The chronic kidney disease outcomes and practice patterns study Brazil (CKDopps-Brazil): Design, data and methodology

Introduction: The chronic kidney disease outcomes and practice patterns study (CKDopps) is an international observational, prospective, cohort study involving patients with chronic kidney disease (CKD) stages 3-5 [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, with a major focus upon care during the advanced CKD period (eGFR < 30 ml/min/1.73 m2)]. During a 1-year enrollment period, each one of the 22 selected clinics will enroll up to 60 advanced CKD patients (eGFR < 30 ml/min/1.73 m2 and not dialysis-dependent) and 20 earlier stage CKD patients (eGFR between 30-59 ml/min/1.73 m2). Exclusion criteria: age < 18 years old, patients on chronic dialysis or prior kidney transplant. The study timeline include up to one year for enrollment of patients at each clinic starting in the end of 2013, followed by up to 2-3 years of patient follow-up with collection of detailed longitudinal patient-level data, annual clinic practice-level surveys, and patient surveys. Analyses will apply regression models to evaluate the contribution of patient-level and clinic practice-level factors to study outcomes, and utilize instrumental variable-type techniques when appropriate. Conclusion: Launching in 2013, CKDopps Brazil will study advanced CKD care in a random selection of nephrology clinics across Brazil to gain understanding of variation in care across the country, and as part of a multinational study to identify optimal treatment practices to slow kidney disease progression and improve outcomes during the transition period to end-stage kidney disease.

Trust Embedded Open Innovation: Human-Centricity in the Financial

Globalization and interconnectedness in the worldwide sphere have changed the existing and prevailing modus operandi of organizations around the globe and have challenged existing practices along with the business as usual mindset. There are no rules in terms of creating a competitive advantage and positioning within an unstable, constantly changing and volatile globalized business environment. The financial industry, the locomotive or the flagship industry of global economy, especially, within the aftermath of the financial crisis, has reached a certain point trying to recover and redefine its strategic orientation and positioning within the global business arena. Innovation has always been a trend and a buzzword and by many has been considered as the ultimate answer to any kind of problem. The mantra Innovate or Die has been prevailing in any organizational entity in a, sometimes, ruthless endeavour to develop cutting-edge products and services and capture a landmark position in the market. The emerging shift from a closed to an open innovation paradigm has been considered as new operational mechanism within the management and leadership of the company of the future. To that respect, open innovation has been experiencing a tremendous growth research trajectory by putting forward a new way of exchanging and using surplus knowledge in order to sustain innovation within organizations and in the level of industry. In the abovementioned reality, there seems to be something missing: the human element. This research, by going beyond the traditional narratives for open innovation, aims at making an innovative theoretical and managerial contribution developed and grounded on the on-going discussion regarding the individual and organizational barriers to open innovation within the financial industry. By functioning across disciplines and researching out to primary data, it debunks the myth that open innovation is solely a knowledge inflow and outflow mechanism and sheds light to the understanding on the why and the how organizational open innovation works by enlightening the broader dynamics and underlying principles of this fascinating paradigm. Little attention has been given to the role of the human element, the foundational pre-requisite of trust encapsulated within the precise and fundamental nature of organizing for open innovation, the organizational capabilities, the individual profiles of open innovation leaders, the definition of open innovation in the realms of the financial industry, the strategic intent of the financial industry and the need for nurturing a societal impact for human development. To that respect, this research introduces the trust-embedded approach to open innovation as a new insightful way of organizing for open innovation. It unveils the peculiarities of the corporate and individual spheres that act as a catalyst towards the creation of productive open innovation activities. The incentive of this research captures the fundamental question revolving around the need for financial institutions to recognise the importance for organizing for open innovation. The overarching question is why and how to create a corporate culture of openness in the financial industry, an organizational environment that can help open innovation excel. This research shares novel and cutting edge outcomes and propositions both under the prism of theory and practice. The trust-embedded open innovation paradigm captures the norms and narratives around the way of leading open innovation within the 21st century by cultivating a human-centricity mindset that leads to the creation of human organizations, leaving behind the dehumanization mindset currently prevailing within the financial industry.

Involving employees in six sigma

Six sigma is a quality improvement philosophy with systematic and formal approach. In order to successfully implement and utilize six sigma the basic disciplines of it should be adopted by the entire organization. Furthermore, employee involvement is crucial in six sigma implementation. This thesis addresses the challenges of long-lasting involvement in the case company. It focuses on gaps of involving six sigma trained employees, Black Belts. Theoretical framework of the thesis illustrates different factors influencing employee involvement. Influencing factors can be divided into ten categories: organizational culture, managerial commitment, leadership style, employee empowerment, employees’ perceptions, communication, training, goals, performance measurement and incentives. Factors and categories overlap and are related to each other. The framework provides holistic view of employee involvement in six sigma context but can be used also with other quality management philosophies. This thesis was conducted as a case study and written on an assignment to a power and automation technology company. Due to the nature of research problem, the data collection was conducted by interviewing case company personnel. In order to study involvement from employees’ point of view interview questions were designed to be open-ended and to allow the interviewees to tell freely about the phenomenon. This thesis provides empirical support on previous studies in organizational support, management commitment and employee empowerment. In addition, it indicates the importance of separate function for Black Belts in the organization. The gaps in Black Belt involvement can be categorized under two categories: Management driven gaps are related to management commitment, organizational structure and culture and information systems. Black Belt driven gaps are related to practice and effort of using six sigma. This thesis finds solutions for bridging these gaps in the case company by applying findings from literature research and suggestions given by the interviewees. For each gap, actions are suggested for bridging the discrepancy between current and desired situations. The thesis states that in order to embed six sigma in the organization the most crucial gaps, lack of management commitment, six sigma vision and possibilities to use six sigma, should be diminished.

Involving employees in six sigma

Six sigma is a quality improvement philosophy with systematic and formal approach. In order to successfully implement and utilize six sigma the basic disciplines of it should be adopted by the entire organization. Furthermore, employee involvement is crucial in six sigma implementation. This thesis addresses the challenges of long-lasting involvement in the case company. It focuses on gaps of involving six sigma trained employees, Black Belts. Theoretical framework of the thesis illustrates different factors influencing employee involvement. Influencing factors can be divided into ten categories: organizational culture, managerial commitment, leadership style, employee empowerment, employees’ perceptions, communication, training, goals, performance measurement and incentives. Factors and categories overlap and are related to each other. The framework provides holistic view of employee involvement in six sigma context but can be used also with other quality management philosophies. This thesis was conducted as a case study and written on an assignment to a power and automation technology company. Due to the nature of research problem, the data collection was conducted by interviewing case company personnel. In order to study involvement from employees’ point of view interview questions were designed to be open-ended and to allow the interviewees to tell freely about the phenomenon. This thesis provides empirical support on previous studies in organizational support, management commitment and employee empowerment. In addition, it indicates the importance of separate function for Black Belts in the organization. The gaps in Black Belt involvement can be categorized under two categories: Management driven gaps are related to management commitment, organizational structure and culture and information systems. Black Belt driven gaps are related to practice and effort of using six sigma. This thesis finds solutions for bridging these gaps in the case company by applying findings from literature research and suggestions given by the interviewees. For each gap, actions are suggested for bridging the discrepancy between current and desired situations. The thesis states that in order to embed six sigma in the organization the most crucial gaps, lack of management commitment, six sigma vision and possibilities to use six sigma, should be diminished.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.

Stretching the drum skin : an analysis of power relations in leadership and succession in the Evangelical Lutheran church in Tanzania-Northern diocese 1942– 1993

-

Examining human-centered design practice in the mobile apps era

Human-Centered Design (HCD) is a well-recognized approach to the design of interactive computing systems that supports everyday and professional lives of people. To that end, the HCD approach put central emphasis on the explicit understanding of users and context of use by involving users throughout the entire design and development process. With mobile computing, the diversity of users as well as the variety in the spatial, temporal, and social settings of the context of use has notably expanded, which affect the effort of interaction designers to understand users and context of use. The emergence of the mobile apps era in 2008 as a result of structural changes in the mobile industry and the profound enhanced capabilities of mobile devices, further intensify the embeddedness of technology in the daily life of people and the challenges that interaction designers face to cost-efficiently understand users and context of use. Supporting interaction designers in this challenge requires understanding of their existing practice, rationality, and work environment. The main objective of this dissertation is to contribute to interaction design theories by generating understanding on the HCD practice of mobile systems in the mobile apps era, as well as to explain the rationality of interaction designers in attending to users and context of use. To achieve that, a literature study is carried out, followed by a mixed-methods research that combines multiple qualitative interview studies and a quantitative questionnaire study. The dissertation contributes new insights regarding the evolving HCD practice at an important time of transition from stationary computing to mobile computing. Firstly, a gap is identified between interaction design as practiced in research and in the industry regarding the involvement of users in context; whereas the utilization of field evaluations, i.e. in real-life environments, has become more common in academic projects, interaction designers in the industry still rely, by large, on lab evaluations. Secondly, the findings indicate on new aspects that can explain this gap and the rationality of interaction designers in the industry in attending to users and context; essentially, the professional-client relationship was found to inhibit the involvement of users, while the mental distance between practitioners and users as well as the perceived innovativeness of the designed system are suggested in explaining the inclination to study users in situ. Thirdly, the research contributes the first explanatory model on the relation between the organizational context and HCD; essentially, innovation-focused organizational strategies greatly affect the cost-effective usage of data on users and context of use. Last, the findings suggest a change in the nature of HCD in the mobile apps era, at least with universal consumer systems; evidently, the central attention on the explicit understanding of users and context of use shifts from an early requirements phase and continual activities during design and development to follow-up activities. That is, the main effort to understand users is by collecting data on their actual usage of the system, either before or after the system is deployed. The findings inform both researchers and practitioners in interaction design. In particular, the dissertation suggest on action research as a useful approach to support interaction designers and further inform theories on interaction design. With regard to the interaction design practice, the dissertation highlights strategies that encourage a more cost-effective user- and context-informed interaction design process. With the continual embeddedness of computing into people’s life, e.g. with wearable devices and connected car systems, the dissertation provides a timely and valuable view on the evolving humancentered design.