Kohti leikkaussalin tuloksellista toiminnanohjausta

Background: The aging population is placing increasing demands on surgical services, simultaneously with a decreasing supply of professional labor and a worsening economic situation. Under growing financial constraints, successful operating room management will be one of the key issues in the struggle for technical efficiency. This study focused on several issues affecting operating room efficiency. Materials and methods: The current formal operating room management in Finland and the use of performance metrics and information systems used to support this management were explored using a postal survey. We also studied the feasibility of a wireless patient tracking system as a tool for managing the process. The reliability of the system as well as the accuracy and precision of its automatically recorded time stamps were analyzed. The benefits of a separate anesthesia induction room in a prospective setting were compared with the traditional way of working, where anesthesia is induced in the operating room. Using computer simulation, several models of parallel processing for the operating room were compared with the traditional model with respect to cost-efficiency. Moreover, international differences in operating room times for two common procedures, laparoscopic cholecystectomy and open lung lobectomy, were investigated. Results: The managerial structure of Finnish operating units was not clearly defined. Operating room management information systems were found to be out-of-date, offering little support to online evaluation of the care process. Only about half of the information systems provided information in real time. Operating room performance was most often measured by the number of procedures in a time unit, operating room utilization, and turnover time. The wireless patient tracking system was found to be feasible for hospital use. Automatic documentation of the system facilitated patient flow management by increasing process transparency via more available and accurate data, while lessening work for staff. Any parallel work flow model was more cost-efficient than the traditional way of performing anesthesia induction in the operating room. Mean operating times for two common procedures differed by 50% among eight hospitals in different countries. Conclusions: The structure of daily operative management of an operating room warrants redefinition. Performance measures as well as information systems require updating. Parallel work flows are more cost-efficient than the traditional induction-in-room model.

A 100MHz to 1GHz, 0.35V to 1.5V supply 256 x 64 SRAM mock using symmetrized 9T SRAM cell with controlled read

In this paper, we present Dynamic Voltage and Frequency Managed 256 x 64 SRAM block in 65nm technology, for frequency ranging from 100MHz to 1GHz. The total energy is minimized for any operating frequency in the above range and leakage energy is minimized during standby mode. Since noise margin of SRAM cell deteriorates at low voltages, we propose Static Noise Margin improvement circuitry, which symmetrizes the SRAM cell by controlling the body bias of pull down NMOS transistor. We used a 9T SRAM cell that isolates Read and Hold Noise Margin and has less leakage. We have implemented an efficient technique of pushing address decoder into zigzag-super-cut-off in stand-by mode without affecting its performance in active mode of operation. The Read Bit Line (RBL) voltage drop is controlled and pre-charge of bit lines is done only when needed for reducing power wastage.

A Bayesian incentive compatible mechanism for decentralized supply chain formation

In this paper we consider a decentralized supply chain formation problem for linear multi-echelon supply chains when the managers of the individual echelons are autonomous, rational, and intelligent. At each echelon, there is a choice of service providers and the specific problem we solve is that of determining a cost-optimal mix of service providers so as to achieve a desired level of end-to-end delivery performance. The problem can be broken up into two sub-problems following a mechanism design approach: (1) Design of an incentive compatible mechanism to elicit the true cost functions from the echelon managers; (2) Formulation and solution of an appropriate optimization problem using the true cost information. In this paper we propose a novel Bayesian incentive compatible mechanism for eliciting the true cost functions. This improves upon existing solutions in the literature which are all based on the classical Vickrey-Clarke-Groves mechanisms, requiring significant incentives to be paid to the echelon managers for achieving dominant strategy incentive compatibility. The proposed solution, which we call SCF-BIC (Supply Chain Formation with Bayesian Incentive Compatibility), significantly reduces the cost of supply chain formation. We illustrate the efficacy of the proposed methodology using the example of a three echelon manufacturing supply chain.

Workers are doing it for themselves? Local labor solidarity in precarious times

Historically, organized labor has played a fundamental role in guaranteeing basic rights and privileges for screen media workers and defending union and guild members (however unevenly) from egregious abuses of power. Yet, despite the recent turn to labor in media and cultural studies, organized labor today has received only scant attention, even less so in locations outside Hollywood. This presentation thus intervenes in two significant ways: first, it acknowledges the ongoing global ‘undoing’ of organized labor as a consequence of footloose production and conglomeration within the screen industries, and second, it examines a case example of worker solidarity and political praxis taking shape outside formal labor institutions in response to those structural shifts. Accordingly, it links an empirical study of individual agency to broader debates associated with the spatial dynamics of screen media production, including local capacity, regional competition, and precariousness. Drawing from ethnographic interviews with local film and television workers in Glasgow, Scotland, I consider the political alliance among three nascent labor organizations in the city: one for below-the-line crew, one for facility operators, and (oddly enough) one for producers. Collectively, the groups share a desire to transform Glasgow into a global production hub, following the infrastructure developments in nearby cities like Belfast, Prague, and Budapest. They furthermore frame their objectives in political terms: establishing global scale is considered a necessary maneuver to improve local working conditions like workplace safety, income disparity, skills training, and job access. Ultimately, I argue these groups are a product of an inadequate union structure and outdated policy vision for the screen sector , once-supportive institutions currently out of sync with the global realities of media production. Furthermore, the groups’ advocacy efforts reveal the extent to which workers themselves (in additional to capital) can seek “spatial fixes” to suture their prospects to specific political and economic goals. Of course, such activities manifest under conditions outside of the workers’ control but nevertheless point to an important tension within capitalist social relations, namely that the agency to reshape the spatial relationships in their own lives recasts the geography of labor in terms that aren’t inherent or exclusive to the interests of global capital.

Creative Labor in Cinema and Media Industries

Introduction The rapidly burgeoning popularity of cinema at the beginning of the 20th century favored industrialized modes of creativity organized around large production studios that could churn out a steady stream of narrative feature films. By the mid-1910s, a handful of Hollywood studios became leaders in the production, distribution, and exhibition of popular commercial movies. In order to serve incessant demand for new titles, the studios relied on a set of conventions that allowed them to regularize production and realize workplace efficiencies. This entailed a socialized mode of creativity that would later be adopted by radio and television broadcasters. It would also become a model for cinema and media production around the world, both for commercial and state-supported institutions. Even today the core tenets of industrialized creativity prevail in most large media enterprises. During the 1980s and 1990s, however, media industries began to change radically, driven by forces of neoliberalism, corporate conglomeration, globalization, and technological innovation. Today, screen media are created both by large-scale production units and by networked ensembles of talent and skilled labor. Moreover, digital media production may take place in small shops or via the collective labor of media users or fans who have attracted attention due to their hyphenated status as both producers and users of media (i.e., “prosumers”). Studies of screen media labor fall into five conceptual and methodological categories: historical studies of labor relations, ethnographically inspired investigations of workplace dynamics, critical analyses of the spatial and social organization of labor, and normative assessments of industrialized creativity.

Food waste, power, and corporate social responsibility in the Australian food supply chain

By examining corporate social responsibility (CSR) and power within the context of the food supply chain, this paper illustrates how food retailers claim to address food waste while simultaneously setting standards that result in the large-scale rejection of edible food on cosmetic grounds. Specifically, this paper considers the powerful role of food retailers and how they may be considered to be legitimately engaging in socially responsible behaviors to lower food waste, yet implement practices that ultimately contribute to higher levels of food waste elsewhere in the supply chain. Through interviews with key actors in the Australian fresh fruit and vegetable supply chain, we highlight the existence of a legitimacy gap in corporate social responsibility whereby undesirable behaviors are pushed elsewhere in the supply chain. It is argued that the structural power held by Australia’s retail duopoly means that supermarkets are able to claim virtuous and responsible behaviors, despite counter claims from within the fresh food industry that the food supermarkets’ private quality standards mean that fresh food is wasted. We argue that the supermarkets claim CSR kudos for reducing food waste at the expense of other supply chain actors who bear both the economic cost and the moral burden of waste, and that this is a consequence of supermarkets’ remarkable market power in Australia.

Does Uncertainty Affect Investment and Labor Demand?

This paper analyzes the effect of uncertainty on investment and labor demand for Finnish firms during the time period 1987 – 2000. Utilizing a stock return based measure of uncertainty decomposed into systematic and idiosyncratic components, the results reveal that idiosyncratic uncertainty significantly reduces both investment and labor demand. Idiosyncratic uncertainty seems to influence investment in the current period, whereas the depressing effect on labor demand appears with a one-year lag. The results provide support that the depressing effect of idiosyncratic uncertainty on investment is stronger for small firms in comparison to large firms. Some evidence is reported regarding differential effects of uncertainty on labor demand conditional on firm characteristics. Most importantly, the depressing effect of lagged idiosyncratic uncertainty on labor demand tends to be stronger for diversified firms compared with focused firms.

Examining effectiveness of an immigrant labor market integration intervention. The role of acculturation, discrimination, self-efficacy, outcome expectances, action and coping planning.

The designing of effective intervention tools to improve immigrants’ labor market integration remains an important topic in contemporary Western societies. This study examines whether and how a new intervention tool, Working Life Certificate (WLC), helps unemployed immigrants to find employment and strengthen their belief of their vocational skills. The study is based on quantitative longitudinal survey data from 174 unemployed immigrants of various origins who participated in the pilot phase of WLC examinations in 2009. Surveys were administered in three waves: before the test, right after it, and three months later. Although it is often argued that the unemployment among immigrants is due either to their lack of skills and cultural differences or to discrimination in recruitment, scholars within social psychology of behavior change argue that the best way of helping people to achieve their goals (e.g. finding employment) is to build up their sense of self-efficacy, alter their outcome expectances in a more positive direction or to help them to construct more detailed action and coping plans. This study aims to shed light on the role of these concepts in immigrants’ labor market integration. The results support the theories of behavior change moderately. Having positive expectances regarding the outcomes of various job search behaviors was found to predict employment in the future. Together with action and coping planning it also predicted increase in job search behavior. The intervention, WLC, was able to affect participants’ self-efficacy, but contrary to expectations, self-efficacy was found not to be related to either job search behavior or future labor market status. Also, perceived discrimination did not explain problems in finding employment, but hints of subtle or structural discrimination were found. Adoption of Finnish work culture together with strong family culture was found to predict future employment. Hence, in this thesis I argue that awarding people diplomas should be preferred in immigrant integration training as it strengthens people’s sense of self-efficacy. Instead of teaching new information, more attention should be directed at changing people’s outcome expectances in a more positive direction and helping them to construct detailed plans on how to achieve their goals.

Reasonability and the Linguistic - Division of Labor in Institutional Work

We examine institutional work from a discursive perspective and argue that reasonability, the existence of acceptable justifying reasons for beliefs and practices, is a key part of legitimation. Drawing on philosophy of language, we maintain that institutional work takes place in the context of ‘space of reasons’ determined by widely held assumptions about what is reasonable and what is not. We argue that reasonability provides the main contextual constraint of institutional work, its major outcome, and a key trigger for actors to engage in it. We draw on Hilary Putnam’s concept ‘division of linguistic labor’ to highlight the specialized distribution of knowledge and authority in defining valid ways of reasoning. In this view, individuals use institutionalized vocabularies to reason about their choices and understand their context with limited understanding of how and why these structures have become what they are. We highlight the need to understand how professions and other actors establish and maintain the criteria of reasoning in various areas of expertise through discursive institutional work.

Effects of permanent and non-permanent forest policy means on timber supply.

XVIII IUFRO World Congress, Ljubljana 1986.

Operationalizing Supply Chain vs. Supply Chain Competion

Competition is an immensely important area of study in economic theory, business and strategy. It is known to be vital in meeting consumers’ growing expectations, stimulating increase in the size of the market, pushing innovation, reducing cost and consequently generating better value for end users, among other things. Having said that, it is important to recognize that supply chains, as we know it, has changed the way companies deal with each other both in confrontational or conciliatory terms. As such, with the rise of global markets and outsourcing destinations, increased technological development in transportation, communication and telecommunications has meant that geographical barriers of distance with regards to competition are a thing of the past in an increasingly flat world. Even though the dominant articulation of competition within management and business literature rests mostly within economic competition theory, this thesis draws attention to the implicit shift in the recognition of other forms of competition in today’s business environment, especially those involving supply chain structures. Thus, there is popular agreement within a broad business arena that competition between companies is set to take place along their supply chains. Hence, management’s attention has been focused on how supply chains could become more aggressive making each firm in its supply chain more efficient. However, there is much disagreement on the mechanism through which such competition pitching supply chain against supply chain will take place. The purpose of this thesis therefore, is to develop and conceptualize the notion of supply chain vs. supply chain competition, within the discipline of supply chain management. The thesis proposes that competition between supply chains may be carried forward via the use of competition theories that emphasize interaction and dimensionality, hence, encountering friction from a number of sources in their search for critical resources and services. The thesis demonstrates how supply chain vs. supply chain competition may be carried out theoretically, using generated data for illustration, and practically using logistics centers as a way to provide a link between theory and corresponding practice of this evolving competition mode. The thesis concludes that supply chain vs. supply chain competition, no matter the conceptualization taken, is complex, novel and can be very easily distorted and abused. It therefore calls for the joint development of regulatory measures by practitioners and policymakers alike, to guide this developing mode of competition.

A macroeconomic analysis of adaptation to climate change impacts on forests in India

We examine the potential for adaptation to climate change in Indian forests, and derive the macroeconomic implications of forest impacts and adaptation in India. The study is conducted by integrating results from the dynamic global vegetation model IBIS and the computable general equilibrium model GRACE-IN, which estimates macroeconomic implications for six zones of India. By comparing a reference scenario without climate change with a climate impact scenario based on the IPCC A2-scenario, we find major variations in the pattern of change across zones. Biomass stock increases in all zones but the Central zone. The increase in biomass growth is smaller, and declines in one more zone, South zone, despite higher stock. In the four zones with increases in biomass growth, harvest increases by only approximately 1/3 of the change in biomass growth. This is due to two market effects of increased biomass growth. One is that an increase in biomass growth encourages more harvest given other things being equal. The other is that more harvest leads to higher supply of timber, which lowers market prices. As a result, also the rent on forested land decreases. The lower prices and rent discourage more harvest even though they may induce higher demand, which increases the pressure on harvest. In a less perfect world than the model describes these two effects may contribute to an increase in the risk of deforestation because of higher biomass growth. Furthermore, higher harvest demands more labor and capital input in the forestry sector. Given total supply of labor and capital, this increases the cost of production in all the other sectors, although very little indeed. Forestry dependent communities with declining biomass growth may, however, experience local unemployment as a result.

Integrated Magnetics-Based Multisource Quality AC Power Supply

This paper proposes a method of sharing power/energy between multiple sources and multiple loads using an integrated magnetic circuit as a junction between sources and sinks. It also presents a particular use of the magnetic circuit as an ac power supply, delivering sinusoidal voltage to load irrespective of the presence of the grid, taking only active power from the grid. The proposed magnetic circuit is a three-energy-port unit, viz.: 1) power/energy from grid; 2) power energy from battery-inverter unit; and 3) power/energy delivery to the load in its particular application as quality ac power supply (QPS). The product provides sinusoidal regulated output voltage, input power-factor correction, electrical isolation between the sources and loads, low battery voltage, and control simplicity. Unlike conventional series-shunt-compensated uninterruptible power supply topologies with low battery voltage, the isolation is provided using a single magnetic circuit that results in a smaller size and lower cost. The circuit operating principles and analysis, as well as simulation and experimental results, are presented for this QPS.

A 100MHz to 1GHz, 0.35V to 1.5V Supply 256 x 64 SRAM Block Using Symmetrized 9T SRAM Cell with Controlled Read

In this paper, we present dynamic voltage and frequency Managed 256 x 64 SRAM block in 65 nm technology, for frequency ranging from 100 MHz to 1 GHz. The total energy is minimized for any operating frequency in the above range and leakage energy is minimized during standby mode. Since noise margin of SRAM cell deteriorates at low voltages, we propose static noise margin improvement circuitry, which symmetrizes the SRAM cell by controlling the body bias of pull down NMOS transistor. We used a 9T SRAM cell that isolates Read and hold noise margin and has less leakage. We have implemented an efficient technique of pushing address decoder into zigzag- super-cut-off in stand-by mode without affecting its performance in active mode of operation. The read bit line (RBL) voltage drop is controlled and pre-charge of bit lines is done only when needed for reducing power wastage.