Success of thrombolysis as a predictor of outcome in acute thrombosis of popliteal aneurysms.

PURPOSE: Acute limb ischemia after thrombosis of a popliteal aneurysm is a distinct and limb-threatening entity. Preoperative intra-arterial thrombolysis may improve the outcome in this challenging situation. This study retrospectively analyzed a consecutive series of patients treated with preoperative thrombolysis and subsequent revascularization. METHODS: Thirteen patients with acute limb ischemia caused by thrombosis of a popliteal aneurysm underwent catheter-directed intra-arterial thrombolysis with urokinase and subsequent vascular reconstruction. The angiographic and clinical outcome was analyzed and compared with that in the literature. RESULTS: Complete aneurysm thrombosis with absence of runoff was documented in 12 cases. Thrombolysis restored perfusion with patency of the popliteal artery and a one- or two-vessel runoff in 77% of cases (10/13). Early cumulative graft patency and limb salvage rates were 68% and 83%, respectively, with an ankle/brachial index of 0.8 +/- 0.2. Lytic failure followed by attempts at bypass grafting was present in three patients (23%) and resulted in above-knee amputation. Severe rhabdomyolysis and fatal pulmonary embolism were responsible for a 15% early mortality rate. CONCLUSION: Preoperative thrombolysis followed by bypass grafting is a valid treatment option for patients who can withstand an additional period of ischemia that does not require immediate revascularization and intraoperative lysis. Lytic failure identifies patients with a highly compromised runoff who are probably best treated by means of subsequent amputation, without any attempts at bypass grafting.

Vendor Managed Inventory: the Critical Success Factors from the Manufacturer Point of View

Yritykset ovat pakotettuja erilaisiin yhteistyömuotoihin pärjätäkseen kiristyvässä kilpailussa. Yhteistyösuhteet kulkevat eri nimillä riippuen teollisuuden alasta ja siitä, missä kohtaa toimitusketjua ne toteutuvat, mutta periaatteessa kaikki pohjautuvat samaan ideaan kuin Vendor Managed Inventory (VMI); varastoon jakysyntään liittyvä tieto jaetaan toimitusketjun eri osapuolien kesken, jotta tuotanto, jakelu ja varastonhallinta olisi mahdollista optimoida. Vendor Managed Inventory on ideana yksinkertainen, mutta vaatii onnistuakseen paljon. Perusolettamus on, että toimittajan on kyettävä hallinnoimaan asiakkaan varastoa paremmin kuin asiakas itse. Tämä ei kuitenkaan ole mahdollista ilman riittävää yhteistyötä, oikeanlaista informaatiota tai sopivia tuoteominaisuuksia. Tämän työn tarkoitus on esitellä kriittiset menestystekijät valmistajan kannalta, kun näkyvyys todelliseen kysyntään on heikko ja kyseessäolevat tuotteet ovat ominaisuuksiltaan toimintamalliin huonosti soveltuvia. VMItoimintamallin soveltuvuus matkapuhelimia valmistavan yrityksen liiketoimintaan, sekä sen vaikutus asiakasyhteistyöhön, kannattavuuteen ja toiminnan tehostamiseen on myös tutkittu.

Motives, Challenges and Success Factors in the Business Partner Network

Tässä työssä käsitellään niitä motiiveja, haasteita ja menestystekijöitä, jotka vaikuttavat lisäarvoatuottavassa liiketoimintaverkostossa. Työssä on selvitetty sitä, miten partneriverkostot syntyvät sekä mitkä seikat vaikuttavat siihen jatkuuko yhteistyö vai ei. Motiiveja partneruuteen on tutkittu kirjallisuudesta sekä analysoimalla työssä esitettyä tapausta. Tässä työssä käydään keskustelua myös partneruuden elinkaaresta, jota ei ole käsitellyssä kirjallisuudessa tuotu esille. Työssä esitettyä tapausta arvioitiin lähettämällä siihen liittyneille henkilöille kysely. Kyselyiden lähettämisen jälkeen järjestettiin haastattelu kyselyyn vastanneiden kanssa. Lopputulokset perustuvat pitkälti haastateltujen henkilöiden kanssa käytyihin keskusteluihin. Kävi ilmi, että arvoa tuottavan partneriverkoston yksi tärkeimpiä tavoitteita on saavuttaa jatkuvuutta liiketoiminnallaan. Ainoastaan pitkäaikaisella partneruudella voidaan saavuttaa merkittäviä etuja markkinoilla. Siksi on tärkeätä, jo partnerin valinnassa, kiinnittää huomiota partneruuden jatkuvuuteen pitkällä tähtäimellä. Liiketoimintaverkostossa partneruudesta syntyvät tuotot ja niiden jakaminen on tärkein yksittäinen osaalue. Oleellista partneruuden jatkuvuudelle pitkällä tähtäimellä on jo partneria valittaessa se, että kyetään arvioimaan miten partneruudesta syntyvät tuotot jaetaan tasapuolisesti ja onko partneruudesta syntyvälle liiketoiminnalle jatkuvuutta. Jotta partneriverkostolle asetetut tavoitteet voitaisiin saavuttaa, on tärkeää suunnitella partneriverkoston hallintaa myös operatiivisella tasolla. Lisäksi tärkeää on jakaa verkostolle asetetut yhteiset tavoitteet organisaatioiden sisällä. Jos ylemmänja operatiivisen tason johdon yhteistyö on riittämätöntä, se vaikeuttaa oleellisesti asetettujen tavoitteiden saavuttamista. Tiedon jakaminen aikaisessa vaiheessa sitouttaa eri sidosryhmät paremmin yhteisiin tavoitteisiin.

Evaluation of healing criteria for success after periapical surgery

Introduction: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes. Objective: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months. Material and methods: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery. Results: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable. Conclusion: Overall evolution according to von Arx and Kurt agreed most closely with the other scales

Evaluation of healing criteria for success after periapical surgery

Introduction: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes. Objective: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months. Material and methods: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery. Results: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable. Conclusion: Overall evolution according to von Arx and Kurt agreed most closely with the other scales

Validation of an Adapted French Form of the Career Adapt-Abilities Scale in four Francophone Countries

This study presents the validation of a French version of the Career Adapt-Abilities Scale in four Francophone countries. The aim was to re-analyze the item selection and then compare this newly developed French-language form with the international form 2.0. Exploratory factor analysis was used as a tool for item selection, and confirmatory factor analysis (CFA) verified the structure of the CAAS French-language form. Measurement equivalence across the four countries was tested using multi-group CFA. Adults and adolescents (N=1,707) participated from Switzerland, Belgium, Luxembourg, and France. Items chosen for the final version of the CAAS French-language form are different to those in the CAAS international form 2.0 and provide an improvement in terms of reliability. The factor structure is replicable across country, age, and gender. Strong evidence for metric invariance and partial evidence for scalar invariance of the CAAS French-language form across countries is given. The CAAS French-language and CAAS international form 2.0 can be used in a combined form of 31 items. The CAAS French-language form will certainly be interesting for practitioners using interventions based on the life design paradigm or aiming at increasing career adapt-ability.

The psychometric properties of the WAI in a career counseling setting: Comparison with a personal counseling sample

This study investigated the psychometric properties of the Working Alliance Inventory-Client version (WAI-C) and Working Alliance Inventory-Short and revised (WAI-SR) in a career counseling setting. Moreover, it compared the impact of career versus personal counseling settings based on results obtained using the WAI-SR. Subjects were 188 French-speaking career counseling clients and 95 French-speaking personal counseling clients, mainly students. For the career counseling sample, total reliability was .87 for the WAI-C and .76 for the WAI-SR. The shape of the distribution was normal but the variance was significantly lower for the career counseling sample. Exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) confirmed the presence of an overall working alliance factor but indicated a clearer hierarchical structure for the WAI- SR than for the WAI-C. The psychometric properties seemed only slightly affected by the counseling setting, suggesting that this inventory is also relevant for career counseling, especially the WAI-SR, which has a more robust factorial structure.

New Product Development (NPD) Success Factors: A Review of the Literature

This paper reviews the literature on managerially actionable new product development success factors and summarises the field in a classic managerial framework. Because of the varying quality, breadth and scope of the field, the review only contains post-1980 studies of tangible product development that are of a rigorous scientific standard. Success is interpreted as a commercial success. The field has gained insight into a broad set of factors that vary in scope, abstraction and context. Main areas that contribute to NPD success are top management support exhibited through resource allocation and communicating the strategic importance of NPD in the organisation. The right projects need to be selected for investment at the beginning of the process and should be aligned to the organisation's internal competencies and the external environment. The NPD process should use cross-functional teams and a competent project champions. Marketing research competency is crucial, as an understanding of the market, customers and competitors is repeatedly highlighted. Product launch competency was also consistently shown to be important. In terms of controlling the NPD process, strict project gates are required to maintain control.

Project Success through Effective Decisions: Case Studies on Project Goal Setting, Success Evaluation and Managerial Decision Making

The objective of the thesis is to structure and model the factors that contribute to and can be used in evaluating project success. The purpose of this thesis is to enhance the understanding of three research topics. The goal setting process, success evaluation and decision-making process are studied in the context of a project, business unitand its business environment. To achieve the objective three research questionsare posed. These are 1) how to set measurable project goals, 2) how to evaluateproject success and 3) how to affect project success with managerial decisions.The main theoretical contribution comes from deriving a synthesis of these research topics which have mostly been discussed apart from each other in prior research. The research strategy of the study has features from at least the constructive, nomothetical, and decision-oriented research approaches. This strategy guides the theoretical and empirical part of the study. Relevant concepts and a framework are composed on the basis of the prior research contributions within the problem area. A literature review is used to derive constructs of factors withinthe framework. They are related to project goal setting, success evaluation, and decision making. On the basis of this, the case study method is applied to complement the framework. The empirical data includes one product development program, three construction projects, as well as one organization development, hardware/software, and marketing project in their contexts. In two of the case studiesthe analytic hierarchy process is used to formulate a hierarchical model that returns a numerical evaluation of the degree of project success. It has its origin in the solution idea which in turn has its foundation in the notion of projectsuccess. The achieved results are condensed in the form of a process model thatintegrates project goal setting, success evaluation and decision making. The process of project goal setting is analysed as a part of an open system that includes a project, the business unit and its competitive environment. Four main constructs of factors are suggested. First, the project characteristics and requirements are clarified. The second and the third construct comprise the components of client/market segment attractiveness and sources of competitive advantage. Together they determine the competitive position of a business unit. Fourth, the relevant goals and the situation of a business unit are clarified to stress their contribution to the project goals. Empirical evidence is gained on the exploitation of increased knowledge and on the reaction to changes in the business environment during a project to ensure project success. The relevance of a successful project to a company or a business unit tends to increase the higher the reference level of project goals is set. However, normal performance or sometimes performance below this normal level is intentionally accepted. Success measures make project success quantifiable. There are result-oriented, process-oriented and resource-oriented success measures. The study also links result measurements to enablers that portray the key processes. The success measures can be classified into success domains determining the areas on which success is assessed. Empiricalevidence is gained on six success domains: strategy, project implementation, product, stakeholder relationships, learning situation and company functions. However, some project goals, like safety, can be assessed using success measures that belong to two success domains. For example a safety index is used for assessing occupational safety during a project, which is related to project implementation. Product safety requirements, in turn, are connected to the product characteristics and thus to the product-related success domain. Strategic success measures can be used to weave the project phases together. Empirical evidence on their static nature is gained. In order-oriented projects the project phases are oftencontractually divided into different suppliers or contractors. A project from the supplier's perspective can represent only a part of the ¿whole project¿ viewed from the client's perspective. Therefore static success measures are mostly used within the contractually agreed project scope and duration. Proof is also acquired on the dynamic use of operational success measures. They help to focus on the key issues during each project phase. Furthermore, it is shown that the original success domains and success measures, their weights and target values can change dynamically. New success measures can replace the old ones to correspond better with the emphasis of the particular project phase. This adjustment concentrates on the key decision milestones. As a conclusion, the study suggests a combination of static and dynamic success measures. Their linkage to an incentive system can make the project management proactive, enable fast feedback and enhancethe motivation of the personnel. It is argued that the sequence of effective decisions is closely linked to the dynamic control of project success. According to the used definition, effective decisions aim at adequate decision quality and decision implementation. The findings support that project managers construct and use a chain of key decision milestones to evaluate and affect success during aproject. These milestones can be seen as a part of the business processes. Different managers prioritise the key decision milestones to a varying degree. Divergent managerial perspectives, power, responsibilities and involvement during a project offer some explanation for this. Finally, the study introduces the use ofHard Gate and Soft Gate decision milestones. The managers may use the former milestones to provide decision support on result measurements and ad hoc critical conditions. In the latter milestones they may make intermediate success evaluation also on the basis of other types of success measures, like process and resource measures.

Career engagement : Investigating intraindividual predictors of weekly fluctuations in proactive career behaviors

The present study applies a micro-level perspective on how within-individual differences in motivational and social-cognitive factors affect the weekly fluctuations of engagement in proactive career behaviors among a group of 67 German university students. Career self-efficacy beliefs, perceived career barriers, experienced social career support, positive and negative emotions, and career engagement were assessed weekly for 13 consecutive weeks. Hierarchical linear regression analyses showed that above-average levels of career engagement within individuals were predicted by higher than average perceived social support and positive emotions during a given week. Conversely, within-individual differences in self-efficacy, barriers, and negative emotions had no effect. The results suggest that career interventions should provide boosts in social support and positive emotions.

How to identify and recruit nurses to a survey 14 and 24 years after graduation in a context of scarce data : lessons learnt from the 2012 nurses at work pilot study on nurses' career paths

Nursing workforce data are scarce in Switzerland, with no active national registry of nurses. The worldwide nursing shortage is also affecting Switzerland, so that evidence-based results of the nurses at work project on career paths and retention are needed as part of the health care system stewardship; nurses at work is a retrospective cohort study of nurses who graduated in Swiss nursing schools in the last 30 years. Results of the pilot study are presented here (process and feasibility). The objectives are (1) to determine the size and structure of the potential target population by approaching two test-cohorts of nursing graduates (1988 and 1998); (2) to test methods of identifying and reaching them 14 and 24 years after graduation; (3) to compute participation rates, and identify recruitment and participation biases.