What characterizes leading companies within business excellence models? An analysis of “EFQM recognized for excellence” recipients in Spain

This paper investigates whether there is a specific approach to the adoption of best management practices embedded in the EFQM Excellence Model, which characterizes leading “Recognized for Excellence” organizations in Spain. In addition, it studies which practices within EFQM’s enablers predict high performance. In contrast to most previous research that used surveys of managers’ perceptions, this study uses the actual criteria and sub-criteria scores attained by organizations in their assessment for EFQM recognition. Scores of a population of 216 organizations, which were assessed in the period from March 2011 to March 2013, are analyzed via ANOVA, factor and regression analyses. The findings show that Spanish organizations adopt the best practices encompassing the EFQM model in a similar fashion: organizations on average follow parallel trends in the scores received per criterion, and there are no significant differences in the importance attributed to enablers. Either role models are being followed, or most organizations know what is expected by the assessors and try to fulfil these expectations. Consequently, an imitative process disseminates and legitimizes the EFQM model in Spain. In addition, it is found that the People criterion makes a difference in attaining high performance, thus emphasizing the relative importance of the softer dimension in Quality Management. This study contributes to the management literature on best practices, by highlighting a consistent trend in the use of the EFQM model, and also provides insights to managers on how to better allocate resources within Business Excellence Models

Health and health belief factors associated with screening and help-seeking behaviours for breast cancer symptoms: a systematic review and meta-analysis of the European evidence

Purpose: The aim of this systematic review was to identify health or health belief factors associated with mammography attendance or with self-initiated medical help-seeking for breast cancer symptoms among women in Europe. Methods: Five databases were searched for articles published between 2005 and 2018. Meta-analyses were conducted for 13 factors related to screening attendance and two factors associated with help-seeking behaviour. Where there were too few studies to include in the meta-analysis a narrative synthesis was undertaken. Results: Sixty-five studies were included. Never having had cervical screening (d=-0.72, p<0.001) and higher perceived barriers to mammography (d=-0.40, p<0.001) were associated with lower levels of screening attendance. Possessing health insurance (d=0.49, p<0.001), greater perceived benefits (d=0.31, p<0.001) and motivation (d=0.36, p=0.003) towards screening, and higher perceived seriousness (d=0.24, p=0.019) and susceptibility (d=0.20, p=0.024) towards breast cancer were associated with a higher level of screening attendance. Presenting with a non-lump symptom was associated with a longer time to presentation (d=0.32, p<0.001). The narrative synthesis revealed that previous benign breast disease was associated with a higher level of screening attendance but with a longer time to presentation. Conclusions: The review identified key similarities in factors associated with screening and help-seeking behaviours which offer scope for combined interventions aimed at women that target both behaviours. Furthermore, the review highlighted that fewer studies have focused on help-seeking behaviour, despite two thirds of breast cancer cases being self-detected. Future research should further examine predictors of help-seeking behaviour including a focus on modifiable factors, such as BMI, and physical activity

Innovation capability and its role in enhancing the relationship between TQM practices and innovation performance

Innovation plays a critical role in predicting the long-term survival of organizations, determining an organization’s success and sustaining its global competitiveness, especially in an environment where technologies, competitive position and customer demands can change almost overnight, and where the life-cycle of products and services are becoming shorter.Therefore, the main purpose of this paper is to extend the existing knowledge as to the relationship between TQM practices and innovation performance by exploring the expected role of innovation capability as mediator to enhance this relationship.At the same time, this study attempted to shed a light on how to improve innovation performance of manufacturing companies in Malaysia.The gained results indicated that innovation capability mediates the relationship between TQM practices and innovation performance. More importantly, this study supports the findings of the past studies that questioned the role of TQM practices in improving innovation performance. Finally, in light of the obtained results, several recommendations were introduced to assist decision makers in manufacturing companies

Brain calcification due to secondary hyperparathyroidism in a child with chronic renal failure

Secondary hyperparathyroidism (SHPT) has been better treated over the last decades, but the rate of metastatic calcifications, which were rarely seen before, was significantly increased in dialysis patients. The presence of uncontrolled SHPT, disorders of calcium (Ca) and phosphorus homeostasis and the common usage of large doses of vitamin D and Ca- containing phosphate binders may all contribute to the metastatic calcifications of soft tissues and vasculature leading to some life-threatening complications. Although the metastatic lung, heart, kidney, intestinal wall, skin, eye and soft tissue calcifications have been commonly reported in adults and also in children undergoing dialysis, the central nervous system calcification is a very rare condition. We report here a pediatric hemodialysis patient who presented with severe neurological findings due to the metastatic brain calcification secondary to his uncontrolled hyperparathyroidism

Central nervous system vasculitis secondary to parvovirus B19 infection in a pediatric renal transplant patient

Central nervous system (CNS)vasculitis secondary to chronic parvovirus B19 (B19) infection presenting with recurrent neurological findings is a very rare disorder during childhood. Here we report a 12-year-old boy with a renal transplant who had chronic B19 infection with skin eruptions and recurrent episodes of encephalopathy with focal neurological deficits. B19 DNA was detected in blood, bone marrow, and skin biopsy specimens. Repeat cranial magnetic resonance (MR) imaging during each episode of encephalopathy showed variable focal findings, and MR angiography revealed vasculitic changes with narrowing of the cerebral arteries. We hypothesized that the CNS vasculitis might be associated with the chronic B19 infection. At the time of his fourth presentation with the same clinical findings, we administered intravenous immunoglobulin (IVIG) (1 g/kg per day, 2 consecutive days), which we continued for 6 months, at monthly intervals. IVIG therapy resulted in remission and has been effective not only for the clearance of B19, but also for the improvement of clinical and radiological findings of CNS vasculitis. We suggest that chronic B19 infection should be considered in immunocompromised patients with suspected CNS vasculitis. IVIG should be considered as a part of the treatment

Crescentic glomerulonephritis in a child with infective endocarditis

Renal manifestations associated with infective endocarditis (IE) may present with different clinical patterns, and the most common renal histopathological finding is diffuse proliferative and exudative type of glomerulonephritis, leading to hematuria and/or proteinuria. Renal failure due to crescentic glomerulonephritis (CGN) in children with IE is a very rare condition. We report here a 6-year-old boy, who had a history of cardiac surgery for pulmonary atresia and ventricular septal defect, presenting with the clinical findings of IE and hematuria associated with renal failure due to CGN. He was treated with a combination of intravenous (IV) methylprednisolone pulses and appropriate antibiotics, but also received one dose of IV cyclophosphamide. Complete serological, biochemical, and clinical improvement was achieved after 2 months of follow-up. Antibiotic therapy is the essential part of the treatment of IE-associated glomerulonephritis; however, this case also highlights the importance of aggressive immunosuppressive therapy to suppress the immunological process related with infection in this life-threatening condition leading to renal failure

EWING TUMOR OF THE MANDIBLE

A primary Ewing's tumor in the mandible is reported, and the diagnostic imaging features of this lesion are discussed. Modalities used included panoramic and plain films, computed tomography, and Tc-99m-MDP scintigraphy

EWING TUMOR OF THE MANDIBLE

A primary Ewing's tumor in the mandible is reported, and the diagnostic imaging features of this lesion are discussed. Modalities used included panoramic and plain films, computed tomography, and Tc-99m-MDP scintigraphy