Metodología de integración de actividades de adaptación al cambio climático en proyectos de desarrollo rural

Hoy en día, ya no se puede pasar por alto la necesidad de una agricultura climáticamente más inteligente para los 500 millones de pequeños agricultores del mundo (Wheeler, 2013). Estos representan aproximadamente el 60 % de la agricultura mundial y proporcionan hasta el 80 % de los alimentos en los países en vías de desarrollo, los pequeños agricultores gestionan vastas extensiones de tierra y lamentablemente incluyen los grupos con mayor proporción de personas en estado de inseguridad alimentaria. El cambio climático está transformando el contexto para la agricultura en pequeña escala. Durante siglos, los pequeños agricultores desarrollaron la capacidad de adaptarse a los cambios ambientales y la variabilidad del clima, pero la velocidad y la intensidad del cambio climático está superando su capacidad de respuesta. Si no se cambia la manera que tenemos de lidiar con el cambio climático, tanto en acciones locales como globales, es muy probable que las personas rurales de entornos vulnerables tengan que adaptarse a un calentamiento global promedio de 4 °C por encima de los niveles preindustriales para el año 2100. Esta alza de las temperaturas aumentará aún más la incertidumbre y provocará desastres naturales como las sequías, la erosión del suelo, la pérdida de biodiversidad y la escasez agua sean mucho más frecuentes. Uno de los factores más importantes para los pequeños agricultores es que ya no pueden depender de los promedios históricos, por lo que es más difícil para ellos para planificar y gestionar la producción debido a los cambios en los patrones climáticos. Algunos de los principales cultivos de cereales (trigo, arroz, maíz, etc.) han alcanzado su umbral de tolerancia al calor y un aumento de la temperatura en torno a 1,5-2 °C podría ser muy perjudicial. Estos efectos a corto plazo podrían ser agravados por otros a medio y largo plazo, los que se refieren al impacto socioeconómico en términos de oportunidades y estabilidad política. El cambio climático está haciendo que el desarrollo de la pequeña agricultura resulte mucho más caro. A nivel de proyectos, los programas resistentes al clima tienen, normalmente, unos costos iniciales más altos, tanto de diseño como de implementación. Por ejemplo, es necesario incluir gastos adicionales en infraestructura, operación y mantenimiento; desarrollo de nuevas capacidades y el intercambio de conocimientos en torno al cambio climático. También se necesita mayor inversión para fortalecer las instituciones frente a los nuevos retos que propone el cambio climático, o generar información que pueda ser de escala reducida y con enfoques que beneficien a la comunidad, el cambio climático es global pero los efectos son locales. Es, por tanto, el momento de redefinir la relación entre agricultura y medio ambiente, ya que se hace cada vez más necesario buscar mejores y más eficientes maneras para responder al cambio climático. Es importante señalar que la respuesta al cambio climático no significa reinventar todo lo que se ha aprendido sobre el desarrollo, significa aplicar un esfuerzo renovado para hacer frente a los cambios en el trabajo de cooperación al desarrollo de una manera más sistemática y más amplia. Una respuesta coherente al cambio climático requiere que la comunidad internacional reconozca la necesidad de aumentar el apoyo financiero para la adaptación así como un mayor énfasis en proporcionar soluciones diseñadas para aumentar la resiliencia1 de los pequeños agricultores a las crisis relacionadas con el clima. Con el fin de responder a algunos de los desafíos mencionados anteriormente, esta investigación pretende contribuir a fortalecer las capacidades de los pequeños productores, aquellos que actualmente están la primera línea frente a los desafíos del cambio climático, promoviendo un desarrollo que tenga un impacto positivo en sus medios de vida. La tesis se compone de cuatro capítulos. El primero define y analiza el marco teórico de las interacciones entre el cambio climático y el impacto en los proyectos de desarrollo rural, especialmente los que tienen por objetivo mejorar la seguridad alimentaria de los pequeños productores. En ese mismo capítulo, se presenta una revisión global de la financiación climática, incluyendo la necesidad de asignar suficientes recursos para la adaptación. Con el fin de lograr una mayor eficacia e impacto en los proyectos de desarrollo, la investigación desarrolla una metodología para integrar actividades de adaptación al cambio climático, presentada en el segundo capítulo. Esta metodología fue implementada y validada durante el periodo 2012-14, trabajando directamente con diferentes equipos gubernamentales en diez proyectos del Fondo Internacional de Desarrollo Agrícola ). El tercero presenta, de manera detallada, la aplicación de la metodología a los estudios de caso de Bolivia y Nicaragua, así como un resumen de las principales conclusiones en la aplicación de los ocho países restantes. Finalmente, en el último capítulo se presentan las conclusiones y un esbozo de futuras líneas de investigación. Actualmente, el tema de la sostenibilidad ambiental y el cambio climático está ganando terreno en la agenda de desarrollo. Es por ello que se alumbra esta investigación, para que a través de los resultados obtenidos y la implementación de la metodología propuesta, sirva como herramienta estratégica para la planificación y la gestión operativa a la hora de integrar iniciativas de adaptación en los proyectos de desarrollo rural. ABSTRACT The need for climate-smart agriculture for the world’s 500 million smallholder farms cannot be overlooked: they account for 60 per cent of global agriculture, provide up to 80 per cent of food in developing countries, manage vast areas of land and make up the largest share of the developing world’s undernourished. Climate change is transforming the context for smallholder agriculture. Over centuries smallholders have developed the capacity to adapt to environmental change and climate variability, but the speed and intensity of climate change is outpacing the speed of historically autonomous actions. In the absence of a profound step-change in local and global action on climate change, it is Increasingly likely that poor rural people would need to contend with an average global warming of 4 degrees above pre-industrial levels by 2100, if not sooner. Such substantial climatic change will further increase uncertainty and exacerbate weather –related disasters, droughts, biodiversity loss, and land and water scarcity. Perhaps most significantly for smallholder farmers, they can no longer rely on historical averages, making it harder for them to plan and manage production when planting seasons and weather patterns are shifting. The major cereal crops (wheat, rice, maize, etc.) are at their heat tolerance threshold and with a 1.5-2°C temperature increase could collapse. These “first-round” effects will be compounded by second-round socio-economic impacts in terms of economic opportunities and political stability. Climate change is making the development of smallholder agriculture more expensive. At project level, climate-resilient programmes typically have higher up-front design and implementation costs – e.g. infrastructure costs and initially increased asset management, operation and maintenance, more capacity-building and knowledge sharing, strengthening institutions, greater project development costs (downscaled data generation and community-based approaches), and greater costs from enhancing cross sectorial and stakeholders collaboration. Consequently it’s time to redefine the relationship between agriculture and environment as we need to look better and more efficient ways to respond to climate change. It is important to note that responding to climate change does not mean to throwing out or reinventing everything that has been learnt about development. It means a renewed effort to tackle wider and well-known development changes in a more systematic way. A coherent response to climate change requires acknowledge of the need to increase the financial support for adaptation and a continued emphasis on provided solutions designed to increase the resilience of smallholders and poor communities to shocks, which are weather related. In order to respond to some of the challenges mentioned before, this research aims to contribute to strengthen the capacities of the smallholders and to promote a development that will positively impact in the rural livelihoods of the most vulnerable smallholders farmers; those who currently are in the first line facing the challenges of climate change. The thesis has four chapters. Chapter one describes and analyses the theoretical framework of the interactions between climate change and the impact on rural development projects, especially those aimed at improving the food security of smallholders producers. In this chapter a comprehensive review of climate financing is presented, including the need to allocate sufficient resources for adaptation. In order to achieve greater effectiveness and impact on development projects, the research develops in the second chapter a methodology to integrate adaptation activities for climate change. This methodology was implemented and validated during the 2012-14 period, working directly with various government teams in ten projects of the International Fund for Agricultural Development (IFAD). The third chapter presents in detail the application of the methodology to the case studies of Bolivia and Nicaragua, as well as a summary of the main conclusions of its implementation in the remaining eight countries. The final chapter exposes the main conclusions and future research topics. At a time when environmental sustainability and climate change issues are gaining more attention, the research and obtained results through the implementation of the model methodology proposed, can be considered a strategic tool for planning and operational management to integrate adaptation initiatives in rural development projects. The use of the proposed methodology will boost incentives to scale up climate resilience programmes and integrate adaptation to climate change into wider smallholder development programmes.

UMA VISÃO BASEADA EM RECURSOS COM DIRECIONAMENTO ESTRATÉGICO: UMA PROPOSTA ÀS INSTITUIÇÕES DE SAÚDE HOSPITALARES PÚBLICAS

Este trabalho investiga a utilização da Visão Baseada em Recursos, tendo por objetivo propor um modelo de gestão de pessoas que atenda a exigibilidade da qualidade de prestação de serviços à saúde. São observadas as relações de trabalho nesses serviços nas diversas modalidades, a sistematização do conhecimento sobre os elementos que figuram na gestão de pessoas e a verificação da necessidade de Gestão Operacional e Estratégica de Pessoas para trabalhadores das Instituições de Saúde Hospitalares Públicas. Trata-se de pesquisa de natureza empírico-exploratória, apoiada em múltiplos casos de hospitais públicos, entrevistando e registrando fatos observados nos locais pesquisados, aplicando-se o Protocolo de Observações. Para atingir o objetivo principal, são utilizados os fundamentos das obras de Marras (2001; 2003 e 2005): Relações Trabalhistas no Brasil: administração e estratégia; Administração de Recursos Humanos: do operacional ao estratégico; e Gestão de Pessoas em Empresas Inovadoras, respectivamente. Além das observações participantes, utilizaram-se entrevistas e questionários com os usuários e profissionais dos hospitais, com instrumentos adaptados para o contexto da instituição e dado tratamento estatístico para análise dos resultados, que se apresentam em tabelas para melhor visualização dos dados e análise. A Gestão de Pessoas nas ISHP permanecem no modelo tradicional e longe de qualquer movimento que possa torná-la estratégica. O nível de satisfação dos pacientes para com os profissionais de saúde é ótimo, mas quanto aos recursos e infra-estrutura, é baixo. Os profissionais de saúde na quase sua totalidade trabalham por vocação, espírito de humanização e por acharem gratificante, embora o nível de insatisfação com a remuneração recebida seja elevado.(AU)

UMA VISÃO BASEADA EM RECURSOS COM DIRECIONAMENTO ESTRATÉGICO: UMA PROPOSTA ÀS INSTITUIÇÕES DE SAÚDE HOSPITALARES PÚBLICAS

Este trabalho investiga a utilização da Visão Baseada em Recursos, tendo por objetivo propor um modelo de gestão de pessoas que atenda a exigibilidade da qualidade de prestação de serviços à saúde. São observadas as relações de trabalho nesses serviços nas diversas modalidades, a sistematização do conhecimento sobre os elementos que figuram na gestão de pessoas e a verificação da necessidade de Gestão Operacional e Estratégica de Pessoas para trabalhadores das Instituições de Saúde Hospitalares Públicas. Trata-se de pesquisa de natureza empírico-exploratória, apoiada em múltiplos casos de hospitais públicos, entrevistando e registrando fatos observados nos locais pesquisados, aplicando-se o Protocolo de Observações. Para atingir o objetivo principal, são utilizados os fundamentos das obras de Marras (2001; 2003 e 2005): Relações Trabalhistas no Brasil: administração e estratégia; Administração de Recursos Humanos: do operacional ao estratégico; e Gestão de Pessoas em Empresas Inovadoras, respectivamente. Além das observações participantes, utilizaram-se entrevistas e questionários com os usuários e profissionais dos hospitais, com instrumentos adaptados para o contexto da instituição e dado tratamento estatístico para análise dos resultados, que se apresentam em tabelas para melhor visualização dos dados e análise. A Gestão de Pessoas nas ISHP permanecem no modelo tradicional e longe de qualquer movimento que possa torná-la estratégica. O nível de satisfação dos pacientes para com os profissionais de saúde é ótimo, mas quanto aos recursos e infra-estrutura, é baixo. Os profissionais de saúde na quase sua totalidade trabalham por vocação, espírito de humanização e por acharem gratificante, embora o nível de insatisfação com a remuneração recebida seja elevado.(AU)

Product warranty logistics: Issues and challenges

Warranty is an important element of marketing new products. The servicing of warranty results in additional costs to the manufacturer. Warranty logistics deals with various issues relating to the servicing of warranty. Proper management of warranty logistics is needed not only to reduce the warranty servicing cost but also to ensure customer satisfaction as customer dissatisfaction has a negative impact on sales and revenue. Unfortunately, warranty logistics has received very little attention. The paper links the literature on warranty and on logistics and then discusses the different issues in warranty logistics. It highlights the challenges and identifies some research topics of potential interest to operational researchers. (C) 2003 Elsevier B.V. All rights reserved.

UMA VISÃO BASEADA EM RECURSOS COM DIRECIONAMENTO ESTRATÉGICO: UMA PROPOSTA ÀS INSTITUIÇÕES DE SAÚDE HOSPITALARES PÚBLICAS

Este trabalho investiga a utilização da Visão Baseada em Recursos, tendo por objetivo propor um modelo de gestão de pessoas que atenda a exigibilidade da qualidade de prestação de serviços à saúde. São observadas as relações de trabalho nesses serviços nas diversas modalidades, a sistematização do conhecimento sobre os elementos que figuram na gestão de pessoas e a verificação da necessidade de Gestão Operacional e Estratégica de Pessoas para trabalhadores das Instituições de Saúde Hospitalares Públicas. Trata-se de pesquisa de natureza empírico-exploratória, apoiada em múltiplos casos de hospitais públicos, entrevistando e registrando fatos observados nos locais pesquisados, aplicando-se o Protocolo de Observações. Para atingir o objetivo principal, são utilizados os fundamentos das obras de Marras (2001; 2003 e 2005): Relações Trabalhistas no Brasil: administração e estratégia; Administração de Recursos Humanos: do operacional ao estratégico; e Gestão de Pessoas em Empresas Inovadoras, respectivamente. Além das observações participantes, utilizaram-se entrevistas e questionários com os usuários e profissionais dos hospitais, com instrumentos adaptados para o contexto da instituição e dado tratamento estatístico para análise dos resultados, que se apresentam em tabelas para melhor visualização dos dados e análise. A Gestão de Pessoas nas ISHP permanecem no modelo tradicional e longe de qualquer movimento que possa torná-la estratégica. O nível de satisfação dos pacientes para com os profissionais de saúde é ótimo, mas quanto aos recursos e infra-estrutura, é baixo. Os profissionais de saúde na quase sua totalidade trabalham por vocação, espírito de humanização e por acharem gratificante, embora o nível de insatisfação com a remuneração recebida seja elevado.(AU)

Editorial

This special issue of the Journal of the Operational Research Society is dedicated to papers on the related subjects of knowledge management and intellectual capital. These subjects continue to generate considerable interest amongst both practitioners and academics. This issue demonstrates that operational researchers have many contributions to offer to the area, especially by bringing multi-disciplinary, integrated and holistic perspectives. The papers included are both theoretical as well as practical, and include a number of case studies showing how knowledge management has been implemented in practice that may assist other organisations in their search for a better means of managing what is now recognised as a core organisational activity. It has been accepted by a growing number of organisations that the precise handling of information and knowledge is a significant factor in facilitating their success but that there is a challenge in how to implement a strategy and processes for this handling. It is here, in the particular area of knowledge process handling that we can see the contributions of operational researchers most clearly as is illustrated in the papers included in this journal edition. The issue comprises nine papers, contributed by authors based in eight different countries on five continents. Lind and Seigerroth describe an approach that they call team-based reconstruction, intended to help articulate knowledge in a particular organisational. context. They illustrate the use of this approach with three case studies, two in manufacturing and one in public sector health care. Different ways of carrying out reconstruction are analysed, and the benefits of team-based reconstruction are established. Edwards and Kidd, and Connell, Powell and Klein both concentrate on knowledge transfer. Edwards and Kidd discuss the issues involved in transferring knowledge across frontières (borders) of various kinds, from those borders within organisations to those between countries. They present two examples, one in distribution and the other in manufacturing. They conclude that trust and culture both play an important part in facilitating such transfers, that IT should be kept in a supporting role in knowledge management projects, and that a staged approach to this IT support may be the most effective. Connell, Powell and Klein consider the oft-quoted distinction between explicit and tacit knowledge, and argue that such a distinction is sometimes unhelpful. They suggest that knowledge should rather be regarded as a holistic systemic property. The consequences of this for knowledge transfer are examined, with a particular emphasis on what this might mean for the practice of OR Their view of OR in the context of knowledge management very much echoes Lind and Seigerroth's focus on knowledge for human action. This is an interesting convergence of views given that, broadly speaking, one set of authors comes from within the OR community, and the other from outside it. Hafeez and Abdelmeguid present the nearest to a 'hard' OR contribution of the papers in this special issue. In their paper they construct and use system dynamics models to investigate alternative ways in which an organisation might close a knowledge gap or skills gap. The methods they use have the potential to be generalised to any other quantifiable aspects of intellectual capital. The contribution by Revilla, Sarkis and Modrego is also at the 'hard' end of the spectrum. They evaluate the performance of public–private research collaborations in Spain, using an approach based on data envelopment analysis. They found that larger organisations tended to perform relatively better than smaller ones, even though the approach used takes into account scale effects. Perhaps more interesting was that many factors that might have been thought relevant, such as the organisation's existing knowledge base or how widely applicable the results of the project would be, had no significant effect on the performance. It may be that how well the partnership between the collaborators works (not a factor it was possible to take into account in this study) is more important than most other factors. Mak and Ramaprasad introduce the concept of a knowledge supply network. This builds on existing ideas of supply chain management, but also integrates the design chain and the marketing chain, to address all the intellectual property connected with the network as a whole. The authors regard the knowledge supply network as the natural focus for considering knowledge management issues. They propose seven criteria for evaluating knowledge supply network architecture, and illustrate their argument with an example from the electronics industry—integrated circuit design and fabrication. In the paper by Hasan and Crawford, their interest lies in the holistic approach to knowledge management. They demonstrate their argument—that there is no simple IT solution for organisational knowledge management efforts—through two case study investigations. These case studies, in Australian universities, are investigated through cultural historical activity theory, which focuses the study on the activities that are carried out by people in support of their interpretations of their role, the opportunities available and the organisation's purpose. Human activities, it is argued, are mediated by the available tools, including IT and IS and in this particular context, KMS. It is this argument that places the available technology into the knowledge activity process and permits the future design of KMS to be improved through the lessons learnt by studying these knowledge activity systems in practice. Wijnhoven concentrates on knowledge management at the operational level of the organisation. He is concerned with studying the transformation of certain inputs to outputs—the operations function—and the consequent realisation of organisational goals via the management of these operations. He argues that the inputs and outputs of this process in the context of knowledge management are different types of knowledge and names the operation method the knowledge logistics. The method of transformation he calls learning. This theoretical paper discusses the operational management of four types of knowledge objects—explicit understanding; information; skills; and norms and values; and shows how through the proposed framework learning can transfer these objects to clients in a logistical process without a major transformation in content. Millie Kwan continues this theme with a paper about process-oriented knowledge management. In her case study she discusses an implementation of knowledge management where the knowledge is centred around an organisational process and the mission, rationale and objectives of the process define the scope of the project. In her case they are concerned with the effective use of real estate (property and buildings) within a Fortune 100 company. In order to manage the knowledge about this property and the process by which the best 'deal' for internal customers and the overall company was reached, a KMS was devised. She argues that process knowledge is a source of core competence and thus needs to be strategically managed. Finally, you may also wish to read a related paper originally submitted for this Special Issue, 'Customer knowledge management' by Garcia-Murillo and Annabi, which was published in the August 2002 issue of the Journal of the Operational Research Society, 53(8), 875–884.

A visual interactive modelling system as a learning tool

This paper presents a case study of the use of a visual interactive modelling system to investigate issues involved in the management of a hospital ward. Visual Interactive Modelling systems are seen to offer the learner the opportunity to explore operational management issues from a varied perspective and to provide an interactive system in which the learner receives feedback on the consequences of their actions. However to maximise the potential learning experience for a student requires the recognition that they require task structure which helps them to understand the concepts involved. These factors can be incorporated into the visual interactive model by providing an interface customised to guide the student through the experimentation. Recent developments of VIM systems in terms of their connectivity with the programming language Visual Basic facilitates this customisation.

Revisão do plano de segurança da água do sistema regional do Carvoeiro

Os Planos de Segurança da Água surgem com a necessidade de aumentar a segurança da água de abastecimento, superando a monitorização de conformidade de “fim de linha”, permitindo aumentar a confiança do consumidor na qualidade da água que lhe é fornecida. Esta nova abordagem recorre a uma metodologia de gestão baseada na identificação e no controlo de riscos em pontos críticos de um sistema de abastecimento, em complemento do controlo realizado através da monitorização da conformidade da água entregue aos consumidores. O Plano de Segurança da Água (PSA) encontra-se implementado no Sistema Regional do Carvoeiro (SRC) desde o ano de 2009. O SRC é um sistema de abastecimento de água em alta, sendo constituído por conjunto de infraestruturas de captação, tratamento, transporte e armazenamento de água desde a sua origem, localizada no rio Vouga, em Carvoeiro, até aos municípios integrados na Associação de Municípios do Carvoeiro-Vouga. Atendendo à obra de expansão do SRC, tornou-se imperativo efetuar uma revisão ao PSA, sendo este o objetivo primordial do trabalho de estágio desenvolvido na empresa Águas do Vouga S.A, concessionária responsável pela gestão do SRC. Para a prossecução deste objetivo, o trabalho desenvolvido envolveu os seguintes passos metodológicos: identificação das operações aplicadas no SRC; identificação de perigos e eventos perigosos em todos os órgãos constituintes do sistema; avaliação de riscos; identificação de pontos críticos de controlo; identificação de pontos de monitorização e medidas preventivas; elaboração do plano de monitorização, incluindo, procedimentos de controlo operacional em condições normais de funcionamento e em caso de desvio; validação deste plano. Deste trabalho resultou a identificação de 166 eventos perigosos, 17 tipologias de perigos, 3 pontos de controlo crítico e 17 pontos de monitorização. Os pontos de controlo crítico foram identificados nos processos de tratamento da ETA do Carvoeiro. O primeiro foi localizado na etapa de filtração com areia, antracite e zeólitos correspondendo aos perigos com metais (Fe e Mn), outros compostos químicos perigosos, partículas, turvação, matéria orgânica e alumínio. O segundo ponto foi identificado na etapa de filtração com filtros de carvão ativado granular relativo ao aparecimento de sabor e cianotoxinas. O terceiro ponto de controlo crítico foi encontrado na etapa de desinfeção referente aos microrganismos patogénicos. Os pontos de monitorização foram localizados ao longo do sistema em situações onde não se dispõem de nenhuma medida de controlo para eliminar o perigo e antes e após os pontos de controlo crítico. O plano de monitorização foi desenvolvido para estes pontos, embora os limites e procedimentos definidos devam ser alvo de revisão após a conclusão da obra de expansão do sistema. A validação da revisão do plano foi iniciada, mas cingiu-se apenas na avaliação preliminar de riscos, prévia ao início de operação da ETA do Carvoeiro. Para além da revisão deste plano, foram realizadas outras tarefas, nomeadamente uma análise à qualidade da água fornecida e distribuída pelo sistema, a elaboração do plano PCQA para o ano de 2016, a configuração da plataforma de gestão operacional NAVIATM e a revisão do Manual de Gestão da Águas do Vouga relativo ao processo de qualidade na captação, tratamento e distribuição e ao processo de qualidade na gestão do PSA.

How to optimize the business model for ConsultaClick an innovative startup in the e-health Portuguese sector

Field lab: Entrepreneurial and innovative ventures

Supply chain management as beyond operational efficiency

The orthodoxy of supply chain management (SCM) emphasises competitive advantage through increased operational efficiency and market responsiveness from production and distribution processes into the hands of consumers. It anticipates that future competition will be between chains rather than between firms. While well established in other industry sectors, the SCM concept is newly developed in the Australian agri-food sector. Critical review of the concept has identified key issues of power among channel members, processes of chain initiation and innovation, and the inability of SCM to offer a viable business strategy for some firms. Building on those insights, this paper examines the supply chain concept for horticulture. Horticultural products are characterised by perishability, heterogeneity and lags in production response to market signals. Producers’ profits are vulnerable to quantity, timing of supply and product specification. Many supply chains in smaller industries are loose, fragmented, interwoven, unstable and unique! Firms operating within these environments need an astute understanding of the chains, the hierarchy of channel members and their relative position. Effective business strategies – for individual firms and supply chains - need to be developed and redeveloped to accommodate the dynamic nature of horticulture. Two case studies are discussed as contributions to this early stage of the theoretical development of supply chain management. The SCM concept also has implications for horticultural researchers, involving a wider range of industry stakeholders, technical problems and research skills. As for business management, the usefulness of the concept will depend on its capacity to increase responsiveness to customers’ preferences and customer value.

Device-specific weighted T-score for two quantitative ultrasounds: operational propositions for the management of osteoporosis for 65 years and older women in Switzerland.

The World Health Organization (WHO) criteria for the diagnosis of osteoporosis are mainly applicable for dual X-ray absorptiometry (DXA) measurements at the spine and hip levels. There is a growing demand for cheaper devices, free of ionizing radiation such as promising quantitative ultrasound (QUS). In common with many other countries, QUS measurements are increasingly used in Switzerland without adequate clinical guidelines. The T-score approach developed for DXA cannot be applied to QUS, although well-conducted prospective studies have shown that ultrasound could be a valuable predictor of fracture risk. As a consequence, an expert committee named the Swiss Quality Assurance Project (SQAP, for which the main mission is the establishment of quality assurance procedures for DXA and QUS in Switzerland) was mandated by the Swiss Association Against Osteoporosis (ASCO) in 2000 to propose operational clinical recommendations for the use of QUS in the management of osteoporosis for two QUS devices sold in Switzerland. Device-specific weighted "T-score" based on the risk of osteoporotic hip fractures as well as on the prediction of DXA osteoporosis at the hip, according to the WHO definition of osteoporosis, were calculated for the Achilles (Lunar, General Electric, Madison, Wis.) and Sahara (Hologic, Waltham, Mass.) ultrasound devices. Several studies (totaling a few thousand subjects) were used to calculate age-adjusted odd ratios (OR) and area under the receiver operating curve (AUC) for the prediction of osteoporotic fracture (taking into account a weighting score depending on the design of the study involved in the calculation). The ORs were 2.4 (1.9-3.2) and AUC 0.72 (0.66-0.77), respectively, for the Achilles, and 2.3 (1.7-3.1) and 0.75 (0.68-0.82), respectively, for the Sahara device. To translate risk estimates into thresholds for clinical application, 90% sensitivity was used to define low fracture and low osteoporosis risk, and a specificity of 80% was used to define subjects as being at high risk of fracture or having osteoporosis at the hip. From the combination of the fracture model with the hip DXA osteoporotic model, we found a T-score threshold of -1.2 and -2.5 for the stiffness (Achilles) determining, respectively, the low- and high-risk subjects. Similarly, we found a T-score at -1.0 and -2.2 for the QUI index (Sahara). Then a screening strategy combining QUS, DXA, and clinical factors for the identification of women needing treatment was proposed. The application of this approach will help to minimize the inappropriate use of QUS from which the whole field currently suffers.

Identification and Management of Operational Risks in IT Organization of Financial Service Provider

Työn tavoitteena on tunnistaa toiminnallisia riskitekijöitä rahoituspalveluita tarjoavan yrityksen IT-organisaatiossa sekä löytää arkipäiväisiä keinoja hallita näitä riskejä. Työssä riskejä on myös tarkasteltu mahdollisen ulkoistuksen yhteydessä. Fuusiot ovat yleisiä rahoitusalan yrityksissä. Yhteenliittymien tuloksena yritysten IT-arkkitehtuuri voi olla monimutkainen ja kulttuurierot yrityksessä suuria. Synergia- ja mittakaavaetuja saadakseen yritys keskittää toimintojaan ja IT-ratkaisujaan. Riskien tunnistaminen on riskienhallintaprosessin tärkein vaihe. Tässä tutkimuksessa riskit ja riskitekijät tunnistettiin itsearvioinnin avulla kysymyssarjoja hyväksikäyttäen. Monet riskitekijät liittyivät sisäisen valvonnan ja seurannan puutteisiin. Myöhemmin näille riskeille pohdittiin työryhmässä käytännönläheisiä hallintakeinoja. Yritys voi siirtää tai jakaa IT -riskejä ulkoistamalla. Ulkoistaminen voi kuitenkin tuoda mukaan myös uusia riskitekijöitä. Ennen ulkoistamispäätöstä yrityksen sisäisten prosessien ja organisaation on oltava järjestyksessä, jotta sopimuksen kannattavuutta voidaan verrata luotettavasti saman palvelun tuottamiseen sisäisesti.

Operational Flexibility: A Model for Effective Project Management

The aim of this study is to investigate the role of operational flexibility for effective project management in the construction industry. The specific objectives are to: a) Identify the determinants of operational flexibility potential in construction project management b) Investigate the contribution of each of the determinants to operational flexibility potential in the construction industry c) Investigate on the moderating factors of operational flexibility potential in a construction project environment d) Investigate whether moderated operational flexibility potential mediates the path between predictors and effective construction project management e) Develop and test a conceptual model of achieving operational flexibility for effective project management The purpose of this study is to findout ways to utilize flexibility inorder to manage uncertain project environment and ultimately achieve effective project management. In what configuration these operational flexibility determinants are demanded by construction project environment in order to achieve project success. This research was conducted in three phases, namely: (i) exploratory phase (ii) questionnaire development phase; and (iii) data collection and analysis phase. The study needs firm level analysis and therefore real estate developers who are members of CREDAI, Kerala Chapter were considered. This study provides a framework on the functioning of operational flexibility, offering guidance to researchers and practitioners for discovering means to gain operational flexibility in construction firms. The findings provide an empirical understanding on kinds of resources and capabilities a construction firm must accumulate to respond flexibly to the changing project environment offering practitioners insights into practices that build firms operational flexibility potential. Firms are dealing with complex, continuous changing and uncertain environments due trends of globalization, technical changes and innovations and changes in the customers’ needs and expectations. To cope with the increasingly uncertain and quickly changing environment firms strive for flexibility. To achieve the level of flexibility that adds value to the customers, firms should look to flexibility from a day to day operational perspective. Each dimension of operational flexibility is derived from competences and capabilities. In this thesis only the influence on customer satisfaction and learning exploitation of flexibility dimensions which directly add value in the customers eyes are studied to answer the followingresearch questions: “What is the impact of operational flexibility on customer satisfaction?.” What are the predictors of operational flexibility in construction industry? .These questions can only be answered after answering the questions like “Why do firms need operational flexibility?” and “how can firms achieve operational flexibility?” in the context of the construction industry. The need for construction firms to be flexible, via the effective utilization of organizational resources and capabilities for improved responsiveness, is important because of the increasing rate of changes in the business environment within which they operate. Achieving operational flexibility is also important because it has a significant correlation with a project effectiveness and hence a firm’s turnover. It is essential for academics and practitioners to recognize that the attainment of operational flexibility involves different types namely: (i) Modification (ii) new product development and (iii) demand management requires different configurations of predictors (i.e., resources, capabilities and strategies). Construction firms should consider these relationships and implement appropriate management practices for developing and configuring the right kind of resources, capabilities and strategies towards achieving different operational flexibility types.