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West, Christian J. (Christian Joseph). "A comparison of software project architectures : agile, waterfall, spiral, and set-based." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/118510.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, System Design and Management Program, 2018.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (pages 99-101).<br>Engineers and managers of software projects have the daunting task of successfully delivering the right product at the right time for the right price. The path to achieving these lofty goals is commonly not a straightforward endeavor. Due to the dynamic nature of software development, varying organizational circumstances, and situational idiosyncrasies of each project this can be a very difficult and sensitive process. Ideally, software development methodologies bring order to the chaos of software development. An ill-fitting development strategy, however, can create unnecessary friction and further complicate the prospect of a successful product delivery. Researchers and private organizations alike spend substantial resources to understand the strengths and weaknesses of commonly used development practices - the validation of which is highly problematic due to conflicting variables. This research ventures to bring clarity to the question: "Which development methodology is right for a particular situation?" Treating the software development project life-cycle as a socio-technical system, it can be decomposed to the most fundamental elements. Using these elements as the architectural building blocks of a project, Agile, Waterfall, Set-Based, and Spiral are each compared at the molecular level. This thesis evaluates these comparisons and how subsequent research applies to today's software projects.<br>by Christian J West.<br>S.M. in Engineering and Management
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Scanlon, Eben Louis 1974. "Predicting the triple beta-spiral fold from primary sequence data." Thesis, Massachusetts Institute of Technology, 2004. http://hdl.handle.net/1721.1/16617.
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Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science; and, (M.B.A.)--Massachusetts Institute of Technology Sloan School of Management, 2004.<br>Includes bibliographical references (leaves 118-125).<br>This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.<br>The Triple β-Spiral is a novel protein structure that plays a role in viral attachment and pathogenesis. At present, there are two Triple β-Spiral structures with solved crystallographic coordinates - one from Adenovirus and the other from Reovirus. There is evidence that the fold also occurs in Bacteriophage SF6. In this thesis, we present a computational analysis of the Triple β-Spiral fold. Our goal is to discover new instances of the fold in protein sequence databases. In Chapter 2, we present a series of sequence-based methods for the discovery of the fold. The final method in this Chapter is an iterative profile-based search that outperforms existing sequence-based algorithms. In Chapter 3, we introduce specific knowledge of the protein's structure into our prediction algorithms. Although this additional information does not improve the profile-based methods in Chapter 2, it does provide insight into the important forces that drive the Triple β-Spiral folding process. In Chapter 4, we employ logistic regression to integrate the score information from the previous Chapter into a single unified framework. This framework outperforms all previous methods in cross-validation tests. We do not discover a great number of additional instances of the Triple β-Spiral fold outside of the Adenovirus and Reovirus families. The results of our profile based templates and score integration tools, however, suggest that these methods might well succeed for other protein structures.<br>by Eben Louis Scanlon.<br>M.B.A.<br>S.M.
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Karlsson, Ann-Charlotte, and Robert Patzelt. "Knowledge Management : en fallstudie av hotellbranchens förutsättningar att införa kunskapsutveckling som styrmedel." Thesis, Södertörn University College, School of Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-2874.
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<p>The purpose with this paper is to find out how the knowledge development is functioning within the hotel industry and if it would be possible to implement Knowledge Management as a strategy.</p><p>The procedure used during the method part is a case study, with semi structured interviews. The method of reasoning during this paper has been abduction this is because the approach to this research has oscillated between both a deduction and a induction approach.</p><p>The theories that this paper have been based upon is Mr I Nonaka’s thoughts around the four modes of knowledge; Socialization, Externalization, Combination and Internalization. The four different modes are comparable to four different ways of learning that are separate from each other but at the same time connected through a knowledge spiral which makes it possible for the four modes to collaborate as a unit of knowledge.</p><p>Six interviews have been carried out for the empirics, the interviews all came from different fields of work. During the interviews almost all of the personnel asked where positive to knowledge development and knowledge exchange both within the hotel and with the outside. The only exception was the cleaner who only was focused on a internalization mode of learning. The interviews also showed that the there is a will amongst almost all personnel to take part in the procedure of all the knowledge modes but the monetary aspect and the lack of time makes it harder for them to do so.</p><p>The result of the analysis of this paper is that the hotel where the case study was made was that, if used the hotel could benefit from a knowledge management strategy but it is nothing they implement in their management of the hotel today.Also shown in the analysis is that if the knowledge management strategy is supposed to be successful within the hotel and make them save both money and time all different fields of work within the hotel must be involved and time must be invested to save time. But most important of all the management must realize how much power there is in knowledge.</p>
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Freiin, von Dörnberg Alix Donata. "Knowledge Management towards Innovation : How can organizations utilize knowledge management to foster innovation?" Thesis, KTH, Industriell ekonomi och organisation (Inst.), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-254199.
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Being innovative allows organizations to be part of the rapid competitive and environmental shifts and requires the development of knowledge as it builds the pathway of innovation. Since most companies find it troublesome to effectively utilize their existing knowledge towards innovations and literature lacks to offer solutions, this study aims to determine factors that contribute to an enhancement of the spiral of knowledge as well as to develop a concept that provides counselling for business and academia on how to overcome this issue. Therefore, this study contributes with new insights to the field of research in knowledge management and innovation management as well as to organizations with a concept on how to operationalize knowledge management towards innovation. Based on literature review on innovation management, knowledge management and organizational agility, a hypothesis was established that claimed that agile feedback loops at the spiral of knowledge would facilitate the utilization of knowledge management towards innovation. Expert interviews allowed the identification of factors that are relevant for tapping the potential of knowledge towards innovation. The analysis of their responses disclosed a common request to include feedback during the knowledge transformation but also revealed that design thinking and an innovative organizational culture are further relevant factors. Thus, the study postulates a concept that refines the spiral of knowledge to the ‘spiral of knowledge and innovation’, which extents the ‘spiral of knowledge’ with agile feedback loops, design thinking as well as an innovative organizational culture.
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Votruba, Jan. "Návrh využití nových přístupů managementu ve strojírenské firmě." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2021. http://www.nusl.cz/ntk/nusl-443240.
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The aim of this thesis is to create a set of recommendations for the selected engineering enterprise. The purpose of these recommendations is to increase the enterprise effectivness and its adaptability quotient. In the first part of this thesis, based on a literature search, the management systems of successful Czech and foreign entrepreneurs are described. In the next part the most appropriate managerial approach is chosen on the basis of the performed qualitative research and this section also describes the current situation of the selected engineering enterprise. In the last part are given individual recommendations and steps to achieve their implementation.
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Mizell, Carolyn. "QUANTITATIVE ASSESSMENT OF SOFTWARE DEVELOPMENT PROJECT MANAGEMENT ISSUES USING PROCESS SIMULATION WITH SYSTEM DYNAMICS ELEMENTS." Doctoral diss., University of Central Florida, 2006. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4291.
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The complexity of software development projects makes estimation and management very difficult. There is a need for improved cost estimation methods and new models of lifecycle processes other than the common waterfall process. This work has developed a new simulation model of the spiral development lifecycle as well as an approach for using simulation for cost and schedule estimation. The goal is to provide a tool that can analyze the effects of a spiral development process as well as a tool that illustrates the difficulties management faces in forecasting budgets at the beginning of a project which may encourage more realistic approaches to budgetary planning. A new discrete event process model of the incremental spiral development lifecycle approach was developed in order to analyze the effects this development approach has on the estimation process as well as cost and schedule for a project. The input data for the key variables of size, productivity, and defect injection rates in the model was based on analysis of Software Engineering Laboratory data and provided for analysis of the effects of uncertainty in early project estimates. The benefits of combining a separate system dynamics model with a discrete event process models was demonstrated as was the effects of turnover on the cost and schedule for a project. This work includes a major case study of a cancelled NASA software development project that experienced cost and schedule problems throughout its history. Analysis was performed using stochastic simulation with derived probability distributions for key software development factors. A system dynamics model of human resource issues was also combined with the process model to more thoroughly analyze the effects of turnover on a project. This research has demonstrated the benefits of using a simulation model when estimating to allow for more realistic budget and schedule determination including an interval estimate to help focus on the uncertainty of early estimates.<br>Ph.D.<br>Department of Industrial Engineering and Management Systems<br>Engineering and Computer Science<br>Industrial Engineering and Management Systems
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Cheong, Chit Sun. "Contractors business development for overseas markets." Thesis, Loughborough University, 2010. https://dspace.lboro.ac.uk/2134/7142.
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The survival and sustainable development of construction contractors depends on their own capacity as well as their ability to cope with the ever changing environment. Hong Kong was once a large construction market by the world standards; but in the period 1998 to 2007 has suffered from long term market shrinkage. This shrinkage in the work load available in the market has demanded that Hong Kong contractors change their business strategy and consider expanding their construction business to the international marketplace. From surveys and studies of Hong Kong contractors, it is noted that traditionally the majority of contractors organizations were not active in participating in the international construction markets. The prime reasons were that the Hong Kong domestic market was large enough to sustain the contractors and that Hong Kong construction professionals are reluctant to work overseas. However due to the continuous shrinkage of the market, Hong Kong contractors were being forced to consider expanding their construction business to the overseas markets in order to survive. This thesis reviews existing theories and previous studies in overseas con-struction business development. It analyzes surveys of Hong Kong con-struction contractors and conducts a scientific study of a Hong Kong based contractor organization which expanded its construction business to overseas markets. This study was conducted through an integrated action research methodology. Based on the problems, impacts, difficulties and success this organization faced during its practical experience in the overseas business expansion, this thesis explores and recommends a structured approach for Hong Kong contractors to re-define and develop their business overseas. The focus of study is the pre-contract award stage of business development. It focuses on the entry modes, strategic planning, risk management and tender management of the organization. The author also presents various models for use in attaining width and depth of understanding of overseas knowledge. These include preliminary entry selection model, dynamic management, and a spiral model (a learning & knowledge based business development model), for use in the management of international construction business development at the pre-contract stage. The groundwork laid down in this thesis will form the basis for further studies and the development of theories / models. It is the expectation of the author that other contractors in Hong Kong and other nation s contractors may make use of this research as assistance to their overseas business development. The ultimate aim of the author has been to change the goal of contractors from being companies able to compete with international contractors in their domestic market to contractors that are able to compete in the international market place.
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Anderson, Jaqualynn Marie. "When Partisanship is Too Risky: Understanding the Expression of Political Identity." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586528699884244.
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Anderson, David Barrett. "Optimising Management of Lumbar Spinal Stenosis." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25075.
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Low back pain is the leading cause of disease burden globally, impacting over half a billion people. Low back pain is a broad classification of a condition which includes multiple clinical presentations, such as spondylosis, discogenic pain, muscle and ligament injuries, and lumbar spinal stenosis (LSS). This thesis has focused on LSS, which itself is a leading cause of pain, disability, and reduced quality of life among older adults. Eight chapters are included in this thesis that aims to improve the management of LSS.
Chapter One was an introduction to LSS, its diagnosis, prevalence, and current management.
Chapter Two outlined the largest known cohort study of emergency department attendance and hospital admission for low back pain conditions (e.g., LSS, disc protrusion) in New South Wales, Australia, between 2005 and 2014. This cohort study found that attendance to emergency departments and hospital admissions increased over the 10-years of the study, possibly due to the ageing Australian population, given an increase in the mean age of the people who presented over the study period. The study also found that people who were from lower socioeconomic backgrounds or who were managed under a worker’s compensation scheme had lower odds of being admitted to hospital following their presentation to the emergency department with a low back pain condition. Having demonstrated that both the attendance rates to hospital emergency departments and the mean age of the population presenting for low back pain had increased in recent years, more information on currently endorsed treatments for LSS, the most common lumbar pain presentation among older people, was sought.
Chapter Three was a systematic review of international LSS clinical practice guidelines that examined the quality of the guidelines themselves, and the evidence supporting their treatment recommendations. Chapter Three found that around three-quarters of the recommendations presented in international practice guidelines for LSS were based on poor-quality evidence. There were no recommendations in the guidelines based on high-quality evidence. This study also identified that overall, guidelines made more recommendations in favour of surgery and injections than for medications and other non-surgical treatments, despite the evidence for both interventions being comparable. The absence of good evidence to support treatments for LSS highlighted the need for more high-quality studies to be conducted on LSS. To assist with increasing the number of high-quality studies conducted on LSS, a series of studies were planned to help inform the design of future studies. Initially, two systematic reviews were planned on key aspects of study design.
The first review in Chapter Four was on the measurement properties of outcome measures and the second, presented in Chapter Five, on placebo-controlled trials of surgery for musculoskeletal conditions, including spinal conditions. Although the choice of appropriate outcome measures should be at the centre of trial design, their measurement properties are often overlooked. The review on outcome measures outlined in Chapter Four aimed to identify the walking test(s) with the best measurement properties in people with LSS. Walking tests were selected as the outcome of priority, as people living with LSS often nominate walking ability as the most important part of their condition that they want improved. A systematic review and meta-analysis were therefore conducted on the measurement properties used to assess LSS. This study found that there was a limited number of studies assessing the key measurement properties of validity, reliability, and responsiveness. Of the data that were available, the self-paced walking test and walking item of the Oswestry Disability Index were recommended to be used together before and after any intervention for LSS.
Next, the review on placebo-controlled trials of surgery for musculoskeletal conditions was completed as presented in Chapter Five. The rationale for this review was based upon the findings of Chapter Three confirming the lack of studies utilising high-quality methods including randomisation, placebo-controls, and adequate blinding. It is well known that randomised, placebo-controlled trials are the gold standard for determining the efficacy of interventions, because of their ability to account for placebo and other non-specific effects. A systematic review was conducted in Chapter Five to investigate the number and quality of existing randomised placebo-controlled trials of surgical management of musculoskeletal conditions. Whilst the study found that no randomised placebo-controlled trials had been completed on LSS, 18 trials had been completed on other musculoskeletal conditions (e.g., vertebroplasty for vertebral compression fractures).
Chapter Five found a rapid increase in the number of placebo-controlled trials of musculoskeletal conditions, from 2 trials before the year 2000 to 20 trials between 2001 and 2020. The study also found that the majority of trials (59%) used a high-fidelity placebo control, which was the degree in which the placebo procedure mimicked all but the ‘active’ component of the surgical procedure being assessed. Minimal fidelity placebo controls were those that had only minimal resemblance to the surgical procedure, such as using a skin incision only, when assessing meniscal repair. The vast use of high-fidelity placebo surgery suggests an increased focus on accounting for non-specific effects and maximising blinding of patients in placebo trials of musculoskeletal surgery. Considering the level of fidelity and other methodological aspects of placebo-controlled trials of surgery can help to improve their feasibility and impact on policy and practice.
Following decisions on level of treatment fidelity, another important aspect to trial design in placebo-trials included engaging key stakeholders in the design process, as discussed by Beard et al (2020) in their Lancet paper on consideration and methods of placebo studies.
In Chapter Six, LSS patients considered eligible for spine surgery were surveyed to determine their opinions, including barriers to participation in a placebo-controlled surgical trial. The study suggested that a placebo-controlled trial was feasible, with just under 1 in 5 eligible patients with LSS stating that they would consider participation in a placebo-surgical trial of LSS. Following the engagement of LSS patients, spinal surgeons were then consulted in Chapter Seven, to better understand how they viewed the current evidence supporting LSS. Surgeons were also asked what change they expected following spine surgery, including on neurogenic claudication following lumbar decompression.
The key findings in Chapter Seven were that spine surgeons expected a mean improvement in neurogenic claudication by 3 months post-surgery of 86% (median: 87%, interquartile range (IQR): 80%, 91%), using a +/- 100% change scale. The majority of surgeons also rated the quality of evidence for lumbar decompression procedures, including decompression alone, decompression with fusion, and interspinous spacer, as low to moderate, supporting the need for future studies.
The combined results of Chapter Six and Seven then helped inform the first randomised placebo-controlled trial of decompression for LSS, which has its protocol outlined in Appendix One.
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Phang, Isaac Sng Khai. "Management of acute traumatic spinal cord injury." Thesis, St George's, University of London, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.703277.
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Traumatic spinal cord injury (TSCI) is a devastating condition. Most patients remain paralysed or wheelchair bound. After TSCI the injured cord swells and is compressed against the dura. My supervisors showed that, after TSCI, intraspinal pressure (ISP) rises and spinal cord perfusion pressure (SCPP) falls, leading to decreased spinal cord blood flow at the injury site. ISP can be monitored, but this is an invasive procedure that requires inserting a pressure probe at the injury site. My supervisors also showed that monitoring ISP and SCPP is feasible and helps guide management of TSCI patients in the intensive care unit. The thesis has five parts: 1) Study of the safety of ISP monitoring in TSCI patients. The data show that ISP monitoring is safe [42 patients]. 2) Study of the safety of performing magnetic resonance imaging (MRI) during ISP monitoring. The data show that MRI is safe with the ISP probe in situ [gel phantoms, 1 patient]. 3) Study of the pressure in and around the injured spinal cord. The data show that three intradural compartments form after TSCI, each with a different pressure profile. The data also show that subdural ISP is the same as intraparenchymal ISP at the injury site [1 patient]. 4) Study of whether laminectomy plus expansion duroplasty decompresses the injured spinal cord more effectively than laminectomy. The data show that laminectomy plus expansion duroplasty lowers ISP, increases SCPP and improves spinal pressure reactivity more than laminectomy [21 patients]. 5) Microdialysis monitoring from the injury site. The data show that increased SCPP is associated with improved metabolic profile at the injury site and that worse neurological status at presentation is associated with worse metabolic profile at the injury site. The data also suggest that the optimum SCPP is around 90 mmHg. Increasing SCPP improves the entry of intravenously administered drugs into the injury site [14 patients). The findings have important implications for the management of TSCI patients and the design of drug trials for TSCI.
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Etienne, Michele. "Total-Quality-Management im Spital erfolgreich gestalten /." Bern : Haupt, 2000. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=008939726&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Hayes, Susan M. "A Mixed Methods Perspective: How Integral Leaders Can Contribute to the Growth of Emerging Leaders." Antioch University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1444736633.
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Jee, Larry Donald. "The urological management of children with spinal dysraphism." Master's thesis, University of Cape Town, 1990. http://hdl.handle.net/11427/25677.
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This project was undertaken with the following aims: 1) To generate a data base concerning the management of children with congenital spinal anomalies, who are known to form a significant proportion of the patients being treated in the Department of Paediatric Urology at Red Cross Hospital. 2) To assess the results of the management of these children, with special attention to the goals of therapy, namely preservation of renal function, establishment of urinary continence and protection from urinary tract infection. 3) To compare the treatment methods and results obtained to those reported in the literature. 4) To evaluate critically the treatment methods and results obtained with a view to identifying areas where improvements are possible.
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Arora, Mohit. "Management of complications in people with spinal cord injury." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/17158.
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Pressure ulcers are a serious complication of spinal cord injury (SCI). This thesis includes four research projects namely a randomised controlled trial (RCT), a Cochrane systematic review and two psychometric studies. The first project was a prospective, multicentre, assessor blinded, parallel, RCT with a built-in economic evaluation. The trial investigated the effectiveness and cost-effectiveness of telephone-based management versus standard care of pressure ulcers in people with SCI in low- and middle-income countries (LMIC). People living in the community (n = 120) were randomly allocated to a control or intervention group. Participants in the intervention group received weekly advice by telephone for 12 weeks about the management of their pressure ulcers. The mean between-group difference for the area of pressure ulcer at 12 weeks was 2.3 cm2 (95% CI, -0.3 to 4.9; favouring the intervention group). Results of 8 of 13 secondary outcomes and cost-effectiveness analysis are sufficiently positive to justify a larger trial with the hope that this simple intervention may provide some relief from this insidious problem in the future. The second project systematically reviewed the evidence from RCTs investigating the effects of electrical stimulation for the treatment of pressure ulcers. This review concluded that surface electrical stimulation may have a small beneficial effect on pressure ulcers. The third and fourth project determined the psychometric properties of a telephone-based version of the SCI Secondary Conditions Scale (SCI-SCS) and measuring wound undermining in people with SCI. The intraclass correlation coefficients for telephone-based version of SCI-SCS and measuring wound undermining were excellent. The problem of pressure ulcers in LMIC is multi-faceted. The work in this thesis now needs to be further directed at prevention and treatment strategies as well as changes to healthcare systems in LMIC. This requires a big effort from national and international organisations to put pressure on policy and decision makers to tackle the challenging and important issue of pressure ulcers in people with SCI.
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Sensor, Jennifer Dawn. "HEARING AND AGE ESTIMATION IN TWO SPECIES OF ARCTIC WHALE." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1512125887991219.
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Alectoridis, Dímitra. "Interação entre profissionais de contabilidade gerencial e gestão de operações: uma observação baseada na construção de conhecimento." Universidade Presbiteriana Mackenzie, 2015. http://tede.mackenzie.br/jspui/handle/tede/956.
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Previous issue date: 2015-02-04<br>The pursuit of excellence in action and consistent results makes professionals have responsibility in managing their own knowledge and transformation in these techniques and tools capable of broadening the qualitative and quantitative gains within departments and companies. Knowledge management well applied to professional practice is a way of ensure good results, but this should be shared - as individual knowledge - and built - as possibility of collective knowledge. This study aims to evaluate the interaction between professionals of management accounting, also called controllership, and operations management professionals, by the light of Nonaka and Takeuchi's theory (1997) on knowledge creation in the company. Its objective was to provide a measure able to identify the maturity level of professionals in each area on modes of knowledge convertion proposed in this theory, including creating entrepreneurial knowledge in the general context. The results show that the professionals care about their individual knowledge and the transmission of this to their own teams, in addition to being concerned about internalize explicit knowledge for themselves. But when evaluating the results of conversion modes that require further relationship with other teams and availability to create knowledge independent of the immediate need, we have a group of professionals evaluated showing restrictions, partly due to lack of incentive from the company, for lack of intent of other professionals for that. The measurement of the knowledge creation to company receives the impact of these restrictions, and the general result this research shows that there is need for improvement in the behavior of management accounting managers and operations managers for the Knowledge Creation bring more effective results for companies.<br>A busca pela excelência nas ações e por resultados sólidos faz com que os profissionais tenham responsabilidade na gestão de seus próprios conhecimentos e na transformação destes em técnicas e ferramentas capazes de ampliar os ganhos qualitativos e quantitativos nos departamentos e nas empresas. A gestão do conhecimento bem aplicado às práticas dos profissionais é um meio de garantir bons resultados, mas para isso deve ser compartilhado enquanto conhecimentos individuais e construído enquanto possibilidade de conhecimentos coletivos. Este trabalho objetiva avaliar a interação entre profissionais das áreas de contabilidade gerencial, também chamada de controladoria, e de profissionais de gestão de operações, sob a luz da teoria de Nonaka e Takeuchi (1997) da Criação de Conhecimento na empresa. Seu objetivo foi gerar uma mensuração capaz de identificar o nível de maturidade dos profissionais de cada área nos modos de conversão de conhecimento proposto nesta teoria, incluindo a criação de conhecimento empresarial no contexto geral. Os resultados encontrados mostram que os profissionais se preocupam com seu conhecimento individual e a transmissão deste para suas próprias equipes, além de se preocuparem em internalizar conhecimentos explícitos para si. Porém quando são avaliados os resultados dos modos de conversão que exigem maior relacionamento com outras equipes e disponibilidade para criar conhecimento independente da necessidade imediata, temos um grupo de profissionais avaliados que mostram restrições, parte em função da falta de incentivo da empresa, parte por falta de intenção dos outros profissionais para isso. A mensuração da criação de conhecimento para empresa recebe o impacto dessas restrições, e como resultado geral a pesquisa mostra que há necessidade de melhoria no comportamento dos gestores de contabilidade gerencial e gestores de operações para que a Criação de Conhecimento traga resultados mais efetivos para as empresas.
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Maher, Christopher Gerard. "Clinical management of low back pain." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/17968.
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The 42 peer-reviewed journal publications in this DMedSc thesis are a subset of Prof Chris Maher’s 574 publications for the period 1988 – January 2018. The information in the published work is derived from his research and scholarship in this period. The publications are grouped in the following eight chapters: introduction to low back pain, triggers for low back pain, prevention, screening for serious pathology, prognosis, pharmacological management, non-pharmacological management and evidence-practice gaps.
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King, Charles. "Coping effectiveness training for people with spinal cord injury." Thesis, Open University, 1997. http://oro.open.ac.uk/54804/.
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This project describes the development, implementation and evaluation of a new psychological intervention for improving psychological adjustment and enhancing adaptive coping following spinal cord injury. The Coping Effectiveness Training programme developed is a group-based seven session long intervention. It is grounded on the cognitive theory of stress and coping developed by Lazarus and Folkman (198-+) and represents an original adaptation of the theory to the needs of this client group. The intervention was successfully implemented as part of the rehabilitation programme of a national spinal injury centre. Proactive strategies were necessary to establish the essential good collaboration with other rehabilitation staff and ensure good patient participation in the groups. A non-randomised controlled trial was used to evaluate the intervention, using nineteen participants from three Coping Effectiveness Training groups and nineteen carefully matched controls selected from the database of a previous study (Kennedy, 1995). Participants who attended the groups showed significantly greater reductions in levels of depression and anxiety compared to matched controls immediately after the intervention and at six weeks follow-up. indicating that the intervention had facilitated a significant improvement in participants' psychological adjustment to spinal cord injury. A trend towards a significant improvement in participants' self-concept was also found over the observation period. However. there was no evidence of significant changes in the coping strategies used by participants who attended the groups compared to matched controls. with the exception of the 'Acceptance' coping strategy. Most participants said the groups had been helpful in making the consequences of the injury more manageable, with the interaction with other group participants being highlighted as the most beneficial aspect of the intervention. It is proposed that the improvements made in psychological adjustment can be understood in terms of changes in participants' beliefs about the implications of spinal cord injury and about the coping skills needed to be able to continue living meaningful and satisfying lives.
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Noordeen, Mohammed Hilali. "Advances in the surgical management of early-onset spinal deformities (EOSD)." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:86208af9-0834-4a89-9ecc-15f590d7eb1a.
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Early-onset spinal deformity (EOSD) is characterised by detection of spinal deformity (scoliosis, kyphosis or multi-planar) in children at aged less than five years. The common causes could be classified under congenital, neuromuscular, syndromic and idiopathic etiologies. Early treatment is paramount in preventing rigid, severe and progressive deformities that can cause pulmonary compromise. The inability of lungs and thoracic cage to support normal ventilation at rest constitutes the pathophysiology in manifestation of thoracic insufficiency syndrome (TIS). The treatment options have evolved from observation, serial casting, bracing to surgery. Early definitive spinal fusion is now obsolete and contra-indicated for EOSD. Growing rods (submuscular or subfascial) continues to be the standard of care in treating these challenging deformities. Vertebral expandable prosthetic titanium rib (VEPTR) continues to be an attractive option for TIS but is fraught with high complication rate. I hereby present a theme on EOSD with a set of thirty three peer reviewed indexed publications and one surgical patent in treating such challenging conditions highlighting my original contribution as Consultant spinal surgeon spanning over two decades. My pioneering and ground-breaking research that has shaped the surgical management of EOSD and helped define 'standard of care' is presented. My novel and innovative concept of treating EOSD using magnet driven growing rod (MdGR) along with its preliminary results is discussed. MdGRs are an attractive alternative in eliminating need for repetitive anaesthesia facilitating normal cognitive development in comparison to growing rods (CGRs). They also improve pulmonary function in neuromuscular scoliosis. A brief one page summary of all my indexed publications with comments on originality and how they contributed to spinal surgery is enclosed at the end of each chapter. My current research update on MdGR project at Royal National Orthopaedic Hospital (Stanmore), my surgical patent National institute of clinical excellence (NICE) position statement on MdGRs and clinical guidance documents are attached appendices I - III.
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Boos, Leo. "Soziales Dilemma und die Organisation des Krankenhauses : die Aufgaben des Spitalmanagements /." Muri/Schweiz : SGGP, 2002. http://www.gbv.de/dms/zbw/357135555.pdf.
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Pountney, Teresa. "The effect of postural management on hip dislocation and spinal curvature in cerebral palsy." Thesis, University of Brighton, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.392865.
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Love, Janine Ann. "Respiratory management of the mechanically ventilated spinal cord injured patient in a critical care unit." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1008451.
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Background: Spinal Cord Injuries (SCIs) are traumatic, life-changing injuries that can affect every aspect of an individual's life and can lead to death if not treated timeously and appropriately. Respiratory complications occur frequently after the SCI and are the leading cause of mortality and morbidity. Respiratory complications are predictable based on the neurological level of impairment of the spinal cord lesion; the higher the neurological injury, the more severe the respiratory complication. Changes in pulmonary function, poor cough, hypersecretion, immobility and bronchospasm all contribute to the development of respiratory complications. If the patient is unable to protect his/her airway or if respiratory failure occurs, mechanical ventilation is often required. Many patients require prolonged ventilation and subsequently need to go for tracheostomies. The critical care nurse plays an important role in the early identification of complications and can, therefore, act to limit and prevent these complications, which may be a direct result from the injury or treatment modality such as mechanical ventilation. Respiratory management has been promoted in preventing and treating respiratory complications and is associated with better prognosis in the SCI patient. Design and method: The research study aims to explore and describe existing literature and to make recommendations for the respiratory management of a mechanically ventilated spinal cord injured patient in a critical care unit (CCU). A systematic review was undertaken with clear inclusion and exclusion criteria. Ethical principles were maintained throughout the study. The quality of the study was ensured by critically appraising data that was utilized in the systematic review. It is envisaged that the results from this systematic review will improve the respiratory management of the SCI patient and prevent any variations in practice. Results: Were presented under the following themes: priorities of care for the SCI patient in the acute phase, during the critical care phase and preventative care. Conclusion: The SCI patient regardless of the neurological level or completeness of injury should be admitted to the CCU for intensive ventilatory, cardiopulmonary support and hemodynamic monitoring in order to detect and prevent respiratory complications. The use of larger tidal volumes is associated with improved comfort and less dyspnea however if a patient has acute lung injury or ARDS the use of low tidal volumes 6ml/kg is recommended. Prevention and early identification of respiratory complications is associated with improved outcomes for the SCI patient.
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Slayback, Benjamin G. "Spinal cord injury and surfing| A quality of life study." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527752.
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<p> A spinal cord injury (SCI) can be debilitating and research is necessary to examine how patients' quality of life (QOL) can be improved through both psychological and physical remedies. This study's central research question was: Does participation in surfing improve perceptions of quality oflife in an individual with spinal cord injury? By interviewing eight individuals with SCis, the researcher attempted to assess, by means of a qualitative semi-structured interviews, whether participation in surfing activities had a positive impact on the respondents' perceived QOL. Respondents experienced improved QOL as a result of their participation in surfing with the Life Rolls On foundation because they felt supported, independent, relaxed, and exhilarated. Their perceived QOL was improved by the benefits of making friends and feeling like part of a community. It was hypothesized that respondents would report psychological benefits from recreational post-injury physical activities. These findings indicate support for the hypothesis.</p>
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Ng, Leo. "Investigation into the prevalence, spinal kinematics and management of adolescent male rowers with low back pain." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/2267.
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This thesis investigated back pain in adolescent rowers. A high prevalence of low back pain was found in adolescent male rowers. Differences in lumbar spine movement patterns during ergometer rowing were observed between genders and in adolescent males with back pain compared to those without. A cognitive functional intervention was tested in a randomized controlled trial and was demonstrated to reduce pain and disability, improve muscle endurance and alter sitting spinal postures in adolescent male rowers.
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Knetsch, Markus [Verfasser]. "B2B-Kommunikation: Mit der Social Media Spirale zum sozialen Unternehmen : eine Betrachtung unter besonderer Berücksichtigung einer konstruktivistischen Perspektive / Markus Knetsch." Siegen : Universitätsbibliothek der Universität Siegen, 2016. http://d-nb.info/1112326197/34.
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Maag, Daniel. "New public Management (NPM) im Gesundheitswesen : ein Überblick über die Ansätze in den Kantonen /." Muri/Schweiz : Zentralsekretariat SGGP, 2000. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=008932365&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Gatehouse, Simon. "Spinal deformity correlations with the use of EOS imaging in adolescent idiopathic scoliosis patients undertaking brace management." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/204296/1/Simon_Gatehouse_Thesis.pdf.
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This study investigated the function of spinal bracing in treating Adolescent idiopathic scoliosis (AIS).
Using bi-planar imaging (EOS), a three-dimensional assessment of how the brace achieves correction of the spinal deformity was performed utilizing the SterEOS software.
Across all scans, the immediate angular correction achieved with bracing appeared modest in the coronal plane. The results suggested no significant change in axial vertebral rotation.
Over sequential episodes there appeared no significant progression of deformity parameters. Bracing of scoliosis patients appeared therefore to have been universally effective across this cohort, though not in the anticipated manner of significant immediate correction.
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King, Jason. "Energy Release Management Through Manipulated Geometries of Surgical Devices." University of Akron / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=akron1342730044.
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Winnerkvist, Anders. "Management of thoracoabdominal aortic aneurysms and dissections : with emphasis on spinal cord protection in aneurysm repair and non-surgical treatment of type-B dissection /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-768-5/.
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Rodesch, Georges L. M. "Contribution to the study and therapeutic management of intra-dural spinal cord arterio-venous shunts in adults and children." Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210920.
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Cairns, Melinda Claire. "A pragmatic RCT comparing specific spinal stabilisation exercises and conventional physiotherapy in the management of recurrent low back pain." Thesis, Coventry University, 2002. http://curve.coventry.ac.uk/open/items/11bbd169-8b0e-ab44-fc10-bfbf23e97b8b/1.
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Background: Altered muscular function of the deep abdominal and back muscles has been implicated as a factor in the development and continuation of low back pain (LBP) and small-scale studies, on specific subgroups of LBP patients, have reported favourable outcomes when these dysfunctions are addressed using specific exercise training. However, these techniques are increasingly being incorporated into treatment packages for non-specific LBP in the UK despite little evidence of their effectiveness in this patient group. A multi-centered, pragmatic, randomized clinical trial, with 12-month follow-up, was therefore designed to investigate the effectiveness of incorporating specific spinal stabilisation exercises within a physiotherapy treatment package in the management of recurrent LBP patients. Methods: Following ethical approval, consenting patients with recurrent LBP, without significant levels of distress (as measured by the distress risk assessment method {DRAM}), were randomized to two groups; 'conventional' physiotherapy and the provision of an advice booklet (Cl) and 'conventional' physiotherapy, the provision of an advice booklet with the addition of specific spinal stabilisation exercises (SSSE). Randomisation was stratified for laterality, duration of symptoms and initial functional disability level {Roland Morris Disability Questionnaire—RMDQ} using a minimization procedure. Functional disability (RMDQ) was the main outcome, and generic, disease-specific and psychological measures were also collected. The trial was powered to detect a 5-point difference between groups using 90% power. A total of 221 patients were screened for entry into the trial and 97 were recruited from three metropolitan physiotherapy departments within the UK between May 1999 and September 2000. Results: All patients were between the ages of 19 and 60 years (mean 38.6, SD: 10.5) and had an average duration of symptoms of 8.7 (8.1) months. Over 30% of the patients screened for entry to the trial were excluded as they showed evidence of psychological distress. Both groups demonstrated improved functioning, reduced pain intensity and an improvement in the physical component of quality of life. Mean change (95% Cl) for RMDQ scores between baseline to 12-month follow-up were —4.5 (-6.2 to —3.6) for the SSSE group and -5.2 (-6.7 to —3.6) for the CT group. No statistically significant differences between the two groups were demonstrated for any of the outcome variables. Patients in the spinal stabilisation group received a slightly greater mean number of treatment sessions over a longer period than the conventional physiotherapy treatment group (7.5 (2.5) over 11 weeks compared to 5.9 (2.3) over 8 weeks respectively). Exploration of the content of each treatment package revealed a combination of treatments was used, most frequently active exercise and manual therapy, with little use of electrotherapy or mechanical lumbar traction. Discussion and Conclusion: This trial represents the largest to date investigating the effects of specific spinal stabilisation exercises, and the first examining their use in a recurrent LBP population. Results indicate that physiotherapy is effective in reducing functional disability and to a lesser extent pain intensity, with improvements maintained at one year following completion of treatment, but that the addition of spinal stabilisation exercises to conventional physiotherapy and an advice booklet, does not provide any obvious additional benefit in terms of functional disability or pain intensity. These findings are of importance as they support the ongoing use of physiotherapy treatment packages in the management of recurrent LBP patients, without significant levels of distress, but challenge the assumption that stabilisation training provides an additional benefit in this particular group of LBP patients.
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Oh, Soo Y. "Oedema in the hands of people with tetraplegia post spinal cord injury: building the evidence." Thesis, Griffith University, 2021. http://hdl.handle.net/10072/410155.
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Oedema in the hands of people with tetraplegia may occur in the early stages of rehabilitation and if left untreated, can cause joint stiffness, pain and decreased range of motion, subsequently affecting hand function (Boomkamp-Koppen et al., 2005; Faghri, 1997; Guerts, 2000; Howard & Krishnagiri, 2001; Villeco, 2012). Optimal hand and arm function has been considered as one of the most important factors in improving quality of life of people with tetraplegia (Anderson, 2004; Simpson et al., 2012; Snoek et al., 2004; Wagner et al., 2007). It is therefore important that secondary consequences, such as oedema, are managed effectively. However, there is a significant lack of research evidence specific to the management of oedema in the hands of people with tetraplegia. In response, the aim of this thesis was to build the evidence for improved oedema management in the hands of people with tetraplegia. The evidence-based practice (EBP) framework by Hoffmann et al. (2017) guided the development of the research questions within this research program. The first research question sought to explore clinical expertise and asked: What is the current clinical practice for the management of oedema in the hands of people with tetraplegia in Australia? The second research question sought to develop objective research evidence for the management of oedema and asked: What are the effects of two treatment methods (the Boxing Glove [BG] compression bandaging and Coban™ compression bandaging) for the management of oedema in the hands of people with tetraplegia? Finally, the patient’s perspectives were explored with the third research question: What is the experience of the two treatment methods from the perspective of people with tetraplegia? The research program included two studies. Firstly, an online survey of clinicians addressed the first research question and collected data regarding their perception of cause and prevalence of oedema, assessment and treatment methods, and challenges with oedema management and impacts on rehabilitation. The survey findings identified inconsistent practice methods for the management of oedema in the hands of people with tetraplegia and use of common practices that were not supported by evidence. For example, the BG splint, which is unique to the spinal cord injury (SCI) population, was reportedly used by 53% of the participants of the survey, was considered effective by no participants, and is not supported by any evidence. Compression bandaging, which has shown to be effective amongst other clinical areas, was only considered to be effective by 41% of the participants of the survey and again, lacked any evidence specific to people with tetraplegia. These survey findings informed the second study, which addressed the second and third research questions. A convergent mixed methods design focused on exploring the effects and experiences of two treatment methods used in current clinical practice: the BG compression bandaging and Coban™ compression bandaging. An ABA single case design (SCD) study measured changes in circumferential measurements following application of either the BG compression bandaging or Coban™ compression bandaging. Interpretative description (ID) (Thorne, 2016) guided semi-structured interviews that explored the experience of the two treatment methods from the perspective of people with tetraplegia. Five people with tetraplegia with oedema in their hands, participated in the mixed methods study and the converged analysis of the quantitative and qualitative results led to four key findings. Firstly, there was minimal treatment effect measured and described by participants for the BG compression bandaging. Secondly, Coban™ compression bandaging showed a promising treatment effect in reducing oedema in the hands and was the preferred treatment method among people with tetraplegia. Thirdly, oedema returned once Coban™ compression bandaging was removed and some people with tetraplegia were disappointed as they felt that they could do more with their hands when applied. Finally, people with tetraplegia expressed various priorities for rehabilitation, and managing oedema was not always the focus especially for those with other priorities relating to medical issues. The findings from this research program have contributed to an important first step in building the evidence for oedema management of the hands of people with tetraplegia. The findings provide low-level evidence in regards to the application of two commonly used treatment methods to manage oedema in the hands of people with tetraplegia. This research program identified implications to clinical practice, as well as an evidence-to-practice gap, and provide clear directions for future research and knowledge translation.<br>Thesis (Masters)<br>Master of Philosophy (MPhil)<br>School of Health Sci & Soc Wrk<br>Griffith Health<br>Full Text
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Berki, Visar. "In Vitro Cadaveric Biomechanical Study on Spinal Deformity Correction." University of Akron / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=akron1374507715.
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Konstantinou, Kika. "Mobilisations with movement in low back pain management : current physiotherapy practice and effects on pain and range of spinal movement." Thesis, Coventry University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272904.
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McCoy, Ashley D. "An Exploration of the Lived Experiences of the Caregiving Role and Life Satisfaction in Caregivers Following Traumatic Spinal Cord Injury." Thesis, University of Nevada, Reno, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10126155.
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<p> Research shows that approximately 12,500 new spinal cord injuries occur each year, which poses a drastic life change for the person who sustained the injury and their closest family members and friends who often times become the ones who care for them in the community. Due to this new, unexpected caregiving role, research shows that many are often unprepared to care for the spinal cord injured person once they are discharged from one of the inpatient settings. </p><p> The purpose of this study was to explore and examine the lived experiences of caregivers of spinal cord injury individuals. The results of this inquiry may benefit clinicians, patients, and caregivers with shared experiences and may help educate and guide future caregiver relationships. This study was guided utilizing van Manen’s six research activities of qualitative inquiry. Participants were recruited for this study through purposeful sampling until data saturation occurred. A total of six participants were recruited for this study; five completed the study. Face-to-face, audio-recorded interviews were conducted. Colaizzi’s 7-step approach was used for data analysis. Six main themes and two subthemes were identified during the interviews, which provided the overall essence to this qualitative study.</p>
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Allison, Lori Anne. "Life care planning for individuals with spinal cord injuries outcomes and considerations /." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1194636813.
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Lin, Dada. "Wissensmanagement Reloaded - Ein Ordnungsrahmen für den systemischen Umgang mit Wissen im Enterprise 2.0." Master's thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2010. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-39354.
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Gegenstand dieser Arbeit ist die Konstruktion eines Ordnungsrahmens für den systemischen Umgang mit Wissen im Enterprise 2.0. Dieser Ordnungsrahmen zeigt Einsatzpotentiale und Handlungsfelder des Enterprise 2.0-Konzepts für Wissensmanagement systematisch auf und vermittelt ein Verständnis über die Zusammenhänge zwischen den Gestaltungsdimensionen Mensch, Organisation und Technologie im speziellen Fall des Enterprise 2.0.
Ergänzend zu den theoretisch erarbeiteten Aspekten wird der konzipierte Ordnungsrahmen verwendet, um die Eignung eines realen Enterprise 2.0-Ansatzes (Wiki-Plattform) für Wissensmanagement zu bewerten.
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Kučera, Dušan. "Weber's thesis "the spirit of capitalism"as a starting point for finding spiritual potentials in business and management environment." Doctoral thesis, Vysoká škola ekonomická v Praze, 2010. http://www.nusl.cz/ntk/nusl-201121.
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Submitted work is based on a critical evaluation of Weber's thesis "the spirit of capitalism", which justified by the "Protestant ethic". The author uses the Weber's starting point for the processing of general spiritual concept, which has a major impact on the emergence, development and maintenance of the economic environment, business and management. After clarification of the fundamental concepts, the work focuses on clarifications to the phenomenon of spirituality, which is connected with the entrepreneurial and managerial activities. Presence of the spiritual character of business potentials was divided into positive and negative factors. General spiritual factors are reflected on the background of basic religious systems -- Judaism, Christianity (Protestantism, Roman Catholicism and Eastern Orthodoxy), Islam, Hinduism, Buddhism and other Asian directions. Spiritual perspectives are compared with the concepts of the science that have their limits or potentials. The practical part is devoted to the proof of spiritual influences on business and economic development. The work culminates in a research of spiritual factors and potentials of entrepreneurship and management between the selected entrepreneurs and managers. The collected factors and potentials are summarized and proposed for their use in the entrepreneurial and managerial practice or managerial training.
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Govender, Sabashnee. "The anatomical description of the erector spinae, paravertebral and epidural block for post-operative pain management in paediatric care." Thesis, University of Pretoria, 2020. http://hdl.handle.net/2263/78938.
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Summary
The anatomical description of the erector spinae -, paravertebral - and epidural block for post-operative pain management in paediatric care
S Govender
Supervisor: Prof AN van Schoor
Co-supervisor: Prof AT Bosenberg
Department of Anatomy: Clinical Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
The fundamental indicative constituent for any successful clinical procedure is patient satisfaction, which is directly related to post-operative analgesia. In paediatric care, due to the nature of the patient – and depending on the age group – it is often difficult, or even impossible, to fully understand the extent of pain perceived, leading to insufficient pain management. A variety of regional anaesthetic techniques have been thoroughly investigated for the ease of administration, as well as enhanced patient satisfaction. Coupled with image modalities, these blocks can be safe and efficient. However, these investigations mainly apply to an adult population. Paediatric procedures may be inaccurately extrapolated from an adult population, when the anatomical discrepancies that exist between population groups are not taken into consideration. Until recently, the gold standard for paediatric truncal procedures relied solely on paravertebral and epidural blocks. With the discovery of the novel interfascial erector spinae plane block, however, this is no longer the case. This block is hypothesised to target the ventral and dorsal rami of spinal nerves, as local anaesthetic is deposited into the erector spinae fascial plane space. The therapeutic effect of the block is attributed to the cranio-caudal spread of anaesthetic over multiple vertebral levels within the tissue plane. This ‘happily accidental’ block serves as a “paravertebral block by proxy” and is an alternative approach, targeting similar nerves as in the paravertebral and epidural blocks. However, the anatomy of the erector spinae plane block is not fully understood. This study aimed to investigate the anatomical differences of these three blocks for the management of post-operative pain
in paediatric care, based on observations and measurements from a fresh paediatric cadaver sample, as well as ultrasound and computed tomography scans. Apart from the easily identifiable bony landmarks, together with the distant application of the erector spinae plane block, the block offers a higher safety profile with various clinical advantages such as improved pre- and post-operative pain management, as well as reduced opioid requirement. In conclusion, it is vital to acknowledge the anatomical differences that exist in a paediatric population for the safe and successful administration of any regional technique to improve the management of pain in a vulnerable population.
Keywords: Erector spinae plane block, paravertebral block, epidural block, interfascial block, paediatric, regional anaesthesia, pain management<br>Thesis (PhD (Anatomy))--University of Pretoria, 2020.<br>National Research Foundation (NRF)<br>Anatomy<br>PhD (Anatomy)<br>Unrestricted
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Adams, Samantha. "A randomised comparison of bolus phenylephrine and ephedrine for the management of spinal hypotension in patients with severe preeclampsia and a non-reassuring fetal heart rate trace." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29804.
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Background: Studies in healthy patients undergoing elective caesarean delivery show that ephedrine used for spinal hypotension is associated with increased fetal acidosis compared with phenylephrine. This has not been investigated prospectively in severe preeclampsia. Methods: Patients with severe preeclampsia requiring caesarean delivery for a non- reassuring fetal heart tracing were randomised to receive bolus ephedrine (7.5-15 mg) or phenylephrine (50-100 μg) for spinal hypotension. The primary outcome was umbilical arterial base deficit. Secondary outcomes were umbilical arterial (UA) and venous (UV) pH and lactate level, venous base deficit, and Apgar scores. Results: A total of 133 women were included;; 64 required vasopressor treatment and were randomised to 2 groups of 32 with similar patient characteristics. Pre- delivery blood pressure changes were similar in the 2 groups. There was no difference in mean [SD] UA base deficit (-4.9 [3.7] vs -6.0 [4.6] mmol·L⁻¹ for ephedrine and phenylephrine respectively;; P = 0.29). Mean [SD] pH (UA and UV) and lactate levels were also similar between groups (7.25 [0.08] vs 7.22 [0.10], 7.28 [0.07] vs 7.27 [0.10], and 3.41 [2.18] vs 3.28 [2.44] mmol·L⁻¹ respectively). In addition, UV PO₂ was higher in the ephedrine group (2.8 [0.7] vs 2.4 [0.62]) kPa, P = 0.02). There was no difference in 1- or 5-minute Apgar scores, numbers of neonates with 1-minute Apgar scores < 7 (10/32 [31%] vs 12/32 [38%]), or with a pH < 7.2 (6/31 [19%] vs 8/29 [28%]). Conclusions: In patients with severe preeclampsia and fetal compromise, fetal acid-base status is independent of the use of bolus ephedrine vs phenylephrine to treat spinal hypotension.
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Brunner, Corinna Bianca. "TQM und organisationales Lernen im Krankenhaus : Untersuchung d. Eignung d. EFQM-Modells für Excellence zur Anwendung im (psychiatrischen) Krankenhaus u. zur Förderung d. organisationalen Lernens /." Konstanz : Hartung-Gorre, 2002. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=009800525&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Lee, Siew Hwa. "A case study analysis to explore the perceptions and experiences of patients, carers and/or family members and healthcare professionals in the management of metastatic spinal cord compression (MSCC)." Thesis, Edinburgh Napier University, 2013. http://researchrepository.napier.ac.uk/Output/6215.
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Background: Metastatic spinal cord compression (MSCC) can result in paralysis and is an oncology emergency. Prognosis is poor if not treated early. There are an estimated 1200-2500 new cases of MSCC per year in Scotland. At 2013 there are limited studies which have explored the issues experienced by patients, carers and/or family members and healthcare professionals in the management of MSCC. Aim: The aim of this study was to explore the perceptions and experiences of patients, carers and/or family members and healthcare professionals in the management of metastatic spinal cord compression. Research Design and Methods: A case study design approach involving two phases was used. Phase One involved three focus groups with healthcare professionals (n=25) and one-to-one interviews with healthcare professionals (n=7). Phase Two involved interviews with patients (n=8), carers (n=6) and healthcare professionals (n=42). Patients and carers were interviewed twice over a period of six months. Braun and Clarke's (2006) thematic inductive-data approach was used for data analysis. Findings: Phase One identified an overarching theme of ‘negotiating the care pathway' with four main themes: what can we do for patients with MSCC; what do we need to ‘trade-off' to meet the needs of patients; how can guidelines help anyway; and how can we deliver optimum care in the midst of uncertainty? The majority of healthcare professionals viewed the existing National Institute for Clinical Excellence (NICE) guidelines (2008) as inadequate and lacking in a strong evidence base. Healthcare professionals acknowledged the importance of meeting the patient's preferred needs and goals given the nature of this condition and the short life expectancy of many patients with MSCC. Phase Two identified three main themes: facing uncertainty in MSCC; finding a balance in MSCC and support beyond the treatment of MSCC. A focus on acute management is often at odds with the palliative nature of the patient's condition and this contributes to the complexity for patients, carers and healthcare professionals. The findings demonstrate the intricacies of uncertainty which affect all the key stakeholders when MSCC presents. There is a constant movement between uncertainty (of the future) and enduring inconsistencies (of information, treatment and advice for the future), which results in a struggle to find a balance. Conclusions: Caring for patients with metastatic spinal cord compression is challenging with uncertainties surrounding the diagnosis of MSCC, spinal instability, treatment and support beyond the treatment of MSCC. A theory of collaborative decision making based on the findings in this thesis is proposed to help reduce uncertainty and enable key stakeholders to make decisions in their journey with MSCC.
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Stachel, Kerstin. "Patientenorientierte Krankenhausführung : Beiträge des Personalmanagements zur Markenbildung und Kundenorientierung von Krankenhäusern /." Wegscheid : WIKOM, 2008. http://www.gbv.de/dms/zbw/561333572.pdf.
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Horn, Joakim. "Vad är laganda?" Thesis, University of Gävle, Department of Business Administration and Economics, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-3128.
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<p><strong>Aim:</strong> Team spirit is a concept often used in both managerial literature and in other contexts where the efficiency of a group is discussed. Despite the fact that team spirit is used as a selling point for courses, books and seminars, no unambiguous definition of the term is available. The purpose of this thesis is to clarify what team spirit means to individuals within companies and team sports.</p><p> </p><p><strong>Method:</strong> The thesis has been carried out using studies of available literature, which has been compiled into a conceivable model of what team spirit may imply. From this model a poll has been made, and handed out to individuals within companies as well as team sports. After having compiled the 37 replies, correlating answers has been sought after within each group of respondents.</p><p> </p><p><strong>Result & Conclusions:</strong> The result shows us that there are varying opinions of what team spirit is, and generally accepted definitions of closely related ideas like cohesion and group development has to the respondents not been able to form a satisfying description of what team spirit means. Team spirit is therefore a concept being defined by each individual for themselves. Combined with peoples desire for team spirit, this constitutes an opportunity to use the term as a linguistic strategy in order to reach own goals.</p><p> </p><p><strong>Suggestions for future research: </strong>Future research should in order to discern any connections between individuals’ opinions of team spirit, and their environment, consist of qualitative interviews. An increased field of research might comprise the questions how team spirit is achieved, what effects it has, and how a leader influences it.</p><p> </p><p><strong>Contribution of the thesis: </strong>The thesis points out that team spirit is a concept not easily defined, which also can be used in several different ways. Anyone working with the making of team spirit, or discussing team spirit, draws benefit of shaping their own conscious perspective of the concept. In this respect, this thesis constitutes a helpful contribution.</p><br><p><strong>Syfte:</strong> Laganda är ett begrepp som används flitigt inom både managementlitteratur och i andra sammanhang där gruppers effektivitet diskuteras. Trots att laganda används som säljargument för kurser, böcker och föreläsningar finns ingen entydig definition på termen. Studiens syfte är att söka klargöra vad laganda innebär för olika individer inom företag och lagidrott.</p><p> </p><p><strong>Metod: </strong>Studien har utförts genom att befintlig litteratur studerats och sammanställts till en möjlig modell över vad laganda kan innebära. Utifrån den utgångsfiguren har en enkät formats och delats ut till individer inom såväl företag som lagidrott. Efter att ha sammanställt de 37 enkätsvar som inkommit har studien sökt finna korrelerande svar inom respondentgrupperna.</p><p><strong> </strong></p><p><strong>Resultat & slutsats: </strong>Resultatet visar att det råder mycket skiftande meningar om vad laganda är, och vedertagna definitioner av närliggande begrepp som exempelvis sammanhållning och grupputveckling har inte för respondenterna kunnat sägas bilda en tillfredsställande beskrivning av laganda. Laganda är således en term som varje individ definierar för sig själv. I kombination till människors begär efter laganda utgör detta en möjlighet att utnyttja begreppet laganda som språkstrategi för att nå egna syften.</p><p> </p><p><strong>Förslag till fortsatt forskning:</strong> Fortsatt forskning bör för att kunna urskilja samband mellan individers uppfattning om laganda och deras miljö utgöras av kvalitativa intervjuer. Ett utökat forskningsområde kan utgöras av frågeställningarna hur laganda åstadkoms, vilka effekter den har samt ledares påverkan av laganda.</p><p> </p><p><strong>Uppsatsens bidrag:</strong> Uppsatsen pekar på att laganda är ett svårdefinierat begrepp som kan användas på olika sätt. Alla som arbetar med att skapa laganda eller diskuterar laganda har nytta av att för sig själv skapa ett medvetet perspektiv på begreppet. Härvid utgör uppsatsen ett användbart bidrag.</p>
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Rodrigues, Cristiano Agostinho Barros. "O key account management e a articulação entre redes externas e internas : um caso de estudo." Master's thesis, Instituto Superior de Economia e Gestão, 2019. http://hdl.handle.net/10400.5/18573.
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Mestrado em Gestão e Estratégia Industrial<br>Key Account Management, uma abordagem frequentemente utilizada pelas empresas para gerir clientes chave, tem sido amplamente estudada na literatura com diversas abordagens. A rica literatura sobre o papel deste arranjo organizacional tem focado aspetos tão variados, como os seus benefícios, fatores de sucesso, ou o papel desses gestores de contas - os key account managers - nos relacionamentos com os clientes.
O foco deste estudo é no key account management como uma atividade que envolve a articulação entre redes intra-organizacionais (rede interna) e redes inter-organizacionais (rede externa). Com esta perspetiva de base, este estudo procura explorar esse papel de interface e, em que medida e como é que a mobilização da rede interna é relevante para manter e desenvolver os relacionamentos com clientes chave.
Com este propósito, conduziu-se um estudo de caso numa empresa, a partir de um conjunto de episódios, analisam-se as interações entre a rede interna da empresa focal, os key account managers e clientes específicos. Adicionalmente, e sendo clientes chave ou valiosos, faz-se uma breve caracterização das dimensões de valores de cada cliente na ótica da empresa focal.
O estudo permite evidenciar a importância do papel dos key account managers na articulação entre redes internas e externas. Neste contexto, noções como alinhamento ou mobilização de recursos envolve não apenas a rede interna como a rede de clientes e de fornecedores. Esta constatação reforça o interesse em encarar os programas de KAM como rearranjos de redes de relacionamentos que se estendem para além das fronteiras de cada empresa.<br>Key account management is an approach mostly used by companies to manage extremely important costumers; this approach has been widely studied in literature in diverse ways. The rich literature about the this organizational arrangement includes its benefits, success factors, the role of key account manager in the relationship with customers.
This study focus on key account management as an activity that involves the interaction between internal network of a company with the external network of it. The main goal is to explore this interface role; particularly how the internal mobilization is relevant to maintain and develop the relationships with key accounts.
With this purpose, a case study was conducted in a company, a group of episodes was analised, these episodes compiled a multitude of interactions by a focal company, the key account managers and specific customers. Additionally, a brief characterization regarding the value dimensions for each customer is done in the point supplier point of view.
The importance associated to the role key account manager in the articualation of internal and external networks is display throughout this research. In this context, notions like alignment or resources mobilization involves not only the internal network but also the costumers and suppliers networks. This fact reinforces the interest in understanding KAM as rearrangements of relationship networks that extends beyond boundaries of a single company.<br>info:eu-repo/semantics/publishedVersion
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Hanson, Maria, and Emilia Söderström. "Den virtuella projektledaren och teamet : Hur skapas teamkänsla på distans?" Thesis, Karlstads universitet, Handelshögskolan, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-36817.
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Informationsteknologins utveckling under de senaste decennierna har möjliggjort en utveckling mot en allt mer global värld. Marknaden internationaliseras och geografiskt avstånd väger inte längre lika tungt när ett samarbete ska etableras. Genom att lösningar för elektronisk kommunikation blir mer spridda, lättillgängliga och billiga, och i takt med att teknikmognaden i organisationer och hos medarbetare ökar, har inte bara den teoretiska organisationsbilden utan även vardagen i många företag börjat präglas av en ny geografisk bredd. Den här studien fokuserar på hur projektledare arbetar med lag- eller teamkänsla i projektgrupper som verkar i en miljö där de fysiska mötena är få eller helt saknas. Undersökningen fokuserar på de praktiska verktyg och arbetssätt som projektledaren har och kan använda i projektet för att skapa lag- eller teamkänsla. Undersökningen genomfördes med hjälp av kvalitativa intervjuer med åtta projektledare i Sverige. De representerar olika branscher inom offentlig och privat verksamhet och arbetar med distribuerade team av olika typ och storlek. Materialet analyserades baserat på sju teman identifierade i tidigare forskning. De projektledare som intervjuas arbetar alla med att stärka teamkänslan gruppen men väljer att fokusera på olika aspekter och verktyg. Kommunikation och tydlighet löper som röda trådar genom de strategier som tillämpas. Trots att projekten är virtuella uppfattar respondenterna i undersökningen att gruppens fysiska möte är betydelsefullt för att teamkänsla ska skapas. Grundläggande är också en välfungerande teknisk plattform med stöd för synkron kommunikation.<br>The development of information technology during the recent decades has enabled a shift towards an increasingly global world. The market becomes international and the geographical distance is of less importance when a new partnership is to be established. As solutions for electronic communication becomes more widespread, accessible and cheap and the technology maturity in organizations and among its employees increase, not only the theoretical organizational image, but also the everyday life of many companies has started to be characterized by a new geographic spread. This study focuses on project teams operating in an environment where the physical meetings are few or non-existent. So-called virtual project teams. The study examines how a project manager for a virtual project works with team cohesiveness within his virtual project team. The study focuses on the practical tools and approaches that the project manager has and can use in the project to create team cohesiveness. The survey is conducted by qualitative interviews with eight project managers working with distributed teams in Sweden, representing various industries in both the public and private sectors. The material is analyzed based on seven themes identified in previous research and in responses. The result shows that the project leaders in the study all are working to strengthen the team cohesiveness. The project managers chose to focus on different aspects and tools in the process. Communication and clarity are common themes in the strategies that the project managers apply. Even though the projects are virtual the physical meeting is pointed out as important in shaping team cohesiveness. Well-functioning technical platforms that support synchronous communication are part of the foundation for the team cohesiveness in a virtual team.
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Weston, Eric Brian. "Evaluation of Risk to the Lumbar Spine and Shoulders During Simulated Wheelchair Pushing." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1480535340490527.
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Kuecker, Aaron J. "The Spirit and the 'other' : social identity, ethnicity and intergroup reconciliation in Luke-Acts." Thesis, St Andrews, 2008. http://hdl.handle.net/10023/532.
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Karsäter, Alexander. "”Vi och dom” : ett fenomen i utlandsstyrkan?" Thesis, Swedish National Defence College, Swedish National Defence College, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:fhs:diva-811.
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<p>En framgångsfaktor vid internationell tjänst är att samspelet mellan samtliga enheter fungerar friktionsfritt. Detta underlättas om samtliga enheter känner varandra innan rotation till missionsområdet. I framtiden kommer hela förband som har kontraktsanställda soldater rotera ner, dock innehar inteförbanden samtliga funktioner för att lösa alla arbetsuppgifter i missionsområdet. Vid dessa fall lånar man in enheter från andra förband. Inlåningar kan skapa friktioner mellan enheterna. Detta är en fallstudie utav KS14, där man valde att förstärka styrkan med enheter som innehade kompetens inom specialområden. Syftet med denna studie är att skapa en förståelse varför det uppstod friktioner inom KS14 när den förstärktes med en ny enhet. Frågeställningarna är följande: Varför blev det motsättningar mellan KS14 och förstärkningsstyrkan? Hur motsättningar tog sig uttryck? Hur kan dessa motsättningar förklaras? För att besvara frågorna har intervjuer gjorts med tre personer som var med i KS14. Undersökningen visar att det uppstod ett ”vi- och dom” känsla mellan KS14 och den förstärkande enheten. Skälen till detta var dels bristen på kommunikation vad det gäller information om den nya enheten och dels att KS14 hade en historia tillsammans. Dessa motsättningar togs i uttryck genom att man vanhedrade minnestavlan, kom på nedvärderande slogans samt ignorerade förstärkningsstyrkan. Detta berodde på bristen av kommunikation, information och öppenhet mellan de bägge parterna.</p><br><p>A success factor in service abroad is the interplay between all the units work smoothly.This is made easier if all the units know each other before rotating to the area of operation. In future, all units have contracted soldiers rotate down, however, they do not hold all the abilities to solve all tasks in the area of operations. In these cases, it borrows in units from other battalions. These attachments may create frictions between the units. This is a case study out of KS14, which chose to reinforce the contingent with a unit with expertise in specialized areas. The purpose of this study is to create an understanding why there was friction within KS14 when it was reinforced with a new unit. The questions are: Why were there differences between KS14 and reinforcing unit? How the frictions expressed? How do you explain these frictions? To answer these questions interviews have been made with three people who were with the KS14. The study shows that there was an "us and them" feeling between KS14 and the reinforcing unit. The reasons for this were the lack of communication when it comes to information on there inforcing unit and that KS14 already had a history to gether. These frictions were reflected in by disgraced the plaque, came in disparaging slogans and ignored the reinforcing unit. This was due to the lack of communication, information and openness between the two parties.</p>
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Gagner, Björn, and Tim Zander. "Tanken är att vi ska få ner luft i patienten, och det är snabbt. : En kvalitativ intervjustudie kring sjuksköterskan i ambulansens upplevelse av luftvägshantering och stöd." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102554.
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Introduktion: Adekvat andning är grundläggande för liv. Att kunna utföra luftvägshantering är därför en kunskap sjuksköterskan måste besitta. I regionen där studien genomförts kan anestesisjuksköterskeresurs medfölja ambulans vid larm om andnings- eller luftvägsproblematik. Denna resurs har tidigare nyttjats per automatik från larmcentral, men har nu övergått till att nyttjas först på ambulanspersonalens begäran. Hur denna förändring upplevs av sjuksköterskan i ambulansen är tidigare inte undersökt. Syfte: Belysa sjuksköterskan i ambulansens upplevelse av luftvägshantering samt upplevelsen av stöd från anestesisjuksköterskan prehospitalt. Metod: Kvalitativ intervjustudie som analyserades med induktiv innehållsanalys. Femton semistrukturerade intervjuer genomfördes på en ambulansavdelning i södra Sverige. Deltagarna var sjuksköterskor aktivt verksamma inom ambulanssjukvården. Resultat: Sjuksköterskan i ambulansen upplevde generellt trygghet i luftvägshantering efter som det övas frekvent. Anestesisjuksköterskans stöd var dock viktigt vid avancerad luftvägshantering. Rutinförändringen, gällande att anestesisjuksköterska endast medföljde på ambulanspersonalens begäran, upplevdes av sjuksköterskan i ambulansen som positivt. Detta skapade fler tillfällen att få möjlighet till luftvägshantering vilket i sin tur skapade ökad trygghet. En annan positiv upplevelse av rutinförändringen var att anestesisjuksköterskeresursen nu kunde nyttjas när den verkligen behövdes. Få tillfällen för samövning mellan anestesisjuksköterskan och sjuksköterskan i ambulansen upplevdes av sjuksköterskan i ambulansen ej ge personlig kännedom för anestesisjuksköterskan, vilket i sin tur påverkade teamkänslan. Deltagarna menade även att det ofta var ”extra händer” som efterfrågades istället för viss kompetens. Slutsats: Luftvägshantering kräver regelbunden övning för att upprätthålla kompetens och känsla av trygghet. Anestesisjuksköterskan bör dock fortsatt finnas att tillgå som stöd vid avancerad luftvägshantering. Rätt resurs ska användas vid rätt tillfälle, vilket sjuksköterskan i ambulansens ansvarar för att så sker. För att möjliggöra en god teamkänsla inom vårdteamet krävs samövning och personlig kännedom.<br>Introduction: Adequate breathing is essential for life. Being able to perform airway management is therefore a knowledge the nurse must possess. Within the prehospital care in the region the study is carried out there is an anesthesia nurse resource in the event of respiratory problems. This resource has previously been used automatically from dispatch, but now this resource is only used on request from the ambulance staff. How this change is experienced by the nurse in the ambulance has not been investigated earlier. Purpose: Illuminate the nurse in the ambulance’s experience of airway management and the experience of support from the anesthesia nurse prehospital. Method: Qualitative interview study that was analysed with inductive content analysis. Fifteen semi-structured interviews were conducted in an ambulance department in southern Sweden. The participants were nurses with an active employment in ambulance care. Result: The nurse in the ambulance generally felt comfortable in airway management as it was frequently practiced. However, the support of the anesthesia nurse was important in advanced airway management. The routine change, regarding the fact that the anesthesia nurse was only included at the request of the ambulance staff, was perceived by the nurse in the ambulance as positive. This created more opportunities for airway management, which in return increased confidence. Another positive experience of the routine change was that the anesthesia nurse resource could now be used when it was really needed. Few opportunities for joint practice between the anesthesia nurse and the nurse in the ambulance were experienced by the nurse in the ambulance as not giving personal knowledge to the anesthesia nurse, which in return affected the team spirit. The participants also said that it was often ”extra hands” that they requested instead of certain skills. Conclusion: Airway management requires regular practice to maintain competence and confidence. However, the anesthesia nurse should continue to be available, as support for advanced airway management. The correct resource must be used in the right situation, which the nurse in the ambulance is responsible for ensuring. To enable a good team spirit within the care team, joint practice and personal knowledge are required.