Variation in performance in low-volume mammography screening programmes: experience from Switzerland.

BACKGROUND: Reading volume and mammography screening performance appear positively correlated. Quality and effectiveness were compared across low-volume screening programmes targeting relatively small populations and operating under the same decentralised healthcare system. Except for accreditation of 2nd readers (restrictive vs non-restrictive strategy), these organised programmes had similar screening regimen/procedures and duration, which maximises comparability. Variation in performance and its determinants were explored in order to improve mammography practice and optimise screening performance. METHODS: Circa 200,000 screens performed between 1999 and 2006 (4 rounds) in 3 longest standing Swiss cantonal programmes (of Vaud, Geneva and Valais) were assessed. Indicators of quality and effectiveness were assessed according to European standards. Interval cancers were identified through linkage with cancer registries records. RESULTS: Swiss programmes met most European standards of performance with a substantial, favourable cancer stage shift. Up to a two-fold variation occurred for several performance indicators. In subsequent rounds, compared with programmes (Vaud and Geneva) that applied a restrictive selection strategy for 2nd readers, proportions of in situ lesions and of small cancers (≤1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. CONCLUSION: Differences in performance could partly be explained by a selective strategy for second readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume programmes.

Diffusion of Administrative Innovation: TQM Implementation and Effectiveness in a Global

The main objective of this dissertation is to create new knowledge on an administrative innovation, its adoption, diffusion and finally its effectiveness. In this dissertation the administrative innovation is approached through a widely utilized management philosophy, namely the total quality management (TQM) strategy. TQM operationalizes a self-assessment procedure, which is based on continual improvement principles and measuring the improvements. This dissertation also captures the theme of change management as it analyzes the adoption and diffusion of the administrative innovation. It identifies innovation characteristics as well as organisational and individual factors explaining the adoption and implementation. As a special feature, this study also explores the effectiveness of the innovation based on objective data. For studying the administrative innovation (TQM model), a multinational Case Company provides a versatile ground for a deep, longitudinal analysis. The Case Company started the adoption systematically in the mid 1980s in some of its units. As part of their strategic planning today, the procedure is in use throughout the entire global company. The empirical story begins from the innovation adoption decision that was made in the Case Company over 22 years ago. In order to be able to capture the right atmosphere and backgrounds leading to the adoption decision, key informants from that time were interviewed, since the main target was to clarify the dynamics of how an administrative innovation develops. In addition, archival material was collected and studied, available memos and data relating to the innovation, innovation adoption and later to the implementation contained altogether 20500 pages of documents. A survey was furthermore conducted at the end of 2006 focusing on questions related to the innovation, organization and leadership characteristics and the response rate totalled up to 54%. For measuring the effectiveness of the innovation implementation, the needed longitudinal objective performance data was collected. This data included the profit unit level experience of TQM, the development of the self assessment scores per profit unit and performance data per profit unit measured with profitability, productivity and customer satisfaction. The data covered the years 1995-2006. As a result, the prerequisites for the successful adoption of an administrative innovation were defined, such as the top management involvement, support of the change agents and effective tools for implementation and measurement. The factors with the greatest effect on the depth of the implementation were the timing of the adoption and formalization. The results also indicated that the TQM model does have an effect on the company performance measured with profitability, productivity and customer satisfaction. Consequently this thesis contributes to the present literature (i) by taking into its scope an administrative innovation and focusing on the whole innovation implementation process, from the adoption, through diffusion until its consequences, (ii) because the studied factors with an effect on the innovation adoption and diffusion are multifaceted and grouped into individual, organizational and environmental factors, and a strong emphasis is put on the role of the individual change agents and (iii) by measuring the depth and consistency of the administrative innovation. This deep analysis was possible due to the availability of longitudinal data with triangulation possibilities.

Improvement of Operational Efficiency effectiveness (OEE) using Six Sigma DMAIC Methodology — Case Bottomer line AD2378

Overall Equipment Effectiveness (OEE) is the key metric of operational excellence. OEE monitors the actual performance of equipment relative to its performance capabilities under optimal manufacturing conditions. It looks at the entire manufacturing environment measuring, in addition to the equipment availability, the production efficiency while the equipment is available to run products, as well as the efficiency loss that results from scrap, rework, and yield losses. The analysis of the OEE provides improvement opportunities for the operation. One of the tools used for OEE improvement is Six Sigma DMAIC methodology which is a set of practices originally developed to improve processes by eliminating defects. It asserts the continuous efforts to reduce variation in process outputs as key to business success, as well as the possibility of measurement, analysis, improvement and control of manufacturing and business processes. In the case of the Bottomer line AD2378 in Papsac Maghreb Casablanca plant, the OEE figures reached 48.65 %, which is below the accepted OEE group performance. This required immediate actions to achieve OEE improvement. This Master thesis focuses on the application of Six Sigma DMAIC methodology in the OEE improvement on the Bottomer Line AD2378 in Papsac Maghreb Casablanca plant. First, the Six Sigma DMAIC and OEE usage in operation measurement will be discussed. Afterwards, the different DMAIC phases will allow the identification of improvement focus, the identification of OEE low performance causes and the design of improvement solutions. These will be implemented to allow further tracking of improvement impact on the plant operations.

Exploring the link between flexible working and organizational performance

The expansion of flexible work experienced since the 1980s in developed economies is consistent with a more generic trend towards organizational flexibility, which many authors see as essential in order to compete in the dynamic global environment (Volberda, 1998). From this point of view, the changing demands of the environment have forced organizations to seek the ability to adapt rapidly and effectively as a means to be successful or even to survive. In the quest for flexibility, every area of the organization has been scrutinized in order to render it as ¿agile¿ as possible. In the human resources arena, this analysis has led to the definition of diverse ¿flexible working practices¿ (FWP) that describe a wide range of employment practices, which differ from the traditional full-time job with a fixed salary and a permanent contract. These practices have been described using other terms, such as ¿alternative¿ (Polivka, 1996; Powell & Mainiero, 1999), ¿non-standard¿ (Kalleberg, 2000), or ¿atypical¿ (De Grip, Hoevenberg, &m Willems, 1997), which coincide in denoting their divergence from the most traditional forms of employment. This article will show that quite different practices have been embraced by the common term ¿flexible working practices.¿ Subsequently, the results of empirical research regarding the implications for organizational performance of a number of flexible practices will be commented on.

Improving the effectiveness of supply chain development work – an expert role perspective

This study focuses to the intersection of three sets of activities in a company: expert work, development work and supply chain management, SCM. Experts and expert work represent a set of individuals whose efficiency and impact this study is intended to improve, while development work defines the set of organizational activities to focus on. SCM as an expertise area acts as the platform on which this study is built. The study has two aims. Firstly, it aims to derive a model helping an SCM expert to increase the effectiveness of expert work in development tasks by understanding the encountered organizational situations and processes better, reflecting his/her past and future actions to organizational processes and selecting and adjusting the processes and contents of his/her work accordingly. Secondly, it aims to develop applicable approaches and methods to understand, evaluate and manage the organizational processes and situations in development work. The integrative model on approaches and methods to improve the effectiveness of development processes is split to two aggregate dimensions: technical performance of the developed solution and consumption of resources of the development process. Six potential approaches and methods aiming at helping in the management of organizational dimensions are presented in enclosed publications. The approaches focus on three subtasks of development work: decision making, implementation and change, and knowledge accumulation. The approaches and methods have been tested in case studies representing typical development processes in the area of supply chain management. As a result, four suggestions are presented. Firstly, SCM experts are advised to consider the SCM development work to be consisting of development processes. Secondly, inside these processes they should identify and evaluate the risk of difficult decision-making related to organizational factors. Thirdly, they are prompted for an active role in implementation and change, supporting the implementation through whole process. Finally, the development should be seen in a holistic view, taking into account the stage of knowledge and organizational issues related to it, and adopt a knowledge development strategy.

Sustainable Waste-to-Energy Production: Performance Evaluation of Distributed Generation fuelled by Landfill Gas

The environmental impact of landfill is a growing concern in waste management practices. Thus, assessing the effectiveness of the solutions implemented to alter the issue is of importance. The objectives of the study were to provide an insight of landfill advantages, and to consolidate landfill gas importance among others alternative fuels. Finally, a case study examining the performances of energy production from a land disposal at Ylivieska was carried out to ascertain the viability of waste to energy project. Both qualitative and quantitative methods were applied. The study was conducted in two parts; the first was the review of literatures focused on landfill gas developments. Specific considerations were the conception of mechanism governing the variability of gas production and the investigation of mathematical models often used in landfill gas modeling. Furthermore, the analysis of two main distributed generation technologies used to generate energy from landfill was carried out. The review of literature revealed a high influence of waste segregation and high level of moisture content for waste stabilization process. It was found that the enhancement in accuracy for forecasting gas rate generation can be done with both mathematical modeling and field test measurements. The result of the case study mainly indicated the close dependence of the power output with the landfill gas quality and the fuel inlet pressure.

The effects of social networks on work-team effectiveness

This is a study of team social networks, their antecedents and outcomes. In focusing attention on the structural configuration of the team this research contributes to a new wave of thinking concerning group social capital. The research site was a random sample of Finnish work organisations. The data consisted of 499 employees in 76 teams representing 48 different organisations. A systematic literature review and quantitative methods were used in conducting the research: the former primarily to establish the current theoretical position on the relationships among the variables and the latter to test these relationships. Social network analysis was the primary method used in identifying the social-network relations among the work-team members. The first and key contribution of this study is that it relates the structuralnetwork properties of work teams to behavioural outcomes, attitudinal outcomes and, ultimately, team performance. Moreover, it shows that addressing attitudinal outcomes is also important in terms of team performance; attitudinal outcomes (team identity) mediated the relationship between the team’s performance and its social network. The second contribution is that it examines the possible antecedents of the social structure. It is thus one response to Salancik’s (1995) call for a network theory in that it explains why certain network characteristics exist. Itdemonstrates that irrespective of whether or not a team is heterogeneous in terms of age or gender, educational diversity may protect it from centralisation. However, heterogeneity in terms of gender turned out to have a negative impact on density. Thirdly, given the observation that the benefits of (team) networks are typically theorised and modelled without reference to the nature of the relationships comprising the structure, the study directly tested whether team knowledge mediated the effects of instrumental and expressive network relationships on team performance. Furthermore, with its focus on expressive networks that link the workplace to a more informal world, which have been rather neglected in previous research, it enhances knowledge of teams andnetworks. The results indicate that knowledge sharing fully mediates the influence of complementarities between dense and fragmented instrumental network relationships, thus providing empirical validation of the implicit understanding that networks transfer knowledge. Fourthly, the study findings suggest that an optimal configuration of the work-team social-network structure combines both bridging and bonding social relationships.

Effectiveness of Pilotage

The objective of the pilotage effectiveness study was to come up with a process descrip-tion of the pilotage procedure, to design performance indicators based on this process description, to be used by Finnpilot, and to work out a preliminary plan for the imple-mentation of the indicators within the Finnpilot organisation. The theoretical aspects of pilotage as well as the guidelines and standards used were determined through a literature review. Based on the literature review, a process flow model with the following phases was created: the planning of pilotage, the start of pilo-tage, the act of pilotage, the end of pilotage and the closing of pilotage. The model based on the literature review was tested through interviews and observation of pilotage. At the same time an e-mail survey directed at foreign pilotage organisations, which included a questionnaire concerning their standards and management systems, operations procedures, measurement tools and their attitude to the passage planning, was conducted. The main issues in the observations and interviews were the passage plan and the bridge team co-operation. The phases of the pilotage process model emerged in both the pilotage activities and the interviews whereas bridge team co-operation was relatively marginal. Most of the pilotage organisations, who responded to the query, also use some standard-based management system. All organisations who answered the survey use some sort of a pilotage process model. According to the query, the main measuring tools for pilotage are statistical information concerning pilotage and the organisations, the customer feedback surveys, and financial results. Attitudes to-wards passage planning were mostly positive among the organisations. A workshop with pilotage experts was arranged where the process model constructed on the basis of the literature review was tuned to match practical pilotage. In the workshop it was determined that certain phases and the corresponding tasks, through which pilo-tage can be described as a process, were identifiable in all pilotage. The result of the workshop was a complemented process model, which separates incoming and outgoing traffic, as well as the fairway pilotage and harbour pilotage from each other. Addition-ally indicators divided according to the data gathering method were defined. Data con-cerning safety and traffic flow is gathered in the form of customer feedback. The pilot's own perceptions of the pilotage process are gathered through self-assessment. The measurement data which is connected to the phases of the pilotage process is generated e.g. by gathering statistics of the success of the pilot dispatches, the accuracy of the pi-lotage and the incidents that occurred during the pilotage, near misses, deviations and accidents. The measurement data is collected via the PilotWeb at the closing of the pilo-tage. A separate project and a project group with pilots also participating will be established for the deployment of the performance indicators. The phases of the project are: the definition phase, the implementation phase and the deployment phase. The purpose of the definition phase is to prepare questions for ship commanders concerning the cus-tomer feedback questionnaire and also to work out the self-assessment queries and the queries concerning the process indicators.

The effectiveness of financial innovation support tools. Comparative study of Latvia and Finland

In the Innovation Union Scoreboard of 2011, Latvia ranked last amongst the EU countries in innovation performance. Even though there is sufficient scientific and technological basis, the results remain modest or low in most of the indicators concerning innovations. Several aspects influence the performance a national innovation system. In Latvia, the low effectiveness is often attributed to lack of financial support tools. As a comparison, Finland was chosen because of its well-established and documented innovation system. The aim of this study is to research the efficiency and effectiveness of the current financial innovation support tool system in Latvia from the point of view of an innovating company. It also attempts to analyze the support tool system of Latvia and compare to the relevant parts of the Finnish system. The study found that it is problematic for innovative companies in Latvia to receive the necessary funding especially for start-ups and SMEs due to the low number of grant programs, funds and lacking offer from banks, venture capital and business angels. To improve the situation, the Latvian government should restructure the funding mechanisms putting a bigger emphasis on innovative start-ups and SMEs. That would lay a foundation for future growth and boost research and scientific activities in Latvia.

Practical Framework for Monitoring the Performance of Agile IT Projects in an Output-Based Outsourcing Context

Over the past decade, organizations worldwide have begun to widely adopt agile software development practices, which offer greater flexibility to frequently changing business requirements, better cost effectiveness due to minimization of waste, faster time-to-market, and closer collaboration between business and IT. At the same time, IT services are continuing to be increasingly outsourced to third parties providing the organizations with the ability to focus on their core capabilities as well as to take advantage of better demand scalability, access to specialized skills, and cost benefits. An output-based pricing model, where the customers pay directly for the functionality that was delivered rather than the effort spent, is quickly becoming a new trend in IT outsourcing allowing to transfer the risk away from the customer while at the same time offering much better incentives for the supplier to optimize processes and improve efficiency, and consequently producing a true win-win outcome. Despite the widespread adoption of both agile practices and output-based outsourcing, there is little formal research available on how the two can be effectively combined in practice. Moreover, little practical guidance exists on how companies can measure the performance of their agile projects, which are being delivered in an output-based outsourced environment. This research attempted to shed light on this issue by developing a practical project monitoring framework which may be readily applied by organizations to monitor the performance of agile projects in an output-based outsourcing context, thus taking advantage of the combined benefits of such an arrangement Modified from action research approach, this research was divided into two cycles, each consisting of the Identification, Analysis, Verification, and Conclusion phases. During Cycle 1, a list of six Key Performance Indicators (KPIs) was proposed and accepted by the professionals in the studied multinational organization, which formed the core of the proposed framework and answered the first research sub-question of what needs to be measured. In Cycle 2, a more in-depth analysis was provided for each of the suggested Key Performance Indicators including the techniques for capturing, calculating, and evaluating the information provided by each KPI. In the course of Cycle 2, the second research sub-question was answered, clarifying how the data for each KPI needed to be measured, interpreted, and acted upon. Consequently, after two incremental research cycles, the primary research question was answered describing the practical framework that may be used for monitoring the performance of agile IT projects delivered in an output-based outsourcing context. This framework was evaluated by the professionals within the context of the studied organization and received positive feedback across all four evaluation criteria set forth in this research, including the low overhead of data collection, high value of provided information, ease of understandability of the metric dashboard, and high generalizability of the proposed framework.

Key performance indicators for successful metadata governance

Metadata in increasing levels of sophistication has been the most powerful concept used in management of unstructured information ever since the first librarian used the Dewey decimal system for library classifications. It remains to be seen, however, what the best approach is to implementing metadata to manage huge volumes of unstructured information in a large organization. Also, once implemented, how is it possible to track whether it is adding value to the company, and whether the implementation has been successful? Existing literature on metadata seems to either focus too much on technical and quality aspects or describe issues with respect to adoption for general information management initiatives. This research therefore, strives to contribute to these gaps: to give a consolidated framework for striving to understand the value added by implementing metadata. The basic methodology used is that of case study, which incorporates aspects of design science, surveys, and interviews in order to provide a holistic approach to quantitative and qualitative analysis of the case. The research identifies the various approaches to implementing metadata, particularly studying the one followed by the unit of analysis of case study, a large company in the Oil and Gas Sector. Of the three approaches identified, the selected company already follows an approach that appears to be superior. The researcher further explores its shortcomings, and proposes a slightly modified approach that can handle them. The research categorically and thoroughly (in context) identifies the top effectiveness criteria, and corresponding key performance indicators(KPIs) that can be measured to understand the level of advancement of the metadata management initiative in the company. In an effort to contrast and have a basis of comparison for the findings, the research also includes views from information managers dealing with core structured data stored in ERPs and other databases. In addition, the results include the basic criteria that can be used to evaluate metrics, in order to classify a metric as a KPI.

Performance and scalability of isolated DC-DC converter topologies in low voltage, high current applications

Fuel cells are a promising alternative for clean and efficient energy production. A fuel cell is probably the most demanding of all distributed generation power sources. It resembles a solar cell in many ways, but sets strict limits to current ripple, common mode voltages and load variations. The typically low output voltage from the fuel cell stack needs to be boosted to a higher voltage level for grid interfacing. Due to the high electrical efficiency of the fuel cell, there is a need for high efficiency power converters, and in the case of low voltage, high current and galvanic isolation, the implementation of such converters is not a trivial task. This thesis presents galvanically isolated DC-DC converter topologies that have favorable characteristics for fuel cell usage and reviews the topologies from the viewpoint of electrical efficiency and cost efficiency. The focus is on evaluating the design issues when considering a single converter module having large current stresses. The dominating loss mechanism in low voltage, high current applications is conduction losses. In the case of MOSFETs, the conduction losses can be efficiently reduced by paralleling, but in the case of diodes, the effectiveness of paralleling depends strongly on the semiconductor material, diode parameters and output configuration. The transformer winding losses can be a major source of losses if the windings are not optimized according to the topology and the operating conditions. Transformer prototyping can be expensive and time consuming, and thus it is preferable to utilize various calculation methods during the design process in order to evaluate the performance of the transformer. This thesis reviews calculation methods for solid wire, litz wire and copper foil winding losses, and in order to evaluate the applicability of the methods, the calculations are compared against measurements and FEM simulations. By selecting a proper calculation method for each winding type, the winding losses can be predicted quite accurately before actually constructing the transformer. The transformer leakage inductance, the amount of which can also be calculated with reasonable accuracy, has a significant impact on the semiconductor switching losses. Therefore, the leakage inductance effects should also be taken into account when considering the overall efficiency of the converter. It is demonstrated in this thesis that although there are some distinctive differences in the loss distributions between the converter topologies, the differences in the overall efficiency can remain within a range of a few percentage points. However, the optimization effort required in order to achieve the high efficiencies is quite different in each topology. In the presence of practical constraints such as manufacturing complexity or cost, the question of topology selection can become crucial.

Measurement of serum estrogen and estrogen metabolites in pre- and postmenopausal women with osteoarthritis using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry

Although 17β-estradiol (E2) deficiency has been linked to the development of osteoarthritis (OA) in middle-aged women, there are few studies relating other estrogens and estrogen metabolites (EMs) to this condition. We developed a high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS) method to measure the levels of six EMs (i.e., estrone, E2, estriol, 2-hydroxyestrone, 2-hydroxyestradiol, and 16a-hydroxyestrone) in healthy pre- and postmenopausal women and women with OA. This method had a precision ranging from 1.1 to 3.1% and a detection limit ranging from 10 to 15 pg. Compared to healthy women, serum-free E2 was lower in the luteal and postmenopausal phases in women with OA, and total serum E2 was lower in postmenopausal women with OA. Moreover, compared to healthy women, total serum 2-hydroxyestradiol was higher in postmenopausal women with OA and total serum 2-hydroxyestrone was lower in both the luteal and follicular phases in women with OA. In conclusion, our HPLC-ESI-MS/MS method allowed the measurement of multiple biochemical targets in a single assay, and, given its increased cost-effectiveness, simplicity, and speed relative to previous methods, this method is suitable for clinical studies.

The use of film coating on the performance of treated corn seed

The main objective of seed coating technology using polymers is to improve the physical, physiological and sanitary characteristics of seed performance. The objectives of the present study were to determine: the plantability of corn seeds treated with insecticide, fungicide and graphite, covered with a film coating; the dust retention on treated corn seeds; and the leaching of applied products on corn seeds covered by a film coating. Seed plantability was determined by counting the skips and double seeds; dust was determined by using fiberglass paper in mg.100 g-1 of seeds; and the leaching was determined by collecting the material leached in a 10 cm layer of sand after irrigation. The following conclusions were made: seeds covered with film coating effectively reduce skips and double seeds; film coating effectively reduces the formation of dust from the seeds; film coated seeds minimize the leaching of the insecticide applied in seed treatment; and there are differences in effectiveness related to film coating type and dosage.

The effectiveness of explicit strategy instruction on the top level structure of a text

Thesis (M.Ed.)-- Brock University, 1995.