Effectiveness of an illustrated home exercise guide on promoting urinary continence during pregnancy: a pragmatic randomized clinical trial

OBJETIVO: Avaliar a efetividade de um manual de orientação de exercícios domiciliares (MOED) para o assoalho pélvico (AP) na promoção da continência urinária em gestantes primigestas.MÉTODOS: Ensaio clínico com 87 participantes, avaliadas 6 vezes durante a gestação e divididas aleatoriamente em 3 grupos: Grupo supervisionado (Gsup), que praticou exercícios com supervisão; Grupo observado (Gobs), que praticou exercícios sem supervisão, e Grupo referência (Gref), que não praticou exercícios. Incontinência urinária (IU) (desfecho primário) e força muscular perineal (FMP) (desfecho secundário) foram avaliadas por intermédio de diário de perdas urinárias e perineometria, respectivamente. Foram utilizados o teste de Kruskal-Wallis, seguido do teste post hoc de Dunn, para variáveis contínuas, e o teste do χ2 e testes Z, com correções de Bonferroni, para proporções, com nível de significância de 5%.RESULTADOS: O Gsup e o Gobs apresentaram 6,9% de gestantes incontinentes, enquanto o Gref apresentou 96,6% de incontinentes. Quanto à FMP, o Gsup e o Gobs apresentaram valores médios de contração de 10 e 8,9 cmH2O, respectivamente, enquanto o Gref apresentou valor de 4,7 cmH2O. Ambos os resultados significantes.CONCLUSÃO: A utilização de um MOED é eficaz na promoção da continência urinária e no aumento da FMP em gestantes primigestas, independentemente de supervisão permanente.

Towards Inter-organizational Working Capital Management

Working capital is an investment which is tied up into the inventories and accounts receivable and which is released with accounts payable. Due to the current business landscape with tightened financial conditions and finance markets, organizations emphasize efficient working capital management. With efficient working capital management, a company can reduce the need of finance, free up cash, increase profitability, improve liquidity, increase the efficiency of operations, and decrease (financing) costs. From the perspective of an individual company, efficient working capital management means decreasing inventory levels by shortening the cycle time of inventories, decreasing accounts receivable by shortening the trade credit terms and effective collection procedures, and increasing the level of accounts payable by paying the suppliers later. From an inter-organizational perspective, however, working capital should not be sub-optimized by a single company but holistic view to working capital management through the supply chain should be adopted to create value and improve performance together. The purpose of this research is to take academic research as well as practical management towards inter-organizational working capital management. The thesis discusses the benefits as well as mechanisms of working capital management in the inter-organizational context and has two main objectives: (1) to examine the effect of inter-organizational working capital management on performance in the value chain context and (2) to develop models of working capital management for internal as well as inter-organizational value chains. The results of the archival research conducted in the value chain of the pulp and paper industry and the value chain of the automotive industry indicate that companies can increase relative profitability by managing working capital comprehensively by taking into account all three components, and holistically though the value chain. Companies in the value chain benefit from different strategies in working capital management depending on the position of the company in the value chain. This can be taken into account in inter-organizational working capital management. The effects of inter-organizational working capital management actions on the financing costs of working capital were studied via simulations. Simulations also show that the value chain and individual companies benefit from an inter-organizational view to working capital management. Inter-organizational working capital management actions include for example: shortening the cycle time of inventories, reducing product costs, shifting inventories, shortening payment terms, and considering the cost of capital. The thesis also provides solutions for the practical requirements for tools to control working capital. The design science part of the research introduces the adjusted cash conversion cycle (ACCC) model for internal value chains, as well as models for working capital management in the inter-organizational value chain context: the working capital management model (WCMM) and the financial cycle time model (FCTM) designed in corporation and product levels respectively. This research contributes to literature on working capital management and interorganizational accounting. The research gives a holistic, inter-organizational view to the management of working capital. It advances the knowledge in working capital management on operational level, increases knowledge in the recently risen theme of supply chainoriented, collaborative working capital management, combines management accounting research with supply chain management research, and contributes to the demand of practical inter-organizational accounting methods. In addition, the research has strong practical focus as new managerial methods are introduced.

The role of customer perspective in organizational renewal. A comparative case study of knowledge-intensive business services.

The objective of this thesis was to study organizational renewal from the customer orientation perspective. Customer orientation is divided into customer relationship management and customer knowledge, which both are important components of customer related organizational renewal capabilities. The study was conducted in knowledge intensive business service firms, which are required to renew their strategy, operations and processes constantly in order to gain and sustain competitive advantage. In the empirical research, two companies were studied, both offering services to their customers. The analysis was done in two phases; first each case was analyzed individually and then the cases were compared in a cross-case analysis. The most important finding was that customer orientation is considered important but it is not being utilized for organizational renewal in full capacity.

Cost-effectiveness analysis in South Karelia Central Hospital

The target organization of this study, otherwise South-Karelia Social and Health Care District (Eksote) provides health, senior, family and social welfare services. South Karelia Central Hospital provides special health care and offers health services from all of the most important medical specialties. Eksote has in use 15D instrument to measure the health-related quality of life (HRQoL) of their patients before and after their interventions for observing the health effects of the medical care. Furthermore, 15D allows measuring the effectiveness and cost-effectiveness of health care when comparing these before and after results of the 15D measurements and adding the costs of the interventions into this research. The main purposes of this study were to analyze the effectiveness and cost-effectiveness of medical care in South Karelia Central Hospital by using the gathered 15D data to calculate effectiveness and cost-effectiveness ratios and to analyze the reliability and availability of the data. Study has been conducted using literature review and quantitative research methods. The results indicate that from the patients within the eight units selected to this study the 15D change information was available from the 52 %, the 15D change and the cost information from 38 % and the information of quality-adjusted life years (QALYs) produced and the cost information from 35 %. The effectiveness and cost-effectiveness of medical care were greatest at the units of Pain Outpatient Clinic and Rheumatic Diseases Outpatient Clinic. The most effective medical care is given in the unit where the average price of one produced QALY is the highest (Orthopedics). However, the calculated standard deviations pointed out that there are great variances in the effectiveness and cost-effectiveness within the units also.

Knowledge, processes and relationships in organizational change: Understanding how to facilitate management of intellectual capital in diverse organization structures and cultures.

This study examined relationships of organizational dependencies, change management and developed intellectual knowledge resources, in different intellectual capital based development programs on ICT-sector. Study was carried out in a research context, where high degree of external organizational contingencies existed and lots of changes in several development programs had taken place in the last years. From a scientific perspective the main contribution was that evidence between relationships of organizational dependencies, change model portfolio and developed knowledge resources could be suggested. From managerial perspective the primary implication was that in situations where sustainable competitive advantage is pursued by means of increasing knowledge based productivity of labor, firms should seek to pursue organizational settings where external dependencies have minimal amount of effect.

Building organizational creativity – a multitheory and multilevel approach for understanding and stimulating organizational creativity

Organizational creativity is increasingly important for organizations aiming to survive and thrive in complex and unexpectedly changing environments. It is precondition of innovation and a driver of an organization’s performance success. Whereas innovation research increasingly promotes high-involvement and participatory innovation, the models of organizational creativity are still mainly based on an individual-creativity view. Likewise, the definitions of organizational creativity and innovation are somewhat equal, and they are used as interchangeable constructs, while on the other hand they are seen as different constructs. Creativity is seen as generation of novel and useful ideas, whereas innovation is seen as the implementation of these ideas. The research streams of innovation and organizational creativity seem to be advancing somewhat separately, although together they could provide many synergy advantages. Thereby, this study addresses three main research gaps. First, as the knowledge and knowing is being increasingly expertized and distributed in organizations, the conceptualization of organizational creativity needs to face that perspective, rather than relying on the individual-creativity view. Thus, the conceptualization of organizational creativity needs clarification, especially as an organizational-level phenomenon (i.e., creativity by an organization). Second, approaches to consciously build organizational creativity to increase the capacity of an organization to demonstrate novelty in its knowledgeable actions are rare. The current creativity techniques are mainly based on individual-creativity views, and they mainly focus on the occasional problem-solving cases among a limited number of individuals, whereas, the development of collective creativity and creativity by the organization lacks approaches. Third, in terms of organizational creativity as a collective phenomenon, the engagement, contributions, and participation of organizational members into activities of common meaning creation are more important than the individualcreativity skills. Therefore, the development approaches to foster creativity as social, emerging, embodied, and collective creativity are needed to complement the current creativity techniques. To address these gaps, the study takes a multiparadigm perspective to face the following three objectives. The first objective of this study is to clarify and extend the conceptualization of organizational creativity. The second is to study the development of organizational creativity. The third is to explore how an improvisational theater based approach fosters organizational creativity. The study consists of two parts comprising the introductory part (part I) and six publications (part II). Each publication addresses the research questions of the thesis through detailed subquestions. The study makes three main contributions to the research of organizational creativity. First, it contributes toward the conceptualization of organizational creativity by extending the current view of organizational creativity. This study views organizational creativity as a multilevel construct constituting both of individual and collective (group and organizational) creativity. In contrast to current views of organizational creativity, this study bases on organizational (collective) knowledge that is based on and demonstrated through the knowledgeable actions of an organization as a whole. The study defines organizational creativity as an overall ability of an organization to demonstrate novelty in its knowledgeable actions (through what it does and how it does what it does).Second, this study contributes toward the development of organizational creativity as multi-level phenomena, introducing developmental approaches that face two or more of these levels simultaneously. More specifically, the study presents the cross-level approaches to building organizational creativity, by using an approach based in improvisational theater and considering assessment of organizational renewal capability. Third, the study contributes on development of organizational creativity using an improvisational theater based approach as twofold meaning. First, it fosters individual and collective creativity simultaneously and builds space for creativity to occur. Second, it models collective and distributed creativity processes, thereby, contributing to the conceptualization of organizational creativity.

Overview on the Cost-effectiveness of Maritime Safety Policy Instruments

Maritime safety is an issue that has gained a lot of attention in the Baltic Sea area due to the dense maritime traffic and transportation of oil in the area. Lots of effort has been paid to enhance maritime safety in the area. The risk exists that excessive legislation and other requirements mean more costs for limited benefit. In order to utilize both public and private resources efficiently, awareness is required of what kind of costs maritime safety policy instruments cause and whether the costs are in relation to benefits. The aim of this report is to present an overview of the cost-effectiveness of maritime safety policy instruments focusing on the cost aspect: what kind of costs maritime safety policy causes, to whom, what affects the cost-effectiveness and how cost-effectiveness is studied. The study is based on a literature review and on the interviews of Finnish maritime experts. The results of this study imply that cost-effectiveness is a complicated issue to evaluate. There are no uniform practices for which costs and benefits should be included in the evaluation and how they should be valued. One of the challenges is how to measure costs and benefits during the course of a longer time period. Often a lack of data erodes the reliability of evaluation. In the prevention of maritime accidents, costs typically include investments in ship structures or equipment, as well as maintenance and labor costs. Also large investments may be justifiable if they respectively provide significant improvements to maritime safety. Measures are cost-effective only if they are implemented properly. Costeffectiveness is decreased if a measure causes overlapping or repetitious work. Costeffectiveness is also decreased if the technology isn’t user-friendly or if it is soon replaced with a new technology or another new appliance. In future studies on the cost-effectiveness of maritime safety policy, it is important to acknowledge the dependency between different policy instruments and the uncertainty of the factors affecting cost-effectiveness. The costs of a single measure are rarely relatively significant and the effect of each measure on safety tends to be positive. The challenge is to rank the measures and to find the most effective combination of different policy instruments. The greatest potential offered for the analysis of cost-effectiveness of individual measures is their implementation in clearly defined risk situations, in which different measures are truly alternative to each other. Overall, maritime safety measures do not seem to be considered burdening for the shipping industry in Finland at the moment. Generally actors in the Finnish shipping industry seem to find maintaining a high safety level important and act accordingly.

Tiedonhallinta verkostoituneessa logistiikkaketjussa – Case: VR-Yhtymä

Tiedon tehokas jakaminen ja tiedon hallinta näyttelee tärkeätä roolia yritysten kannattavuuden ja tehokkuuden kehittämisessä. Laadukkaan tiedon tehokas jakaminen ja omaksuminen korostuvat verkostoituneessa logistiikkaketjussa ja kolmannen osapuolen logistiikkaa harjoittavissa yrityksissä. Tehokkaalla tiedon jakamisella, tietämyksen hallinnalla sekä tietojohtamisen keinoilla voidaan luoda tehokkaita ja kilpailukykyisiä businessprosesseja. Työn tuloksena saavutettiin kuvaus tietojohtamisen eri näkökulmista sekä tietojohtamisesta tiedon hallinnan työkaluna. Työn teoreettisessa osuudessa käsitellään tietoa ja sen eri tasoja sekä perspektiivejä tietojohtamisessa käytettyinä syötteinä, sen prosesseina sekä lopputuloksena, joita tietojohtamisen käsitteen alla olevilla työkaluilla ja käytännöillä toteutetaan. Aiempi tutkimus osoittaa, että tietojohtaminen on yksi johtamisen malli, jonka avulla voidaan saavuttaa tehokkaan yritystoiminnan edellytykset sekä asetetut strategiset tavoit- teet. Kirjallisuuden perusteella pyrittiin kartoittamaan verkostoituneen logistiikkaketjun tiedonhallinnan esteet ja sitä rajoittavat tekijät. Työn empiirinen osuus toteutettiin kvalitatiivisena kysely- sekä haastattelututkimuksena, jonka avulla kerättiin työssä käytetty tutkimusaineisto. Työn empiirisessä osuudessa kartoitettiin kohdeorganisaation tiedonhallintaprosesseja sen kuljetustuotannon toiminnoissa, sekä niiden toteuttamista vaikeuttavia ja hidastavia tekijöitä. Empiirisen aineiston perusteella yritykselle ehdotettiin organisaation muokkaamista enemmän tiedon jakamista tu- kevaan suuntaan, joka voidaan teoriatiedon perusteella toteuttaa esimerkiksi luomalla fyysisiä ja henkisiä tiloja tietoprosessien toteuttamiselle.

The Relationship of Organizational Culture, Employee Motivation and Innovativeness: Evidence from Finnish Technology Industries

The purpose of this thesis is to analyze the effects of tangible and intangible incentives on the dimensions of motivation and organizational innovativeness in the context of different organizational cultures. Theory suggests that an antecedent of innovativeness is individual creativity of employees, which is influenced by intrinsic motivation, flexible organizational structures, and transformational leadership. Empirical evidence for this research is derived from 424 respondents representing technology-driven industries in Finland. Data is collected through an online questionnaire and analyzed using SPSS statistics software. The results imply that intangible incentives and intrinsic motivation have an important role in determining organizational innovativeness. The positive relationships of intangible incentives, intrinsic motivation and innovativeness seem to be higher in flexible organizational cultures. As practical implications, managers should foster flexible organizational cultures that highlight employee empowerment. The motivating power of non-financial intrinsic incentives and recognition of good work should not be undermined when compared to tangible monetary rewards.

Glyphosate Effectiveness in the Control of Macrophytes Under a Greenhouse Condition

The aim of this study was to assess the effectiveness of glyphosate, as Rodeo(r) formulation, to control Eichhornia crassipes, Pistia stratiotes, Salvinia molesta, Salvinia herzogii and Urochloa subquadripara, under greenhouse conditions. The doses assessed were (480, 960, 1440, 1920, 2400, 2880, 3360 and 3840 g ha-1 of glyphosate) with 0.5% of the Aterbane(r) BR surfactant and a control, with no herbicide application. All experiments were conducted in a completely randomized experimental design with ten replications. Applications were carried out by precision backpack sprayer at a CO2 constant pressure of 25 psi and spray solution consumption of 200 L ha-1. Product effectiveness was determined by assessing the growth inhibitions and phytotoxicity signals during the periods of 3, 7, 15, 21, 30 and 45 days after application (DAA). At 45 DAA, the highest glyphosate dose (3840 g ha-1) displayed 100% effectiveness for all four macrophyte species. Under greenhouse conditions, the glyphosate in formulation Rodeo(r) with 0.5% of Aterbarne(r) BR surfactant showed excellent effectiveness, inhibiting the growth of the floating aquatic macrophytes. This procedure can be included on the tillage plans for these species.

Managing Change: An Organizational Outline for Reimagining the Digital Repository Infrastructure at The Ohio State University Libraries

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014