The high costs associated with turnover and the loss of skilled employees have a significant adverse effect on organizational performance. The loss of one skilled worker can cost 25-500% of an employee's salary with respect to replacement, training, and productivity. The purpose of this descriptive multiple case study was to explore strategies for frontline managers and human resource managers to reduce voluntary employee turnover. The sample consisted of 5 frontline supervisors and 6 human resource leaders with successful experience designing and implementing strategies to reduce voluntary employee turnover in 8 organizations in Orange County, Florida. The conceptual framework for this study was the competing values framework, which researchers have used to explore turnover in different settings. Methodological triangulation occurred from individual interviews, a focus group, and companies' documents. Interview data were analyzed using the modified van Kaam method and the constant comparative method. Analysis resulted in 4 themes (a) knowledge of your workforce, including what motivates your employees; (b) communication, including addressing communication barriers; (c) employee engagement, including leadership development; and (d) performance evaluations, including using a 360-degree feedback system. Social change implications include the potential to help human resource leaders align employee values with the organizational culture, thus increasing job satisfaction and decreasing voluntary employee turnover, which may contribute to lowering unemployment and minimizing the need for social services due to the loss of income.

Knowledge management (KM) has been determined by many researchers as one of the most important domains within the information systems (IS) field, and knowledge sharing (KS) has been identified as the most vital component of KM. Lack of KS within organizations has been approached from many perspectives. One perspective that has been outlined in recent studies is the organizational culture (OC) perspective, which examines the interaction between OC and KS behaviors. Although research has been conducted on OC and KS, the findings of recent studies have been contradictory. These conflicts were due to the different operationalization of KS. The purpose of this research was to conduct a multi method study to investigate the interaction between KS and OC in detail. A case study within a Fortune 50 organization was undertaken to address the problem. By focusing on socialization adopted from the socialization, externalization, combination, internalization (SECI) model, the iceberg theory, and the Competing Values Framework (CVF), two questions were explored to address an unexamined area within the body of knowledge. Per the recent calls for research, the questions addressed KS itemized into knowledge seeking and knowledge contributing, and investigated the phenomenon at multiple levels of the organization. The first question examined the interaction between OC and KS via socialization amongst peers for: (a) overall organization, (b) non-managers, (c) first level managers, and (d) second-level managers. The second question examined the interaction between OC and KS via socialization amongst various levels for: (a) subordinates and managers in overall organization, (b) non-managers and first level managers, and (c) first level managers and second level managers. Data were collected through 82 surveys, 23 interviews, 23 observations, and company records for the calendar year of 2017 to provide multiple types of data for triangulation. The quantitative data were analyzed through descriptive statistics, correlation tables, multivariate analysis of covariance (MANCOVA), and visualization. The qualitative data were analyzed through open coding, axial coding, and selective coding. The combined results were triangulated to reach the conclusions. The MANCOVA displayed a significant interaction between OC and KS via socialization. Furthermore, the triangulated results showcased that perceived bureaucratic culture and perceived competitive- bureaucratic culture had a negative relationship with KS via socialization amongst peers, knowledge seeking for manager to subordinate, and subordinate to manager, but not for between level knowledge contributing. While perceived clan culture had a positive relationship with KS via socialization amongst peers, and for knowledge seeking from managers, but not for between level knowledge contributing. Perceived competitive culture was only discovered to have a negative relationship with knowledge seeking for level two managers, while having a positive relationship with knowledge contributing to employees, and knowledge contributing amongst peers with knowledge seeking as moderating variable. The various organizational levels also showcased distinct results which requires further investigation. Future research suggestions were made to extend the body of knowledge through various directions, alongside an IS solution recommendation for organizations to improve KS.

No description available.

Thesis (MAud (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy)--Stellenbosch University, 2008. / Individuals are increasingly undergoing bilateral cochlear implantation in an attempt to benefit from binaural hearing. The main aim of the present study was to compare the speech recognition of children fitted with bilateral cochlear implants, under binaural and monaural listening conditions, in quiet and in noise. Ten children, ranging in age from 5 years 7 months to 15 years 4 months, were tested using the Children’s Realistic Index for Speech Perception (CRISP). All the children were implanted with Nucleus multi-channel cochlear implant systems in sequential operations and used the ACE coding strategy bilaterally. The duration of cochlear implant use ranged from 4 years to 8 years 11 months for the first implant and 7 months to 3 years 5 months for the second implant. Each child was tested in eight listening conditions, which included testing in the presence and absence of competing speech. Performance with bilateral cochlear implants was not statistically better than performance with the first cochlear implant, for both quiet and noisy listening conditions. A ceiling effect may have resulted in the lack of a significant finding as the scores obtained during unilateral conditions were already close to maximum. A positive correlation between the length of use of the second cochlear implant and speech recognition performance was established. The results of the present study strongly indicated the need for testing paradigms to be devised which are more sensitive and representative of the complex auditory environments in which cochlear implant users communicate.

Objectif : La néphrectomie partielle est reconnue actuellement comme le traitement de choix des tumeurs de moins de 7 cm. Le but de notre étude est de comparer le taux de mortalité lié au cancer du rein suite au traitement par néphrectomie partielle ou radicale chez les patients de stade T1b, de présenter la tendance temporelle du taux d'intervention par néphrectomie partielle pour les tumeurs de stade T1b et d’identifier les facteurs sociodémographiques et tumoraux qui influencent le choix thérapeutique entre les deux types de traitement chirurgical. Méthode : Il s’agit d’une étude épidémiologique de type rétrospective. La population de patients provient de la base de donnée SEER (Surveillance, Epidemiology, and End Results) qui regroupe une grande proportion de la population nord-américaine. Dans notre étude, nous avons utilisé l’analyse par régression logistique pour identifier les facteurs sociodémographiques associés à l'intervention par néphrectomie partielle. Dans un deuxième temps, nous avons comparé la mortalité liée au cancer entre les deux options chirurgicales, après association par score de tendance pour diminuer les différences de base entre les deux populations. Nos critères étaient l’âge, la race, le sexe, l’état civil, le niveau socioéconomique, la taille tumorale, le grade nucléaire, l’histologie et la localité du centre hospitalier. L’analyse des données a été faite par le logiciel SPSS. Résultats : Le taux d'interventions par néphrectomie partielle a augmenté de 1,2% en 1988 à 15,9% en 2008 (p <0,001). Les jeunes patients, les tumeurs de petite taille, les patients de race noire, ainsi que les hommes sont plus susceptibles d'être traités par néphrectomie partielle (tous les p < 0,002). Parmi le groupe ciblé, le taux de mortalité lié au cancer à 5 ans et à 10 ans est de 4,4 et de 6,1% pour les néphrectomies partielles et de 6,0 et 10,4% pour les néphrectomies radicales (p = 0,03). Après ajustement de toutes les autres variables, les analyses de régression montrent que le choix entre les deux types de néphrectomie n’est pas associé à la mortalité lié au cancer (hazard ratio: 0,89, p = 0,5). Conclusion : Malgré un contrôle oncologique équivalent, le taux d'intervention par néphrectomie partielle chez les patients ayant un cancer du rein T1b est faible en comparaison à la néphrectomie radicale. / Objectives: To examine utilization rates of partial nephrectomy relative to radical nephrectomy for T1b renal cell carcinoma in contemporary years, to identify sociodemographic and disease characteristics associated with partial nephrectomy use, and to compare effectiveness of partial vs. radical nephrectomy with respect to cancer control outcomes. Materials and Methods: Using the Surveillance, Epidemiology, and End results database, 16,333 patients treated with partial or radical nephrectomy for T1bN0M0 renal cell carcinoma between 1988 and 2008 were identified. Logistic regression models were performed to identify determinants of partial nephrectomy. Subsequently, cumulative incidence rates of cancer-specific and other-cause mortality between partial and radical nephrectomy were assessed, within the matched cohort. Finally, we relied on competing-risks regression analyses for prediction of cancer-specific mortality, after adjusting for other-cause mortality, and vice-versa. Results: The utilization rate of partial nephrectomy increased from 1.2% in 1988 to 15.9% in 2008 (P<0.001). Younger individuals, smaller tumors, persons of black race, as well as men were more likely to be treated with partial nephrectomy in the current cohort (all P≤0.002). In the post-propensity cohort, the 5- and 10-year cancer-specific mortality rates were 4.4 and 6.1% for partial vs. 6.0 and 10.4% for radical nephrectomy, respectively (P=0.03). Following adjustment for other covariates, competing-risks regression analyses showed that nephrectomy type was not statistically significantly associated with cancer-specific mortality, even after adjusting for other-cause mortality (hazard ratio: 0.89, P=0.5). Conclusions: Despite a comparable cancer control outcome, consideration of partial over radical nephrectomy in T1b renal cell carcinoma individuals remains conservative in recent years.

Ce travail a eu pour objectif de proposer des méthodes statistiques pour évaluer et comparer les capacités prédictives de divers outils pronostiques. Le Brier score et principalement les courbes ROC dépendant du temps ont été étudiés. Tous deux dépendent d'un temps t, représentant un horizon de prédiction. Motivé par les applications à la prédiction de la démence et des données de cohortes de personnes âgées, ce travail s'est spécifiquement intéressé à des procédures d'inférence en présence de données censurées et de risques concurrents. Le risque concurrent de décès sans démence est en effet important lorsque l'on s'intéresse à prédire une démence chez des sujets âgés. Pour obtenir des estimateurs consistants, nous avons utilisé une méthode appelée “Inverse Probability of Censoring Weighting” (IPCW). Dans un premier travail, nous montrons qu'elle permet d'étendre simplement les estimateurs pour données non censurées et de prendre en compte une censure éventuellement dépendante de l'outil pronostique étudié. Dans un second travail, nous proposons des adaptations pour les situations de risques concurrents. Quelques résultats asymptotiques sont donnés et permettent de dériver des régions de confiance et des tests de comparaison d'outils pronostiques. Enfin, un troisième travail s'intéresse à la comparaison d'outils pronostiques dynamiques, basés sur des marqueurs longitudinaux. Les mesures de capacités pronostiques dépendent ici à la fois du temps s auquel on fait la prédiction et de l'horizon de prédiction t. Des courbes de capacités pronostiques selon s sont proposées pour leur évaluation et quelques procédures d'inférence sont développées, permettant de construire des régions de confiance et des tests de comparaison de ces courbes. L'application des méthodes proposées a permis de montrer que des outils prédictifs de la démence basés sur des tests cognitifs ou des mesures répétées de ces tests ont de bonnes capacités pronostiques. / The objective of this work is to develop statistical methods that can be used to evaluate and compare the prognostic ability of different prognostic tools. To measure prognostic ability, mainly the time-dependent ROC curve is studied and also the Brier score for a prediction horizon t. Motivated by applications where the aim is to predict the risk of dementia in cohort data of elderly people, this work focuses on inference procedures in the presence of right censoring and competing risks. In elderly populations death is a highly prevalent competing risk. To define consistent estimators of the prediction ability measures, we use the inverse probability of censoring weighting (IPCW) approach. In our first work, we show that the IPCW approach provides consistent estimators of prediction ability based on right censored data, even when the censoring distribution is marker-dependent. In our second work, we adapt the estimators to settings with competing risks. Asymptotic results are provided and we derive confidence regions and tests for comparing different prognostic tools. Finally, in a third work we focus on comparing dynamic prognostic tools which use information from repeated marker measurements to predict future events. The prognostic ability measures now depend on both the time s at which predictions are made and on the prediction horizon t. Curves of the prognostic ability as a function of s are developed for the evaluation of dynamic risk predictions. Inference procedures are adapted and so are confidence regions and tests to compare the curves. The applications of the proposed methods to cohort data show that the prognostic tools that use cognitive tests, or repeated measurements of cognitive tests, have high prognostic abilities.

Les infections nosocomiales demeurent un véritable défi de santé publique en dépit des progrès techniques considérables enregistrés. Inhérentes à la prise en charge de soins, se sont les services de réanimation qui comptabilisent les plus fort taux de prévalence. En effet, quelle que soit leur orientation (chirurgicale, médicale ou mixte), ces services, ont pour mission la prise en charge des patients dont le processus vital est menacé par la survenue brutale d’une ou de plusieurs défaillances organiques nécessitant un arsenal diagnostic et/ou thérapeutique souvent invasif.Parmi les conséquences induites par ces infections ; i) l’allongement de la durée de séjour, ii) le surcoût, iii) une augmentation de la mortalité, et iv) la résistance bactérienne.Pouvoir anticiper en amont et en aval cette problématique aux motifs complexes et aux conséquences parfois fatales serait un atout majeur au profit des patients et un outil stratégique pour les équipes soignantes.Organisée autour de trois étapes charnières, la présente étude s’est d’abord attelée à la phasede l’identification des facteurs de risque de l’évènement nosocomial et de mortalité au service de réanimation ou s’est passé l’étude –prise en compte du case-mix du service de réanimation CHU la TIMONE-. Réalisée grâce à deux méthodes statistiques différentes à savoir la régression logistique et la méthode des risques compétitifs. L’étape suivante a consisté dans un premier temps à comparer les capacités prédictives des scores APACHE II, LOD, SOFA et SAPS II chez ces patients -hospitalisés en réanimation-ayant développé un épisode nosocomial. Dans un second temps de déterminer si la variation des scores LOD, SOFA, APACHEII et SAPS II est un facteur pronostique du risque nosocomial. Les résultats obtenus révèlent que la meilleure performance prédictive est objectivée au profit du SOFA et que seule la variation de ce même score entre le premier jour d’hospitalisation et celui du diagnostic de l’infection nosocomiale mesurée grâce à l’AUC est prédictive du risque nosocomial.À l’issue de ces étapes et au moyen des résultats obtenus une construction d’un score prédictif est réalisée grâce à la méthode de régression logistique. L’objectif de ce score est d’éclairer voire d’influencer le prescripteur lors de ses prises de décisions ou d’éventuelle démarche d’ajustement de ses conduites thérapeutiques. / Limiting nosocomial infections is still a health challenge although the technical development has improved. They are inherent in medical care and the health care services have the highest prevalence. Indeed, whatever the service (surgical, medical or both), the patients life-giving process is under attack because of the emergence of one or several organ faillures;This generates a diagnostic and therapeutic arsenal which is often invasive.Among the consequences resulting from these infections we will take into account :i) a longer stay in hospitalii) an extra costiii) a higher mortality rateiv) bacterial resistance .If we could anticipate upstream and downstream this issue with complex origins and sometimes fatal consequences, it would be a major asset for patients and a strategic tool for medical teams.The present study is organized in three parts, and first focusses onto the identification of the nosocomial event and death risk factors in intensive care where the study took place. We took into account the the case-mix of the intensive care unit in the TIMONE University Hospital. The study was made with two different statistic methods that is logistic regression and the competitive risks method.The next step first consisted in comparing the predictive capacities of the APACHE II, LOD, SOFA and SAPS II scores in nosocomial patients hospitalized in intensive care . Then it tried to determine if the variation of the LOD, SOFA, APACHEII and SAPS II scores was a prognostic risk factor.Results showed that the best predictive performance was objectively measured by the SOFA and that only the variation of this score between the first day in hospital and the day of the diagnosis of a nosocomial infection, calculated thanks to the AUC, could be predictive of a nosocomal risk. After these steps, and with the results calculated , the construction of a predictive score could be established thanks to the logistic regression method. The objective of this score is to help, or even influence the prescribing doctors when they take decisions or when they try to adjust their therapeutic practices.

This thesis comparatively analyses dilemmas arising from the unresolved Georgian-Abkhazian and Moldovan-Transnistrian conflicts. The many existing differences in the nature and dynamics of each conflict point to a sui generis situation, yet, many similarities also exist, including Soviet era legacies. The research premise is based on very considerable resourcing being dedicated to the resolution of these conflicts since their inception, yet no significant conflict transformation (Abkhazia has Russian recognition) has occurred, let alone peace. Given the mandate from the OSCE, EU and UN, the purpose of the thesis is to analyse their involvement. While evidence – local vested interests and strategic interests – illustrates the obvious obstructions, the thesis focuses on the IOs and asks why no tangible successes were achieved. This is done by critically analysing their performance, by assuming that success is often overlooked and by identifying a range of misperceptions. Therefore, by considering conflict transformation and engaging in analysis of many sources, including documents and about five-dozen interviews, the thesis reappraises the ethno-national origins, the geopolitical dimension and the entrenched conflicting party positions in the context of pan-European actors' responses. The analyses of the comparative peace processes illuminate the IOs' own challenges in reaching consensus as well as on the conflicting parties' competing narratives. Answering the question of what to produce first – a political solution to improve societal conditions, or the pursuing exercise of confidence-building measures (CBMs) to settle the status question – is part of the objective. I argue that a typology of success and failure more comprehensively explains IO performance between 1992 and the EU's Vilnius Summit in 2013.

Lean manufacturing is one of the most developing manufacturing philosophies through which firms can minimise waste in the production process. Implementing lean practices successfully enables firms to lower unit costs of production and maximise value to the customer, which in turn helps them to increase their competitive edge over rivals. The emerging literature considers organisational culture as a necessary intangible source for achieving a competitive advantage for companies, and to have a critical role in the success or failure of lean practices implementation. The aim of this thesis is to investigate the effect of organisational culture on lean technical practices in the manufacturing firms in Jordan. More specifically, four conceptual models have been developed in the current study highlighting the effect of each type of organisational culture on lean technical practices implementation. In addition, more emphasis was on understanding the mechanism through which customers' involvement, employees’ involvement and suppliers’ involvement affect the relationship between organisational culture and lean technical practices. Thus, the four conceptual models bring to light the potential intervening role of the human lean practices in the organisational culture/ lean technical practices association. After identifying and reviewing the relevant literature, the socio-technical system theory, contingency theory and RBV are adopted to develop the conceptual models and associated hypotheses. A Structural Equation Modelling (SEM) techniques have been adopted to analyse a dataset of over 200 manufacturing firms in Jordan, collected by using a self-administered survey. The findings of this study indicate that the hierarchical culture has the highest substantial positive effect on lean technical practices followed by developmental culture, group culture and rational culture respectively. In addition, it is found that each type of organisational culture (group, developmental, hierarchical and rational) affects positively lean human practices (customers' involvement, employees’ involvement and suppliers’ involvement) in different statistical levels. For example, all types of organisational culture affect suppliers’ involvement more than customers’ involvement and employees’ involvement respectively. Moreover, it is found that customers’ involvement and suppliers’ involvement have the highest positive effect on lean technical practices in the rational culture and the least positive effect in the hierarchical culture. Furthermore, it is found that the positive effect of each type of organisational culture on lean technical practices is partially mediated by customers' involvement and partially mediated by suppliers’ involvement. The highest significant mediating effect of customers' involvement and suppliers’ involvement lies in the rational culture/lean technical practices link whereas the lowest significant mediating effect of customers' involvement and suppliers’ involvement lies is in the hierarchical culture/ lean technical practices link. Finally, it is found that employees’ involvement does not mediate the relationship between organisational culture and lean technical practices. These findings provide new evidence from Jordan to support the hypotheses that the organisational culture can act as a crucial pre-condition for lean technical practices to be fully effective. Additionally, the findings reinforce the notion that emphasizing the human side of lean especially for customers' involvement and suppliers' involvement can promote the effectiveness of lean implementation. The current study contributes to the current literature at two levels. First, at the theoretical level, this study develops multiple conceptual models which crosses two streams of literature mainly, organisational culture literature and lean manufacturing literature with a focus on the human side of lean. Unlike previous studies, the models integrate the direct effect of organisational culture on lean technical practices and the intervening role of lean human practices due to which the organisational culture is assumed to have also an indirect effect on lean technical practices. Furthermore, employing a powerful statistical technique (Analysis of Moment Structure-SEM) provides more credibility to the results reported in this study. Second, at the empirical level, this study is conducted in the Jordanian context. As such, this study is one of the first, to our knowledge, that examines the effect of organisational culture on lean technical practices, as well as having examined the mechanism of how each type of organisational culture affects lean technical practices using empirical survey data from this context.

Made available in DSpace on 2014-06-11T19:22:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-20Bitstream added on 2014-06-13T20:09:20Z : No. of bitstreams: 1 salomao_mh_me_sjrp.pdf: 880828 bytes, checksum: 1acf7804cf3583279a73a79a2dcffae2 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A atuação de processos de redução e de supressão de segmentos consonantais em fenômenos redundantes, como a concordância nominal, tende a suprimir marcas de pluralidade, provocando a possibilidade de ambiguidade referencial. Um fenômeno fonológico que reflete o processo gramatical de concordância é o da supressão de /S/, que pode afetar a marcação de pluralidade em contexto nominal. Com base nisso, o objetivo deste trabalho é o de submeter a um tratamento variacionista, de base quantitativa, dados de marcação variável de plural no SN e no SA em contexto de predicativo, obtidos em córpus coletado na região de São José do Rio Preto. O trabalho procura examinar se a marcação de pluralidade nos predicativos pode ser explicada com base em motivações exclusivamente formais, ou exclusivamente funcionais, ou ainda, com base na interação entre ambas, que consistiriam, assim, em motivações em competição (DU BOIS, 1985). A análise dos resultados mostra, por um lado, que um princípio funcional, como o as Condições de Distintividade de Kiparsky (1972), atua positivamente na marcação variável de pluralidade, mas não tem força suficiente para governar isoladamente o processo. Mostra, por outro, que as motivações formais, gerenciadas pelo Princípio do Paralelismo Formal, também exercem influência significativa na marcação variável de plural no predicativo, mas não como força predominante, na medida em que se submete a uma influência significativa das variáveis extralinguísticas escolaridade e idade. Esse comportamento dos dados não permite dar a esse princípio o poder explanatório que Labov (1996) lhe atribui, isto é, como a atuação mecânica de forças inerentemente internas ao sistema linguístico. Por essa razão, a explicação mais plausível para a marcação variável de pluralidade nos predicativos, na variedade estudada... / Both the reduction and the suppression of consonantal segments when those occur in contexts of nominal agreement tends to drop plural markers, thus creating referential ambiguities. Amongst those phenomena reflecting a process of grammatical agreement is the suppresion of /S/ in spoken Portuguese, which characterizes a phonological phenomenon that may affect plurality marking in the NP. Considering that, the present work employs a variationist and quantitative method to analyse data containing instances of predicative variable plural marking both in the NP and AP taken from a corpus collected in the area of São José do Rio Preto. This research aims to attest to whether plurality marking in the predicative context can be explained in terms of exclusively formal or exclusively functional motivations, or else, in terms of the interaction between these two kinds of motivations, thus consisting in competing motivations (DU BOIS, 1985). On the one hand, the analysis of the results evinces that a functional principle such as Kiparsky‟s Distinctiveness Conditions (1972) acts in a positive way in the variable plural marking; yet it alone does not suffice to govern the entire process. On the other hand, this work demonstrates that formal motivations governed by the Principle of Formal Parallelism have a significant influence on predicative plural marking, but not in a predominant fashion, inasmuch as the latter is subject to significant influence of extralinguistic variables such as „education‟ and „age‟. The situation of the data do not authorize that such a principle be bestowed the explanatory power that Labov (1996) ascribes to it, i.e., that idea of a mechanical acting of inherent forces whithin the inner linguistic system. For that reason, the most plausible explanation is that the predicative plural marking in the variety under scrutiny constitutes a process influenced... (Complete abstract click electronic access below)