Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Enriching enterprise resource planning systems for strategic advantage: a semiotic motivated approach

Enterprise Resource Planning is often endorsed as a means to facilitate strategic advantage for businesses. The scarcity of resources is the method by which some businesses maintain their position. However, the ubiquitous trend towards the adoption of Enterprise Resourcing Planning systems coupled with market saturation makes the promise of advantage less compelling. Reported in this paper is a proposed solution based upon semiotic theory that takes a typical Enterprise Resource Planning deployment scenario and shapes it according to the needs of people in post-implementation contexts to leverage strategic advantage in different ways.