Managing Cultural Diversity in Healthcare Partnerships: The Case of LIFT

Purpose: The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. Design/methodology/approach: The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Findings: Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. Research limitations/implications: As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care. Originality/value: To the authors' knowledge this is the first study of the role of culture in mediating LIFT partnerships and the findings add to the evidence on public-private partnerships in the NHS

Managing SMT Resource Usage through Speculative Instruction Window Weighting

Simultaneous multithreading processors dynamically share processor resources between multiple threads. In general, shared SMT resources may be managed explicitly, for instance, by dynamically setting queue occupation bounds for each thread as in the DCRA and Hill-Climbing policies. Alternatively, resources may be managed implicitly; that is, resource usage is controlled by placing the desired instruction mix in the resources. In this case, the main resource management tool is the instruction fetch policy which must predict the behavior of each thread (branch mispredictions, long-latency loads, etc.) as it fetches instructions.

Thalidomide for managing cancer cachexia [review paper]

Cancer cachexia is a multidimensional syndrome characterised by wasting, loss of weight, loss of appetite, metabolic alterations, fatigue and reduced performance status. A significant number of patients with advanced cancer develop cachexia before death. There is no identified optimum treatment for cancer cachexia. While the exact mechanism of the action of thalidomide is unclear, it is known to have immunomodulatory and anti-inflammatory properties, which are thought to help reduce the weight loss associated with cachexia. Preliminary studies of thalidomide have demonstrated encouraging results. This review aimed to (1) evaluate the effectiveness of thalidomide, and (2) identify and assess adverse effects from thalidomide for cancer cachexia. Electronic searches were undertaken in CENTRAL, MEDLINE, EMBASE, Web of Science and CINAHL (from inception to April 2011). Reference lists from reviewed articles, trial registers, relevant conference documents and thalidomide manufacturers identified additional literature. This review included randomised controlled trials (RCTs) and non-RCTs. Participants were adults diagnosed with advanced or incurable cancer and weight loss or a clinical diagnosis of cachexia who were administered thalidomide. All titles and abstracts retrieved by electronic searching were downloaded to a reference management database. Duplicates were removed and the remaining citations were read by two review authors and checked for eligibility. Studies that were deemed ineligible for inclusion had clear reasons for exclusion documented. Data were extracted independently by two review authors for all eligible studies. While a meta-analysis was planned for this review, this was not possible due to the small number of studies included and high heterogeneity among them. Thus a narrative synthesis of the findings is presented. The literature search revealed a dearth of large, well conducted trials in this area. This has hindered the review authors' ability to make an informed decision about thalidomide for the management of cancer cachexia. At present, there is insufficient evidence to refute or support the use of thalidomide for the management of cachexia in advanced cancer patients. The review authors cannot confirm or refute previous literature on the use of thalidomide for patients with advanced cancer who have cachexia and there is inadequate evidence to recommend it for clinical practice. Additional, well conducted, large RCTs are needed to test thalidomide both singularly and in combination with other treatment modalities to ascertain its true benefit, if any, for this population. Furthermore, one study (out of the three reviewed) highlighted that thalidomide was poorly tolerated and its use needs to be explored further in light of the frailty of this population

Managing Island Life:Social, Economic and Political Dimensions of Formality and Informality in Island Life

"Managing Island Life: Social, Economic and Political Dimensions of Formality and Informality in Island Life" is a significant and timely contribution to the study of islands and island life. Wide-ranging in terms of both geographical and theoretical sweep, contributions consider the conceptualisation of the island as well as social, economic and political dimensions of island life and living. Showcasing the current state of island research, contributors cover diverse areas of island life such as: informal economies in the West Indies; the effects of natural convservation policies in the Highlands and Islands of Scotland; the role of internet sites in British Isles heritage tourism, and the impact of multicultural policies in the Indian Ocean. This volume will appeal to undergraduate social scientists as well as professional anthropologists, sociologists and geographers, policy makers and islands and regional specialists.

Managing i-branding to create brand equity

Purpose: Given the emergent nature of i-branding as an academic field of study and a lack of applied research output, the aim of this paper is to explain how businesses manage i-branding to create brand equity.

Design/methodology/approach: Within a case-study approach, seven cases were developed from an initial sample of 20 food businesses. Additionally, utilising secondary data, the analysis of findings introduces relevant case examples from other industrial sectors.

Findings: Specific internet tools and their application are discussed within opportunities to create brand equity for products classified by experience, credence and search characteristics. An understanding of target customers will be critical in underpinning the selection and deployment of relevant i-branding tools. Tools facilitating interactivity – machine and personal – are particularly significant.

Research limitations/implications: Future research positioned within classification of goods constructs could provide further contributions that recognise potential moderating effects of product/service characteristics on the development of brand equity online. Future studies could also employ the i-branding conceptual framework to test its validity and develop it further as a means of explaining how i-branding can be managed to create brand equity.

Originality/value: While previous research has focused on specific aspects of i-branding, this paper utilises a conceptual framework to explain how diverse i-branding tools combine to create brand equity. The literature review integrates fragmented literature around a conceptual framework to produce a more coherent understanding of extant thinking. The location of this study within a classification of goods context proved critical to explaining how i-branding can be managed.