An examination of factors influencing effective and continuous improvement of Indonesian contractors' quality management systems

This paper presents the results of a pilot study examining the factors that impact most on the effective implementation of, and improvement to, Quality Mangement Sytems (QMSs) amongst Indonesian construction companies. Nine critical factors were identified from an extensive literature review, and a survey was conducted of 23 respondents from three specific groups (Quality Managers, Project Managers, and Site Engineers) undertaking work in the Indonesian infrastructure construction sector. The data has been analyzed initially using simple descriptive techniques. This study reveals that different groups within the sector have different opinions of the factors regardless of the degree of importance of each factor. However, the evaluation of construction project success and the incentive schemes for high performance staff, are the two factors that were considered very important by most of the respondents in all three groups. In terms of their assessment of tools for measuring contractor’s performance, additional QMS guidelines, techniques related to QMS practice provided by the Government, and benchmarking, a clear majority in each group regarded their usefulness as ‘of some importance’.

Restorative treatment practices and dentist-related factors

This study aimed at elucidating real-life aspects of restorative treatment practices. In addition, dentists' views and perceptions of and variation in restorative treatment practices with respect to dentist-related factors were evaluated. Reasons for placement and replacement of restoration, material selection, posterior restoration longevity, and the use of local anesthesia were assessed on two cross-sectional data sets. Data from the Helsinki Public Dental Service (PDS) included details on 3057 restorations performed by dentists (n=134) during routine clinical work in 2001. The other PDS data from Vantaa were based on 205 patient records of young adults containing information on 1969 restorations investigated retrospectively from 1994-1996 backwards; 51 dentists performed the restorations. In addition, dentists’ self-reported use of local anesthesia and estimates of restoration longevity were investigated by means of a nationwide questionnaire sent to 592 general dental practitioners selected by systematic sampling from the membership list of the Finnish Dental Association in 2004. All data sets included some background information on dentists such as gender, year of birth or graduation, and working sector. In PDS in 2001, primary caries was the reason for placement of restoration more often among patients aged under 19 years than among older patients (p<0.001). Among patients over 36 years of age, replacements represented the majority. Regarding dentist-related factors, replacements of restorations were made by younger dentists more frequently than by older dentists (p<0.001). In PDS in 1994-1996, the replacement rate of posterior restorations was greater among female dentists than among male dentists (p=0.01), especially for amalgams (p=0.008). The mean age of replaced posterior restoration among young adults was 8.9 (SD 5.2) years for amalgam and 2.4 (SD 1.4) years for tooth-colored restorations, the actual replacement rate for all existing posterior restorations being 7% in PDS in 1994-1996. Of all restorative materials used, a clear majority (69%) were composites in PDS in 2001. Local anesthesia was used in 48% of cases and more frequently for older patients (55%) than for patients aged under 13 years (35%) (p<0.001). Younger dentists more often used local anesthesia for primary restoration than did the older dentists (p<0.001), especially for primary teeth (p=0.005). Working sector had an impact on dentists’ self-reported use of local anesthesia and estimates of restoration longevity; public sector dentists reported using local anesthesia more frequently than private sector dentists for Class II (p=0.04) and for Class III restorations (p=0.01). Private sector dentists gave longer estimates of posterior composite longevity than public sector dentists (p=0.001). In conclusion, restorative treatment practices seem to vary according to patient age and also dentist-related factors. Replacements of restorations are common for adults. For children, clear underuse of local anesthesia prevails.

Pour une constitutionnalisation du droit à la sécession au Canada

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit, option recherche (LL.M.)"

La démocratie et la Loi sur la clarté : réflexions sur la règle de la majorité dans le cadre d'un référendum

"Mémoire présenté à la faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit (LL.M.)"

Securing provision for children with autistic spectrum disorders: the views of parents

An original questionnaire was designed to seek the perspectives of parents about the process of securing appropriate educational provision for their child with autism spectrum disorder. In total, 738 responses were analysed using both quantative and qualitative data. Although a broad range of opinion was evidenced and a clear majority of families were happy with the end decision of placement, most families were significantly less happy with the process to determine that provision. Most families found this process difficult to navigate and frustrating. This caused a high level of stress for a significant proportion of families. Implications for practice are discussed.

Concepts for a geostationary-like polar missions

An evidence-led scientific case for development of a space-based polar remote sensing platform at geostationary-like (GEO-like) altitudes is developed through methods including a data user survey. Whilst a GEO platform provides a nearstatic perspective, multiple platforms are required to provide circumferential coverage. Systems for achieving GEO-like polar observation likewise require multiple platforms however the perspective is non-stationery. A key choice is between designs that provide complete polar view from a single platform at any given instant, and designs where this is obtained by compositing partial views from multiple sensors. Users foresee an increased challenge in extracting geophysical information from composite images and consider the use of non-composited images advantageous. Users also find the placement of apogee over the pole to be preferable to the alternative scenarios. Thus, a clear majority of data users find the “Taranis” orbit concept to be better than a critical inclination orbit, due to the improved perspective offered. The geophysical products that would benefit from a GEO-like polar platform are mainly estimated from radiances in the visible/near infrared and thermal parts of the electromagnetic spectrum, which is consistent with currently proven technologies from GEO. Based on the survey results, needs analysis, and current technology proven from GEO, scientific and observation requirements are developed along with two instrument concepts with eight and four channels, based on Flexible Combined Imager heritage. It is found that an operational system could, mostly likely, be deployed from an Ariane 5 ES to a 16-hour orbit, while a proof-of-concept system could be deployed from a Soyuz launch to the same orbit.

Physicians' knowledge and continuing medical education regarding fitness to drive: a questionnaire-based survey in Southeast Switzerland

Valid information for physicians in Switzerland concerning knowledge and continuing education in traffic medicine is not available. Also, their attitude to the legally prescribed periodic driving fitness examinations is unclear. In order to gain more information about these topics, 635 resident physicians in Southeast Switzerland were sent a questionnaire (response rate 52%). In a self-estimation, 79% of the queried physicians claimed to know the minimal medical requirements for drivers which are important in their specialty. Statistically significant differences existed between the specialties, whereby general practitioners most frequently claimed to know the minimal medical requirements (90%). It appears that the minimal medical requirements for drivers are well known to the queried physicians. Fifty-two percent of the physicians favored an expansion of continuing education in traffic medicine. Such an expansion was desired to a lesser extent by physicians without knowledge of the minimal requirements (p < 0.001). A clear majority of the medical professionals adjudged the legally prescribed periodic driving fitness examinations as being an expedient means to identify unfit drivers. A national standardized form for reporting potentially unfit drivers to the licensing authorities was supported by 68% of the responding physicians. Such a form could simplify and standardize the reports to the licensing authorities.

Euro 2012 – Ukraine’s wasted opportunity? OSW Commentary 80, 2012-06.08

Ukraine saw hosting the European Football Championship as an important project in terms of image-building and modernisation from the very beginning. The country’s government assumed, during the presidency of Viktor Yushchenko and Viktor Yanukovych alike, that Euro 2012 would provide a major impulse for economic development and show that the young Ukrainian state was capable of successfully preparing one of the most important sport tournaments in the world. Although UEFA’s decision raised eyebrows both in the West and in Ukraine, after initial delays the work gained momentum and, shortly before the championship, Ukraine’s progress could be evaluated as being satisfactory at the least. As part of the preparations, four stadiums were built or modernised, four airports in the host cities were developed and 1,600 km of roads were repaired or built from the ground up. The investments have doubtlessly contributed to an improvement of the infrastructure in Ukraine, but it would be rather inaccurate to say that Euro 2012 has brought about a real modernisation of the country. The funds allocated for the preparations were relatively modest, and part of them was spent in a non-transparent way, which gives rise to suspicions of corruption. The chance to improve Ukraine’s perception in the West has been to a great extent lost due to the trial of the former prime minister, Yulia Tymoshenko, who was sentenced to seven years in prison in October 2011. Over the past few weeks, Euro 2012 as a sports event has been overshadowed by discussions among Western politicians and in the Western media about rising authoritarian tendencies in Ukraine. In turn, football is currently treated as a minor issue in Ukraine’s internal politics. The government has so far not used Euro 2012 to improve its popularity although hosting it is supported by a clear majority of the Ukrainian public. It is still an open question as to whether the Ukrainian government will try to capitalise politically on this sports event; this is especially significant as parliamentary elections are approaching.

Awkward partner once again? Repercussions for Europe of Poland’s elections. EPIN Commentary No. 27, 3 November 2015

A clear majority of Poles voted to end eight years of Civic Platform (PO) government on October 25th when they brought the national-conservative Law and Justice Party (PiS) back to power. This outcome might be difficult to understand for Poland’s West European partners and may also confuse some EU officials who have observed developments in Poland since it joined the EU in 2004. The implications of these elections for relations with Germany and France, and for Poland’s own EU policy, are a source of concern. Do the results herald a return to the country Poland was during its early years as EU member? In this EPIN commentary the author attempts to throw light on the reasons behind the return to power of Law and Justice Party and considers the wider implications for the EU and European cohesion.

Ethical issues about shared medical records

Focal points: Patient views on pharmacists' access to medical records was studied using a self-completion questionnaire in medical practice and two community pharmacies There was some support for pharmacist access to records with a third of the sample being unsure There was a majority support when the purpose was clearly pharmacy related A clear majority was confident of confidentiality in the pharmacy

Comply-or-explain in Sweden : A study on the quality of non-compliance explanations

Purpose: The purpose of this study is to examine the effectiveness of the comply-or-explain principle in Sweden to determine if the flexible approach is functioning as in-tended. Research design: This paper scrutinizes the quality of the explanations with respect to the Swedish Corporate Governance Code. A quantitative research with a cross-sectional design has been performed and the data collection covers 241 companies listed on Nasdaq OMX Stockholm for the fiscal year of 2014. The secondary data has been gathered from corporate governance reports of the researched companies and analysed by using a tax-onomy of explanations. Findings: The report demonstrates that the comply-or-explain principle in Sweden is effective. A clear majority of the explanations, 71,8%, were deemed as informative, mean-ing that a large proportion of the Swedish firms are utilizing the flexible approach in an effective manner. However, one out of four explanations were classified as insufficient and we have thus provided recommendations in order for the code to become even more effective. Contribution: Our findings provide insights on how the comply-or-explain principle works in a country that is supposed to be a leading example of how the comply-or-explain approach should be implemented. This study should be of significance for policy makers considering that we have outlined how the principle works and provided recommenda-tions on how the Swedish Corporate Governance Code can be improved. Value: Our findings demonstrate that companies listed on Nasdaq OMX Stockholm pro-vide high quality explanations that can serve as an inspiration for companies listed in other countries. Furthermore, the results indicate that managers are likely to act within ethically desired norm. Considering the social implications, as Swedish firms are informative in terms of explanations, it minimizes the risk of firms acting dishonestly.

What do participants of the Crohn's and Colitis UK (CCUK) Annual York Walk think of their Inflammatory bowel disease care? A short report on a survey

There has been a growing interest in a patient-centered model of care in inflammatory bowel disease; however, no relevant study using a mixed methodology has been conducted to date. Thus, our multidisciplinary group aimed to explore the issue of patient involvement in care among the inflammatory bowel disease community. A mixed-methods anonymous survey was conducted during the Crohn's and Colitis UK annual event. Summary statistics were used to describe the sample, and a simple thematic analysis identified key themes in qualitative responses. There were 64 survey respondents, representing 73% of the total family/friend groups participating (N = 87). Overall, 75% of respondents answered that they had the opportunity to discuss their care with their inflammatory bowel disease practitioner and 81% felt their opinions were taken on board and valued. A clear majority (84%) had at some point been treated by a gastroenterologist. In contrast, less than half (44%) had the opportunity for a dietician consultation and only 28% had the opportunity for a psychologist/counselor consultation. Although satisfaction with inflammatory bowel disease care was high, access to specialty services was concerning. Efforts should be made to provide access to mental health practitioners for those with clinically significant anxiety and/or depression.

An innovative online intervention: The Steering Clear First Offender Drink Driving Program

Drink driving remains a substantial public health issue warranting investigation. First offender drink drivers are seen to be less risky than repeat offenders, though the majority of first offenders report drink driving prior to detection, and many continue to drink drive following conviction. Few first offenders are offered treatment programs, and as such there is a need to address drink driving behaviour at this stage. A comprehensive approach including first offender treatment is needed to address the problem. Online interventions have demonstrated effectiveness in reducing risky behaviours such as harmful substance use. Such interventions allow for personalised tailored content to be delivered to individuals targeting specific mechanisms of behavioural change. This method also allows for targeting screening to ensure relevance of content on an individual level. However, there have been no research based online programs to date aimed at reducing repeat drink driving by first offenders. The Steering Clear First Offender Drink Driving Program is a self-guided, research based online program aimed at reducing recidivism by first time drink driving offenders. It includes a specialised web app to track drinks and build plans to prevent future drink driving. This allows for elongation of learning and encouragement of sustained behavioural change using self-monitoring after initial program completion. An outline of the program is discussed and the qualitative experience of the program on a sample of first offenders recruited at the time of court appearance is described.

Searching for the majority: algorithms of voluntary control.

Voluntary control of information processing is crucial to allocate resources and prioritize the processes that are most important under a given situation; the algorithms underlying such control, however, are often not clear. We investigated possible algorithms of control for the performance of the majority function, in which participants searched for and identified one of two alternative categories (left or right pointing arrows) as composing the majority in each stimulus set. We manipulated the amount (set size of 1, 3, and 5) and content (ratio of left and right pointing arrows within a set) of the inputs to test competing hypotheses regarding mental operations for information processing. Using a novel measure based on computational load, we found that reaction time was best predicted by a grouping search algorithm as compared to alternative algorithms (i.e., exhaustive or self-terminating search). The grouping search algorithm involves sampling and resampling of the inputs before a decision is reached. These findings highlight the importance of investigating the implications of voluntary control via algorithms of mental operations.

Role of transforming growth factor-α in von Hippel– Lindau (VHL)−/− clear cell renal carcinoma cell proliferation: A possible mechanism coupling VHL tumor suppressor inactivation and tumorigenesis

Mutations of the VHL tumor suppressor gene occur in patients with VHL disease and in the majority of sporadic clear cell renal carcinomas (VHL−/− RCC). Loss of VHL protein function is associated with constitutive expression of mRNAs encoding hypoxia-inducible proteins, such as vascular endothelial growth factor. Overproduction of angiogenic factors might explain why VHL−/− RCC tumors are so highly vascularized, but whether this overproduction is sufficient for oncogenesis still remains unknown. In this report, we examined the activity of transforming growth factor-α (TGF-α), another VHL-regulated growth factor. We show that TGF-α mRNA and protein are hypoxia-inducible in VHL−/− RCC cells expressing reintroduced VHL. In addition to its overexpression by VHL−/− RCC cells, TGF-α can also act as a specific growth-stimulatory factor for VHL−/− RCC cells expressing reintroduced wild-type VHL, as well as primary renal proximal tubule epithelial cells, the likely site of origin of RCC. This role is in contrast to those of other growth factors overexpressed by VHL−/− RCC cells, such as vascular endothelial growth factor and TGF-β1, which do not stimulate RCC cell proliferation. A TGF-α-specific antisense oligodeoxynucleotide blocked TGF-α production in VHL−/− RCC cells, which led to the dependence of those cells on exogenous growth factors to sustain growth in culture. Growth of VHL−/− RCC cells was also significantly reduced by a drug that specifically inhibits the epidermal growth factor receptor, the receptor through which TGF-α stimulates proliferation. These results suggest that the generation of a TGF-α autocrine loop as a consequence of VHL inactivation in renal proximal tubule epithelial cells may provide the uncontrolled growth stimulus necessary for the initiation of tumorigenesis.