Case problems in internal auditing and control.

Mode of access: Internet.

The relationship of mask angles to terrain geometry and its applicability to military problems (Project CATVAR) Contract no. Internal research 86-119.

Mode of access: Internet.

Clinical relationships and ethical problems in primary care, Sao Paulo, SP, Brazil

Objectives: Main Objective: to identify ethical problems in primary care according to nurses` and doctors` perceptions. Secondary Objective: to know ethical issues of patient-professional relationships in primary care. Design: Synthesis to integrate and reinterpret primary results of qualitative studies. Setting: Primary healthcare centers, Sao Paulo, SP, Brazil. Participants and/or context: Incidental sample of 34 nurses and 36 medical doctors working in primary healthcare centers selected by convenience. Methods: Individual, semi-structured interviews to identity situations considered as sources of ethical problems. The sample is socially representative of primary care health centers and professionals. Data collection assured discourse saturation. Hermeneutic-dialectical discourse analysis was used to study the results. Results: Patient-professional relationships and team work were the main sources of ethical problems. The most important problems were patient information, privacy, confidentiality, interpersonal relationship, linkage and patient autonomy. These issues reflect the recent changes in clinical relation ships and show the peculiarities of primary care with its continuous care which lasts a long time. Healthcare involves multiprofessional team work in the midst of the patient claims for autonomy. Good care of patients needs requires a relationship based on communication and cooperation, and includes feelings and values, with communication skills. Conclusions: Ethical problems in primary care are common situations. For quality and humane primary care the relationship should consist of dialogue, trust and cooperation. (C) 2009 Elsevier Espana, S.L. All rights reserved.

Limiting Internal Supply Voltage Spikes in DC-DC Converters

Implementing monolithic DC-DC converters for low power portable applications with a standard low voltage CMOS technology leads to lower production costs and higher reliability. Moreover, it allows miniaturization by the integration of two units in the same die: the power management unit that regulates the supply voltage for the second unit, a dedicated signal processor, that performs the functions required. This paper presents original techniques that limit spikes in the internal supply voltage on a monolithic DC-DC converter, extending the use of the same technology for both units. These spikes are mainly caused by fast current variations in the path connecting the external power supply to the internal pads of the converter power block. This path includes two parasitic inductances inbuilt in bond wires and in package pins. Although these parasitic inductances present relative low values when compared with the typical external inductances of DC-DC converters, their effects can not be neglected when switching high currents at high switching frequency. The associated overvoltage frequently causes destruction, reliability problems and/or control malfunction. Different spike reduction techniques are presented and compared. The proposed techniques were used in the design of the gate driver of a DC-DC converter included in a power management unit implemented in a standard 0.35 mu m CMOS technology.

Innovative method for carbon dioxide determination in human postmortem cardiac gas samples using headspace-gas chromatography-mass spectrometry and stable labeled isotope as internal standard.

A novel approach to measure carbon dioxide (CO2) in gaseous samples, based on a precise and accurate quantification by (13)CO2 internal standard generated in situ is presented. The main goal of this study was to provide an innovative headspace-gas chromatography-mass spectrometry (HS-GC-MS) method applicable in the routine determination of CO2. The main drawback of the GC methods discussed in the literature for CO2 measurement is the lack of a specific internal standard necessary to perform quantification. CO2 measurement is still quantified by external calibration without taking into account analytical problems which can often occur considering gaseous samples. To avoid the manipulation of a stable isotope-labeled gas, we have chosen to generate in situ an internal labeled standard gas ((13)CO2) on the basis of the stoichiometric formation of CO2 by the reaction of hydrochloric acid (HCl) with sodium hydrogen carbonate (NaH(13)CO3). This method allows a precise measurement of CO2 concentration and was validated on various human postmortem gas samples in order to study its efficiency.

Staffing strategies in SME's: determinants of external recruitment and internal promotion

The purpose of this paper is to examine the determinants of use internal or external labour market to fill a firm vacancy in SME’s taking into account the differences existing among blue and white collar jobs. Following different theories we can identify three main reasons for use internal candidates rather than external ones‐ firm specific knowledge, adverse selection problems and motivation‐. However, there are others factors that might affect this choice but the last theories don’t take into account. In this paper we try to shed some light on what are these other factors that may affect firm decision to use internal or external labour market. Particularly we analyses the relationship among new technologies, innovation activity and firm location on the staffing strategy. The results shows difference behaviour on the decision to fill a vacancy using internal or external labour markets between manufacturing and service firms, and this decision depends not only on firm internal characteristics, like technological complexity or innovation activity, but also on firm location. The results also support the hypothesis of ports of entry especially in the manufacturing sector.

Relève en médecine interne générale: enjeux et perspectives [Perspectives and challenges to guarantee training and renewal in general internal medicine]

Training new doctors in general internal medicine represents a challenge. This requires to define future needs, which result from interest that are not necessarily convergent between patients, doctors, insurers and politicians. Problems related to medical demography in Switzerland, with the ageing of the population, the increase in health care costs and the place of Switzerland within the European Community require the implementation of specific objectives to train new physicians in general internal medicine. The success of these opportunities depends on social factors, political choices and choices from physician's association. In this article we will approach these challenges by formulating some proposals--nonexhaustive--in order to guarantee sufficient renewal in general internal medicine.

La médecine interne generate: un terrain propice à l'exercice de l'éthique au quotidien [Everyday bioethics in general internal medicine]

The knowledge of the national legislation and the key concepts of bioethics are necessary for medical practice. The four principles of bioethics are autonomy, beneficence, non-maleficence, and justice. General internal medicine is the speciality of comprehensive care for often elderly patients with multiple chronic illnesses. This care is related to many ethically difficult decisions. In our article, we discuss common ethical problems in general internal medicine, including ethical aspects of the patient-physician relationship and medical decision making, the ethical significance of time management, research in bioethics and medical education.

Traducción comentada de «Management of the Clinically Positive Axilla» y «Management of the Internal Mammary Lymph Nodes», Essentials of Breast Surgery

La transmisión de conocimiento científico constituye una de las necesidades de traducción más importantes; es preciso realizar un estudio sobre la traducción del inglés médico. Este trabajo presenta una traducción inédita de fragmentos de Essentials of Breast Surgery y un análisis de esta jerga mediante un glosario y problemas de traducción.

Internal material logistics development in customer-driven production

Työn tavoitteena oli synkronoida yleinen materiaalivirta tuotannon kanssa. Pyrkimyksenä oli virtaviivaistaa materiaalivirta, jotta materiaalin määrä, sekä turhat työvaiheet tuotantoalueella vähenisivät. Päämääränä oli vähentää materiaalilavojen määrää lattialla, sekä parantaa materiaalitoimitusten OTD (On-Time-Delivery) prosenttia.Teoreettinen osa käsittelee nykypäivän toimitusketjun tärkeimpiä elementtejä. Keskeisenä asiana perehdytään materiaalivirtaan ja sen tehokkaaseen hallintaan. Työ esittelee myös synkronisen johtamismallin periaatteet, sekä materiaalivirran synkronoimisen tuotannon kanssa.Empiirinen osuus kuvaa yrityksen materiaalihallinnan nykypäivän tilanteen, sen keskeiset ongelmat, sekä uuden toimintamalliehdotuksen. Työ esittelee kaksi pilottia, joiden tulokset varmistivat uuden virtaviivaistetun materiaalivirran ja täydennysmallin toimivuuden.Työn tulokset osoittavat, miten uusi materiaalin täydennysmalli vähentää materiaalilavojen, sekä jalostamattoman työn määrää tuotantoalueella.

On Innovative Search: the use of internal and external sources of innovation among Finnish innovators

This dissertation explores the use of internal and external sources of knowledge in modern innovation processes. It builds on a framework that combines theories such as a behavioural theory of the firm, the evolutionary theory of economic change, and modern approaches to strategic management. It follows the recent increase in innovation research focusing on the firm-level examination of innovative activities instead of traditional industry-level determinants. The innovation process is seen as a problem- and slack- driven search process, which can take several directions in terms of organizational boundaries in the pursuit of new knowledge and other resources. It thus draws on recent models of technological change, according to which firms nowadays should build their innovative activities on both internal and external sources of innovation rather than relying solely on internal resources. Four different research questions are addressed, all of which are empirically investigated via a rich dataset covering Finnish innovators collected by Statistics Finland. Firstly, the study examines how the nature of problems shapes the direction of any search for new knowledge. In general it demonstrates that the nature of the problem does affect the direction of the search, although under resource constraints firms tend to use external rather than internal sources of knowledge. At the same time, it shows that those firms that are constrained in terms of finance seem to search both internally and externally. Secondly, the dissertation investigates the relationships between different kinds of internal and external sources of knowledge in an attempt to find out where firms should direct their search in order to exploit the potential of a distributed innovation process. The concept of complementarities is applied in this context. The third research question concerns how the use of external knowledge sources – openness to external knowledge – influences the financial performance of firms. Given the many advantages of openness presented in the current literature, the focus is on how it shapes profitability. The results reveal a curvilinear relationship between profitability and openness (taking an inverted U-shape), the implication being that it pays to be open up to a certain point, but being too open to external sources may be detrimental to financial performance. Finally, the dissertation addresses some challenges in CISbased innovation research that have received relatively little attention in prior studies. The general aim is to underline the fact that comprehensive understanding of the complex process of technological change requires the constant development of methodological approaches (in terms of data and measures, for example). All the empirical analyses included in the dissertation are based on the Finnish CIS (Finnish Innovation Survey 1998-2000).

Business intelligence viewpoint on managerial decision-making : Ill-structured problems and decision support systems

Vaikka liiketoimintatiedon hallintaa sekä johdon päätöksentekoa on tutkittu laajasti, näiden kahden käsitteen yhteisvaikutuksesta on olemassa hyvin rajallinen määrä tutkimustietoa. Tulevaisuudessa aiheen tärkeys korostuu, sillä olemassa olevan datan määrä kasvaa jatkuvasti. Yritykset tarvitsevat jatkossa yhä enemmän kyvykkyyksiä sekä resursseja, jotta sekä strukturoitua että strukturoimatonta tietoa voidaan hyödyntää lähteestä riippumatta. Nykyiset Business Intelligence -ratkaisut mahdollistavat tehokkaan liiketoimintatiedon hallinnan osana johdon päätöksentekoa. Aiemman kirjallisuuden pohjalta, tutkimuksen empiirinen osuus tunnistaa liiketoimintatiedon hyödyntämiseen liittyviä tekijöitä, jotka joko tukevat tai rajoittavat johdon päätöksentekoprosessia. Tutkimuksen teoreettinen osuus johdattaa lukijan tutkimusaiheeseen kirjallisuuskatsauksen avulla. Keskeisimmät tutkimukseen liittyvät käsitteet, kuten Business Intelligence ja johdon päätöksenteko, esitetään relevantin kirjallisuuden avulla – tämän lisäksi myös dataan liittyvät käsitteet analysoidaan tarkasti. Tutkimuksen empiirinen osuus rakentuu tutkimusteorian pohjalta. Tutkimuksen empiirisessä osuudessa paneudutaan tutkimusteemoihin käytännön esimerkein: kolmen tapaustutkimuksen avulla tutkitaan sekä kuvataan toisistaan irrallisia tapauksia. Jokainen tapaus kuvataan sekä analysoidaan teoriaan perustuvien väitteiden avulla – nämä väitteet ovat perusedellytyksiä menestyksekkäälle liiketoimintatiedon hyödyntämiseen perustuvalle päätöksenteolle. Tapaustutkimusten avulla alkuperäistä tutkimusongelmaa voidaan analysoida tarkasti huomioiden jo olemassa oleva tutkimustieto. Analyysin tulosten avulla myös yksittäisiä rajoitteita sekä mahdollistavia tekijöitä voidaan analysoida. Tulokset osoittavat, että rajoitteilla on vahvasti negatiivinen vaikutus päätöksentekoprosessin onnistumiseen. Toisaalta yritysjohto on tietoinen liiketoimintatiedon hallintaan liittyvistä positiivisista seurauksista, vaikka kaikkia mahdollisuuksia ei olisikaan hyödynnetty. Tutkimuksen merkittävin tulos esittelee viitekehyksen, jonka puitteissa johdon päätöksentekoprosesseja voidaan arvioida sekä analysoida. Despite the fact that the literature on Business Intelligence and managerial decision-making is extensive, relatively little effort has been made to research the relationship between them. This particular field of study has become important since the amount of data in the world is growing every second. Companies require capabilities and resources in order to utilize structured data and unstructured data from internal and external data sources. However, the present Business Intelligence technologies enable managers to utilize data effectively in decision-making. Based on the prior literature, the empirical part of the thesis identifies the enablers and constraints in computer-aided managerial decision-making process. In this thesis, the theoretical part provides a preliminary understanding about the research area through a literature review. The key concepts such as Business Intelligence and managerial decision-making are explored by reviewing the relevant literature. Additionally, different data sources as well as data forms are analyzed in further detail. All key concepts are taken into account when the empirical part is carried out. The empirical part obtains an understanding of the real world situation when it comes to the themes that were covered in the theoretical part. Three selected case companies are analyzed through those statements, which are considered as critical prerequisites for successful computer-aided managerial decision-making. The case study analysis, which is a part of the empirical part, enables the researcher to examine the relationship between Business Intelligence and managerial decision-making. Based on the findings of the case study analysis, the researcher identifies the enablers and constraints through the case study interviews. The findings indicate that the constraints have a highly negative influence on the decision-making process. In addition, the managers are aware of the positive implications that Business Intelligence has for decision-making, but all possibilities are not yet utilized. As a main result of this study, a data-driven framework for managerial decision-making is introduced. This framework can be used when the managerial decision-making processes are evaluated and analyzed.

Improving internal performance of a company - Introducing employee empowerment via job redesign in Finnish small and medium sized enterprises

This bachelor's thesis is about to find out to what extent Finnish managers and small and medium sized organizations are willing and able to put employee empowerment into practice and what experiences they have got from employee empowerment as an approach towards job redesign. Some of the top enterprises in the world are known for their empowered employees as a single most important factor for their success and this thesis focuses on introducing the subject to Finnish managers and organizations to find out what benefits, barriers and other thoughts they have about the whole idea of empowered employees in Finnish organization culture. Most notable findings in this thesis are that Finnish managers do think that their organization's employees are capable to work efficiently if their job is extended and the organizations would perform better when right person's job is enriched and he/she is given more power to solve problems.

Evaluation of hygienic-sanitary conditions of hospital nutrition and dietary services from the perspectives of internal and external auditors

The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition and dietary services using external and internal auditors. Eleven hospitals were evaluated for their nutrition and dietary services using an evaluation checklist based on food safety requirements in the current legislation. The checklist was applied by an internal auditor (a technical supervisor) and an external auditor (a professional with experience in food services) between August and October 2011. According to the number of items on the evaluation checklist that were considered adequate, the hospital facilities were ranked as excellent, good, regular, bad, or very bad. The results obtained by the auditors were compared. According to these results, it can be said that most of the hospital nutrition and dietary services were rated as good for overall quality by the internal auditor, while the external auditor classified them as Regular. There was a clear difference between the evaluations of the auditors, both in terms of the number of items considered adequate and the overall requirements' average score. It can be concluded that hospital nutrition and dietary services should meet safety requirements in order to provide food. These facilities should have external audits conducted as a way to prevent routine problems from being perpetuated.

Von Neumann-Morgenstern Stable Sets in Matching Problems

The following properties of the core of a one well-known: (i) the core is non-empty; (ii) the core is a lattice; and (iii) the set of unmatched agents is identical for any two matchings belonging to the core. The literature on two-sided matching focuses almost exclusively on the core and studies extensively its properties. Our main result is the following characterization of (von Neumann-Morgenstern) stable sets in one-to-one matching problem only if it is a maximal set satisfying the following properties : (a) the core is a subset of the set; (b) the set is a lattice; (c) the set of unmatched agents is identical for any two matchings belonging to the set. Furthermore, a set is a stable set if it is the unique maximal set satisfying properties (a), (b) and (c). We also show that our main result does not extend from one-to-one matching problems to many-to-one matching problems.