882 resultados para Health policy, Planning and management
Resumo:
In modem hitec industry Advanced Planning and Scheduling (APS) systems provide the basis for e-business solutions towards the suppliers and the customers. One objective of this thesis was to clarify the modem supply chain management with the APS systems and especially concentrate on the area of Collaborative Planning. In order Advanced Planning and Scheduling systems to be complete and usable, user interfaces are needed. Current Visual Basic user interfaces have faced many complaints and arguments from the users as well as from the development team. This thesis is trying to analyze the reasons and causes for the encountered problems and also provide ways to overcome them. The decision has been made to build the new user interfaces to be Web-enabled. Therefore another objective of this thesis was to research and find suitable technologies for building the Web-based user interfaces for Advanced Planning and Scheduling Systems in Nokia Demand/Supply Planning business area. Comparison between the most suitable technologies is made. Usability issues of Web-enabled user interfaces are also covered. The empirical part of the thesis includes design and implementation of a Web-based user interface with the chosen technology for a particular APS module that enables Collaborative Planning with suppliers.
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PURPOSE: to assess the trends of prevalence of self-reported cardiovascular risk factors (CV RFs: hypertension, hypercholesterolemia, diabetes) and their management for the period of 1992 to 2007 in Switzerland. METHODS: four health interview surveys conducted between 1992 and 2007 in representative samples of the Swiss population (63,782 subjects overall). Self-reported CV RFs prevalence, treatment and control levels were computed after weighting. Weights were calculated by raking ratio such that the marginal distribution of the weighted totals conforms to the marginal distribution of the target population. Multivariate analysis was conducted using logistic regression. RESULTS: prevalence of all CV RFs increased between 1992 and 2007. Also, the prevalence of self-reported treatment among subjects with CV RFs increased, as confirmed by multivariate analysis: OR for hypolipidemic treatment relative to 1992: 0.64 [0.52-0.78]; 1.39 [1.18-1.65] and 2.00 [1.69-2.36] for 1997, 2002 and 2007, respectively. Still, in 2007, circa 40% of hypertensive, 60% of hypercholesterolemic and 50% of diabetic subjects weren't treated. On the other hand, there is an increase of the prevalence of controlled RFs as reported by treated subjects. This was confirmed by multivariate analysis 12.1 [12.0 - 12.2]; 4.16 [4.1 - 4.23] and 2.85 [2.79 - 2.90] for hypertension, hypercholesterolemia and diabetes, respectively, in 2007, relative to 1992. CONCLUSION: the prevalence of self-reported hypertension, hypercholesterolemia and diabetes increased between 1992 and 2007 in the Swiss population. Despite a good control of treated subjects, still a significant percentage of subjects with CV RFs are not treated.
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Tutkielman tavoitteena on tarkastella uuden yritysidentiteetin suunnittelua ja käyttöönottoa maailmanlaajuisessa palveluyrityksessä. Tutkielma jakaantuu teoreettiseen ja empiiriseen osaan. Teoreettisessa osassa käsitellään yritysidentiteetin käsitettä sekä tarkastellaan uuden yritysidenteetin suunnittelua ja käyttöönottoa. Teoriaa tarkastellaan keskeisten kirjallisten lähteiden perusteella, jotka käsittelevät markkinoinnin johtamista, palveluyritystä, yritysidentiteettiä, imagoa ja brändiä. Empiirinen tarkastelu pohjautuu yritysesimerkkiin. Yritysesimerkkinä on maailmanlaajuinen palveluyritys, ja sen uuden yritysidentiteetin suunnittelu- ja lanseeraustoimenpiteet. Empiirinen aineisto perustuu markkinointipäälliköiden haastatteluihin Australiassa ja Suomessa sekä yrityksen sisäiseen suunnittelu- ja lanseerausmateriaaliin. Tutkielmassa tulee esille yritysidentiteettikäsitteen monimuotoisuus. Yritysidentiteetin rakentaminen lähtee visiosta, missiosta ja yrityksen tavoitteista, jotka pitää olla selkeät ja johdonmukaiset. Yritysidentiteetti käsittää visuaalisen ilmeen lisäksi kaikki ne prosessit, joissa ollaan tekemisissä sidosryhmien kanssa. Yritysidentiteetin rakentaminen ja ylläpitäminen vaatii, että jokainen liiketoimintafunktio ymmärtää yritysidenteetin sisällön ja toimii sen mukaisesti kaikissa tilanteissa. Yrityksen on viestittävä henkilöstölle ja ulkoisille sidosryhmilleen, miksi se on olemassa. Henkilöstön tulee ymmärtää yrityksen tapa toimia, jotta he pystyvät vastaamaan yrityksen asettamiin haasteisiin kohdatessaan asiakkaan. Uuden yritysidentiteetin suunnitteluun on panostettava. Onnistumisen edellytykseksi osoittautui, että suunnitellaan tarkasti toimenpiteet ennen käyttöönottoa, käyttöönoton aikana sekä käyttöönoton jälkeen.
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BACKGROUND: Information about the impact of cancer treatments on patients' quality of life (QoL) is of paramount importance to patients and treating oncologists. Cancer trials that do not specify QoL as an outcome or fail to report collected QoL data, omit crucial information for decision making. To estimate the magnitude of these problems, we investigated how frequently QoL outcomes were specified in protocols of cancer trials and subsequently reported. DESIGN: Retrospective cohort study of RCT protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We compared protocols to corresponding publications, which were identified through literature searches and investigator surveys. RESULTS: Of the 173 cancer trials, 90 (52%) specified QoL outcomes in their protocol, 2 (1%) as primary and 88 (51%) as secondary outcome. Of the 173 trials, 35 (20%) reported QoL outcomes in a corresponding publication (4 modified from the protocol), 18 (10%) were published but failed to report QoL outcomes in the primary or a secondary publication, and 37 (21%) were not published at all. Of the 83 (48%) trials that did not specify QoL outcomes in their protocol, none subsequently reported QoL outcomes. Failure to report pre-specified QoL outcomes was not associated with industry sponsorship (versus non-industry), sample size, and multicentre (versus single centre) status but possibly with trial discontinuation. CONCLUSIONS: About half of cancer trials specified QoL outcomes in their protocols. However, only 20% reported any QoL data in associated publications. Highly relevant information for decision making is often unavailable to patients, oncologists, and health policymakers.
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The United Kingdom (UK) for last few decades has been faced with a growing need for health personnel and has therefore attracted professionals, particularly overseas nurses. The country has been characterised by a historical migration policy favourable to the recruitment of foreign health staff. However, in the context of deep shortage and high level of diseases and health system weakness, the international health professional recruitment from Sub Saharan Africa has created unprecedented ethical controversies which have pushed the UK to the centre of discussions because of its liberal policies towards international recruitment that have been considered as aggressive. While the 'brain drain' controversy is well known, less attention has been devoted to the specific international health migration controversy and the pivotal role of the UK in the diffusion of ethical code of practice. Using mainly the perspective of the policy analysis of controversy (Roe 1994) and the analysis of discourses (de Haas 2008), our paper comes back respectively to the nature of the controversy and the pivotal role of the UK. It also analyses how the implementation of UK ethical policies - Code of Practice, banned countries list of recruitment, restrictive immigration policies - have been considered as inefficient and unethical in their contents and their targets.
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Although social capital and health have been extensively studied during the last decade, there are still open issues in current empirical research. These concern for instance the measurement of the concept in different contexts, as well as the association between different types of social capital and different dimensions of health. The present thesis addressed these questions. The general aim was to promote the understanding of social capital and health by investigating the oldest old and the two major language groups in Finland, Swedish- and Finnish-speakers. Another aim was to contribute to the discussion on methodological issues in social capital and health research. The present thesis investigated two empirical data sets, Umeå 85+ and Health 2000. The Umeå 85+ study was a cross-sectional study of 163 individuals aged 85, 90, and 95 or older, living in the municipality of Umeå, Sweden, in the year of 2000. The Health 2000 survey was a national study of 8,028 persons aged 30 or above carried out in Finland in 2000-2001. Different indicators of structural (e.g. social contacts) and cognitive (e.g. trust) social capital, as well as health indicators were used as variables in the analyses. The Umeå 85+ data set was analyzed with factor analysis, as well as univariate and multivariate analysis of variance. The Health 2000 data was analyzed with logistic regression techniques. The results showed that the Swedish-speakers in the Finnish data set Health 2000 had consistently higher prevalence of social capital compared to the Finnish-speakers even after controlling for central sociodemographic variables. The results further showed that even if the language group differences in health were small, the Swedishspeakers experienced in general better self-reported health compared with the Finnish-speakers. Common sociodemographic variables could not explain these observed differences in health. The results imply that social capital is often, but not always, associated with health. This was clearly seen in the Umeå 85+ data set where only one health indicator (depressive symptoms) was associated with structural social capital among the oldest old. The results based on the analysis of the Health 2000 survey demonstrated that the cognitive component of social capital was associated with self-rated health and psychological health rather than with participation in social activities and social contacts. In addition, social capital statistically reduced the health advantage especially for Swedish-speaking men, indicating that high prevalence of social capital may promote health. Finally, the present thesis also discussed the issue of methodological challenges faced with when analyzing social capital and health. It was suggested that certain components of social capital such as bonding and bridging social capital may be more relevant than structural and cognitive components when investigating social capital among the two language groups in Finland. The results concerning the oldest old indicated that the structural aspects of social capital probably reflect current living conditions, whereas cognitive social capital reflects attitudes and traits often acquired decades earlier. This is interpreted as an indication of the fact that structural and cognitive social capital are closely related yet empirically two distinctive concepts. Taken together, some components of social capital may be more relevant to study than others depending on which population group and age group is under study. The results also implied that the choice of cut-off point of dichotomization of selfrated health has an impact on the estimated effects of the explanatory variables. When the whole age interval, 35-64 years, was analyzed with logistic regression techniques the choice of cut-off point did not matter for the estimated effects of marital status and educational level. The results changed, however, when the age interval was divided into three shorter intervals. If self-rated health is explored using wide age intervals that do not account for age-dependent covariates there is a risk of drawing misleading conclusions. In conclusion, the results presented in the thesis suggest that the uneven distribution of social capital observed between the two language groups in Finland are of importance when trying to further understand health inequalities that exist between Swedish- and Finnish-speakers in Finland. Although social capital seemed to be relevant to the understanding of health among the oldest old, the meaning of social capital is probably different compared to a less vulnerable age group. This should be noticed in future empirical research. In the present thesis, it was shown that the relationship between social capital and health is complex and multidimensional. Different aspects of social capital seem to be important for different aspects of health. This reduces the possibility to generalize the results and to recommend general policy implementations in this area. An increased methodological awareness regarding social capital as well as health are called for in order to further understand the cfomplex association between them. However, based on the present data and findings social capital is associated with health. To understand individual health one must also consider social aspects of the individuals’ environment such as social capital.
Resumo:
The purpose of this study is to explore the possibilities of utilizing business intelligence (BI)systems in management control (MC). The topic of this study is explored trough four researchquestions. Firstly, what kind of management control systems (MCS) use or could use the data and information enabled by the BI system? Secondly, how the BI system is or could be utilized? Thirdly, has BI system enabled new forms of control or changed old ones? The fourth and final research question is whether the BI system supports some forms of control that the literature has not thought of, or is the BI system not used for some forms of control the literature suggests it should be used? The study is conducted as an extensive case study. Three different organizations were interviewed for the study. For the theoretical basis of the study, central theories in the field of management control are introduced. The term business intelligence is discussed in detail and the mechanisms for governance of business intelligence are presented. A literature analysis of the uses of BI for management control is introduced. The theoretical part of the study ends in the construction of a framework for business intelligence in management control. In the empirical part of the study the case organizations, their BI systems, and the ways they utilize these systems for management control are presented. The main findings of the study are that BI systems can be utilized in the fields suggested in the literature, namely in planning, cybernetic, reward, boundary, and interactive control. The systems are used both as the data or information feeders and directly as the tools. Using BI systems has also enabled entirely new forms of control in the studied organizations, most significantly in the area of interactive control. They have also changed the old control systems by making the information more readily available to the whole organization. No evidence of the BI systems being used for forms of control that the literature had not suggested was found. The systems were mostly used for cybernetic control and interactive control, whereas the support for other types of control was not as prevalent. The main contribution of the study to the existing literature is the insight provided into how BI systems, both theoretically and empirically, are used for management control. The framework for business intelligence in management control presented in the study can also be utilized in further studies about the subject.
Resumo:
The present study estimated the prevalence of metabolic syndrome (MS) according to the criteria established by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) and analyzed the contribution of social factors in an adult urban population in the Southeastern region of Brazil. The sample plan was based on multistage probability sampling according to family head income and educational level. A random sample of 1116 subjects aged 30 to 79 years was studied. Participants answered a questionnaire about socio-demographic variables and medical history. Fasting capillary glucose (FCG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined and all non-diabetic subjects were submitted to the 75-g oral glucose tolerance test. Body mass index (BMI, kg/m²), waist circumference and blood pressure (BP) were determined. Age- and gender-adjusted prevalence of MS was 35.9 and 43.2% according to NCEP-ATPIII and IDF criteria, respectively. Substantial agreement was found between NCEP-ATPIII and IDF definitions. Low HDL-C levels and high BP were the most prevalent MS components according to NCEP-ATPIII criteria (76.3 and 59.2%, respectively). Considering the diagnostic criteria adopted, 13.5% of the subjects had diabetes and 9.7% had FCG ≥100 mg/dL. MS prevalence was significantly associated with age, skin color, BMI, and educational level. This cross-sectional population-based study in the Southeastern region of Brazil indicates that MS is highly prevalent and associated with an important social indicator, i.e., educational level. This result suggests that in developing countries health policy planning to reduce the risk of MS, in particular, should consider improvement in education.
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This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.
Resumo:
Today India is seeking a speedy transformation of her semi-stagnant economy to a dynamic one by means of economic planning in a democratic set up. In the context of this growth oriented endeavour public sector has a vital role to play. After three decades of planned development, it has become important that India must make fresh appraisals on the role of public sector in the economic renaissance of the country. Almost no comprehensive study has been made on this vital segment of the economy vis-a-vis the growth economics. This study is an attempt to fill this need in a very modest way. It presents the subject in a new perspective. An earnest attempt is made to reveal the critical problems inhibiting the growth of the public sector from a new angle which focusses the spot-light on the economics of development.
Resumo:
Rapid changes in the technological environment of marine logistics and the increasing integration of waterborne, air and land transport systems have fostered a revolution in the design and operations of transport vehicles, cargo handling technology, and terminal facilities. This in turn has caused major changes in the functions of and uses of ports. From literature, it was found that these changes were very slow in case of Indian ports and the performances of port operations were poor when compared with similar ports in the same region. It was also found that a very few studies were conducted to identify the reasons for slow improvements in the performances of Indian major ports. In this thesis, an attempt is made to find out the operational problems of Indian major ports and to analyze the reasons for it. Some solutions have also been found out using management tools
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La presente investigación tiene como objetivo analizar en qué medida la estrategia de liderazgo regional de la India ha sido impulsada a través de los programas y proyectos de cooperación sur-sur ofrecidos por este país en el periodo de 2003-2012. De igual forma se pretende indagar sobre el papel histórico que ha jugado la India en el establecimiento y posterior evolución de esta nueva forma de cooperación que ha sido vista por la mayoría de los académicos como un complemento de la cooperación norte-sur, y que responde a una serie de intereses particulares. En este caso en particular, la cooperación sur-sur ha sido utilizada por India como una herramienta para incrementar sus capacidades de poder que le permitan consolidarse como líder regional.
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Este documento presenta los resultados del componente cuantitativo de la evaluación del Programa de Educación para la Sexualidad y Construcción de Ciudadanía (PESCC) del Ministerio de Educación Nacional de Colombia (MEN). Para identificar el efecto, la estrategia empírica explota la variación en la implementación del componente pedagógico del PESCC entre los colegios y la variación en el componente de fortalecimiento institucional del programa a nivel departamental. El principal hallazgo de este trabajo es que el PESCC mejora las prácticas docentes de planeación y los conocimientos de los estudiantes en servicios en salud sexual y reproductiva y en derechos humanos sexuales y reproductivos. No hay efectos significativos en otros índices de Conocimientos, Actitudes o Prácticas (CAP) de profesores o estudiantes.
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A range of funding schemes and policy instruments exist to effect enhancement of the landscapes and habitats of the UK. While a number of assessments of these mechanisms have been conducted, little research has been undertaken to compare both quantitatively and qualitatively their relative effectiveness across a range of criteria. It is argued that few tools are available for such a multi-faceted evaluation of effectiveness. A form of Multiple Criteria Decision Analysis (MCDA) is justified and utilized as a framework in which to evaluate the effectiveness of nine mechanisms in relation to the protection of existing areas of chalk grassland and the creation of new areas in the South Downs of England. These include established schemes, such as the Countryside Stewardship and Environmentally Sensitive Area Schemes, along with other less common mechanisms, for example, land purchase and tender schemes. The steps involved in applying an MCDA to evaluate such mechanisms are identified and the process is described. Quantitative results from the comparison of the effectiveness of different mechanisms are presented, although the broader aim of the paper is that of demonstrating the performance of MCDA as a tool for measuring the effectiveness of mechanisms aimed at landscape and habitat enhancement.
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Consideration of the quality, relevance and utility of research in educational leadership and management has been a growing concern of researchers, policy-makers and practitioners, but there is little agreement about its current state or priorities for development. The article reflects on the key criticisms that have been made of research in educational leadership and management in this issue, and elsewhere. It considers how we might begin to devise better ways of understanding its audiences, judging its quality and identifying priorities for the future. It argues that the research reflects its capture by those with particular interests or values, and impacts in ways which are complex and indirect. If educational leadership and management research is to be secure in its perceived value and contribution in the future, several developments are needed, including a greater emphasis on interdisciplinarity, an expansion of the range of methodologies, particularly qualtitative studies; and these shifts must be evident in training researchers as well as in the conduct of research.