Frequent users of the emergency department in a universal health coverage system : a randomized controlled trial of a case-management intervention

BACKGROUND: Frequent emergency department users represent a small number of patients but account for a large number of emergency department visits. They should be a focus because they are often vulnerable patients with many risk factors affecting their quality of life (QoL). Case management interventions have resulted in a significant decrease in emergency department visits, but association with QoL has not been assessed. One aim of our study was to examine to what extent an interdisciplinary case management intervention, compared to standard emergency care, improved frequent emergency department users' QoL. METHODS: Data are part of a randomized, controlled trial designed to improve frequent emergency department users' QoL and use of health-care resources at the Lausanne University Hospital, Switzerland. In total, 250 frequent emergency department users (≥5 attendances during the previous 12 months; ≥ 18 years of age) were interviewed between May 2012 and July 2013. Following an assessment focused on social characteristics; social, mental, and somatic determinants of health; risk behaviors; health care use; and QoL, participants were randomly assigned to the control or the intervention group (n=125 in each group). The final sample included 194 participants (20 deaths, 36 dropouts, n=96 in the intervention group, n=99 in the control group). Participants in the intervention group received a case management intervention by an interdisciplinary, mobile team in addition to standard emergency care. The case management intervention involved four nurses and a physician who provided counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system. The participants' QoL was evaluated by a study nurse using the WHOQOL-BREF five times during the study (at baseline, and at 2, 5.5, 9, and 12 months). Four of the six WHOQOL dimensions of QoL were retained here: physical health, psychological health, social relationship, and environment, with scores ranging from 0 (low QoL) to 100 (high QoL). A linear, mixed-effects model with participants as a random effect was run to analyze the change in QoL over time. The effects of time, participants' group, and the interaction between time and group were tested. These effects were controlled for sociodemographic characteristics and health-related variables (i.e., age, gender, education, citizenship, marital status, type of financial resources, proficiency in French, somatic and mental health problems, and behaviors at risk).

Integrated Project Portfolio Management as a Tool for Strategic Steering and Business Control

Tutkielman päätavoitteena oli tutkia miten projektisalkun hallinnalla voidaan tukea organisaation strategista ohjausta ja liiketoimintaa. Tämän lisäksi avaintavoitteina oli kuvata projektisalkun hallinnan nykytilanne kohdeyrityksessä, paljastaa erityisiä kehitystarpeita ja lopulta luoda kohdeyrityksen projektisalkunhallinnalle tavoitetila. Kirjallisuuskatsauksessa pohdittiin projektisalkun hallinnan roolia ja tavoitteita, projektisalkun hallinnassa käyttävää prosessia, sekä menetelmiä ja tekniikoita, joilla salkkua hallitaan. Työn empiirisessä osassa syvennyttiin tutkimaan projektinsalkun hallintaan liittyviä erityispiirteitä kohdeyrityksessä. Tutkimustulosten huolellinen analysointi osoitti, että aikaisempi kirjallisuus ei riittävästi huomioi kokonaisvaltaisen, integroidun lähestymistavan tarvetta ja viestinnän tärkeyttä projektisalkun hallinnassa. Tutkimuksen johtopäätöksinä luotiin uusi integroitu projektisalkun hallintamalli ja määriteltiin kohdeyritykselle projektisalkun hallinnan tavoitetila sekä ne kehitysaskeleet, joita yrityksen tulisi lähitulevaisuudessa ottaa.

Standardisation process of Universal Mobile Telecommunication System in Third Generation Partnership Project

Third Generation Partnership Project (3GPP) on organisaatio, joka määrittelee ja ylläpitää kolmannen sukupolven matkapuhelinverkon standardeja. Organisaatio luotiin monien eri standardointielinten toimesta havaittaessa, ettei maailmanlaajuista kolmannen sukupolven matkapuhelinteknologiaa voitaisi määritellä ilman laajaa yhteistyötä. 3GPP:ssä standardointityö on jakautunut usealle tekniselle määrittelyryhmälle. Jokaisen ryhmän tehtävänä on kehittää määrittelyjä ja raportteja omalla vastuualueellaan. 3GPP:ssä määrittelytyötä tehdään samanaikaisesti teknillisten määrittelyryhmien välillä. Tämä vaatii tiukkoja sääntöjä määrittelyjen luonti-, hyväksyntä- ja ylläpitotehtäviin. Vain siten on mahdollista hallita määrittelyihin tulevia muutoksia ja tarvittavaa kokonaistyömäärää. Tämä diplomityö kuvaa 3GPP:n määrittelemän UMTS-teknologian. Työssä keskitytään tarkemmin 3GPP-organisaation rakenteeseen, määritysten tekemiseen ja työskentelytapoihin. Tämä diplomityö osoittaa millainen organisaatio ja säännöt vaaditaan maailmanlaajuisen matkapuhelinjärjestelmän kehittämiseen.

A Reappraisal of the Allocation Puzzle through the Portfolio Approach

Paradoxically, high-growth, high-investment developing countries tend to experience capital outflows. This paper shows that this allocation puzzle can be explained simply by introducing uninsurable idiosyncratic investment risk in the neoclassical growth model with international trade in bonds, and by taking into account not only TFP catch-up, but also the capital wedge, that is, the distortions on the return to capital. The model fits the two following facts, documented on a sample of 67 countries between 1980 and 2003: (i) TFP growth is positively correlated with capital outflows in a sample including creditor countries; (ii) the long-run level of capital per efficient unit of labor is positively correlated with capital outflows. Consistently, we show that the capital flows predicted by the model are positively correlated with the actual ones in this sample once the capital wedge is accounted for. The fact that Asia dominates global imbalances can be explained by its relatively low capital wedge.

The Dynamic Customer Portfolio Method in Customer Relationship Management

Tutkielman tavoitteena on määritellä keskeiset ja sopivat asiakasportfoliomallit ja asiakasmatriisit asiakassuhteen määrittämiseen. Tutkimus keskittyy asiakassuhteen arvottamiseen ja avainasiakkaiden määrittämiseen kohdeyrityksessä. Keskeisimmät ja sopivimmat asiakasportfliomallit huomioidaan asiakkaiden arvioinnissa. Tutkielman teoriaosassa esitellään tunnetuimmat ja käytetyimmät asiakasportfoliomallit ja matriisit alan kirjallisuuden perusteella. Tämän lisäksi asiakasportfoliomalleihin yhdistetään näkökulmia suhdemarkkinoinnin, asiakkuuksien johtamisen ja tuoteportfolioiden teorioista. Keskeisimmät kirjallisuuden lähteet ovat johtamisen ja markkinoinnin alalta. Tutkielman empiriaosassa esitellään kohdeyritys ja sen tämän hetkinen asiakassuhteiden johtamiskäytäntö. Lisäksi tehdään parannusehdotuksia kohdeyrityksen nykyiseen asiakassuhteiden arvottamismenetelmään jotta asiakassuhteiden arvon laskeminen vastaisi mahdollisimman hyvin kohdeyrityksen nykyisiä tarpeita. Asiakassuhteen arvon määrittämiseksi käytetään myös fokusryhmähaastattelua. Avainasiakkaat määritellään ja tilannetta havainnollistetaan sijoittamalla avainasiakkaat asiakasportfolioon.

Universal Service Policies in Europe & Latam: Evidence on Bridging the Divide in Rural Areas

Broadband access is a key factor for economic and social development. However, providing broadband to rural areas is not attractive to private telecommunications operators due its low or zero investment return. To deal with broadband provision in rural areas, different governance systems based on private and public cooperation have appeared. This paper not only identifies and defines public and private cooperation models but also assesses their impact on overcoming the digital divide in rural areas. The results show that public ownership infrastructure under private management policy has had positive effects on reducing the broadband digital divide and being applied to areas with higher digital divide; subsides to private operators providers only positive effects on reducing broadband digital divide; but public infrastructure with public management programs did not. The results, obtained using quasi-experimental methods, suggest the importance of incentives and control mechanisms in broadband universal service provision plans.

Assessment of research competences using e-portfolio

The challenges posed by the assessment of distance learning is a topic that requires, on the one hand, evolution with new trends and, on the other improving evaluative processes, to promote good practices. This demand becomes more imperative when we are dealing with a formativescenario based on distance assessment of competence-based learning.The Open University of Catalonia has begun to work with these formative tools, promoting new practices for online education. A very clear example of these educational practices is the assessment of research competences using the e-portfolio system. To meet this aim a profound and solid process has been developed over recent years, with the intention of making this tool an assessment alternative, and providing the opportunity to use it in a formative context. The objective is to study its strengths and limitations keeping in mind the final goal of offering the higher education community a validated assessment system.

Creating a research network for a successful e-portfolio design and implementation

The presence of e-portfolios in educational centres, companies and administrations has emergedstrongly during the last years by creating very different practices coming from different objectives and purposes. This situation has led researchers and practitioners to design and implement e-portfolios with little reference to previous knowledge of them; consequently, developments are disparate with many of the processes and dimensions used both in development and use being unnecessary complex. In order to minimize the inconveniences, unify these developmental processes and improve the resultsof implementation and use of e-portfolios, it seemed necessary to create a network of researchers, teachers and trainers coming from different universities and institutions of different kinds who are interested in the investigation and the practice of e-portfolios in Spain. Therefore, The Network on e-portfoliowas created in 2006, funded by the Spanish Ministry of Education and led by the UniversitatOberta de Catalunya. Besides the goals associatedwith the creation of this network and which wewanted to share with other European researchers and experts of other continents, we will also present in this paper some data concerned with the first study carried out on the use of e-portfolios in our country that shows where we are and which trends are the most important for the near future.

The practical application of e-Portfolio at the Open University of Catalonia : assessment of competence based learning

The paper presents the results of the piloting or pilot test in a virtual classroom. This e-portfolio was carried out in the 2005-2006 academic year, with students of the Doctorate in Information Society, at the Open University of Catalonia. The electronic portfolio is a strategy for competence based assessment. This experience shows the types of e-portfolios, where students show their work without interactions, and apply the competence-based learning theories in an interactive portfolio system. The real process of learning is developed in the competency based system, the portfolio not only is a basic bio document, has become a real space for learning with competence model. The paper brings out new ideas and possibilities: the competence-based learning promotes closer relationships between universities and companies and redesigns the pedagogic act.

Mutual feedback in e-portfolio assessment : an approach to the netfolio system

Peer-reviewed

The role of alliance capabilities in alliance portfolio management

The question of why some firms perform better in managing their alliances has raised interest among scholars and managers. Whereas inter-firm factors influencing the alliance performance such as strategic fit between partners and the existence of complementarities have been studied extensively, research on firm-level antecedents is rather scarce. Therefore this study investigates the role of firm’s alliance capability in the alliance success equation. Particularly it analyses the specialized mechanisms and processes set up by firm in order to facilitate alliancerelated know-how leverage organization-wise. Evidence from a cross-industry sample of R&D intensive Finnish companies supports the fact that firms which have invested in institutionalizing alliance capabilities outperform their counterparts in alliance portfolio management. Results also suggest that firms need to adjust alliance management tools depending on the alliance portfolio size, prior experience with inter-firm partnerships and the strategic importance of alliances. Furthermore, absorptive capacity is found to be crucial for successful alliance management, its role being complementary to that of alliance capability. Finally, firms that have successful alliances also enjoy higher financial, market and innovation performance.

Digital learner portfolio as a tool for inovating assessment in the European Higher Education Area

The present article comes from a doctoral thesis that turns on digital learner portfolio, which is an innovating methodology from the perspective of European Higher Education Area. First, the educative concept of eportfolio is described in the sense of its procedure and its structure, by means of the technological support of a platform of virtual campus. Second, it is shown the pedagogical model of an eportfolio that adapts subjects with an instrumental character to one organization based on tasks and reflections. This design of virtual learning environment is based on a teaching- learning methodology sustained in the activity of the student, which tries to give support to the management of his or her own process of learning and assessment. Finally, the article illustrates the experience of implementation of the first digital learner portfolios in the University of Barcelona and the Autonomous University of Barcelona, with the objective of reflecting about the pedagogical consequences that this assessment model with technological support has in a traditional higher education institution.

Investigating university students' adaptation to digital learner course portfolio

Digital learner portfolios are of growing importance in higher education as the sector seeks new teaching-learning-assessment methods which promote students" autonomy as managers of their own virtual learning environment. The purpose of this study was to analyse descriptively the undergraduate students" perceptions, attitudes and behaviour when using an eportfolio to support their learning and assessment in practice based courses at two traditional Spanish universities. The participants were 88 students, who were studying through a blended learning mode. Data were collected through questionnaires: a computer experience survey, another which examined the psychological, pedagogical and technological dimensions of eportfolios use. Further, an individual overall reflection was obtained from each student to help gain an understanding of their experiences of using the eportfolio. A mixed-method analysis was applied in order to study the impact of this technological innovation on students and their satisfaction. The results showed that the students had positive opinions and self-efficiency through the eportfolio as a tool to manage their learning and assessment during a semester, especially from the second month of use. However, the expected impact on their learning was not so significant. Nevertheless, the students emphasised that the eportfolio was valuable as a personal developmental learning tool.