Verkostoitumisen vaikutus yrityksen taloudenohjaukseen

Tapaustutkimuksen tavoitteena on selvittää verkostoitumisen vaikutusta yrityksen taloudenohjaukseen. Tutkielmassa tarkastelun kohteena on suuri metallialan yritys, joka on ulkoistanut tehtaan kunnossapitotoiminnon. Yrityksen taloudenohjausta tarkastellaan prosessien kautta muuttuneessa liiketoimintaympäristössä, joka asettaa vaatimuksia yrityksen johtamisjärjestelmälle. Verkostoitumista tarkastellaan transaktiokustannusteorian perusteella sekä pohditaan yritysjohdon roolia verkostoitumisessa ja verkosto-organisaatiossa. Verkostoitumishankkeen prosessointia varten luotiin ylemmän tason prosessimalli, jonka perusteella verkostoitumisen vaikutuksia yrityksen operatiiviseen ja strategiseen taloudenohjaukseen tarkastellaan.

Availability, Cost or Culture ? : Obstacles to Childcare Services for Low-Income Families

Recent research has highlighted the existence of a social bias in the extent to which children have access to childcare. In general, children living in higher income households are more likely to be cared for in childcare centres. While the existence of a social bias in access to childcare services has been clearly demonstrated, we currently lack a clear explanation as to why this is the case. This paper uses a unique dataset based on survey data collected specifically to study patterns of childcare use in the Swiss canton of Vaud (N = 875). The paper exploits the variation in the way childcare is organised within the canton. Childcare is a municipal policy, as a result of which there are twenty-nine different systems in operation. Fees are progressive everywhere, but variation is substantial. Availability is also very different. This peculiar institutional setup provides an ideal situation to examine the determinants of childcare use by different income groups. Our findings suggest that differences in the fees charged to low-income households, as well as the degree of progressivity of the fee structure, are significant predictors of use, while availability seems to matter less.

Digitalización del sistema de control de nivel en calentadores y tanques de drenaje de una Central Nuclear

Contexto Una central nuclear, al igual que cualquier otro tipo de central generadora de energía eléctrica, mediante turbinas de vapor, está basada en un proceso termodinámico. El rendimiento de las mismas es función del salto entálpico del vapor, para mejorarlo las centrales están constituidas por un ciclo compound formado por turbina de alta presión y turbinas de baja presión, y un ciclo regenerativo consistente en calentar el agua de alimentación antes de su introducción a los generadores de vapor. Un ciclo regenerativo está basado en etapas de calentadores o cambiadores de calor para aprovechar al máximo la energía térmica del vapor, este proyecto está basado en la mejora y optimización del proceso de control de estos para contribuir a mejorar el rendimiento de la central. Objetivo Implementar un sistema de control que nos permita modernizar los clásicos sistemas basados en controles locales y comunicaciones analógicas. Mejorar el rendimiento del ciclo regenerativo de la central, aprovechando las mejoras tecnológicas que ofrece el mercado, tanto en el hardware como en el software de los sistemas de instrumentación y control. Optimizar el rendimiento de los lazos de control de cada uno de los elementos del ciclo regenerativo mediante estrategias de control. Procedimiento Desarrollo de un sistema de control actualizado considerando, como premisa principal, la fiabilidad del sistema, el análisis de fallos y la jerarquización del riesgo. Análisis y cálculo de los lazos de control considerando las premisas establecidas. Configuración de los lazos mediante estrategias de control que nos permitan optimizar y minimizar los efectos del fallo. Para ello se han utilizado parámetros y datos extraídos de la Central Nuclear de Ascó. Conclusiones Se ha modernizado y optimizado el sistema de control mejorando el rendimiento del ciclo regenerativo. Se ha conseguido un sistema más fiable, reduciendo el riesgo del fallo y disminuyendo los efectos de los mismos. El coste de un proyecto de estas características es inferior al de un sistema convencional y ofrece más posibilidades. Es un sistema abierto que permite utilizar e interconectar equipos de diferentes fabricantes, lo que favorece tanto el mantenimiento como las posibles ampliaciones futuras del sistema.

Kiinteistönhoidon make-or-buy -analyysin valmistelu toimintoperusteisesti Case: Andritz-Ahlstrom Oy

Tutkielmassa kartoitetaan tekijöitä, jotka vaikuttavat yrityksen kiinteistönhoidon make-or-buy –päätöksiin. Tutkielman päätavoitteena on selvittää case –yrityksen kiinteistönhoidon toimintoperusteiset kustannukset. Osatavoitteena testataan toimintoperusteisen kustannuslaskennan soveltuvuutta yrityksen tukitoimintojen kustannuslaskennassa. Tutkielma on tyypiltään laadullinen tutkimus ja tutkimusotteena on käytetty konstruktiivista tutkimusotetta. Tutkimusmetodiltaan työ on case-tutkimus. Tutkielmassa rakennetaan toimintoperusteinen kustannuslaskentamalli, jolla selvitetään case -yrityksen kiinteistönhoidon palveluiden tuottamisesta aiheutuvat kustannukset. Laskentatulosten pohjalta todetaan ne toiminnot, joihin kiinteistönhoidon järjestäminen case -yrityksessä sitoo rahaa ja joihin tulisi kohdistaa kustannusten leikkaamistoimenpiteet. Kiinteistönhoidon toimintoja analysoidaan yksitellen sekä toiminnon toimintoperusteisten kustannusten kautta että etsien tekijöitä, jotka vaikuttavat palvelun itse tekemiseen tai palvelun ostamiseen ulkopuoliselta toimittajalta. Tutkielmassa ei tehdä kannattavuusvertailuja itse tekemisen ja ostopalveluiden välillä.

Maintenance process development for remote administration of network servers

Maintenance is a part of system development and it is possible to develop operation models for accomplishing maintenance tasks. These models can be applied to individual maintenance tasks, maintenance projects and version management. Beneficial operation models makes maintenance more effective and they assist in managing various changes. The purpose of this thesis was to develop a maintenance process which can be used to remote administer network servers. This consisted of defining those operation models and technical specifications which enable to set up, manage changes, maintain and monitor resources of information systems that are located in several different sites. At first in this thesis the needs of the process were determined and requirements were defined based on those needs. The meaning of processes in maintenance of information systems, maintenance workflows and challenges were studied. Then current practical problems and disadvantages of maintenance work were analyzed in order to focus the development to proper issues. Because available operation models did not cover all the recent needs, new maintenance process which fulfilled the requirements was developed.

STRATEGIC-1: A multiple-lines, randomized, open-label GERCOR phase III study in patients with unresectable wild-type RAS metastatic colorectal cancer.

BACKGROUND: The management of unresectable metastatic colorectal cancer (mCRC) is a comprehensive treatment strategy involving several lines of therapy, maintenance, salvage surgery, and treatment-free intervals. Besides chemotherapy (fluoropyrimidine, oxaliplatin, irinotecan), molecular-targeted agents such as anti-angiogenic agents (bevacizumab, aflibercept, regorafenib) and anti-epidermal growth factor receptor agents (cetuximab, panitumumab) have become available. Ultimately, given the increasing cost of new active compounds, new strategy trials are needed to define the optimal use and the best sequencing of these agents. Such new clinical trials require alternative endpoints that can capture the effect of several treatment lines and be measured earlier than overall survival to help shorten the duration and reduce the size and cost of trials. METHODS/DESIGN: STRATEGIC-1 is an international, open-label, randomized, multicenter phase III trial designed to determine an optimally personalized treatment sequence of the available treatment modalities in patients with unresectable RAS wild-type mCRC. Two standard treatment strategies are compared: first-line FOLFIRI-cetuximab, followed by oxaliplatin-based second-line chemotherapy with bevacizumab (Arm A) vs. first-line OPTIMOX-bevacizumab, followed by irinotecan-based second-line chemotherapy with bevacizumab, and by an anti-epidermal growth factor receptor monoclonal antibody with or without irinotecan as third-line treatment (Arm B). The primary endpoint is duration of disease control. A total of 500 patients will be randomized in a 1:1 ratio to one of the two treatment strategies. DISCUSSION: The STRATEGIC-1 trial is designed to give global information on the therapeutic sequences in patients with unresectable RAS wild-type mCRC that in turn is likely to have a significant impact on the management of this patient population. The trial is open for inclusion since August 2013. TRIAL REGISTRATION: STRATEGIC-1 is registered at Clinicaltrials.gov: NCT01910610, 23 July, 2013. STRATEGIC-1 is registered at EudraCT-No.: 2013-001928-19, 25 April, 2013.

An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.

AIM: The study aimed to compare the rate of success and cost of anal fistula plug (AFP) insertion and endorectal advancement flap (ERAF) for anal fistula. METHOD: Patients receiving an AFP or ERAF for a complex single fistula tract, defined as involving more than a third of the longitudinal length of of the anal sphincter, were registered in a prospective database. A regression analysis was performed of factors predicting recurrence and contributing to cost. RESULTS: Seventy-one patients (AFP 31, ERAF 40) were analysed. Twelve (39%) recurrences occurred in the AFP and 17 (43%) in the ERAF group (P = 1.00). The median length of stay was 1.23 and 2.0 days (P < 0.001), respectively, and the mean cost of treatment was euro5439 ± euro2629 and euro7957 ± euro5905 (P = 0.021), respectively. On multivariable analysis, postoperative complications, underlying inflammatory bowel disease and fistula recurring after previous treatment were independent predictors of de novo recurrence. It also showed that length of hospital stay ≤ 1 day to be the most significant independent contributor to lower cost (P = 0.023). CONCLUSION: Anal fistula plug and ERAF were equally effective in treating fistula-in-ano, but AFP has a mean cost saving of euro2518 per procedure compared with ERAF. The higher cost for ERAF is due to a longer median length of stay.

Cost evaluation and comparison of three decision strategies for cardiac revascularization : results of the suspected CAD protocol of the European CMR registry

Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness. Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD. Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.

Maintenance and development of supplier relationships in an environment of irregular demand

The main target of the study was to find ideas for maintenance and development of supplier relations in irregular business environment. The other aim was to find out the suppliers’ opinions concerning the case company and the relationship between the companies. The study was conducted by using both qualitative and quantitative research methods. A mail survey was used to find out supplier opinions and an interview to find out suppliers’ ideas for relationship maintenance and development. It was found out that the use of relational elements is essential in the relationship maintenance in an irregular environment. In development of supplier relations the company should make better use of its suppliers’ potential, assure better flow of information and utilize the possibilities of Supplier Relationship Management.

Recerca i adaptació d'eines e-commerce baix cost del mercat a un petit comerç

Recerca de eines d'e-commerce existents al mercat, gratuïtes o de baix cost. I adaptació d'una d'elles a un petit comerç, en concret a una llibreria de barri.

Performance benchmarking and incentive regulation – considerations of directing signals for electricity distribution companies

After the restructuring process of the power supply industry, which for instance in Finland took place in the mid-1990s, free competition was introduced for the production and sale of electricity. Nevertheless, natural monopolies are found to be the most efficient form of production in the transmission and distribution of electricity, and therefore such companies remained franchised monopolies. To prevent the misuse of the monopoly position and to guarantee the rights of the customers, regulation of these monopoly companies is required. One of the main objectives of the restructuring process has been to increase the cost efficiency of the industry. Simultaneously, demands for the service quality are increasing. Therefore, many regulatory frameworks are being, or have been, reshaped so that companies are provided with stronger incentives for efficiency and quality improvements. Performance benchmarking has in many cases a central role in the practical implementation of such incentive schemes. Economic regulation with performance benchmarking attached to it provides companies with directing signals that tend to affect their investment and maintenance strategies. Since the asset lifetimes in the electricity distribution are typically many decades, investment decisions have far-reaching technical and economic effects. This doctoral thesis addresses the directing signals of incentive regulation and performance benchmarking in the field of electricity distribution. The theory of efficiency measurement and the most common regulation models are presented. The chief contributions of this work are (1) a new kind of analysis of the regulatory framework, so that the actual directing signals of the regulation and benchmarking for the electricity distribution companies are evaluated, (2) developing the methodology and a software tool for analysing the directing signals of the regulation and benchmarking in the electricity distribution sector, and (3) analysing the real-life regulatory frameworks by the developed methodology and further develop regulation model from the viewpoint of the directing signals. The results of this study have played a key role in the development of the Finnish regulatory model.

Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for Glioblastoma: A Randomized Clinical Trial.

IMPORTANCE: Glioblastoma is the most devastating primary malignancy of the central nervous system in adults. Most patients die within 1 to 2 years of diagnosis. Tumor-treating fields (TTFields) are a locoregionally delivered antimitotic treatment that interferes with cell division and organelle assembly. OBJECTIVE: To evaluate the efficacy and safety of TTFields used in combination with temozolomide maintenance treatment after chemoradiation therapy for patients with glioblastoma. DESIGN, SETTING, AND PARTICIPANTS: After completion of chemoradiotherapy, patients with glioblastoma were randomized (2:1) to receive maintenance treatment with either TTFields plus temozolomide (n = 466) or temozolomide alone (n = 229) (median time from diagnosis to randomization, 3.8 months in both groups). The study enrolled 695 of the planned 700 patients between July 2009 and November 2014 at 83 centers in the United States, Canada, Europe, Israel, and South Korea. The trial was terminated based on the results of this planned interim analysis. INTERVENTIONS: Treatment with TTFields was delivered continuously (>18 hours/day) via 4 transducer arrays placed on the shaved scalp and connected to a portable medical device. Temozolomide (150-200 mg/m2/d) was given for 5 days of each 28-day cycle. MAIN OUTCOMES AND MEASURES: The primary end point was progression-free survival in the intent-to-treat population (significance threshold of .01) with overall survival in the per-protocol population (n = 280) as a powered secondary end point (significance threshold of .006). This prespecified interim analysis was to be conducted on the first 315 patients after at least 18 months of follow-up. RESULTS: The interim analysis included 210 patients randomized to TTFields plus temozolomide and 105 randomized to temozolomide alone, and was conducted at a median follow-up of 38 months (range, 18-60 months). Median progression-free survival in the intent-to-treat population was 7.1 months (95% CI, 5.9-8.2 months) in the TTFields plus temozolomide group and 4.0 months (95% CI, 3.3-5.2 months) in the temozolomide alone group (hazard ratio [HR], 0.62 [98.7% CI, 0.43-0.89]; P = .001). Median overall survival in the per-protocol population was 20.5 months (95% CI, 16.7-25.0 months) in the TTFields plus temozolomide group (n = 196) and 15.6 months (95% CI, 13.3-19.1 months) in the temozolomide alone group (n = 84) (HR, 0.64 [99.4% CI, 0.42-0.98]; P = .004). CONCLUSIONS AND RELEVANCE: In this interim analysis of 315 patients with glioblastoma who had completed standard chemoradiation therapy, adding TTFields to maintenance temozolomide chemotherapy significantly prolonged progression-free and overall survival. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00916409.