Tietohallintoympäristön ylläpitopalveluiden laadun parantaminen ja suorituskyvyn mittaaminen

Suorituskyvyn mittaaminen korostuu yhä nopeammin muuttuvassa ja monimutkaisemmassa toimintaympäristössä. Taloudellisia mittareita laajempi suorituskyvyn mittaaminen mahdollistaa muutosten huomaamisen ja niihin reagoinnin aikaisemmin kuin pelkkä taloudellisten lukujen seuraaminen. Asiakkaiden vaatimuksien ja kilpailun kasvaessa tulee IT- yritysten pyrkiä yhä laadukkaampaan toimintaan pysyäkseen kilpailussa mukana. Tutkimuksen aiheena on rakentaa tasapainotettu mittaristo tietohallintoympäristön ylläpitopalveluille sekä esittää menetelmiä laadun parantamiseen. Palveluiden laadun parantamisen osalta käsitellään palvelun laadun ominaisuuksia, laadunhallintaa ja laadunhallintajärjestelmien käyttökokemuksia, kehitysmenetelmiä sekä laadun parantamisen vaikutuksia. Huomio kiinnittyi ennakoivaan laatutyöskentelyyn ja palvelun laadun ominaisuuksien monipuoliseen käsittelyyn. Palveluiden ollessa kyseessä painotus on toiminnanja suunnittelun laadussa. Suorituskyvyn mittaamisessa käsitellään suorituskyvynominaisuuksia, suorituskyvyn mittaamisen käyttöä, tasapainotettua mittaristoa ja mittariston rakentamista. Soveltavassa osiossa rakennetaan tasapainotettu mittaristo sekä esitetään menetelmiä palveluiden laadun parannukseen. Mittareiden valinnassa ja laadun kehittämisessä on käytetty hyväksi IT- yritysten viitekehyksiä ITILiä ja COBITia.

Comorbidity and nutritional indices as predictors of morbidity after transurethral procedures: A prospective cohort study.

INTRODUCTION: Preoperative scores are widely used predictors of complications after major surgery. These scores, however, are not widely used in transurethral procedures. The aim of this study was to assess the value of the Charlson Comorbidity Index (CCI), the age-adjusted CCI, the American Society of Anesthesiologist score (ASA) and the Nutritional Risk Score (NRS) in predicting early morbidity after transurethral urological procedures. METHODS: Consecutive patients undergoing transurethral resection of the bladder or the prostate were prospectively enrolled. The scores were calculated preoperatively; 30-day complications were prospectively recorded according to the Dindo-Clavien classification. Univariate logistic regression was performed to investigate the value of each score and of other factors (i.e., age, sex, body mass index, anemia, smoking habit, type of operation and anaesthesia) as predictors of complications. A multivariate model was then calculated using these predictors. RESULTS: Overall, 197 patients were included. The mean age was 72 (standard deviation ± 10). In total, 26.9% patients had at least 1 complication. Using univariate analysis, we found that each score significantly predicted complications. In multivariate analysis, only the ASA (odds ration [OR] 2.11; 95% confidence interval [CI] 1.01-4.43) and the NRS (OR 2.42; 95% CI 1.56-3.74) remained independent predictors. The best model incorporated ASA, NRS and gender, and predicted morbidity with an area under the curve of 76%. Our study's main limitations are population heterogeneity and limited sample size. CONCLUSION: The ASA and the NRS are important and independent determinants of early morbidity after transurethral procedures. The use of these indices may assist clinicians in the decision-making process to balance the possible benefits of transurethral procedures with the potential risks.

Asiakasorientaatio taloushallinnossa - Innovaation leviäminen Suomessa

Tutkielman tavoitteena oli selvittää taloushallinnon asiakasorientaation tilanne Suomessa. Asiakasorientaatio taloushallinnossa ymmärretään asiakaskannattavuuslaskentana, joka on osa asiakkuuden johtamista. Asiakaskannattavuuslaskentaa tutkittiin innovaationa ja tutkimusongelmana selvitettiin miten ja minkä tekijöiden vaikutuksesta diffuusio on tapahtunut Suomessa ajanjaksolla 1995-2006. Alatutkimusongelmina tutkittiin innovaation omaksuneiden yritysten erityispiirteitä sekä syitä innovaation hitaaseen diffuusioon. Tutkielma toteutettiin tapaustutkimuksena. Aineisto koottiin talouslehtien antamien viitteiden sekä aiheesta teetettyjen diplomitöiden ja pro gradujen case-osuuksien pohjalta. Tutkielman empiria-osiota on analysoitu sekä kvalitatiivisesti että kvantitatiivisesti, painoarvon ollessa kvalitatiivisessa tekniikassa. Asiakaskannattavuuslaskenta on levinnyt Suomeen konsultointiyritysten, yliopistojen ja median välityksellä. Innovaation leviämiseen ovat osaltaan vaikuttanut tasapainoitetun mittariston ja CRM:n levimäinen. Tärkeimpiä motiiveja ja syitä yritysten haluun omaksua innovaatio ovat kiristyvä kilpailu, tietojärjestelmien kehittyminen ja vanhan laskentajärjestelmän informatiivisyyden riittämättömyys. Syitä hitaaseen diffuusion puolestaan löytyi 1990-luvun lopun kehittymättömistä tietojärjestelmistä, markkinoinnin ja taloushallinnon erilaisista näkökannoista sekä resurssien puutteesta.

Palveluhankintojen analysointi ja mittaaminen, case Stora Enso Saimaa Services Oy

Tutkimuksen tavoitteena oli luoda Stora Enso Saimaa Services Oy:lle palveluhankintojen suorituskyvyn mittaristo Balanced Scorecardin avulla. Yrityksen palveluhankintakentän kirjavuuden vuoksi työ rajattiin koskemaan vain Etelä-Karjalan Yrityksiltä (= EKY) ostettavia kunnossapitopalveluja. Mittariston muodostamisen lähtökohtana oli hankintatoimen strateginen tavoite, kokonaiskustannusten alentaminen. Tämä tavoite konkretisoituu parhaiten hankintojen elinkaarikustannusten minimoimisena. Työssä käytettiin kvalitatiivista tutkimusmenetelmää. Tutkimuskohdetta analysoitiin tapaustutkimusmenetelmällä. Aineisto kerättiin sisäisille asiakkaille suunnatulla puolistrukturoidulla haastatteluilla, ostajien ajankäytönseurantakyselyllä sekä osallistuvalla havainnoinnilla. Haastatteluja tehtiin 10 ja kyselyjä 6. Palveluhankintojen elinkaarikustannusten ja mittaamisen osalta on tehty tutkimuksia hyvin vähän. EKY-palveluhankintoihin onnistuttiin kuitenkin luomaan tasapainotettu mittaristo palvelujen erityispiirteet huomioiden. EKY-elinkaarikustannusanalysoinnissa keskityttiin palveluhankintojen keskeisiin kustannuskomponentteihin kuten transaktiokustannusteoriaan, hintojen määräytymiseen ja huonon laadun kustannuksiin. Näiden pohjalta kriittisiksi palveluhankintojen menestystekijöiksi nousivat mm. ostajien ajankäytön suuntaaminen strategisiin työtehtäviin, hintojen hallinta sekä toimittajien laadun arviointi. Nämä tekijät muotoiltiin EKY-palveluhankintojen tuloskorttiin ja niihin valittiin hankintatoimen mittausmalleista sopivat suorituskyvyn mittarit. Mittarit jaettiin EKY-palveluhankintoihin määriteltyihin neljään näkökulmaan Balanced Scorecard -prosessin mukaisesti.

Tuloskortti, strategia ja tavoitteet, Case: TeliaSonera Finland Oyj, Verkot ja tuotanto -divisioona

Tuloskortti on mittaristo, jonka avulla yritystä johdetaan, tuloksia mitataan, luodaan yrityksen strategia ja asetetaan sekä pitkän että lyhyen aikavälin tavoitteet. Se toimii myös raportoinnin välineenä. Tutkielman teoreettinen tavoite on selvittää miten tuloskorttia voi hyödyntää yrityksen strategian implementoinnissa ja sitä kauttayrityksen sille asettamiin tavoitteisiin pääsemisessä. Tuloskortin avulla ohjataan liiketoimintaa sekä organisaation nykyistä ja tulevaisuuden suorituskykyä. Tuloskortin mittariston tavoitteet johdetaan strategiasta ja toisaalta strategia johdetaan tuloskortin tavoitteista. Hyvätuloskortti kertoo tarinan yrityksen strategiasta ja visiosta. Tutkielman empiirinen osa liittyy caseyrityksen TeliaSonera Finland Oyj:n Verkot ja tuotanto - divisioonassa suoritettuun kyselytutkimukseen. Empiirisenä tavoitteena on tutkia, miten työntekijän asema organisaatiossa vaikuttaa suhtautumisessa tuloskorttiin ja sen avulla suoritettavaan työn ohjaukseen. Miten vastaajat kokevat tuloskortin avulla asetetun yrityksen suunnan sekä tuloksellisuuden mittauksen? Onko näkemyseroja esimiesten ja asiantuntijoiden välillä? Kirjoittaja havaitsi, että kyseiset luokat suhtautuvat varsin yhteneväisesti kysymyksiin. Näkemyseroa ilmenee lähinnä siinä, miten tuloskortin avulla voidaan vaikuttaa ja miten tärkeää se on. Tuloskortti koetaan myös tärkeänä sitouttamisen sekä palkitsemisen välineenä.

Asiakaspalveluprosessin mittariston luominen: Case Borealis Polymers Oy

Työn tavoitteena oli luoda asiakaspalveluprosessin mittaristo päivittäisen operatiivisen toiminnan seuraamiseksi ja parantamiseksi. Tarkoituksena oli mitata tilaustoimitusketjun suorituskykyä sekä tutkia mahdollisia kehitys ja parannuskohteita. Työ tehtiin Borealis Polymers Oy:n Fenolin Liiketoimintayksikölle. Yhtiön käytössä on Balanced Scorecard KPI- mittaristo. Asiakaspalveluprosessin mittaristo luotiin BSC asiakasnäkökulman mukaisesti soveltuen yhtiön toimintaympäristöön ja tavoitteisiin. Mittariston tarkoituksena on täydentää KPI- mittareita keskittyen päivittäisen asiakaspalveluprosessin suorituskyvyn ja asiakastyytyväisyyden parantamiseen. Asiakaspalveluprosessia kuvaavia mittareita testattiin suorittamalla asiakastyytyväisyyskysely, joka käytännössä toteutettiin sähköpostitse tehtynä tyytyväisyysmittauksena. Mittauksella haluttiin selvittää asiakastyytyväisyyden taso, palvelun eritekijöiden suhteellinen tärkeys asiakkaille eli mitkä laadun tekijät ovat asiakkaille tärkeimmät sekä miten asiakas kokee Borealiksen asiakaspalvelun suhteessa kilpailijoihin. Asiakaspalvelukysely on osa yhtiön kuluen vuoden aikana tehtävää asiakastyytyväisyysselvitystä. Lisäksi työn tavoitteena oli luoda jatkuvan toiminnan seuraamiseksi tulevaisuutta varten mittarit asiakkaille tärkeimpien laadun tekijöiden seuraamiseksi.

OSINKOJENJAKO: Helsingin pörssin toimialakohtainen osingonjakopolitiikka

Tutkielmani päätavoitteena on selvittää onko jokin Helsingin Pörssin kymmenestä toimialasta jakanut suhteessa enemmän osinkoja tulokseen nähden kuin toinen toimiala vuosien 2001-2005 välillä. Empiirisessä osassa tutkimusta käytetään johtopäätöksien muodostamisessa varianssianalyysiä. Testausmenetelmänä ovat kuvailevien tunnuslukujen lisäksi Tamhane K2 - sekä Kruskal- Wallis -testit. Aluksi tutkimuksessa on perehdytty teoriapohjalta yrityksien osingonjakopolitiikkaan ja tekijöihin, jotka vaikuttavat yrityksien maksamaan payout ratioon eli osinko/tulos -tunnuslukuun. Tämän jälkeen teoriaosuus jatkuu target payot ration ja tähän mahdollisesti vaikuttavien tekijöiden tarkasteluna. Tutkimustuloksien mukaan Helsingin Pörssin toimialojen kesken - pois lukien energia, informaatioteknologia ja terveydenhuolto ¿ ei ole merkittävää keskiarvolista eroa. Toimialojen sisällä vaihtelua payout ration maksamisen suhteen esiintyy kuitenkin reilusti. Osakkeiden ostaja ei voi tehdä osakkeiden ostopäätöstä toimialan perusteella.

Tulospalkkausjärjestelmä ja sen toteutus

Työssä tutustuimme tulospalkkausjärjestelmän ominaisuuksiin, suunnitteluun sekä tulosmittareihin. Tarkoituksena on saada kokonaisvaltainen kuva tuloksen ja toiminnan tilan mittaamisesta sekä tuloksen mukaan palkitsemisesta. Lisäksi saimme luvan Midas Touch Gateway Lappeenrannan toimiyksiköltä lulvan ottaa heidät mukaan käytönnön esimerkiksi työhömme.

Supply chain integration: studies on linking customer responsiveness and operational efficiency in logistics policy planning

Abstract The research problem in the thesis deals with improving the responsiveness and efficiency of logistics service processes between a supplier and its customers. The improvement can be sought by customizing the services and increasing the coordination of activities between the different parties in the supply chain. It is argued that to achieve coordination the parties have to have connections on several levels. In the framework employed in this research, three contexts are conceptualized at which the linkages can be planned: 1) the service policy context, 2) the process coordination context, and 3) the relationship management context. The service policy context consists of the planning methods by which a supplier analyzes its customers' logistics requirements and matches them with its own operational environment and efficiency requirements. The main conclusion related to the service policy context is that it is important to have a balanced selection of both customer-related and supplier-related factors in the analysis. This way, while the operational efficiency is planned a sufficient level of service for the most important customers is assured. This kind of policy planning involves taking multiple variables into the analysis, and there is a need to develop better tools for this purpose. Some new approaches to deal with this are presented in the thesis.The process coordination context and the relationship management context deal with the issues of how the implementation of the planned service policies can be facilitated in an inter-organizational environment. Process coordination includes typically such mechanisms as control rules, standard procedures and programs, but inhighly demanding circumstances more integrative coordination mechanisms may be necessary. In the thesis the coordination problems in third-party logistics relationship are used as an example of such an environment. Relationship management deals with issues of how separate companies organize their relationships to improve the coordination of their common processes. The main implication related to logistics planning is that by integrating further at the relationship level, companies can facilitate the use of the most efficient coordination mechanisms and thereby improve the implementation of the selected logistics service policies. In the thesis, a case of a logistics outsourcing relationship is used to demonstrate the need to address the relationship issues between the service provider andthe service buyer before the outsourcing can be done.The dissertation consists of eight research articles and a summarizing report. The principal emphasis in the articles is on the service policy planning context, which is the main theme of six articles. Coordination and relationship issues are specifically addressed in two of the papers.

R&D Performance Analysis: Case Studies on the Challenges and Promotion of the Evaluation and Measurement of R&D

Due to the intense international competition, demanding, and sophisticated customers, and diverse transforming technological change, organizations need to renew their products and services by allocating resources on research and development (R&D). Managing R&D is complex, but vital for many organizations to survive in the dynamic, turbulent environment. Thus, the increased interest among decision-makers towards finding the right performance measures for R&D is understandable. The measures or evaluation methods of R&D performance can be utilized for multiple purposes; for strategic control, for justifying the existence of R&D, for providing information and improving activities, as well as for the purposes of motivating and benchmarking. The earlier research in the field of R&D performance analysis has generally focused on either the activities and considerable factors and dimensions - e.g. strategic perspectives, purposes of measurement, levels of analysis, types of R&D or phases of R&D process - prior to the selection of R&Dperformance measures, or on proposed principles or actual implementation of theselection or design processes of R&D performance measures or measurement systems. This study aims at integrating the consideration of essential factors anddimensions of R&D performance analysis to developed selection processes of R&D measures, which have been applied in real-world organizations. The earlier models for corporate performance measurement that can be found in the literature, are to some extent adaptable also to the development of measurement systemsand selecting the measures in R&D activities. However, it is necessary to emphasize the special aspects related to the measurement of R&D performance in a way that make the development of new approaches for especially R&D performance measure selection necessary: First, the special characteristics of R&D - such as the long time lag between the inputs and outcomes, as well as the overall complexity and difficult coordination of activities - influence the R&D performance analysis problems, such as the need for more systematic, objective, balanced and multi-dimensional approaches for R&D measure selection, as well as the incompatibility of R&D measurement systems to other corporate measurement systems and vice versa. Secondly, the above-mentioned characteristics and challenges bring forth the significance of the influencing factors and dimensions that need to be recognized in order to derive the selection criteria for measures and choose the right R&D metrics, which is the most crucial step in the measurement system development process. The main purpose of this study is to support the management and control of the research and development activities of organizations by increasing the understanding of R&D performance analysis, clarifying the main factors related to the selection of R&D measures and by providing novel types of approaches and methods for systematizing the whole strategy- and business-based selection and development process of R&D indicators.The final aim of the research is to support the management in their decision making of R&D with suitable, systematically chosen measures or evaluation methods of R&D performance. Thus, the emphasis in most sub-areas of the present research has been on the promotion of the selection and development process of R&D indicators with the help of the different tools and decision support systems, i.e. the research has normative features through providing guidelines by novel types of approaches. The gathering of data and conducting case studies in metal and electronic industry companies, in the information and communications technology (ICT) sector, and in non-profit organizations helped us to formulate a comprehensive picture of the main challenges of R&D performance analysis in different organizations, which is essential, as recognition of the most importantproblem areas is a very crucial element in the constructive research approach utilized in this study. Multiple practical benefits regarding the defined problemareas could be found in the various constructed approaches presented in this dissertation: 1) the selection of R&D measures became more systematic when compared to the empirical analysis, as it was common that there were no systematic approaches utilized in the studied organizations earlier; 2) the evaluation methods or measures of R&D chosen with the help of the developed approaches can be more directly utilized in the decision-making, because of the thorough consideration of the purpose of measurement, as well as other dimensions of measurement; 3) more balance to the set of R&D measures was desired and gained throughthe holistic approaches to the selection processes; and 4) more objectivity wasgained through organizing the selection processes, as the earlier systems were considered subjective in many organizations. Scientifically, this dissertation aims to make a contribution to the present body of knowledge of R&D performance analysis by facilitating dealing with the versatility and challenges of R&D performance analysis, as well as the factors and dimensions influencing the selection of R&D performance measures, and by integrating these aspects to the developed novel types of approaches, methods and tools in the selection processes of R&D measures, applied in real-world organizations. In the whole research, facilitation of dealing with the versatility and challenges in R&D performance analysis, as well as the factors and dimensions influencing the R&D performance measure selection are strongly integrated with the constructed approaches. Thus, the research meets the above-mentioned purposes and objectives of the dissertation from the scientific as well as from the practical point of view.

Personality and job stress: a comparison of direct effects on parenting

The impact of personality and job characteristics on parental rearing styles was compared in 353 employees. Hypotheses concerning the relationships between personality and job variables were formulated in accordance with findings in past research and the Belsky’s model (1984). Structural equation nested models showed that Aggression-hostility, Sociability and job Demand were predictive of Rejection and Emotional Warmth parenting styles, providing support for some of the hypothesized relationships. The findings suggest a well-balanced association of personality variables with both parenting styles: Aggression-Hostility was positively related to Rejection and negatively to Emotional Warmth, whereas Sociability was positively related to Emotional Warmth and negatively related to Rejection. Personality dimensions explained a higher amount of variance in observed parenting styles. However, a model that considered both, personality and job dimensions as antecedent variables of parenting was the best representation of observed data, as both systems play a role in the prediction of parenting behavior.

Sensitivity analysis, dominant factors, and robustness of the ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5 occupational exposure models

Occupational exposure modeling is widely used in the context of the E.U. regulation on the registration, evaluation, authorization, and restriction of chemicals (REACH). First tier tools, such as European Centre for Ecotoxicology and TOxicology of Chemicals (ECETOC) targeted risk assessment (TRA) or Stoffenmanager, are used to screen a wide range of substances. Those of concern are investigated further using second tier tools, e.g., Advanced REACH Tool (ART). Local sensitivity analysis (SA) methods are used here to determine dominant factors for three models commonly used within the REACH framework: ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5. Based on the results of the SA, the robustness of the models is assessed. For ECETOC, the process category (PROC) is the most important factor. A failure to identify the correct PROC has severe consequences for the exposure estimate. Stoffenmanager is the most balanced model and decision making uncertainties in one modifying factor are less severe in Stoffenmanager. ART requires a careful evaluation of the decisions in the source compartment since it constitutes ∼75% of the total exposure range, which corresponds to an exposure estimate of 20-22 orders of magnitude. Our results indicate that there is a trade off between accuracy and precision of the models. Previous studies suggested that ART may lead to more accurate results in well-documented exposure situations. However, the choice of the adequate model should ultimately be determined by the quality of the available exposure data: if the practitioner is uncertain concerning two or more decisions in the entry parameters, Stoffenmanager may be more robust than ART.

Self-navigated isotropic three-dimensional cardiac T2 mapping.

PURPOSE: To implement and characterize an isotropic three-dimensional cardiac T2 mapping technique. METHODS: A self-navigated three-dimensional radial segmented balanced steady-state free precession pulse sequence with an isotropic 1.7-mm spatial resolution was implemented at 3T with a variable T2 preparation module. Bloch equation and Monte Carlo simulations were performed to determine the influence of the heart rate, B1 inhomogeneity and noise on the T2 fitting accuracy. In a phantom study, the accuracy of the pulse sequence was studied through comparison with a gold-standard spin-echo T2 mapping method. The robustness and homogeneity of the technique were ascertained in a study of 10 healthy adult human volunteers, while first results obtained in patients are reported. RESULTS: The numerical simulations demonstrated that the heart rate and B1 inhomogeneity cause only minor deviations in the T2 fitting, whereas the phantom study showed good agreement of the technique with the gold standard. The volunteer study demonstrated an average myocardial T2 of 40.5 ± 3.3 ms and a <15% T2 gradient in the base-apex and anterior-inferior direction. In three patients, elevated T2 values were measured in regions with expected edema. CONCLUSION: This respiratory self-navigated isotropic three-dimensional technique allows for accurate and robust in vitro and in vivo T2 quantification. Magn Reson Med 73:1549-1554, 2015. © 2014 Wiley Periodicals, Inc.

Moment Operators of Observables in Quantum Mechanics, with Applications to Quantization and Homodyne Detection

The questions studied in this thesis are centered around the moment operators of a quantum observable, the latter being represented by a normalized positive operator measure. The moment operators of an observable are physically relevant, in the sense that these operators give, as averages, the moments of the outcome statistics for the measurement of the observable. The main questions under consideration in this work arise from the fact that, unlike a projection valued observable of the von Neumann formulation, a general positive operator measure cannot be characterized by its first moment operator. The possibility of characterizing certain observables by also involving higher moment operators is investigated and utilized in three different cases: a characterization of projection valued measures among all the observables is given, a quantization scheme for unbounded classical variables using translation covariant phase space operator measures is presented, and, finally, a mathematically rigorous description is obtained for the measurements of rotated quadratures and phase space observables via the high amplitude limit in the balanced homodyne and eight-port homodyne detectors, respectively. In addition, the structure of the covariant phase space operator measures, which is essential for the above quantization, is analyzed in detail in the context of a (not necessarily unimodular) locally compact group as the phase space.

Data triangulation in the context of opioids monitoring via wastewater analyses.

BACKGROUND: The need to contextualise wastewater-based figures about illicit drug consumption by comparing them with other indicators has been stressed by numerous studies. The objective of the present study was to further investigate the possibility of combining wastewater data to conventional statistics to assess the reliability of the former method and obtain a more balanced picture of illicit drug consumption in the investigated area. METHODS: Wastewater samples were collected between October 2013 and July 2014 in the metropolitan area of Lausanne (226,000 inhabitants), Switzerland. Methadone, its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), the exclusive metabolite of heroin, 6-monoacetylmorphine (6-MAM), and morphine loads were used to estimate the amounts of methadone and heroin consumed. RESULTS: Methadone consumption estimated from EDDP was in agreement with the expectations. Heroin estimates based on 6-MAM loads were inconsistent. Estimates obtained from morphine loads, combined to prescription/sales data, were in agreement with figures derived from syringe distribution data and general population surveys. CONCLUSIONS: The results obtained for methadone allowed assessing the reliability of the selected sampling strategy, supporting its ability to capture the consumption of a small cohort (i.e., 743 patients). Using morphine as marker, in combination with prescription/sales data, estimates in accordance with other indicators about heroin use were obtained. Combining different sources of data allowed strengthening the results and suggested that the different indicators (i.e., administration route, average dosage and number of consumers) contribute to depict a realistic representation of the phenomenon in the investigated area. Heroin consumption was estimated to approximately 13gday(-1) (118gday(-1) at street level).