Towards the adoption of new management methods in a modernising national business system?: a study of the responses of middle managers to Total Quality Management in Greek service industry

Total Quality Management (TQM) emerged as a promising management practice mainly in the US and the UK. Its principles challenge the managerial traditions of other countries. A prime example is Greece. In view of the widespread argument that Middle Managers (MMs) are key elements in making TQM work, this study explores the relationship between these people and TQM in the Greek National Business System (NBS). It focuses on how TQM is perceived by them and it investigates whether MMs' perceived awareness of TQM affects their responses to a set of individual and organisational aspects. This study adopts the contingency approach to TQM. This approach argues that TQM does not have determinate effects and that its consequences are shaped by the context in which it operates. This thesis expands knowledge by developing a theoretical framework that addresses the relationship between TQM and Middle Management in this specific national context. It offers strong evidence on four specific contingencies, in the light of which managers' responses to TQM should be explored. These factors are the business/management culture, the modernisation agenda, the sector of employment and the educational background of managers. Moreover, this study contributes to the development of the research methodology in the area, by combining quantitative (survey questionnaire) and qualitative (follow-up interviews) methods. 241 questionnaires were collected and 18 follow-up interviews were conducted in 43 different public (19) and private (24) service organisations. Finally this thesis offers statistically reliable measurement of the 'soft' and 'hard' sides of TQM. In this respect, six major arguments about the relationship between TQM and MMs are supported. First, it is recognised by the MMs that the business system needs modernisation and QM is a part of it. Second, although the acronym TQM and some of its concepts and practices are known by a range of public and private sector managers, actual awareness of its 'soft' side is often superficial, and people have a relatively poor understanding of it. Third, MMs tend to see TQM from the technical point of view, being aware only of the importance of its 'hard' aspects. Fourth, whilst MMs perceive TQM as enhancing individual aspects like autonomy, loyalty and career prospects, at the same time they acknowledge the increased work effort and stress due to the perceived awareness of TQM. Fifth, they hold sceptical positions about the adoption and actual application TQM related organisational issues like empowerment and top management commitment and support. The sixth, overall, conclusion is that TQM was neither resisted nor directly absorbed. The principles of quality improvement have been widely accepted, but convincing Greek managers to apply 'soft' TQM aspects remains a major challeng

Understanding Total Quality Management in Context: Qualitative Research on Managers’ Awareness of TQM Aspects in the Greek Service Industry

This study addresses managers’ awareness and familiarity with Total Quality Management (TQM). Eighteen (18) semi-structured, in-depth interviews were conducted with managers working in a variety of service organizations in Greece. The major argument of the study is that although the acronym TQM and some of its concepts and practices are known by a range of public and private sector managers, actual awareness of its “soft” side is often superficial, and managers have a relatively poor understanding of it. TQM is neither resisted nor directly absorbed by them, but they tend to see it from the technical point of view, being aware only of the importance of its “hard” aspects

Towards the adoption of new management methods in a modernising national business system? : a study of the responses of middle managers to Total Quality Management in Greek service industry

Total Quality Management (TQM) emerged as a promising management practice mainly in the US and the UK. Its principles challenge the managerial traditions of other countries. A prime example is Greece. In view of the widespread argument that Middle Managers (MMs) are key elements in making TQM work, this study explores the relationship between these people and TQM in the Greek National Business System (NBS). It focuses on how TQM is perceived by them and it investigates whether MMs' perceived awareness of TQM affects their responses to a set of individual and organisational aspects. This study adopts the contingency approach to TQM. This approach argues that TQM does not have determinate effects and that its consequences are shaped by the context in which it operates. This thesis expands knowledge by developing a theoretical framework that addresses the relationship between TQM and Middle Management in this specific national context. It offers strong evidence on four specific contingencies, in the light of which managers' responses to TQM should be explored. These factors are the business/management culture, the modernisation agenda, the sector of employment and the educational background of managers. Moreover, this study contributes to the development of the research methodology in the area, by combining quantitative (survey questionnaire) and qualitative (follow-up interviews) methods. 241 questionnaires were collected and 18 follow-up interviews were conducted in 43 different public (19) and private (24) service organisations. Finally this thesis offers statistically reliable measurement of the 'soft' and 'hard' sides of TQM. In this respect, six major arguments about the relationship between TQM and MMs are supported. First, it is recognised by the MMs that the business system needs modernisation and QM is a part of it. Second, although the acronym TQM and some of its concepts and practices are known by a range of public and private sector managers, actual awareness of its 'soft' side is often superficial, and people have a relatively poor understanding of it. Third, MMs tend to see TQM from the technical point of view, being aware only of the importance of its 'hard' aspects. Fourth, whilst MMs perceive TQM as enhancing individual aspects like autonomy, loyalty and career prospects, at the same time they acknowledge the increased work effort and stress due to the perceived awareness of TQM. Fifth, they hold sceptical positions about the adoption and actual application TQM related organisational issues like empowerment and top management commitment and support. The sixth, overall, conclusion is that TQM was neither resisted nor directly absorbed. The principles of quality improvement have been widely accepted, but convincing Greek managers to apply 'soft' TQM aspects remains a major challengeEThOS - Electronic Theses Online ServiceGreek State Scholarship Foundation (IKY)University of Warwick (UoW)GBUnited Kingdo

Making Sense of Crisis: Cognitive Barriers of Learning in Critical Situations

This paper explores the role of cognitive issues in learning from crisis situations, in particular the managers’ mental representations of crisis and the relationship of these “maps” with the learning process through “sense-making”, as well as the possible cognitive barriers that might prevent the process of learning from crisis and thus allow the incubation of crises to develop in the company. Reviewing secondary data from the current literature, the paper focuses on the complexity of human “sense-making” and understanding the phenomena of crisis and the meaning people assign to it. Considerable attention and analysis has been done in order to assess the manner in which organizations can effectively learn to prevent crisis situations, addressing the theoretical frameworks that analyse the barriers that might occur in the learning from crisis process at an individual and group level, pointing out the need of recognition and sense-making that sometimes the current state of knowledge is not well. The paper argues that the effective organizational learning from crises requires changes in the core beliefs, values and assumptions of organizational members, which translate into sustained behavioural changes and that these changes are possible through intense cognitive processes, in particular through the way managers make sense of crisis situations.  Keywords: crisis, learning, cognitive barriers, sense-making, managers, literature revie

Employee participation and representation in Central and Eastern Europe

Using data from the 2013 European Company Survey, this article presents a study of employee involvement and participation (EIP) in decision-making in 12 Central and Eastern European (CEE) countries, a context that is rather less studied but interesting because of its political past and its current emerging economic status. The study explores how these countries can be clustered according to positive employee attitude towards employee representation (ER) and EIP in decision-making. It examines the association between these two components and the effectiveness of the ER body, as well as whether there are differences between country clusters. Finally, the article examines how the degree of EIP in decision-making is related to ER body effectiveness. This research contributes to prior work by seeking to understand EIP in decision-making in an understudied sample of CEE countries and provides an insightful classification

Estimation of Outage Capacity for Free Space Optical Links Over I-K and K Turbulent Channels

The free space optical communication systems are attracting great research and commercial interest due to their capability of transferring data, over short distances, with high rate and security, low cost demands and without licensing fees. However, their performance depends strongly on the atmospheric conditions in the link’s area. In this work, we investigate the influence of the turbulence on the outage capacity of such a system for weak to strong turbulence channels modeled by the I-K and the K-distribution and we derive closed-form expressions for its estimation. Finally, using these expressions we present numerical results for various link cases with different turbulence conditions

A Small Volatile Bacterial Molecule Triggers Mitochondrial Dysfunction in Murine Skeletal Muscle

Mitochondria integrate distinct signals that reflect specific threats to the host, including infection, tissue damage, and metabolic dysfunction; and play a key role in insulin resistance. We have found that the Pseudomonas aeruginosa quorum sensing infochemical, 2-amino acetophenone (2-AA), produced during acute and chronic infection in human tissues, including in the lungs of cystic fibrosis (CF) patients, acts as an interkingdom immunomodulatory signal that facilitates pathogen persistence, and host tolerance to infection. Transcriptome results have led to the hypothesis that 2-AA causes further harm to the host by triggering mitochondrial dysfunction in skeletal muscle. As normal skeletal muscle function is essential to survival, and is compromised in many chronic illnesses, including infections and CF-associated muscle wasting, we here determine the global effects of 2-AA on skeletal muscle using high-resolution magic-angle-spinning (HRMAS), proton (1H) nuclear magnetic resonance (NMR) metabolomics, in vivo 31P NMR, whole-genome expression analysis and functional studies. Our results show that 2-AA when injected into mice, induced a biological signature of insulin resistance as determined by 1H NMR analysis-, and dramatically altered insulin signaling, glucose transport, and mitochondrial function. Genes including Glut4, IRS1, PPAR-γ, PGC1 and Sirt1 were downregulated, whereas uncoupling protein UCP3 was up-regulated, in accordance with mitochondrial dysfunction. Although 2-AA did not alter high-energy phosphates or pH by in vivo 31P NMR analysis, it significantly reduced the rate of ATP synthesis. This affect was corroborated by results demonstrating down-regulation of the expression of genes involved in energy production and muscle function, and was further validated by muscle function studies. Together, these results further demonstrate that 2-AA, acts as a mediator of interkingdom modulation, and likely effects insulin resistance associated with a molecular signature of mitochondrial dysfunction in skeletal muscle. Reduced energy production and mitochondrial dysfunctional may further favor infection, and be an important step in the establishment of chronic and persistent infections

Evolution of Cortical and White Matter Lesion Load in Early-Stage Multiple Sclerosis: Correlation With Neuroaxonal Damage and Clinical Changes.

Introduction: Changes in cortical and white matter lesion (CL, WML) load are pivotal metrics to diagnose and monitor multiple sclerosis patients. Yet, the relationship between (i) changes in CL/WML load and disease progression and between (ii) changes in CL/WML load and neurodegeneration at early MS stages is not yet established. In this work, we have assessed the hypothesis that the combined CL and WML load as well as their 2-years evolution are surrogate markers of neurodegeneration and clinical progression at early MS stages. To achieve this goal, we have studied a group of RRMS patients and have investigated the impact of both CL and WML load on neuroaxonal damage as measured by serum neurofilament light chain (sNfL). Next, we have explored whether changes in CL/WML load over 2 years in the same cohort of early-MS are related to motor and cognitive changes. Methods: Thirty-two RRMS patients (<5 years disease duration) underwent: (i) 3T MRI for CL/WML detection and clinical assessment at baseline and 2-years follow-up; and (ii) baseline blood test for sNfL. The correlation between the number and volume of CL/WML and sNfL was assessed by using the Spearman's rank correlation coefficient and a generalized linear model (GLM). A GLM was also used to assess the relationship between (i) the number/volume of new, enlarged, resolved, shrunken, stable lesions and (ii) the difference in clinical scores between two time-points. Results: At baseline, sNfL levels correlated with both total CL count/volume (ρ = 0.6/0.7, Corr-P <0.017/Corr-P < 0.001) and with total WML count/volume (ρ = 0.6/0.6, Corr-P < 0.01 for both). Baseline sNfL levels also correlated with new WML count/volume (ρ = 0.6/0.5, Corr-P < 0.01/Corr-P < 0.05) but not with new CL. Longitudinal changes in CL and WML count and volume were significantly associated with (i) sustained attention, auditory information, processing speed and flexibility (p < 0.01), (ii) verbal memory (p < 0.01); (iii) verbal fluency (p < 0.05); and (iv) hand-motor function (p < 0.05). Discussion: Changes in cortical and white matter focal damage in early MS patients correlate with global neuroaxonal damage and is associated to cognitive performances

Endovascular Treatment for Anterior Circulation Large-Vessel Occlusion Ischemic Stroke with Low ASPECTS: a Systematic Review and Meta-Analysis

Background: Endovascular treatment (EVT) for acute ischemic stroke (AIS) patients presenting with Alberta Stroke Program Early CT Score (ASPECTS) 0-5 has not yet proven safe and effective by clinical trials. Objectives: The aim of the study was to assess whether EVT in AIS patients presenting with low ASPECTS is beneficial. Design: Systematic review and meta-analysis of available studies in accordance with the PRISMA statement. Data sources and methods: We have searched MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 28 May 2022 with the aim to calculate (1) modified Rankin scale (mRS) score 0-3 at 3 months, (2) mRS score 0-2 at 3 months, (3) symptomatic intracranial hemorrhage (sICH), and (3) mortality at 3 months. Results: Overall, 24 eligible studies were included in the meta-analysis, comprising a total of 2539 AIS patients with ASPECTS 0-5 treated with EVT. The pooled proportion of EVT-treated patients achieving mRS 0-3 at 3 months was calculated at 38.4%. The pooled proportion of EVT-treated patients achieving mRS 0-2 at 3 months was 25.7%. Regarding safety outcomes, sICH occurred in 12.8% of patients. The 3-month pooled mortality was 30%. In pairwise meta-analysis, patients treated with EVT had a higher likelihood of achieving mRS 0-3 at 3 months compared with patients treated with best medical therapy (BMT, OR: 2.41). sICH occurred more frequently in EVT-treated patients compared with the BMT-treated patients (OR: 2.30). Mortality at 3 months was not different between the two treatment groups (OR: 0.71). Conclusion: EVT may be beneficial for AIS patients with low baseline ASPECTS despite an increased risk for sICH. Further data from randomized-controlled clinical trials are needed to elucidate the role of EVT in this subgroup of AIS patients. Registration: The protocol has been registered in the International Prospective Register of Ongoing Systematic Reviews PROSPERO; Registration Number: CRD42022334417.info:eu-repo/semantics/publishedVersio

Primary appendiceal mucinous adenocarcinoma in two first-degree relatives: case report and review

Carcinomas of the appendix are exceedingly rare tumors and have an annual age-adjusted incidence of around 0.4 cases per 100,000. Appendiceal adenocarcinoma accounts for < 0.5% of all gastrointestinal neoplasms and, of these, mucinous adenocarcinomas account for the majority. Published accounts of familial instances of primary appendiceal tumors are strikingly rare. We report two siblings who both developed primary mucinous adenocarcinomas. A genetics evaluation was conducted to determine if there was a recognizable underlying single gene disorder; no DNA mismatch repair defect was evident, and no other diagnosis was apparent. A review of appendiceal cancers seen at Mayo Clinic from l997 to the present was conducted to search for additional familial cases. Among 316 cases of primary appendiceal cancer of any histologic type, this sib pair was the only family reporting a second affected family member. The occurrence of appendiceal cancer in siblings may represent a random occurrence. An exceedingly rare predisposition syndrome cannot be ruled out