Exploring the Use of Balanced Scorecards in a Transport Public Administration in Albania

The board of the Directory of transport decided to implement Total Quality Management in the beginning of the 2013. In 2013 the Directory decided to implement the Balanced Scorecard (BSC) as a new way of following up the units’ results. The BSC implementation has led to that all production units write their follow-up reports according to the perspectives suggested in the BSC framework. The head of the production units are responsible for the dissemination and implementation of the BSC in their own units. The purpose of the thesis is to increase the understanding of the use of the BSC in an organization in the Albania. Two research questions derive from the purpose: (1) How is the BSC designed, implemented and used in the organization? (2) What factors enable or constrain the use of the BSC in the organization? Findings from the case study show that the BSC is used in the annual planning, in reporting measures to superiors and in following up the activities in the transport organization. The BSC is also used in discussions between employees, to disseminate information within and outside the organization, to create orderliness and understanding of the annual activities, and in developmental activities.The findings indicate that the BSC has been adapted to the current conditions of the organization with regard to the existing terminology and organizational structures. The BSC is not primarily used as a strategic management system, but rather as an information system that aims to communicate measurable information within and outside the organization. The autonomy of the department and units enables people to develop their own scorecards without considerable influence from superiors. The emphasis on employees’ participation is also identified as an important aspect in making people accept the new concept. In addition, the case shows that change agents play a major role in how the BSC is used in the organization today. Several adaptations have been made to current conditions, that both enable and constrain the use of the BSC in the transport organization

Street network analysis by spot imagery for urban morphology study: case study: Melaka

This paper is based on the study of morphological changes in Melaka, Malaysia. In order to identify the morphology of this city, the street network has been studied to determine the evolutionary of urban form and structure. The objective of this paper is to examine the movement and direction of the street pattern in influenced the morphology of the city from the year 1993 to 2016. Three series of satellite images on the year 1993, 2005 and 2015 from SPOT satellite have been used in detecting the development of street network pattern aided by remote sens-ing and GIS software. By extracting the street in 20 years of development, a com-parison of the street pattern will be taken into consideration to examine the direc-tion of the expansion of Melaka city. The finding shows that the streets expansion growth fast as the more settlement were built along this process and the expansion was merely influenced by the location of the site which near to Malacca Straits and as a port for trade sector. Further, the movement of streets expanding inwards to the inner city and along the shoreline. Finally, this study shows a street network as one of the principle elements in the urbanization process and it provides an understanding key on how cities are formed and develop in order to achieve a resilient city

Rivers as integration devices in cities

Background: As dynamic systems rivers and cities have been in interaction under changing relations over time, and the morphology of many cities has risen through a long and steady struggle between the city functions and the river system flowing inside. This makes river cities an interesting case to study how the presence of geographical features interacts with spatial morphology in the formation of cities. Methods: The basis of this research is enabled by utilizing a novel model for cross-city comparison presented by Hillier in his Santiago keynote in 2012 called a “star model”. This is done on large samples of cities investigating concurrent configurations, as well as how the properties in this star model react to specific forms of disturbance. Results: Results illustrate that the foreground network as identified through maximum choice values in cities are more vital to the structure of cities than the bridges. The overall syntactic structure tends to retain its character (degree of distributedness) and the location of its foreground network (which street segments constitute the foreground network) even when bridges are targeted. Furthermore, counter to the initial hypothesis, river cities tend to change less than non-river cities after targeted disturbance of the systems. Finally, the results show that while there is a statistical morphological difference between river cities and non-river cities, this difference is not directly explained through the bridges. Conclusion: Integrating space syntax with statistical and geospatial analysis can throw light on the way in which the properties of city networks and urban structure reflect the relative effect of rivers on the morphology of river cities. The paper, finally, contributes through offering one piece of a better perception of the structure of river-cities that can support strategies of river-cities interaction as well as enhance our knowledge on the constraints and limits to that interaction.QC 20160309</p

Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score

Background Treatment guidelines recommend a stepwise approach to primary biliary cholangitis: all patients begin treatment with ursodeoxycholic acid (UDCA) monotherapy and those with an inadequate biochemical response after 12 months are subsequently considered for second-line therapies. However, as a result, patients at the highest risk can wait the longest for effective treatment. We determined whether UDCA response can be accurately predicted using pretreatment clinical parameters. Methods We did logistic regression analysis of pretreatment variables in a discovery cohort of patients in the UK with primary biliary cholangitis to derive the best-fitting model of UDCA response, defined as alkaline phosphatase less than 1·67 times the upper limit of normal (ULN), measured after 12 months of treatment with UDCA. We validated the model in an external cohort of patients with primary biliary cholangitis and treated with UDCA in Italy. Additionally, we assessed correlations between model predictions and key histological features, such as biliary injury and fibrosis, on liver biopsy samples. Findings 2703 participants diagnosed with primary biliary cholangitis between Jan 1, 1998, and May 31, 2015, were included in the UK-PBC cohort for derivation of the model. The following pretreatment parameters were associated with lower probability of UDCA response: higher alkaline phosphatase concentration (p&lt;0·0001), higher total bilirubin concentration (p=0·0003), lower aminotransferase concentration (p=0·0012), younger age (p&lt;0·0001), longer interval from diagnosis to the start of UDCA treatment (treatment time lag, p&lt;0·0001), and worsening of alkaline phosphatase concentration from diagnosis (p&lt;0·0001). Based on these variables, we derived a predictive score of UDCA response. In the external validation cohort, 460 patients diagnosed with primary biliary cholangitis were treated with UDCA, with follow-up data until May 31, 2016. In this validation cohort, the area under the receiver operating characteristic curve for the score was 0·83 (95% CI 0·79–0·87). In 20 liver biopsy samples from patients with primary biliary cholangitis, the UDCA response score was associated with ductular reaction (r=–0·556, p=0·0130) and intermediate hepatocytes (probability of response was 0·90 if intermediate hepatocytes were absent vs 0·51 if present). Interpretation We have derived and externally validated a model based on pretreatment variables that accurately predicts UDCA response. Association with histological features provides face validity. This model provides a basis to explore alternative approaches to treatment stratification in patients with primary biliary cholangitis

Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score

Background Treatment guidelines recommend a stepwise approach to primary biliary cholangitis: all patients begin treatment with ursodeoxycholic acid (UDCA) monotherapy and those with an inadequate biochemical response after 12 months are subsequently considered for second-line therapies. However, as a result, patients at the highest risk can wait the longest for effective treatment. We determined whether UDCA response can be accurately predicted using pretreatment clinical parameters. Methods We did logistic regression analysis of pretreatment variables in a discovery cohort of patients in the UK with primary biliary cholangitis to derive the best-fitting model of UDCA response, defined as alkaline phosphatase less than 1·67 times the upper limit of normal (ULN), measured after 12 months of treatment with UDCA. We validated the model in an external cohort of patients with primary biliary cholangitis and treated with UDCA in Italy. Additionally, we assessed correlations between model predictions and key histological features, such as biliary injury and fibrosis, on liver biopsy samples. Findings 2703 participants diagnosed with primary biliary cholangitis between Jan 1, 1998, and May 31, 2015, were included in the UK-PBC cohort for derivation of the model. The following pretreatment parameters were associated with lower probability of UDCA response: higher alkaline phosphatase concentration (p<0·0001), higher total bilirubin concentration (p=0·0003), lower aminotransferase concentration (p=0·0012), younger age (p<0·0001), longer interval from diagnosis to the start of UDCA treatment (treatment time lag, p<0·0001), and worsening of alkaline phosphatase concentration from diagnosis (p<0·0001). Based on these variables, we derived a predictive score of UDCA response. In the external validation cohort, 460 patients diagnosed with primary biliary cholangitis were treated with UDCA, with follow-up data until May 31, 2016. In this validation cohort, the area under the receiver operating characteristic curve for the score was 0·83 (95% CI 0·79–0·87). In 20 liver biopsy samples from patients with primary biliary cholangitis, the UDCA response score was associated with ductular reaction (r=–0·556, p=0·0130) and intermediate hepatocytes (probability of response was 0·90 if intermediate hepatocytes were absent vs 0·51 if present). Interpretation We have derived and externally validated a model based on pretreatment variables that accurately predicts UDCA response. Association with histological features provides face validity. This model provides a basis to explore alternative approaches to treatment stratification in patients with primary biliary cholangitis