from 27 volatile flavor compounds in the first sampling to a maximum of 62 species, with the content increasing from 8.686 μg/mL to 106.083 μg/mL. Olefins and alcohols had the highest proportions throughout the fermentation process. The Spearman correlation coefficient revealed that 77 volatile flavor compounds and 22 bacterial genera had medium-high correlations (|ρ| >0.6). Lactobacillus (Gen1), the most dominant genus, was significantly positively correlated with 21 volatile compounds (ρ > 0.6), including myrcene (Ole7), terpinene (Ole12) and ocimene (Ole1), but negatively associated with 13 volatile compounds (ρ < -0.6), including 5-methyl-4-nonene (Ole5l), anisole (Ole26) and 2-octen-4-one (Ket6). Thus, this study may provide a theoretical basis to improve the flavour and overall quality of the new pickle fermentation broth.

Comparison of the Formation of Plant-Microbial Interface in Pisum sativum L. and Medicago truncatula Gaertn. Nitrogen-Fixing Nodules.

Different components of the symbiotic interface play an important role in providing positional information during rhizobial infection and nodule development: successive changes in cell morphology correspond to subsequent changes in the molecular architecture of the apoplast and the associated surface structures. The localisation and distribution of pectins, xyloglucans, and cell wall proteins in symbiotic nodules of Pisum sativum and Medicago truncatula were studied using immunofluorescence and immunogold analysis in wild-type and ineffective mutant nodules. As a result, the ontogenetic changes in the symbiotic interface in the nodules of both species were described. Some differences in the patterns of distribution of cell wall polysaccharides and proteins between wild-type and mutant nodules can be explained by the activation of defence reaction or premature senescence in mutants. The absence of fucosylated xyloglucan in the cell walls in the P. sativum nodules, as well as its predominant accumulation in the cell walls of uninfected cells in the M. truncatula nodules, and the presence of the rhamnogalacturonan I (unbranched) backbone in meristematic cells in P. sativum can be attributed to the most striking species-specific features of the symbiotic interface.

Critical success factors for change management in business process management

PurposeThe purpose of this study is to determine the influence of project critical success factors (CSFs) on change management in the context of business process management (BPM). Despite widespread interest in BPM, the existing literature is insufficient in addressing the antecedents that contribute to change management in business process projects.Design/methodology/approachKey factors of change management success in BPM projects were initially identified in a systematic literature review (SLR) and were used as antecedents of change management through a structural equation modeling (SEM) with 464 business project stakeholders. Next, a neural network analysis allowed the key factors to be ranked non-linearly. Finally, a latent class analysis (LCA) was performed to determine the sample's heterogeneous groups based on their project management characteristics.FindingsProject management, top management support and technological competencies were the main CSFs identified as having positive effects on change management. The most important factor is project management, followed by top management support, which plays a crucial mediating role in enabling change management. Although relevant, technological competencies were secondary in the study. Regarding project management CSF, four heterogeneous classes of individuals were determined.Research limitations/implicationsAlthough this study provides an opportunity to observe CSFs, it does not address the need to analyze the phenomenon in different classifications of projects, regarding maturity, complexity, project management approach and other aspects that differentiate projects in a meaningful way.Practical implicationsThe study allows practitioners to understand the critical factors underlying change management and take necessary actions to manage it, recognizing that individuals have heterogeneous profiles regarding project management.Originality/valueThis study pioneeringly discusses the CSFs of change management BPM projects to enable successful change management, ranking the main factors and mapping heterogeneous profiles.

Biodiversity change in light of succession theory

Biodiversity is rapidly changing in the Anthropocene, but not all directional changes observed in biodiversity time series are anthropogenic. We discuss key research findings in global change ecology from the past decade, considering the possibility that natural succession contributes as a driving force of directional change. Succession theory suggests the possibility that: 1) accelerated rates of species temporal turnover could also reflect ecosystem recovery rather than global biodiversity redistribution; 2) natural changes in local diversity over time may not be zero, with successional diversity change being variable but often showing a positive temporal trend; 3) biotic homogenization may not only be driven by non‐native species, but also by natural processes alone; and 4) successional dynamics may strongly modify the relationship between biodiversity and ecosystem functioning. We propose that a holistic integration of succession theory into global change ecology could provide a baseline for natural biodiversity change and allow us to better isolate the impact of anthropogenic drivers.

Domain Applications of Project Management Knowledge (DAPMK): Beneficial Knowledge Transfer and Soft Skill Development for Life-long Enhancement

The focus of higher education in the developed economies of the Global North has steadily shifted since the 1970s from being dominantly rooted in academic knowledge and learning as an end in themselves towards a wider perspective. The needs of the professions, careers and employability were present then, but were generally a secondary concern for the HEIs. The expansion of HE across more diverse populations has produced successive changes in curriculum and more broadly in purposes, strategies, and philosophies of HE. Against the background of global, economic, societal, and technological changes, the need to maintain ‘traditions’ but with wider relevance to society, personal adaptability, and capability as well as support for lifelong careers and learning have come to impact, HE main agendas.&#x0D; Most undertakings in life require the ability to define requirements, shape responses and form processes which will lead to achieving desired goals. In short, this is the nature of ‘project’ as a concept and of project management as a means to undertake what is necessary. This paper reports on how the concepts and techniques of Project Management (PM) can be beneficially transferred in a process of soft skill development for life-long enhancement in the transitions from HE to employability and career. A project was set up at University of West London as part of their knowledge transfer activities. The researchers have established ‘proof of concept’ and are currently trialling pathways for providing learning opportunities with knowledge transfer and soft skill enhancement. The opportunity to adapt the root concepts of PM to any domain carries enormous potential for enhancing HE outcomes and for wider continuing education and skills development across communities.

Revealed deliberate preference change

We propose a model of deliberate preference change that is identifiable, empirically testable, and founded on two normative principles. First, the decision maker (DM) must be able to justify her preference change by making attributes of the alternatives relevant or irrelevant to her choices. Second, DM's successive preference changes must result from consistent deliberations about which attributes to make relevant or irrelevant for her future choices. We show that these two principles are necessary and sufficient to rationalize preference changes by the maximization of a meta-preference. Finally, we illustrate how our model can generate the polarization of political preferences among ex-ante identical voters.

Age trajectories in extra-pair siring success suggest an effect of maturation or early-life experience.

Across birds, male age is the most consistent predictor of extra-pair siring success, yet little is known about age effects on paternity over the lifetime of individuals. Here, we use data from a 13-year study of a population of blue tits (Cyanistes caeruleus) to investigate how extra-pair siring success changes with age within individuals. Our results indicate that extra-pair siring success does not continuously increase with male age. Instead, siring success was related to male age in a threshold fashion, whereby yearling males were less likely to gain paternity than older males. This effect was independent of the age of the social partner, but influenced by the age of the extra-pair female: success of yearlings at siring extra-pair young (EPY) with older females was even lower. Among males that sired at least one EPY, the number of extra-pair mates and the proportion of EPY sired were unrelated to male age. We found no evidence for an influence of selective disappearance on extra-pair reproduction. Senescence, if anything, only occurs at ages blue tits rarely reach. A literature review indicates that an effect of male age on extra-pair siring success may be limited to the switch from yearling to older in many species. Thus, the generally observed age effect on male extra-pair siring success may be linked to age class rather than continuous ageing. This suggests that lack of experience or not fully completed maturation are important drivers of age patterns in extra-pair paternity.

Comparison of self- and balloon-expandable valves in patients with dilatated ascending aorta undergoing transcatheter aortic valve replacement.

Limited studies have focused on the performance of self-expandable valves (SEVs) and balloon-expandable valves (BEVs) in patients with dilatated ascending aorta (AA) undergoing transcatheter aortic valve replacement (TAVR). The present study compared the performance of widely used Edwards BEVs and domestic SEVs in patients with dilatated AA among Chinese population. We identified and reviewed 207 patients who had baseline AA diameter ≥40 mm and underwent transfemoral TAVR. Patients were divided into two groups: SEV and BEV. The SEVs were locally manufactured valves that have received Chinese regulatory approval (Venus-A, Taurus One, and VitaFlow), while the BEVs were Edwards Sapien XT and Sapien3. Procedural device success and post-procedural changes of AA diameters were compared. The sample size of SEV group was larger than that of BEV group because BEVs were not available in China in the early clinical practice. The overall device success was slightly lower in SEV group compared with BEV group (84.2% vs. 95.8%, P=0.213). However, in the univariable and multivariable logistic regression analyses, only bicuspid aortic valve (BAV) was found to be an independent risk factor for device failure (OR: 2.632, CI: 1.107-6.257, P=0.029). During the median follow-up of 21 months, no statistical difference was found between the two groups regarding the overall survival (83.1%±4.7% vs. 95.8%±4.1%, P=0.533), and no aortic dissection nor rupture was observed. In a subgroup of patients who had follow-up CTs ≥12-month intervals, the AA diameter appeared to remain stable in SEV group with an aortic expansion rate of 0 (-0.4 to 0.8) mm (P=0.102), while it slightly enlarged in BEV group with an aortic expansion rate of 0.4 (-0.4 to 0.6) mm/y (P=0.038). In addition, the AA diameter also slightly enlarged in patients with BAV [0.2 (0 to 1.0) mm/y, P=0.015], while it remained stable in patients with tricuspid aortic valve (TAV) [0 (-0.8 to 0.6) mm/y, P=0.640]. In patients with dilatated AA who underwent TAVR, the type of THVs did not affect the procedural device success. BAV appeared to be a risk factor for both device failure and higher aortic expansion rate in these patients.

Cutting the cord : How and why HERE Technologies fired their service provider and took real estate in-house (and whether other end users should too)

This case study challenges the traditional model of real estate outsourcing by end users, by providing an alternative approach to the delivery of real estate services by an insourced team. While acknowledging the reasons why end users have historically opted to partner with third parties, this case study outlines the evaluation process and tactical tasks needed to decide and then act on this shift. The case study details the stated up-front objectives and provides learnings from a successful model change. The intention is that other end users will be able to use it as a model for making their own evaluations of feasibility and appropriateness.

Ergonomics Advances in Office Work and Work-from-Home

Office ergonomics deals with the equipment and environment that office workers interact to perform their job duties. With constant advances in tools, technology, organizations, and society as a whole, the consequent advantages and impacts on office ergonomics warrant constant examination. In this panel discussion, five researchers will share their recent efforts. The panel starts with two studies on components of office works: the impact of ultrawide computer displays and the utility of sit/stand desks. While these components can be used in both traditional and home office environment, the latter three studies focus on the emergence of work from home (WFH), or hybrid work styles. The determinants of successful WFH ergonomics settings, the physical and mental well-being as well as the productivity among workers in the new workstyle, and an example of organizational intervention for a successful change are presented. The panelists will engage the attendees to explore the future of office ergonomics landscape.

The Intention of Empowering Excellence on the Path to Professional Qualification in Sustainable Development and Governance

This study examined the influence of perceptions related to prestige/status, job security/stability, opportunity for advancement, program difficulty, and salary on the intention to pursue the Certified Internal Auditor (CIA) Qualification among students in public and private universities. Based on the Theory of Planned Behavior (TPB), this study employed collecting data using a questionnaire survey that consists of 243 Bachelor of Accounting students from 11 Malaysian higher learning institutions. The findings indicated that perceptions of prestige/status, opportunity for advancement, and program difficulty significantly impacted the intention to pursue the CIA Qualification. Participants display a positive perception of the credibility and reputation of the CIA exam and career. The findings offer insights for educators and practitioners to foster stronger collaborations between universities and the Institute of Internal Auditors Malaysia (IIAM), facilitating tailored curriculum and activities to promote long-term corporate sustainability. The results showed that having a professional qualification is critical for enabling individuals to succeed in sustainable governance and its ability to equip individuals to become successful change agents that aligned with the Sustainable Development Goal (SDG) 4. Keywords: intention, Certified internal auditor qualification, CIA, Malaysia, professional qualification, sustainability, Theory of Planned Behavior, SDG4

658 Adolescent-Targeted Organ Donation Education to Improve the Impact of Opt-Out Legislation

Abstract Aim Opt-out organ donation legislation in the UK has not led to sustained improvements in donation rates. Given poor familial authorisation rates (66% in 2021-2022) in the soft opt-out model, altering public perceptions of organ donation, through means including engaging young people and promoting family discussion, are prerequisites for successful legislation changes. We explore the impact of an educational intervention on organ donation, family discussions and knowledge of the opt-out law. Method We delivered a 15-minute educational presentation, along with an optional questionnaire, to UK secondary schools across five counties between Jan-May 2022. Results 616 students aged 11-18 years (mean 14.6±1.9) completed the survey. Following the intervention, the proportion of individuals on/planning to join the ODR increased from 9% to 31%. Of the remaining students, 48% said they would consider joining. Pre-intervention, 58% of adolescents agreed they had knowledge of organ donation, which increased to 85% post-intervention. Originally, 28% knew about the opt-out law, this increased to 77% post-intervention. The proportion of students that expressed knowledge of issues relating to organ donation in Black, Asian and ethnic minority communities, increased from 27% to 72% post-intervention. 28% had previously discussed organ donation with family, whilst 70% intended to do so post-intervention. 91% of responders would or would consider recommending the presentation to their peers. Conclusions Educational intervention increased adolescent understanding of organ donation, opt-out legislation, and intention to join the ODR and discuss donation with family. Through promoting wider public discussions, adolescent educational interventions can positively impact public perceptions of organ donation.

Light impurities: equilibrium, transport and density profiles in tokamak and stellarator plasmas

The density profiles of light impurities observed in recent decades in a relatively wide variety of experiments on tokamaks and stellarators are analyzed and modeled based on the concept of self-consistent equilibrium and transport of impurity charge states (Shurygin 2020 Nuclear Fusion 60 046001). The emphasis is on the formation of charge-radial equilibrium and its invariant properties affecting transport and density profile. The impurity invariant equilibrium arises due to random compatible charge-radial variations, linking the impurity motion into a general ergodic (Markovian) process governed by a matrix of final probabilities. More than 60 profiles of helium, boron and carbon with central accumulation, flat and hollow were accurately reproduced by invariant dimensionless transport functions. It is shown that the leading processes determining the formation of impurity invariant density profiles in stationary plasma are the processes of ionization-recombination, and not the transport of particles. Successive variations in the hollow density profiles of helium, boron, and carbon observed in experiments can be described as successive invariant profile changes in the recombination rate profiles. The invariant particle diffusive-convective profiles can be calculated directly from the impurity density profiles. A general empirical formula for equilibrium constant of light impurities was proposed.