Software process improvement using an electronic process guide

Kasvava kiinnostus ohjelmistojen laatua kohtaan on herättänyt ohjelmistoprosesseihin ja niiden kehittämiseen kohdistuvaa huomiota viime vuosina. Ohjelmistoyritykset ympäri maailmaa ovat ottaneet käyttöön ohjelmistoprosessin kehittämismalleja, kuten CMM ja SPICE, pyrkiessään kohti parempilaatuisia ohjelmistotuotteita. Samalla on huomattu, että tehokas prosessien parantaminen ja suorittaminen tarvitsee tuekseen kuvauksen prosessista, jotta prosessin perusteellinen ymmärtäminen ja kommunikointi olisi mahdollista. Ohjelmistoprosesseja voidaan kuvata monilla eri tavoilla. Prosessiopas on prosessin esitysmuoto, jonka päätarkoituksena on helpottaa prosessin ymmärtämistä ja kommunikointia. Elektroninen prosessiopas on Web-teknologiaa hyödyntävä prosessiopas. Tässä työssä luodaan kehitysympäristö elektronisille prosessioppaille, joiden tarkoituksena on tukea ohjelmistoprosessin kehittämistä ja suorittamista. Ympäristö mahdollistaa ohjelmistoprosessinmallintamisen sekä yksilöllisten oppaiden luomisen ja muokkaamisen. Kehitysympäristöä käytetään mallintamaan tietoliikenneohjelmistoja valmistavan yrityksen ohjelmistoprosessia sekä luomaan elektronisia prosessioppaita tukemaan prosessin kehitystä ja suorittamista. Lopuksi pohditaan prosessioppaiden tarjoamaa tukea sekä mahdollisuuksia kohdeyrityksessä.

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks.

OBJECTIVE: The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. METHODS: This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. RESULTS: Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). CONCLUSION: A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective.

Quality of Disease Management and Risk of Mortality in English Primary Care Practices

OBJECTIVE: To investigate whether better management of chronic conditions by family practices reduces mortality risk. DATA: Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. STUDY DESIGN: Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. PRINCIPAL FINDINGS: Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. CONCLUSIONS: The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions.

Describing and Analyzing Information Technology through Total Quality Management and Process Management: Case Stora Enso Newsprint

Laatu on osaltaan vahvistamassa asemaansa liike-elämässä yritysten kilpaillessa kansainvälisillä markkinoilla niin hinnalla kuin laadulla. Tämä suuntaus on synnyttänyt useita laatuohjelmia, joita käytetään ahkerasti yritysten kokonais- valtaisen laatujohtamisen (TQM) toteuttamisessa. Laatujohtaminen kattaa yrityksen kaikki toiminnot ja luo vaatimuksia myös yrityksen tukitoimintojen kehittämiselle ja parantamiselle. Näihin lukeutuu myös tämän tutkimuksen kohde tietohallinto (IT). Tutkielman tavoitteena oli kuvata IT prosessin nykytila. Tutkielmassa laadittu prosessikuvaus pohjautuu prosessijohtamisen teoriaan ja kohdeyrityksen käyttämään laatupalkinto kriteeristöön. Tutkimusmenetelmänä prosessin nykytilan selvittämiseksi käytettiin teemahaastattelutta. Prosessin nykytilan ja sille asetettujen vaatimusten selvittämiseksi haastateltiin IT prosessin asiakkaita. Prosessianalyysi, tärkeimpien ala-prosessien tunnistaminen ja parannusalueiden löytäminen ovat tämän tutkielman keskeisemmät tulokset. Tutkielma painottui IT prosessin heikkouksien ja parannuskohteiden etsimiseen jatkuvan kehittämisen pohjaksi, ei niinkään prosessin radikaaliin uudistamiseen. Tutkielmassa esitellään TQM:n periaatteet, laatutyökaluja sekä prosessijohtamisen terminologia, periaatteet ja sen systemaattinen toteutus. Työ antaa myös kuvan siitä, miten TQM ja prosessijohtaminen niveltyvät yrityksen laatutyössä.

Health-related quality-of-life in patients with newly diagnosed multiple myeloma in the FIRST trial: lenalidomide plus low-dose dexamethasone versus melphalan, prednisone, thalidomide.

We compared the health-related quality-of-life of patients with newly diagnosed multiple myeloma aged over 65 years or transplant-ineligible in the pivotal, phase III FIRST trial. Patients received: i) continuous lenalidomide and low-dose dexamethasone until disease progression; ii) fixed cycles of lenalidomide and low-dose dexamethasone for 18 months; or iii) fixed cycles of melphalan, prednisone, thalidomide for 18 months. Data were collected using the validated questionnaires (QLQ-MY20, QLQ-C30, and EQ-5D). The analysis focused on the EQ-5D utility value and six domains pre-selected for their perceived clinical relevance. Lenalidomide and low-dose dexamethasone, and melphalan, prednisone, thalidomide improved patients' health-related quality-of-life from baseline over the duration of the study across all pre-selected domains of the QLQ-C30 and EQ-5D. In the QLQ-MY20, lenalidomide and low-dose dexamethasone demonstrated a significantly greater reduction in the Disease Symptoms domain compared with melphalan, prednisone, thalidomide at Month 3, and significantly lower scores for QLQ-MY20 Side Effects of Treatment at all post-baseline assessments except Month 18. Linear mixed-model repeated-measures analyses confirmed the results observed in the cross-sectional analysis. Continuous lenalidomide and low-dose dexamethasone delays disease progression versus melphalan, prednisone, thalidomide and has been associated with a clinically meaningful improvement in health-related quality-of-life. These results further establish continuous lenalidomide and low-dose dexamethasone as a new standard of care for initial therapy of myeloma by demonstrating superior health-related quality-of-life during treatment, compared with melphalan, prednisone, thalidomide.

Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity.

BACKGROUND: Knowledge about determinants of quality of life (QoL) in eosinophilic oesophagitis (EoO) patients helps to identify patients at risk of experiencing poor QoL and to tailor therapeutic interventions accordingly. AIM: To evaluate the impact of symptom severity, endoscopic and histological activity on EoE-specific QoL in adult EoE patients. METHODS: Ninety-eight adult EoE patients were prospectively included (64% male, median age 39 years). Patients completed two validated instruments to assess EoE-specific QoL (EoO-QoL-A) and symptom severity (adult EoE activity index patient-reported outcome) and then underwent esophagogastroduodenoscopy with biopsy sampling. Physicians reported standardised information on EoE-associated endoscopic and histological alterations. The Spearman's rank correlation coefficient was calculated to determine the relationship between QoL and symptom severity. Linear regression and analysis of variance was used to quantify the extent to which variations in severity of EoE symptoms, endoscopic and histological findings explain variations in QoL. RESULTS: Quality of life strongly correlated with symptom severity (r = 0.610, P < 0.001). While the variation in severity of symptoms, endoscopic and histological findings alone explained 38%, 35% and 22% of the variability in EoE-related QoL, respectively, these together explained 60% of variation. Symptom severity explained 18-35% of the variation in each of the five QoL subscale scores. CONCLUSIONS: Eosinophilic oesophagitis symptom severity and biological disease activity determine QoL in adult patients with eosinophilic oesophagitis. Therefore, reduction in both eosinophilic oesophagitis symptoms as well as biological disease activity is essential for improvement of QoL in adult patients. Clinicaltrials.gov number, NCT00939263.

Sanitary quality of edible bivalve mollusks in Southeastern Brazil using an UV based depuration system

The increase in seafood production, especially in mariculture worldwide, has brought out the need of continued monitoring of shellfish production areas in order to ensure safety to human consumption. The purpose of this research was to evaluate pathogenic protozoa, viruses and bacteria contamination in oysters before and after UV depuration procedure, in brackish waters at all stages of cultivation and treatment steps and to enumerate microbiological indicators of fecal contamination from production site up to depuration site in an oyster cooperative located at the Southeastern estuarine area of Brazil. Oysters and brackish water were collected monthly from September 2009 to November 2010. Four sampling sites were selected for enteropathogens analysis: site 1- oyster growth, site 2- catchment water (before UV depuration procedure), site 3 - filtration stage of water treatment (only for protozoa analysis) and site 4- oyster's depuration tank. Three microbiological indicators ! were examined at sites 1, 2 and 4. The following pathogenic microorganisms were searched: Giardia cysts, Cryptosporidium oocysts, Human Adenovirus (HAdV), Hepatitis A virus (HAV), Human Norovirus (HnoV) (genogroups I and II), JC strain Polyomavirus (JCPyV) and Salmonella sp. Analysis consisted of molecular detection (qPCR) for viruses (oysters and water samples); immunomagnetic separation followed by direct immunofluorescence assay for Cryptosporidium oocysts and Giardia cysts and also molecular detection (PCR) for the latter (oysters and water samples); commercial kit (Reveal-Neogee (R)) for Salmonella analysis (oysters). Giardia was the most prevalent pathogen in all sites where it was detected: 36.3%, 18.1%, 36.3% and 27.2% of water from sites 1, 2, 3 and 4 respectively; 36.3% of oysters from site 1 and 54.5% of depurated oysters were harboring Giardia cysts. The huge majority of contaminated samples were classified as Giardia duodenalis. HAdv was detected in water and o! ysters from growth site and HnoV GI in two batches of oysters ! (site 1) in huge concentrations (2.11 x 10(13), 3.10 x 10(12) gc/g). In depuration tank site, Salmonella sp., HAV (4.84 x 10(3)) and HnoV GII (7.97 x 10(14)) were detected once in different batches of oysters. Cryptosporidium spp. oocysts were present in 9.0% of water samples from site four. These results reflect the contamination of oysters even when UV depuration procedures are employed in this shellfish treatment plant. Moreover, the molecular comprehension of the sources of contamination is necessary to develop an efficient management strategy allied to shellfish treatment improvement to prevent foodborne illnesses. (C) 2011 Elsevier Ltd. All rights reserved.

Toimittajayhteistyön kehittäminen tilausohjautuvassa toimitusketjussa

Tämän tutkimuksen tavoitteena oli tuottaa kehittämiskeinoja toimittajayhteistyöhön tilausohjautuvassa toimitusketjussa. Tutkimuksen empiriaosuudessa on tutkittu Valtran ja sen ohjaamotoimittajan välistä yhteistyötä. Tutkimusta aloitettaessa monella yhteistyön osa-alueella oli ongelmia, jotka näkyivät ohjaamoissa erilaisina laatuvirheinä. Tutkimuksen teoreettisessa osassa esitellään ensin tilausohjautuvuutta ja sen toimittajayhteistyöhön tarjoamia toimintatapoja ja ohjauskeinoja. Tämän jälkeen tutkimuksessa käsitellään toimittajayhteistyön merkitystä tilausohjautuvassa toimitusketjussa ja yritysten välisen yhteistyön eri elementtejä. Tutkimuksen empiriaosuudessa tehtiin ensimmäisenä laatuvirheanalyysi. Virheanalyysin perusteella tunnistettiin ne toiminnan alueet, joissa aiheutui suurin osa virheistä. Tämän analyysin jälkeen tunnistettiin nykyisestä tilausohjautuvasta toimintatavasta tai ohjauskeinoista johtuvat virheet. Viimeiseksi tunnistettiin yritysten välisestä yhteistyöstä aiheutuneet ongelmat. Näiden analyysien perusteella osoittautui, että suurimmat ongelmat yhteistyössä aiheutuivat yhteistyön puutteellisesta organisoinnista, joka puolestaan heikensi yritysten välisen vuorovaikutuksen laatua ja luottamusta. Erityisesti laadun osalta oli nähtävissä yritysten välisen yhte-näisyyden puute niin järjestelmien kuin myös prosessien osalta. Sen sijaan Valtran toimitusketjun ohjauksessa käyttämissä toimittajien ohjaustavoissa ei ollut puuttei- ta läheskään niin paljon kuin tutkimusta aloitettaessa kuviteltiin. Joka tapauksessa ohjauksen merkitys toimittajayhteistyössä on erittäin suuri, vaikka tehdyn virheanalyysin perusteella niiden osuus analysoiduista virheistä ei ollutkaan kovin suuri. Yhteistyön kehityskohteiden löydyttyä viimeisessä vaiheessa muodostettiin kehittämissuosituksia, joista osa jakautui tilausohjautuvan toimintatavan ja ohjauskeinojen kehittämiseen ja osa taas yritysten välisen yhteistyön kehittämiseen esimerkiksi rakenteellisten linkkien avulla. Erilaisilla yhteistyömuodoilla on mahdollista ke-hittää toiminnasta yhtenäisempää rajapintarakenteiden osalta, mikä on puolestaan laadukkaan vuorovaikutuksen ja siten laadukkaan informaation edellytys. Näitä rakenteita kehittämällä toimittajan ohjaamista ja samalla lopputuotteen laatua on mahdollista parantaa.

Facilitating coordination improvement efforts in cross-functional process development programs

Business process improvement is a common approach in increasing the effectiveness of an organization. It can be seen as an effort to increase coordination between units. Process improvement has proved to be challenging, and most management consultation firms facilitate organizations in this kind of initiatives. Cross-functional improvement is one of the main areas for internal consultants as well. However, the needs, challenges and means of cross-functional help have been rarely discussed in the literature. The objective of this thesis is on one hand to present a conceptual and descriptive framework to help understand the challenges of facilitating coordination improvement efforts in cross-functional improvement programs, and on the other hand to develop and test feasible solutions for some facilitation situations. The research questions are: 1. Why and in what kind of situations do organizations need help in developing coordination in cross-functional processes? 2. How can a facilitator help organizations in improving coordination to develop cross-functional processes? The study consists of two parts. The first part is an overview of the dissertation, and the second part comprises six research publications. The theoretical background for the study are the differentiation causing challenges in cross-functional settings, the coordination needed to improve processes, change management principles, methods and tools, and consultation practises. Three of the publications introduce tools for helping in developing prerequisites, planning responsibilities and supporting learning during the cross-functional program. The three other papers present frameworks to help understand and analyse the improvement situation. The main methodological approaches used in this study are design science research, action research and case research. The research data has been collected from ten cases representing different kinds of organizations, processes and developing situations. The data has been collected mainly by observation, semi-structured interviews and questionnaires. The research contributes to the rare literature combining coordination theories and process improvement practises. It also provides additional understanding of a holistic point of view in process improvement situations. The most important contribution is the addition to the theories of facilitating change in process improvement situations. From the managerial point of view, this study gives advice to managers and consultants in planning and executing cross-functional programs. The main factors increasing the need for facilitation are the challenges for differentiation, challenges of organizational change in general, and the novelty of initiatives and improvement practices concerning process development. Organizations need help in creating the prerequisites to change, in planning initiatives, easing conflict management and collaboration between groups, as well as supporting the learning of cross-functional improvement. The main challenges of facilitation are combining the different roles as a consultant, maintaining the ownership for the improvement project with the client, and supporting learning in the client organization.

Calidad de vida y cáncer de próstata: un programa progresivo de fuerza-resistencia = Quality of life and prostate cancer: a progressive resistance strength program

This article presents the design and implementation of a progressive resistance strength program adapted to prostate cancer. The initial model corresponds to the guide of the American College Sports Medicine Position Stand (ACSM, 2009). This program includes the most habitual symptoms related to the illness and its treatments. The study design is quasi-experimental. The sample is 33 subjects in treatment phase. Study variables are tumour classification TNM, anthropometric measures, resistance strength, hypertension, fatigue, incontinence, pain and quality of life. After 24 weeks a significant improvement on resistance strength capacity is observed. This result is more consistent in lower extremities. Also improves hypertension, urinary incontinence, pain and quality of life. As conclusion, the improvement of the quality of life is mediated by the functional and physical capacity of the ill person

Robotic-Assisted Surgery Improves the Quality of Total Mesorectal Excision for Rectal Cancer Compared to Laparoscopy: Results of a Case-Controlled Analysis.

BACKGROUND: The use of a robotic surgical system is claimed to allow precise traction and counter-traction, especially in a narrow pelvis. Whether this translates to improvement of the quality of the resected specimen is not yet clear. The aim of the study was to compare the quality of the TME and the short-term oncological outcome between robotic and laparoscopic rectal cancer resections. METHODS: 20 consecutive robotic TME performed in a single institution for rectal cancer (Rob group) were matched 1:2 to 40 laparoscopic resections (Lap group) for gender, body mass index (BMI), and distance from anal verge on rigid proctoscopy. The quality of TME was assessed by 2 blinded and independent pathologists and reported according to international standardized guidelines. RESULTS: Both samples were well matched for gender, BMI (median 25.9 vs. 24.2 kg/m(2), p = 0.24), and level of the tumor (4.1 vs. 4.8 cm, p = 0.20). The quality of the TME was better in the Robotic group (complete TME: 95 vs. 55 %; p = 0.0003, nearly complete TME 5 vs. 37 %; p = 0.04, incomplete TME 0 vs. 8 %, p = 0.09). A trend for lower positive circumferential margin was observed in the Robotic group (10 vs. 25 %, p = 0.1). CONCLUSIONS: These results suggest that robotic-assisted surgery improves the quality of TME for rectal cancer. Whether this translates to better oncological outcome needs to be further investigated.

Creating dynamic continuous improvement system for Larox Corporation

Today´s organizations must have the ability to react to rapid changes in the market. These rapid changes cause pressure to continuously find new efficient ways to organize work practices. Increased competition requires businesses to become more effective and to pay attention to quality of management and to make people to understand their work's impact on the final result. The fundamentals in continmuois improvement are systematic and agile tackling of indentified individual process constraints and the fact tha nothin finally improves without changes. Successful continuous improvement requires management commitment, education, implementation, measurement, recognition and regeneration. These ingredients form the foundation, both for breakthrough projects and small step ongoing improvement activities. One part of the organization's management system are the quality tools, which provide systematic methodologies for identifying problems, defining their root causes, finding solutions, gathering and sorting of data, supporting decision making and implementing the changes, and many other management tasks. Organizational change management includes processes and tools for managing the people in an organizational level change. These tools include a structured approach, which can be used for effective transition of organizations through change. When combined with the understanding of change management of individuals, these tools provide a framework for managing people in change,

Assessment of hydrochemical quality of ground water under some urban areas within sana'a secreteriat

Groundwater from nine wells of three different districts, located at Sana'a secretariat was analyzed for hydrochemical quality assessment. Measurements of water quality parameters including pH, EC, CO3(2-), HCO3-, Cl-, NO3-, SO4(2-), Ca2+, Mg2+, Fe3+, K+, and Na+ were carried out . Classification of the groundwater samples according to Cl, SO4(2-), CO3(2-) and HCO3-, hardness (H), total dissolved solids (TDS), base-exchange, and meteoric genesis was demonstrated. Suitability of ground water samples for irrigation and industrial uses according to sodium adsorption ration (SAR), ratio of dissolved sodium (RDS), residual sodium carbonate (RSC) and saturation index (SI) was also investigated. The results of this study showed that almost all ground water samples were of good quality that makes them suitable for drinking and domestic uses. Results also indicated that even though some of the ground water samples were suitable for irrigation purposes, almost all of them were found not be good for industrial uses. Despite all drawbacks of the sewerage system built around Sana'a secretariat at the beginning of the first decade of the third millennium, the results of this study indicate that there is scope of significant improvement in Sana'a secretariat ground water quality.

Improvement of Surface Strength of Paper

Offset printing is a popular printing method that is especially suitable for large and fast print jobs. Newspapers, magazines and books are typical examples of products printed with offset method. In high volume printing production high efficiency is essential. Offset printing uses tacky inks that cause serious stress to the paper surface. Dusting and linting are terms that describe how loose and weakly bonded particles are removed from the paper surface in the printing process. The removed particles accumulate in the process causing deteriorating print quality. This forces the printing operators to stop production for washing and cleaning. Time and money are lost. Dusting and linting tendency of paper can be decreased by improving the surface strength of paper. In the present work a method to increase the surface strength of paper was studied. In the literature part offset printing method and challenges related to offset printing are presented. A review of new methods for surface sizing of paper is also presented. The experimental part presents trials where an apparatus for improving paper surface strength was tested and developed in mill scale. Laboratory work supporting the actual mill scale operations is also presented. The acquired results provide a solid base of information to make decisions on how to proceed with research in the present field of study.

Process approach in quality management - Case: ECO process development in EMS industry

The aim of the thesis was to study quality management with process approach and to find out how to utilize process management to improve quality. The operating environment of organizations has changed. Organizations are focusing on their core competences and networking with suppliers and customers to ensure more effective and efficient value creation for the end customer. Quality management is moving from inspection of the output to prevention of problems from occurring in the first place and management thinking is changing from functional approach to process approach. In the theoretical part of the thesis, it is studied how to define quality, how to achieve good quality, how to improve quality, and how to make sure the improvement goes on as never ending cycle. A selection of quality tools is introduced. Process approach to quality management is described and compared to functional approach, which is the traditional way to manage operations and quality. The customer focus is also studied, and it is presented, that to ensure long term customer commitment, organization needs to react to changing customer requirements and wishes by constantly improving the processes. In the experimental part the theories are tested in a process improvement business case. It is shown how to execute a process improvement project starting from defining the customer requirements, continuing to defining the process ownership, roles and responsibilities, boundaries, interfaces and the actual process activities. The control points and measures are determined for the process, as well as the feedback and corrective action process, to ensure continual improvement can be achieved and to enable verification that customer requirements are fulfilled.