Toiminnan laadun parantaminen organisaation itsearvioinnilla – tutkimus Suomen puolustusvoimien tulosyksiköissä

Laajoilla kyselylomaketutkimuksilla on tutkittu organisaation itsearvioinnin käyttöönoton motiiveja, käyttöä ja käytön hyötyjä 1990-luvulla ja 2000-luvun alussa. Organisaation itsearviointia on myös tutkittu laatupalkintomallien soveltamisen yhteydessä. Kolmas tutkimussuuntaus, johon myös tämä tutkimus sisältyy, on organisaation itsearvioinnin tutkiminen erilaisissa asiayhteyksissä. Tämän tutkimuksen tarkoituksena on lisätä tietoa ja ymmärrystä organisaation itsearvioinnista ja sen vaikuttavuudesta tutkimalla, miten organisaatiota itsearvioidaan maavoimien valmiusyhtymissä ja Maasotakoulussa. Näissä neljässä paikallistutkimuksessa käytin tutkimusotteena tapaustutkimuksen mukaista tutkimusstrategiaa. Aiempien tutkimuksien tulosten perusteella tärkein yhdistävä tekijä toiminnan parantamisessa on pyrkimys kokonaisvaltaisuuteen toiminnan laadun parantamisessa ja erinomaisuuden tavoittelussa. Osin kokonaisvaltaisuuteen sisältyviä ja sitä tukevia tekijöitä ovat jatkuvan parantamisen periaatteen käyttäminen ja oppivan organisaation edellyttämien toimintaedellytyksien luominen ja niiden huomioon ottaminen toiminnassa. Edelleen yhteisenä tekijänä ovat johdon sitoutumisen ja osallistumisen vaikutukset työntekijöiden osallistumiseen ja sitoutumiseen. Teorian perusteella olen arvioinut muodostuvan kolme organisaation itsearvioinnin strategisen tason johtamiskäytäntöä, jotka ovat ”Laatupalkinnon hakeminen”, ”Toiminnan ja tulosten arviointi” sekä ”Toiminnan kypsyyden arviointi”. Tutkimuksen tulosten perusteella organisaation itsearvioinnin vaikuttavuuden merkityskokonaisuus on selitettävissä viiden teeman avulla. Koko tutkimusaineiston yhdistäväksi vaikuttavuuden teemaksi, josta myös organisaation itsearvioinnin vaiheistus saa tukea, muodostuu teema ”organisaation itsearviointi ja tulosjohtaminen”. Tämän teeman perusteella organisaation itsearvioinnin vaikuttavuus perustuu itsearvioinnin käyttämiseen sekä tulosyksikön sisäisenä että johdon strategisen tason itsearviointina osana tulosjohtamista. Samoin teema ”ollaanko samaa perhettä” löytyy jokaisesta tutkimuskohteena olleesta tulosyksiköstä. Teeman perusteella vaikuttavuus perustuu siihen, että organisaation itsearvioinnin tilaisuus koetaan sosiaalisena tapahtumana ja organisaation itsearviointi vahvistaa työntekijöiden osallistumista ja sitoutumista toiminnan laadun parantamiseen. Vaikuttavuuden teemoissa ”poistetaan kivi kengästä, ja hiertäminen loppuu siihen”, ”strateginen valinta” ja ”henkilöstön työhyvinvoinnin edistäminen” organisaation itsearvioinnin vaikuttavuus on tulosyksikkökohtainen. Organisaation itsearvioinnista haetaan vaikuttavuutta organisaation itsearvioinnista saatavien tulosten nopealla toimeenpanolla. Vaikuttavuuteen pyritään systemaattisella eri organisaation tasoilla tehtävillä toiminnan kuvauksilla, mihin liittyy laatupalkinnon hakeminen. Vaikuttavuuteen voidaan myös päästä työpistelähtöisesti henkilöstön johtamisen ja hallinnon kautta. Vaiheistettua organisaation itsearviointia voidaan käyttää osana tulosjohtamista. Muita keskeisiä tutkimustuloksia ovat organisaation itsearvioinnin välittömät ja välilliset vaikutukset. Tutkimuksen tulosten perusteella teen suositukset organisaation itsearvioinnin johtamiskäytännöistä ja organisaation itsearvioinnin vaiheistuksesta osana tulosyksikön tulosjohtamista. Kolmas suositus käsittää organisaation itsearvioinnin käytön palautejärjestelmänä.

Study of criteria influencing the success rate of DNA swabs in operational conditions: a contribution to an evidence-based approach to crime scene investigation and triage

DNA is nowadays swabbed routinely to investigate serious and volume crimes, but research remains scarce when it comes to determining the criteria that may impact the success rate of DNA swabs taken on different surfaces and situations. To investigate these criteria in fully operational conditions, DNA analysis results of 4772 swabs taken by the forensic unit of a police department in Western Switzerland over a 2.5-year period (2012-2014) in volume crime cases were considered. A representative and random sample of 1236 swab analyses was extensively examined and codified, describing several criteria such as whether the swabbing was performed at the scene or in the lab, the zone of the scene where it was performed, the kind of object or surface that was swabbed, whether the target specimen was a touch surface or a biological fluid, and whether the swab targeted a single surface or combined different surfaces. The impact of each criterion and of their combination was assessed in regard to the success rate of DNA analysis, measured through the quality of the resulting profile, and whether the profile resulted in a hit in the national database or not. Results show that some situations - such as swabs taken on door and window handles for instance - have a higher success rate than average swabs. Conversely, other situations lead to a marked decrease in the success rate, which should discourage further analyses of such swabs. Results also confirm that targeting a DNA swab on a single surface is preferable to swabbing different surfaces with the intent to aggregate cells deposited by the offender. Such results assist in predicting the chance that the analysis of a swab taken in a given situation will lead to a positive result. The study could therefore inform an evidence-based approach to decision-making at the crime scene (what to swab or not) and at the triage step (what to analyse or not), contributing thus to save resource and increase the efficiency of forensic science efforts.

Direct tumor recognition by a human CD4(+) T-cell subset potently mediates tumor growth inhibition and orchestrates anti-tumor immune responses.

Tumor antigen-specific CD4(+) T cells generally orchestrate and regulate immune cells to provide immune surveillance against malignancy. However, activation of antigen-specific CD4(+) T cells is restricted at local tumor sites where antigen-presenting cells (APCs) are frequently dysfunctional, which can cause rapid exhaustion of anti-tumor immune responses. Herein, we characterize anti-tumor effects of a unique human CD4(+) helper T-cell subset that directly recognizes the cytoplasmic tumor antigen, NY-ESO-1, presented by MHC class II on cancer cells. Upon direct recognition of cancer cells, tumor-recognizing CD4(+) T cells (TR-CD4) potently induced IFN-γ-dependent growth arrest in cancer cells. In addition, direct recognition of cancer cells triggers TR-CD4 to provide help to NY-ESO-1-specific CD8(+) T cells by enhancing cytotoxic activity, and improving viability and proliferation in the absence of APCs. Notably, the TR-CD4 either alone or in collaboration with CD8(+) T cells significantly inhibited tumor growth in vivo in a xenograft model. Finally, retroviral gene-engineering with T cell receptor (TCR) derived from TR-CD4 produced large numbers of functional TR-CD4. These observations provide mechanistic insights into the role of TR-CD4 in tumor immunity, and suggest that approaches to utilize TR-CD4 will augment anti-tumor immune responses for durable therapeutic efficacy in cancer patients.

Operational Reliability Analysis of a Three-Tiered Thin-Client ERP-system in an International Corporate Environment

Internationalization and the following rapid growth have created the need to concentrate the IT systems of many small-to-medium-sized production companies. Enterprise Resource Planning systems are a common solution for such companies. Deployment of these ERP systems consists of many steps, one of which is the implementation of the same shared system at all international subsidiaries. This is also one of the most important steps in the internationalization strategy of the company from the IT point of view. The mechanical process of creating the required connections for the off-shore sites is the easiest and most well-documented step along the way, but the actual value of the system, once operational, is perceived in its operational reliability. The operational reliability of an ERP system is a combination of many factors. These factors vary from hardware- and connectivity-related issues to administrative tasks and communication between decentralized administrative units and sites. To accurately analyze the operational reliability of such system, one must take into consideration the full functionality of the system. This includes not only the mechanical and systematic processes but also the users and their administration. All operational reliability in an international environment relies heavily on hardware and telecommunication adequacy so it is imperative to have resources dimensioned with regard to planned usage. Still with poorly maintained communication/administration schemes no amount of bandwidth or memory will be enough to maintain a productive level of reliability. This thesis work analyzes the implementation of a shared ERP system to an international subsidiary of a Finnish production company. The system is Microsoft Dynamics Ax, currently being introduced to a Slovakian facility, a subsidiary of Peikko Finland Oy. The primary task is to create a feasible base of analysis against which the operational reliability of the system can be evaluated precisely. With a solid analysis the aim is to give recommendations on how future implementations are to be managed.

Judicialisation and Direct Democracy. Switzerland's Ban on Minaret Construction

Launched by representatives from the Union démocratique du centre (UDC) with the aim of circumventing political and judicial decisions made at both local and national levels, the 2009 federal popular initiative calling for a ban on the construction of minarets rekindled the stigmatisation of Muslims living in Switzerland. Within the prevalent institutional configuration it moreover revived controversies surrounding issues such as direct democracy versus fundamental rights, or "the will of the people" versus "the power of the judges", whether national or international. "Judicialisation" is a polysemous concept. It is not understood here as the transfer to the courts of matters of political significance - in this instance the public regulation of religion - but as a process of juridification (or juridicalisation) in which court rulings were constantly anticipated in the political debate provoked by the popular initiative.

Improvement of Operational Efficiency effectiveness (OEE) using Six Sigma DMAIC Methodology — Case Bottomer line AD2378

Overall Equipment Effectiveness (OEE) is the key metric of operational excellence. OEE monitors the actual performance of equipment relative to its performance capabilities under optimal manufacturing conditions. It looks at the entire manufacturing environment measuring, in addition to the equipment availability, the production efficiency while the equipment is available to run products, as well as the efficiency loss that results from scrap, rework, and yield losses. The analysis of the OEE provides improvement opportunities for the operation. One of the tools used for OEE improvement is Six Sigma DMAIC methodology which is a set of practices originally developed to improve processes by eliminating defects. It asserts the continuous efforts to reduce variation in process outputs as key to business success, as well as the possibility of measurement, analysis, improvement and control of manufacturing and business processes. In the case of the Bottomer line AD2378 in Papsac Maghreb Casablanca plant, the OEE figures reached 48.65 %, which is below the accepted OEE group performance. This required immediate actions to achieve OEE improvement. This Master thesis focuses on the application of Six Sigma DMAIC methodology in the OEE improvement on the Bottomer Line AD2378 in Papsac Maghreb Casablanca plant. First, the Six Sigma DMAIC and OEE usage in operation measurement will be discussed. Afterwards, the different DMAIC phases will allow the identification of improvement focus, the identification of OEE low performance causes and the design of improvement solutions. These will be implemented to allow further tracking of improvement impact on the plant operations.

L'utilisation des anticoagulants oraux directs chez les patients âgés : les limites de la médecine fondée sur les preuves [The use of the new direct oral anticoagulants among older subjects: The limits of the evidence-based medicine?].

The growing use of direct oral anticoagulants, in particular among older subjects, raises questions about the limits of the evidence-based medicine. The phase III studies that have validated the efficacy and the safety profile of these molecules (dabigatran, rivaroxaban, apixaban, edoxaban) in their both indications, the venous thromboembolic disease and the non-valvular atrial fibrillation raise concerns in four major fields: the financial support of pharmaceutical companies, the links of interest for many authors with the industry, the study design (exclusively non-inferiority studies), and the poor representativeness of the older subjects included. All these points are discussed, using data of sub-groups studies, post-marketing studies and recent meta-analysis. The lack of data for the very old subjects, with frailty or comorbidities, remains the main concern from these phase III studies.

The transatlantic business community faced with US direct investment in Western Europe, 1958-1968

This article examines the position of US and European business in the debate about American direct investment in Western Europe in a historical perspective, from the establishment of the Common Market to the introduction of US regulation of foreign direct investment (FDI) a decade later. Based on abundant and diverse archival documents, it sheds new light on the process of Americanisation and contributes to existing research on transnational networks, by revealing the active role industrial leaders on both sides of the Atlantic played in shaping the political responses to problems raised by the American firms' massive presence in the Common Market.

Operational sex ratio, sexual conflict and the intensity of sexual selection.

Modern sexual selection theory indicates that reproductive costs rather than the operational sex ratio predict the intensity of sexual selection. We investigated sexual selection in the polygynandrous common lizard Lacerta vivipara. This species shows male aggression, causing high mating costs for females when adult sex ratios (ASR) are male-biased. We manipulated ASR in 12 experimental populations and quantified the intensity of sexual selection based on the relationship between reproductive success and body size. In sharp contrast to classical sexual selection theory predictions, positive directional sexual selection on male size was stronger and positive directional selection on female size weaker in female-biased populations than in male-biased populations. Thus, consistent with modern theory, directional sexual selection on male size was weaker in populations with higher female mating costs. This suggests that the costs of breeding, but not the operational sex ratio, correctly predicted the strength of sexual selection.

Transcranial Direct Current Stimulation for the Treatment of Chronic Tinnitus: A Randomized Controlled Study.

BACKGROUND: Tinnitus is an often disabling condition for which there is no effective therapy. Current research suggests that tinnitus may develop due to maladaptive plastic changes and altered activity in the auditory and prefrontal cortex. Transcranial direct current stimulation (tDCS) modulates brain activity and has been shown to transiently suppress tinnitus in trials. OBJECTIVE: To investigate the efficacy and safety of tDCS in the treatment of chronic subjective tinnitus. METHODS: In a randomized, parallel, double-blind, sham-controlled study, the efficacy and safety of cathodal tDCS to the auditory cortex with anode over the prefrontal cortex was investigated in five sessions over five consecutive days. Tinnitus was assessed after the last session on day 5, and at follow-up visits 1 and 3 months post stimulation using the Tinnitus Handicap Inventory (THI, primary outcome measure), Subjective Tinnitus Severity Scale, Hospital Anxiety and Depression scale, Visual Analogue Scale, and Clinical Global Impression scale. RESULTS: 42 patients were investigated, 21 received tDCS and 21 sham stimulation. There were no beneficial effects of tDCS on tinnitus as assessed by primary and secondary outcome measures. Effect size assessed with Cohen's d amounted to 0.08 (95% CI: -0.52 to 0.69) at 1 month and 0.18 (95% CI: -0.43 to 0.78) at 3 months for the THI. CONCLUSION: tDCS of the auditory and prefrontal cortices is safe, but does not improve tinnitus. Different tDCS protocols might be beneficial.

Direct Interrogation of Viral Peptides Presented by the Class I HLA of HIV-Infected T Cells

Identification of CD8+ cytotoxic T lymphocyte (CTL) epitopes has traditionally relied upon testing of overlapping peptide libraries for their reactivity with T cells in vitro. Here, we pursued deep ligand sequencing (DLS) as an alternative method of directly identifying those ligands that are epitopes presented to CTLs by the class I human leukocyte antigens (HLA) of infected cells. Soluble class I HLA-A*11:01 (sHLA) was gathered from HIV-1 NL4-3-infected human CD4+ SUP-T1 cells. HLA-A*11:01 harvested from infected cells was immunoaffinity purified and acid boiled to release heavy and light chains from peptide ligands that were then recovered by size-exclusion filtration. The ligands were first fractionated by high-pH high-pressure liquid chromatography and then subjected to separation by nano-liquid chromatography (nano-LC)–mass spectrometry (MS) at low pH. Approximately 10 million ions were selected for sequencing by tandem mass spectrometry (MS/MS). HLA-A*11:01 ligand sequences were determined with PEAKS software and confirmed by comparison to spectra generated from synthetic peptides. DLS identified 42 viral ligands presented by HLA-A*11:01, and 37 of these were previously undetected. These data demonstrate that (i) HIV-1 Gag and Nef are extensively sampled, (ii) ligand length variants are prevalent, particularly within Gag and Nef hot spots where ligand sequences overlap, (iii) noncanonical ligands are T cell reactive, and (iv) HIV-1 ligands are derived from de novo synthesis rather than endocytic sampling. Next-generation immunotherapies must factor these nascent HIV-1 ligand length variants and the finding that CTL-reactive epitopes may be absent during infection of CD4+ T cells into strategies designed to enhance T cell immunity.