Search

Management literature has suggested that the advent of mass customisation marks the end for trade-offs between customisation and other competitive priorities (Pine et al. 1993; Westbrook and Williamson 1993; Tu et al. 2001). However, evidence supporting this proposition is anecdotal. This paper examines the impact of product customisation on four competitive priorities, drawing upon the results of a recent survey of 102 U.K. manufacturing firms from eight industry sectors. The study indicates significant compatibility between customisation and quality, volume flexibility, delivery reliability and non-manufacturing costs. On the other hand, trade-offs remain between customisation and manufacturing costs and delivery lead times. The results contradict the initial proposition that customisation can be “free,” and have important implications for firms embarking upon a mass customisation strategy.

The literature on innovation has been both rich and varied in approach and has provided much insight into the process of, and difficulties contained within, innovation. A number of important concepts including those of path dependency, technological trajectories, together with the plethora of articles concerned with organizational learning, involving the contribution and limitations of tacit knowledge, have helped us to understand the nature of innovation. As important as these strands of literature are, we suggest that a key weakness in much of the literature on innovation is that it does not deal sufficiently with the contextual issues concerning the changing paradigms of manufacturing and the profound impact that these developments have had upon the innovation process. We offer the concept of strategic resonance as a missing ingredient within some firms who are now faced with conditions of hyper competition where ongoing innovation is a key requirement. The concept of strategic resonance is not offered as a prescriptive panacea but it is suggested that firms need to understand and remove the blockages to strategic resonance as part of their innovation development processes.

Background: People with serious mental illness have high rates of mortality and physical morbidity. Some of this is due to unhealthy lifestyle factors. Many mental health services are beginning to develop health promotion interventions for this population but these have not, to date, been properly evaluated.Aims: To measure whether a brief health promotion intervention delivered by a non-specialist worker can deliver useful health gains in a population with serious mental illness.Method: A randomized controlled trial (RCT) of a particular health promotion package using physiological measures and validated research instruments to measure outcome.Results: The study population had an unhealthy lifestyle at outset. The intervention produced small but statistically significant gains in exercise and weight loss with a trend to improved subjective well being. There was a high drop out rate.Conclusions: People with serious mental illness are an appropriate target group for health promotion activities. They are co...

In this paper we make the case for strategic resonance in the strategy making process within dynamic and highly volatile market conditions. We discuss how managers are faced with competing paradigms of resource-driven versus market-led approaches to strategy but we suggest that both paradigms have flaws and may cause strategic dissonance to occur. Moreover, we offer additional insights into why strategic dissonance can occur within the strategy process of the firm. We suggest that a key omission often lies in the neglect of operations managers’ potentially important contributions to the strategy mainstream process.

Managing innovation is one of the key strategic challenges facing firms in many industries. The nature of competitive capabilities has resulted in conditions of hyper-competition within many industries and both new entrants and existing players have little choice but to innovate speedily and with success in new product introductions. However, this is only part of the ‘world of innovation’. Products and processes in other sectors also need to be innovated, and this often proceeds in a no less appropriate manner for the environment in which those firms operate. This paper presents a typology of innovation firms. It does not pretend to be exhaustive but aids our understanding by drawing upon a range of empirical studies of innovation practices. A classification of firms is proposed, which assists in understanding the different policies, practices and levels of performance in each category. In addition, it differentiates the rates of improvement, and shows some of the latest thinking and practices from the highest performing firms and the nature of the challenge for the rest.

This paper provides evidence of links between the nature of strategic formulation within firms and subsequent plant performance. The research focuses on how some firms have managed to link operations and supply into an integrated set of mutually supportive strategies. In the current competitive arena firms can no longer rely wholly on internal resource-based capabilities but must instead form strategic partnerships within what are often complex networks. The paper explores how operations and supply functions have pursued parallel paths but have often not been fully integrated within firms. It is argued that such integration, which forms part of what has been termed strategic resonance, can reap enormous benefits in terms of plant-level capabilities for firms.

Background: Psychiatric Intensive Care Units (PICU) are small, highly staffed, low secure wards, designed to treat acute challenging psychotic behaviour. They have become a standard component of psychiatric hospital design despite minimal published data about their clinical activity and effectiveness. Aims: To compare the characteristics, treatment and outcome of a series of patients admitted to a PICU unit with a control group treated on the open wards of the same hospital. Method: Case controlled retrospective case note analysis. Results: PICU patients were predominantly young male Caucasians, with psychotic illness, a history of violence and substance misuse. Most had a relatively brief PICU admission. The PICU also acted as a de facto long stay low secure unit because of a shortage of more appropriate facilities. Conclusions: The PICU appears to be a useful resource for treating highly disturbed individuals who are at high risk of violence and who would be difficult to manage safely on an open ward. M...

Lean manufacturing appears to hold considerable promise for addressing a range of simultaneous, competitive demands including high levels of process and product quality, low cost and reductions in lead times. These requirements have been recognised within the aerospace sector and efforts are now well established to implement Lean practices. Lean manufacturing was initiated within the automotive sector. However, since the publication of the influential book, The Machine That Changed the World ( Womack et al., 1990 ) there has been a range of documented cases of Lean implementation in a variety of sectors. Despite this evidence, the perception remains that Lean manufacturing is to some degree, an ‘automotive idea’ and difficult to transfer to other sectors especially when there are major differences between them. In this paper we discuss the key drivers for Lean in aerospace and examine the assumption that cross-sector transfer may be difficult. A Lean implementation case comparison examines how difficulties that arise may have more to do with individual plant context and management than with sector specific factors.

BACKGROUND PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) was established in 2000 to monitor antimicrobial resistance among respiratory tract pathogens across the United States. METHODS During 2000 to 2001, 75 southern US centers collected 3,867 Streptococcus pneumoniae, 1,455 Streptococccus pyogenes and 1,042 Haemophilus influenzae. RESULTS Overall, 46.1% of S. pneumoniae isolates were nonsusceptible to penicillin, 35.8% were resistant to erythromycin, and 0.5% were resistant to fluoroquinolones. Against S. pneumoniae the most active agents were telithromycin (99.7% susceptible), linezolid (99.8%) and the fluoroquinolones (levofloxacin 99.4%, gatifloxacin 99.5%). The prevalence of erythromycin-resistant S. pyogenes isolates was 4.5%. Telithromycin, at concentration of < or = 1 mg/L, inhibited 99.9% of S. pyogenes. The prevalence of beta-lactamase positive H. influenzae was 26.2%. Telithromycin was active (MIC90 4 mg/L) against H. influenzae, irrespective of beta-lactamase production. CONCLUSION The prevalence of penicillin and macrolide resistance among respiratory tract pathogens from the southern United States is high. Fluoroquinolone resistance is low. Telithromycin is highly active against respiratory tract pathogens with reduced susceptibility to beta-lactams, macrolides, and fluoroquinolones.

This paper is based on longitudinal case studies of research into strategy formulation within six plants from large firms – three in the car industry and three from the computer industry – that have embarked on mass customisation. The core theme of this paper is that, in spite of the increasing attention given to manufacturing strategy from the seminal work of Skinner through to the plethora of articles in recent times, little is mentioned about its application to paradigms of agility or mass customisation. As a consequence firms attempt to become agile and to pursue mass customisation without appreciating the contribution of plant‐specific manufacturing strategies that might enable them to achieve these aspirations. We examine the enablers and strategic blockages in pursuing mass customisation, via a mapping process, and reveal reasons why some firms remain unable to devise and implement manufacturing strategies.

Summary Background HIV-1 viral load testing is recommended to monitor antiretroviral therapy (ART) but is not universally available. The aim of our study was to assess monitoring of first-line ART and switching to second-line ART in sub-Saharan Africa. Methods We did a collaborative analysis of cohort studies from 16 countries in east Africa, southern Africa, and west Africa that participate in the international epidemiological database to evaluate AIDS (IeDEA). We included adults infected with HIV-1 who started combination ART between January, 2004, and January, 2013. We defined switching of ART as a change from a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based regimen to one including a protease inhibitor, with adjustment of one or more nucleoside reverse-transcriptase inhibitors (NRTIs). Virological and immunological failures were defined according to WHO criteria. We calculated cumulative probabilities of switching and hazard ratios with 95% CIs comparing routine viral load monitoring, targeted viral load monitoring, CD4 monitoring, and clinical monitoring, adjusting for programme and individual characteristics. Findings Of 297 825 eligible patients, 10 352 (3%) switched to second-line ART during 782 412 person-years of follow-up. Compared with CD4 monitoring, hazard ratios for switching were 3·15 (95% CI 2·92–3·40) for routine viral load monitoring, 1·21 (1·13–1·30) for targeted viral load monitoring, and 0·49 (0·43–0·56) for clinical monitoring. Of 6450 patients with confirmed virological failure, 58·0% (95% CI 56·5–59·6) switched by 2 years, and of 15 892 patients with confirmed immunological failure, 19·3% (18·5–20·0) switched by 2 years. Of 10 352 patients who switched, evidence of treatment failure based on one CD4 count or viral load measurement ranged from 86 (32%) of 268 patients with clinical monitoring to 3754 (84%) of 4452 with targeted viral load monitoring. Median CD4 counts at switching were 215 cells per μL (IQR 117–335) with routine viral load monitoring, but were lower with other types of monitoring (range 114–133 cells per μL). Interpretation Overall, few patients switched to second-line ART and switching happened late in the absence of routine viral load monitoring. Switching was more common and happened earlier after initiation of ART with targeted or routine viral load testing. Funding National Institute of Allergy and Infectious Diseases, Swiss National Science Foundation.

Purpose– The purpose of this paper is to define event evaluation, develop a conceptual model of its process and elements, review pertinent literature, and draw conclusions pertaining both to the discourse on evaluation and its praxis.Design/methodology/approach– General review of literature and development of a conceptual model of the evaluation process.Findings– The review suggests that impact assessments have dominated, but are only one type of evaluation; research and papers on evaluating the worth of events has been minimal, while those on the evaluation of various management and marketing functions is fragmented.Research limitations/implications– It is concluded that little has been written about evaluation paradigms and systems, although the discourse on sustainability and triple bottom line accountability has led to a greater emphasis on non-economic considerations.Originality/value– The conceptual model of the evaluation process and its components offers a systematic approach to shaping evaluation discourse and methods. Conclusions are drawn on how to advance evaluation research and methods applied to events.

SummaryTreatment of psychotic agitation is an area that is very poorly evidenced, principally because research evidence from patients with moderate agitation may not generalise to the more severely agitated patients. There is a significant gap between current treatment recommendations and what is seen in clinical practice. There are also big differences in clinical practice between different units treating seemingly similar patient groups. This commentary considers possible reasons for these findings and also discusses non-pharmacological interventions, which probably contribute more to the management of psychotic agitation than does the choice of one antipsychotic drug over another.

This chapter aims to develop a holistic conceptual understanding of how tourism experiences are constructed, contextualized and packaged in the context of travel blogs. Tourist experiences are highlighted as an on-going process, continuously changing and altering during pre-, on-site-, and post-visit of tourist experiences. This chapter also examines the relationships between travel blog users’ motivation and engagement and tourist experience construction. As a result, a new dimension to the previous tourist experiences is offered.

Managing process and product technology is a profoundly difficult and uncertain task. The innovation process is firm-specific and, within large, multi-divisional firms, it is often divisional-specific. Learning and know-how must be accumulated over time in order for process technology to be applied successfully. Vast amounts of investment have taken place in firms and such investments have, often, provided little or no tangible benefits for the firm. This paper examines how various manufacturing plants manage process technology and the paper suggests that a number of key, organizational factors need to be in place prior to investment. The factors include the importance of the role and contribution of senior-level manufacturing personnel, as well as having plant-specific manufacturing strategies in place, which include process technology management as part of their scope and content.

BackgroundThe excess mortality of schizophrenia is well recognised, but its precise causes are not well understood.AimsTo measure the standardised mortality ratio (SMR) and examine the reasons for any excess mortality in a community cohort with schizophrenia.MethodWe carried out a 13-year follow-up of 370 patients with schizophrenia, identifying those who died and their circumstances.ResultsNinety-six per cent of the cohort was traced. There were 79 deaths. The SMRs for all causes (298), for natural (232) and for unnatural causes (1273), were significantly higher than those to be expected in the general population, as were the SMRs for disease of the circulatory, digestive, endocrine, nervous and respiratory systems, suicide and undetermined death. Smoking-related fatal disease was more prominent than in the general population.ConclusionsSome of the excess mortality of schizophrenia could be lessened by reducing patients' smoking and exposure to other environmental risk factors and by improving the management of medical disease, mood disturbance and psychosis.

In the Australian state of Queensland responsibility for determining criminal responsibility in a mentally ill person charged with offences lies with the mental health tribunal (MHT), a special sitting of the Supreme Court. The MHT consists of a senior judge, advised by two eminent psychiatrists, who adopts an inquisitorial approach to the examination of psychiatric evidence. A hospital order is usually imposed for serious offences but community treatment can also be ordered. The Queensland system aims to provide access to psychiatric treatment and to careful consideration of criminal responsibility for all persons charged with an indictable offence, and to make these options available even to defendants facing relatively minor charges. The system is broadly popular with local forensic psychiatrists though they criticize its speed and flexibility. It is less popular with politicians and the press, who complain that it allows criminals to evade responsibility for their offences. There is no resear...

Background. Schizophrenia has a high natural mortality of a largely environmental aetiology. There is, however, little research about possible risk factors. This study measured the diet, cigarette and alcohol use, exercise and obesity of a cohort of people with schizophrenia and compared results to general population rates.Methods. Semi-structured interview using validated research instruments on 102 middle-aged subjects with a diagnosis of schizophrenia, living in the community. Results were compared to general population norms using standard statistical tests.Results. The subjects ate a diet higher in fat and lower in fibre than the general population. They took little exercise but were not significantly more obese. They smoked heavily but drank less alcohol. Most differences remained significant after controlling for social class.Conclusions. People with schizophrenia have an unhealthy lifestyle, which probably contributes to the excess mortality of the disease. They are therefore an appropriate target group for health promotion interventions.

A pilot telecare system was trialled in Liverpool. It was used to support the provision of care to 21 of the city council's elderly and frail social services clients. A typical installation consisted of about 20 wireless, ambient sensors in the client's home. A home gateway device ran alerting algorithms designed to learn the normal patterns of user behaviour and to identify deviations from this in real-time. When deviations were detected, social service delivery teams were alerted to a possible cause for concern. The pilot service ran for about 30 months and included a period of examination by independent evaluators. The evaluation found that overall the people who used the service – both users and carers – were overwhelmingly pleased with it and viewed it as a great success.

On a nearly cloudless and unseasonably pleasant late-summer day, the Society of Exploration Geophysicists (SEG) on 20 August hosted a grand-opening ceremony for its recently completed $20 million, 78,992-square-foot Geophysical Resource Center 2 (GRC2) building in Tulsa, Oklahoma.

I welcome any contribution that might improve the shocking mortality disadvantage associated with severe mental illness. Yeomans et al1 should, however, be aware that this issue was identified long before the 1990s. William Farr reported in 1841 that the mortality of lunatics in England and Wales varied between three and fourteen times from that of the general population.2 He concluded that some of the excess deaths ‘may be fairly ascribed to insanity. The excess above this must be attributed to the diseases generated by the limited space in which the unhappy lunatics are confined – to the collection of large numbers under the same roof – the impurity of atmosphere – the want of exercise and warmth – the poor unvaried diet – and the deficiency of medical attendance.’ Plusca change. While it is positive that the excess natural mortality of mental illness is attracting greater attention, we should be wary of blindly jumping on the cardiovascular screening bandwagon. There is no evidence that health checks improve the mortality of the general population.3 However, people with severe mental illness are a high-risk group for cardiovascular disease and thus their risk/benefit balance may be different. Still, screening takes resources that could be used for other interventions and has harmful consequences for significant numbers of patients. Rather than setting up huge cardiovascular screening programmes, we might do better to put far more effort into smoking cessation work and to review our prescribing practice and avoid those drugs with particularly bad metabolic profiles. At the very least, we need far better audit of these programmes – audit that measures whether they improve mortality.

Aims and methodThis paper describes the prevalence of substance misuse in a population with chronic psychosis and compares the results with staff estimates. Keyworkers were interviewed using validated questionnaires.ResultsThe prevalence rate of substance misuse was higher than in the general population but significantly lower than staff estimates. Staff had little specific training or experience in treating substance misuse.Clinical implicationsSubstance misuse is a significant problem among patients with chronic psychosis. Service providers should ensure than staff working with these patients are adequately trained in the management of this problem.

BackgroundThis paper presents 15-year outcome data on place of residence, clinical and social morbidity and carer distress in a cohort of 179 people with schizophrenia who were living with their families in 1981–1982MethodData on morbidity and carer distress were derived from replicated patient and informant interviews using standardised research instruments. Details of residence came from patient and informant interviews corroborated by case note information.ResultsThirty-nine (22%) of the original 179 patients were dead and six (3%) lost to follow-up. Of the remaining 134 patients, 74 (55%) still lived with their families, 31 (23%) lived in institutional accommodation, 26 (19%) lived alone and 3 (2%) were homeless. There was little change in the level of clinical or social morbidity or carer distress.ConclusionsThese findings suggest that most people with schizophrenia who live with their families remain significantly disabled by their illness, while their carers suffer ongoing distress. Mental health services should seek to support families who want to care for relatives with schizophrenia. Appropriate alternative accommodation must be provided when family care is not possible.

This paper examines three key factors that help to explain the differences between high and low performing plants in process quality. The three factors are: first, the seniority of manufacturing personnel within the plants; second, the involvement of these senior managers in the business, rather than being confined to the role of a production/technology functional specialist; third, the contribution of a manufacturing strategy which includes quality as part of its content and which feeds into, and forms part of, the overall business plan within the plant. The paper argues that these three factors help to maintain the strategic importance of quality and, consequently, help to explain the subsequent quality performance within the manufacturing plant. The conclusions are that two distinct groups emerge ‐ one, Traditional, and the other, Enlightened ‐ which are different in terms of attitudes, commitment to, and capabilities in, quality.

Business schools in developing countries face a dilemma: How can they meet world educational standards and still serve local needs? Ghana, like most other African countries, uses the British system...

The need to involve the manufacturing function in the process of new product development has already been argued by others. Many firms do not successfully link Innovation and Manufacturing. However, there has been little evidence forthcoming at plant level to demonstrate how Manufacturing's involvement in innovation helps to explain why some plants/divisions are better than others in new product development within the same industries. This paper looks at three key factors which help to explain differences in the speed and success of new product developments. The three factors are: 1. the seniority of Manufacturing personnel within the firms; 2. the involvement of these senior managers in the business , rather than being confined to the role of production/technology functional specialists — this involvement includes being central to new product developments from early stages of the development process; and 3. the contribution of a manufacturing strategy which feeds into, and forms part of, the overall business plan within the plant. Again, part of the manufacturing strategy in some firms is manifested in the central and major involvement of senior Manufacturing personnel in new product development. This paper argues that these three factors help to maintain the strategic importance of new product development and, consequently, help to explain the subsequent performance of new product development within the manufacturing plant.

Shows evidence of two types of manufacturing firm: traditional (low performing plants) and enlightened (high performing plants), and makes the case that the distinction in quality is not so much between Japanese versus Western, as it is between traditional and enlightened approaches to quality. The enlightened firms have the following characteristics. First, they see quality as an ongoing, never‐ending pursuit of customer satisfaction, rather than as a managerial fad which might be replaced by subsequent “management‐guru” terms. Second, they have senior manufacturing personnel committed to quality. Third, they have manufacturing strategies which help to translate external customer requirements into internal operational approaches. The differences in capability of quality levels between traditional and enlightened manufacturers are both intriguing and, for the traditional group, alarming. Clearly, the enlightened firms recognize the enormous benefits of, and remain committed to, TQM and they offer an approach which sets them apart from the traditional group.

The Mechanical Engineering Department at Washington State University has recently completed 6 years of a CAD sequence for freshmen and sophomores beginning with fundamental CAD skills leading rapidly into more advanced topics and culminating in CAD applications for engineering design and analysis. The students learn how to follow an abbreviated set of written instructions; master advanced modeling techniques, model for analysis, use an assortment of computational CAD tools to analyze models, incorporate CAD analysis into the design process, and use CAD analysis to drive design optimization. This sequence has been instrumental in preparing students for the subsequent set of design classes at the junior and senior level. This paper will discuss some of the unique aspects of this instructional sequence and some of the best practices that were integrated into the curriculum.Copyright © 2013 by ASME

Zeeman Doppler Imaging (ZDI) is a recent technique for measuring magnetic fields on rapidly rotating, active stars. ZDI employs spectropolarimetry taken at different rotational phases to derive information on the magnetic field distribution over the stellar surface. The Zeeman effect is used to identify the presence of a magnetic field, and variations in Doppler wavelength shifts across the rapidly rotating star allow fields to be resolved on different parts of the visible disk. Analysis of the spectra can be used to produce both thermal and surface magnetic images. ZDI requires very high S/N spectra to be acquired within a time interval short compared to the stellar rotation period. As a result, a large-aperture telescope is needed. Since an initial successful test in 1989, the 3·9 m Anglo-Australian Telescope has been used to obtain ZDI spectra of active stars of different evolutionary stages. The observations have concentrated on the K subgiant in the RSCVn system HR 1099 to monitor changes on this bright and active star. With the advent in 1991 of ZDI spectropolarimetry with the AAT échelle spectrograph, it has become possible to co-add the polarisation signature from the many magnetically sensitive lines recorded simultaneously. As a result, stellar magnetic field detections of unprecedented quality have been obtained. The aims of this paper are to briefly outline the principles of ZDI, describe the instrumental setup at the AAT and present some preliminary results from recent observations.

Increasingly, librarians are being offered the same information from a range of different sources and through a variety of different delivery channels. Many Journal titles, for example, are now available as print subscriptions, on CD‐ROM, via online hosts and from on demand document delivery services. As part of the UK Electronic Libraries programme, the authors have developed a simple decision support tool which allows a Library Manager to compare the total cost of acquiring a given item of information from each of a number of different sources. The costing approach employed was developed by the Task Force on MA/HEM — Methodology for Access/Holdings Economic Modelling — and the system was implemented using Microsoft Excel.