The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role. © 2004 Elsevier Ltd. All rights reserved.

Introduction: improving manufacturing performance through technology diffusion, implementation and management

The role of technology management in achieving improved manufacturing performance has been receiving increased attention as enterprises are becoming more exposed to competition from around the world. In the modern market for manufactured goods the demand is now for more product variety, better quality, shorter delivery and greater flexibility, while the financial and environmental cost of resources has become an urgent concern to manufacturing managers. This issue of the International Journal of Technology Management addresses the question of how the diffusion, implementation and management of technology can improve the performance of manufacturing industries. The authors come from a large number of different countries and their contributions cover a wide range of topics within this general theme. Some papers are conceptual, others report on research carried out in a range of different industries including steel production, iron founding, electronics, robotics, machinery, precision engineering, metal working and motor manufacture. In some cases they describe situations in specific countries. Several are based on presentations made at the UK Operations Management Association's Sixth International Conference held at Aston University at which the conference theme was 'Achieving Competitive Edge: Getting Ahead Through Technology and People'. The first two papers deal with questions of advanced manufacturing technology implementation and management. Firstly Beatty describes a three year longitudinal field study carried out in ten Canadian manufacturing companies using CADICAM and CIM systems. Her findings relate to speed of implementation, choice of system type, the role of individuals in implementation, organization and job design. This is followed by a paper by Bessant in which he argues that a more a strategic approach should be taken towards the management of technology in the 1990s and beyond. Also considered in this paper are the capabilities necessary in order to deploy advanced manufacturing technology as a strategic resource and the way such capabilities might be developed within the firm. These two papers, which deal largely with the implementation of hardware, are supplemented by Samson and Sohal's contribution in which they argue that a much wider perspective should be adopted based on a new approach to manufacturing strategy formulation. Technology transfer is the topic of the following two papers. Pohlen again takes the case of advanced manufacturing technology and reports on his research which considers the factors contributing to successful realisation of AMT transfer. The paper by Lee then provides a more detailed account of technology transfer in the foundry industry. Using a case study based on a firm which has implemented a number of transferred innovations a model is illustrated in which the 'performance gap' can be identified and closed. The diffusion of technology is addressed in the next two papers. In the first of these, by Lowe and Sim, the managerial technologies of 'Just in Time' and 'Manufacturing Resource Planning' (or MRP 11) are examined. A study is described from which a number of factors are found to influence the adoption process including, rate of diffusion and size. Dahlin then considers the case of a specific item of hardware technology, the industrial robot. Her paper reviews the history of robot diffusion since the early 1960s and then tries to predict how the industry will develop in the future. The following two papers deal with the future of manufacturing in a more general sense. The future implementation of advanced manufacturing technology is the subject explored by de Haan and Peters who describe the results of their Dutch Delphi forecasting study conducted among a panel of experts including scientists, consultants, users and suppliers of AMT. Busby and Fan then consider a type of organisational model, 'the extended manufacturing enterprise', which would represent a distinct alternative pure market-led and command structures by exploiting the shared knowledge of suppliers and customers. The three country-based papers consider some strategic issues relating manufacturing technology. In a paper based on investigations conducted in China He, Liff and Steward report their findings from strategy analyses carried out in the steel and watch industries with a view to assessing technology needs and organizational change requirements. This is followed by Tang and Nam's paper which examines the case of machinery industry in Korea and its emerging importance as a key sector in the Korean economy. In his paper which focuses on Venezuela, Ernst then considers the particular problem of how this country can address the problem of falling oil revenues. He sees manufacturing as being an important contributor to Venezuela's future economy and proposes a means whereby government and private enterprise can co-operate in development of the manufacturing sector. The last six papers all deal with specific topics relating to the management manufacturing. Firstly Youssef looks at the question of manufacturing flexibility, introducing and testing a conceptual model that relates computer based technologies flexibility. Dangerfield's paper which follows is based on research conducted in the steel industry. He considers the question of scale and proposes a modelling approach determining the plant configuration necessary to meet market demand. Engstrom presents the results of a detailed investigation into the need for reorganising material flow where group assembly of products has been adopted. Sherwood, Guerrier and Dale then report the findings of a study into the effectiveness of Quality Circle implementation. Stillwagon and Burns, consider how manufacturing competitiveness can be improved individual firms by describing how the application of 'human performance engineering' can be used to motivate individual performance as well as to integrate organizational goals. Finally Sohal, Lewis and Samson describe, using a case study example, how just-in-time control can be applied within the context of computer numerically controlled flexible machining lines. The papers in this issue of the International Journal of Technology Management cover a wide range of topics relating to the general question of improving manufacturing performance through the dissemination, implementation and management of technology. Although they differ markedly in content and approach, they have the collective aim addressing the concepts, principles and practices which provide a better understanding the technology of manufacturing and assist in achieving and maintaining a competitive edge.

Strategy paradigms for the management of quality:dealing with complexity

Quality management is dominated by rational paradigms for the measurement and management of quality, but these paradigms start to “break down”, when faced with the inherent complexity of managing quality in intensely competitive changing environments. In this article, the various theoretical strategy paradigms employed to manage quality are reviewed and the advantages and limitations of these paradigms are highlighted. A major implication of this review is that when faced with complexity, an ideological stance to any single strategy paradigm for the management of quality is ineffective. A case study is used to demonstrate the need for an integrative multi-paradigm approach to the management of quality as complexity increases.

Offshoring:a multi-country study of FDI in high-technology sectors

This paper examines what is still a relatively new phenomenon in the literature, the outsourcing / offshoring of high technology manufacturing and services. This has become a concern for both policy makers and academics for two reasons. Firstly, policy makers have become concerned that the offshoring of high technology sectors in the West will follow the more labour intensive sectors, and move to lower cost locations. Secondly, international business theory has tended to view low costs, and high levels of indigenous technological development as being the two main drivers of location advantage in the attraction of FDI. We show that this may not be the case for offshored high technology manufacturing or services.

Reconfigurable service-oriented architecture for autonomic computing

Almost a decade has passed since the objectives and benefits of autonomic computing were stated, yet even the latest system designs and deployments exhibit only limited and isolated elements of autonomic functionality. In previous work, we identified several of the key challenges behind this delay in the adoption of autonomic solutions, and proposed a generic framework for the development of autonomic computing systems that overcomes these challenges. In this article, we describe how existing technologies and standards can be used to realise our autonomic computing framework, and present its implementation as a service-oriented architecture. We show how this implementation employs a combination of automated code generation, model-based and object-oriented development techniques to ensure that the framework can be used to add autonomic capabilities to systems whose characteristics are unknown until runtime. We then use our framework to develop two autonomic solutions for the allocation of server capacity to services of different priorities and variable workloads, thus illustrating its application in the context of a typical data-centre resource management problem.

Using quantitative analysis to implement autonomic IT systems

The software underpinning today’s IT systems needs to adapt dynamically and predictably to rapid changes in system workload, environment and objectives. We describe a software framework that achieves such adaptiveness for IT systems whose components can be modelled as Markov chains. The framework comprises (i) an autonomic architecture that uses Markov-chain quantitative analysis to dynamically adjust the parameters of an IT system in line with its state, environment and objectives; and (ii) a method for developing instances of this architecture for real-world systems. Two case studies are presented that use the framework successfully for the dynamic power management of disk drives, and for the adaptive management of cluster availability within data centres, respectively.

Implementation of a generic autonomic framework

Based on insights from the implementation of commercial products for data-centre resource management, we identified key challenges in the development of cost-effective autonomic solutions, and best practices for overcoming these challenges. In a related paper, we proposed a generic autonomic framework that complies with these best practices, and suggested ways in which existing technologies could be used to realise this framework. In this paper, we describe the actual implementation of our autonomic framework as a service-oriented architecture, and we show how the universal policy engine at its core can be configured to manage the allocation of server capacity to services of different priorities. This case study demonstrates the effectiveness of our generic approach to autonomic solution development in an area of great interest for commercial data centres, research laboratories and application service providers.

Run-time connector synthesis for autonomic systems of systems

A key objective of autonomic computing is to reduce the cost and expertise required for the management of complex IT systems. As a growing number of these systems are implemented as hierarchies or federations of lower-level systems, techniques that support the development of autonomic systems of systems are required. This article introduces one such technique, which involves the run-time synthesis of autonomic system connectors. These connectors are specified by means of a new type of autonomic computing policy termed a resource definition policy, and enable the dynamic realisation of collections of collaborating autonomic systems, as envisaged by the original vision of autonomic computing. We propose a framework for the formal specification of autonomic computing policies, and use it to define the new policy type and to describe its application to the development of autonomic system of systems. To validate the approach, we present a sample data-centre application that was built using connectors synthesised from resource-definition policies.

Managing careers and managing fairness : an organisational justice theory perspective on employee evaluations of, and reactions to, organisational career management practices

This thesis presents the results of a multi-method investigation of employee perceptions of fairness in relation to their career management experiences. Organisational justice theory (OJT) was developed as a theoretical framework and data were gathered via 325 quantitative questionnaires, 20 semi-structured interviews and the analysis of a variety of company documents and materials. The results of the questionnaire survey provided strong support for the salience of employee perceptions of justice in regard to their evaluations of organisational career management (OCM) practices, with statistical support emerging for both an agent-systems and interaction model of organisational justice. The qualitative semi-structured interviews provided more detailed analysis of how fairness was experienced in practice, and confirmed the importance of the OJT constructs of fairness within this career management context. Fairness themes to emerge from this analysis included, equity, needs, voice, bias suppression, consistency, ethicality, respect and feedback drawing on many of the central tenants of distributive, procedural, interpersonal and information justice. For the career management literature there is empirical confirmation of a new theoretical framework for understanding employee evaluations of, and reactions to, OCM practices. For the justice literatures a new contextual domain is explored and confirmed, thus extending further the influence and applicability of the theory. For practitioners a new framework for developing, delivering and evaluating their own OCM policies and systems is presented.

Environmental and nature conservation : a facet study of concern for the quality of the natural environment

A multi-variate descriptive model of environmental and nature conservation attitudes and values is proposed and empirically supported. A mapping sentence is developed out of analysis of data from a series of Repertory Grid interviews addressing conservation employees' attitudes towards their profession's activities. The research is carried out within the meta-theoretical framework of Facet Theory. A mapping sentence is developed consisting of 9 facets. From the mapping sentence 3 questionnaires were constructed viewing the selective orientations towards environmental concern. A mapping sentence and facet model is developed for each study. Once the internal structure of this model had been established using Similarity Structure Analysis, the elements of the facets are subjected to Partial Order Scalogram Analysis with base coordinates. A questionnaire was statistically analysed to assess the relationship between facet elements and 4 measures of attitudes towards, and involvement with, conservation. This enabled the comparison of the relative strengths of attitudes associated with each facet element and each measure of conservation attitude. In general, the relationship between the social value of conservation and involvement pledges to conservation were monotonic; perceived importance of a conservation issue appearing predictive of personal involvement. Furthermore, the elements of the life area and scale facets were differentially related to attitude measures. The multi-variate descriptive model of environmental conservation values and attitudes is discussed in relation to its implications for psychological research into environmental concern and for environmental and nature conservation.

The use of spot simulation imagery for forestry mapping and management

SPOT simulation imagery was acquired for a test site in the Forest of Dean in Gloucestershire, U.K. This data was qualitatively and quantitatively evaluated for its potential application in forest resource mapping and management. A variety of techniques are described for enhancing the image with the aim of providing species level discrimination within the forest. Visual interpretation of the imagery was more successful than automated classification. The heterogeneity within the forest classes, and in particular between the forest and urban class, resulted in poor discrimination using traditional `per-pixel' automated methods of classification. Different means of assessing classification accuracy are proposed. Two techniques for measuring textural variation were investigated in an attempt to improve classification accuracy. The first of these, a sequential segmentation method, was found to be beneficial. The second, a parallel segmentation method, resulted in little improvement though this may be related to a combination of resolution in size of the texture extraction area. The effect on classification accuracy of combining the SPOT simulation imagery with other data types is investigated. A grid cell encoding technique was selected as most appropriate for storing digitised topographic (elevation, slope) and ground truth data. Topographic data were shown to improve species-level classification, though with sixteen classes overall accuracies were consistently below 50%. Neither sub-division into age groups or the incorporation of principal components and a band ratio significantly improved classification accuracy. It is concluded that SPOT imagery will not permit species level classification within forested areas as diverse as the Forest of Dean. The imagery will be most useful as part of a multi-stage sampling scheme. The use of texture analysis is highly recommended for extracting maximum information content from the data. Incorporation of the imagery into a GIS will both aid discrimination and provide a useful management tool.

River basin surveillance using remotely sensed data: a water resources information management system

This thesis describes the development of an operational river basin water resources information management system. The river or drainage basin is the fundamental unit of the system; in both the modelling and prediction of hydrological processes, and in the monitoring of the effect of catchment management policies. A primary concern of the study is the collection of sufficient and sufficiently accurate information to model hydrological processes. Remote sensing, in combination with conventional point source measurement, can be a valuable source of information, but is often overlooked by hydrologists, due to the cost of acquisition and processing. This thesis describes a number of cost effective methods of acquiring remotely sensed imagery, from airborne video survey to real time ingestion of meteorological satellite data. Inexpensive micro-computer systems and peripherals are used throughout to process and manipulate the data. Spatial information systems provide a means of integrating these data with topographic and thematic cartographic data, and historical records. For the system to have any real potential the data must be stored in a readily accessible format and be easily manipulated within the database. The design of efficient man-machine interfaces and the use of software enginering methodologies are therefore included in this thesis as a major part of the design of the system. The use of low cost technologies, from micro-computers to video cameras, enables the introduction of water resources information management systems into developing countries where the potential benefits are greatest.

Dynamic QoS management and optimisation in service-based systems

Service-based systems that are dynamically composed at run time to provide complex, adaptive functionality are currently one of the main development paradigms in software engineering. However, the Quality of Service (QoS) delivered by these systems remains an important concern, and needs to be managed in an equally adaptive and predictable way. To address this need, we introduce a novel, tool-supported framework for the development of adaptive service-based systems called QoSMOS (QoS Management and Optimisation of Service-based systems). QoSMOS can be used to develop service-based systems that achieve their QoS requirements through dynamically adapting to changes in the system state, environment and workload. QoSMOS service-based systems translate high-level QoS requirements specified by their administrators into probabilistic temporal logic formulae, which are then formally and automatically analysed to identify and enforce optimal system configurations. The QoSMOS self-adaptation mechanism can handle reliability- and performance-related QoS requirements, and can be integrated into newly developed solutions or legacy systems. The effectiveness and scalability of the approach are validated using simulations and a set of experiments based on an implementation of an adaptive service-based system for remote medical assistance.

The management of diversification in a large industrial company

This work is the result of an action-research-type study of the diversification effort of part of a major U.K. industrial company. Work in contingency theory concerning the impact of environmental factors on organizational design, and the systemic model of viable systems put forward by Stafford Beer form the theoretical basis of the vvork. The two streams of thought are compared and found to offer similar conclusions about the design of effective organizations. These findings are taken as the framework for an analysis both of organization structures for promoting innovation described in the literature, and of those employed by the company for this purpose in recent years. Much attention is given to the use of venture groups, and conclusions are drawn on particular factors which may influence their success or failure. Both theoretical considerations, and the examination of the company' s recent experience suggested that the formation of the policy of diversification, as well as the method of implementation of the police, might affect its outcorre. Attention is therefore focused on the policy-making and planning process, and in particular on possible problems that this process could generate in a multi-division company. The view finally taken of diversification effort is that it should be regarded as a learning system. This view helps to expose some ambiguities in the concepts of success and failure in this area, and demonstrates considerable weaknesses in traditional project evaluation procedures.

Simulating the value of collaboration in multi-actor conservation planning

The loss of habitat and biodiversity worldwide has led to considerable resources being spent for conservation purposes on actions such as the acquisition and management of land, the rehabilitation of degraded habitats, and the purchase of easements from private landowners. Prioritising these actions is challenging due to the complexity of the problem and because there can be multiple actors undertaking conservation actions, often with divergent or partially overlapping objectives. We use a modelling framework to explore this issue with a study involving two agents sequentially purchasing land for conservation. We apply our model to simulated data using distributions taken from real data to simulate the cost of patches and the rarity and co-occurence of species. In our model each agent attempted to implement a conservation network that met its target for the minimum cost using the conservation planning software Marxan. We examine three scenarios where the conservation targets of the agents differ. The first scenario (called NGO-NGO) models the situation where two NGOs are both are targeting different sets of threatened species. The second and third scenarios (called NGO-Gov and Gov-NGO, respectively) represent a case where a government agency attempts to implement a complementary conservation network representing all species, while an NGO is focused on achieving additional protection for the most endangered species. For each of these scenarios we examined three types of interactions between agents: i) acting in isolation where the agents are attempting to achieve their targets solely though their own actions ii) sharing information where each agent is aware of the species representation achieved within the other agent’s conservation network and, iii) pooling resources where agents combine their resources and undertake conservation actions as a single entity. The latter two interactions represent different types of collaborations and in each scenario we determine the cost savings from sharing information or pooling resources. In each case we examined the utility of these interactions from the viewpoint of the combined conservation network resulting from both agents' actions, as well as from each agent’s individual perspective. The costs for each agent to achieve their objectives varied depending on the order in which the agents acted, the type of interaction between agents, and the specific goals of each agent. There were significant cost savings from increased collaboration via sharing information in the NGO-NGO scenario were the agent’s representation goals were mutually exclusive (in terms of specie targeted). In the NGO-Gov and Gov-NGO scenarios, collaboration generated much smaller savings. If the two agents collaborate by pooling resources there are multiple ways the total cost could be shared between both agents. For each scenario we investigate the costs and benefits for all possible cost sharing proportions. We find that there are a range of cost sharing proportions where both agents can benefit in the NGO-NGO scenarios while the NGO-Gov and Gov-NGO scenarios again showed little benefit. Although the model presented here has a range of simplifying assumptions, it demonstrates that the value of collaboration can vary significantly in different situations. In most cases, collaborating would have associated costs and these costs need to be weighed against the potential benefits from collaboration. The model demonstrates a method for determining the range of collaboration costs that would result in collaboration providing an efficient use of scarce conservation resources.