Coordination of palliative cancer care in the community: "unfinished business"

Goal: This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Participants and method: Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Main results: Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. Conclusions: The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care. © 2009 Springer-Verlag.

Towards Utilizing Model-Driven Engineering of Composite Applications for Business Performance Analysis

Composite Applications on top of SAPs implementation of SOA (Enterprise SOA) enable the extension of already existing business logic. In this paper we show, based on a case study, how Model-Driven Engineering concepts are applied in the development of such Composite Applications. Our Case Study extends a back-end business process which is required for the specific needs of a demo company selling wine. We use this to describe how the business centric models specifying the modified business behaviour of our case study can be utilized for business performance analysis where most of the actions are performed by humans. In particular, we apply a refined version of Model-Driven Performance Engineering that we proposed in our previous work and motivate which business domain specifics have to be taken into account for business performance analysis. We additionally motivate the need for performance related decision support for domain experts, who generally lack performance related skills. Such a support should offer visual guidance about what should be changed in the design and resource mapping to get improved results with respect to modification constraints and performance objectives, or objectives for time.

Digital loyalty card 'Big Data' and small business marketing: Formal versus informal or complementary?

This article proposes that a complementary relationship exists between the formalised nature of digital loyalty card data, and the informal nature of small business market orientation. A longitudinal, case-based research approach analysed this relationship in small firms given access to Tesco Clubcard data. The findings reveal a new-found structure and precision in small firm marketing planning from data exposure; this complemented rather than conflicted with an intuitive feel for markets. In addition, small firm owners were encouraged to include employees in marketing planning.

Psychic Distance, its Business Impact and Modes of Coping: A Study of British and Indian Partner SMEs

This paper reports one of the first investigations to analyze inter-partner perceptions of psychic distance between two countries. Its empirical focus is British and Indian SMEs engaged in business with each other. It examines different dimensions of psychic distance, their impact and modes of coping with them. Potential firm-level and individual influences are also taken into account. The paper aims to transcend some of the conceptual and methodological limitations of previous research on the subject and to identify the theoretical and practical implications that arise. A ‘mirror’ approach is applied, accessing both partners’ perceptions. These are assessed through a ‘mixed’ method combining quantitative measurement with qualitative interpretations. Psychic distance dimensions are found to vary in their impact on doing business with the other country, and there is also variation according to the firm’s sector. There is considerable asymmetry in British and Indian partners’ perceptions of psychic distance but the degree of difference between their psychic distance evaluations lacks predictive power. Culturally embedded psychic distance dimensions tend to have less impact and to be easier to cope with than institutionally embedded dimensions. Four categories of coping are identified. The principal theoretical implication of this study is that a contingency perspective needs to be adopted in the field of ‘distance’ research, taking account of factors such as a firm’s sector, and that this will require a more complex analytical framework that hitherto.

Parameter estimation and equation formulation in Business Dynamics

System Dynamics enables modelling and simulation of highly non-linear feedback systems to predict future system behaviour. Parameter estimation and equation formulation are techniques in System Dynamics, used to retrieve the values of parameters or the equations for ?ows and/or variables. These techniques are crucial for the annotations and thereafter the simulation. This paper critically examines existing and well established approaches in parameter estimation and equation formulation along with their limitations, identifying performance gaps as well as providing directions for potential future research.

Incubation or Induction? Gendered Identity Work in the Context of Technology Business Incubation

While there is a substantial body of literature exploring the influence of business incubation upon early stage firms, this debate remains almost entirely gender blind. This article challenges this assumption by adopting a feminist perspective to reveal business incubation as a gendered process shaping the identity work undertaken by women seeking legitimacy as technology venturers. In so doing, we critically evaluate prevailing normative analyses of the business incubation process and entrepreneurial legitimation. To illustrate this argument, we draw upon empirical evidence which reveals technology incubation as a legitimating induction process encouraging women to reproduce masculinized representations of the normative technology entrepreneur.

A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace

Background: Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer’s perspective.

Methods: Employees used a ‘loyalty card’ to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates.

Results: The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds.

Conclusions: The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer’s perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable “business model” which should become more cost-effective as it is delivered to more participants and can be adapted to suit other health behaviors and settings. This comes at a time when both UK and US governments are encouraging business involvement in tackling public health challenges.

An exploration of business model development in the commercialization of technology innovations

Research on business model development has focused on the relationships between elements of value conceptualization and organization having a linear sequence in which business models are first designed and then implemented. Another stream of research points to business model development with these elements interacting in a cyclical manner. There is a need to improve our understanding of the connective mechanisms and dynamics involved in business model development, particularly from the challenging perspective of commercializing innovations. The aim of this paper was to explore business model development during the commercialization of innovations through a case-based qualitative study. This study found from four case studies that specific elements of business model development, representative of the conceptualization of value and organizing for value creation, integrate in a dynamic and cyclical process in the commercialization of technology innovations. The study provides empirical evidence that adds new insights to literature on sequential and more interactive processes of business model development. It also contributes to literature on business model development and particularly how it relates to the commercialization of innovations.

Structural Capital of University Spin-Out Firms: The Moderating Role of University Incubators

University incubators (UI) are generally believed to be important in the successful commercialisation of university spin-outs (USO) with over half of all UK Universities having established an on-campus UI. In this chapter we examine the value of UIs in the spin-out process, focusing on the structural networks of USOs located in a UI as compared to USOs in a University with no access to a UI. Our primary research question is therefore: to what extent does the structural network of USOs with access to an on-campus UI differ from USOs without? The research therefore con-tributes to a growing critique of the effectiveness of UIs in commercialis-ing academic research and the recognition of positive direct and indirect externalities from participation in networks. Through network mapping of all USOs from two research intensive universities, we profile and ana-lyse the formal and informal network ties of USOs to various partners in-ternal and external to the host university. Through interviews we also consider how these networks enhance the resources and capabilities of USOs. Our findings highlight significant differences, with USOs located in a UI having more informal but fewer formal ties, both to other USOs as well as within the host University. In contrast, location in an incuba-tor was not found to affect the extent and nature of ties with external or-ganisations. Reasons for these differences are examined through inter-views with the USOs and point to various factors including the proactive brokering role of incubator and university staff, university bureaucracy, the hidden networks of executive board members across USOs, university equity investment policy and complementary technologies.

The changing university business model: a stakeholder perspective

Universities are in a current state of transition, whereby they are expected to develop a wide range of relationships with stakeholders in order to enhance regional innovation systems. However, despite external environmental pressures commonly regarded as one of the main drivers of business model evolution, there is a lack of studies that explore business model innovation as a result of multiple stakeholder influences. Accordingly, the aim of this paper is to examine the changing university business model within a region of the United Kingdom, using a stakeholder perspective that will aid theoretical development and refinement in both the business model and stakeholder fields. This examination is aided by consideration of the university business model as an activity system. Repeat interviews, combined with stakeholder theory, have been used to show how the changing university business model–stakeholder relationship has progressed through different stakeholder stages with resultant changes in content, structure and governance. Furthermore, conflicting objectives between each of the stakeholder groups (i.e. academics, industry liaison staff, technology transfer office staff and government support agency representatives) have led to the university business model evolving not as a process of co-creation but rather in a series of transitions whereby multiple stakeholders are continually shaping the university business model through strategies that are dependent upon their salience. Finally, this paper contributes to the development and refinement of business model innovation research, in that the use of stakeholder constructs can illustrate the impact of multiple stakeholders' power and influence on business model innovation.