880 resultados para Small-sized hospitals


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Estudia los problemas referentes a la relación con el mercado internacional, de capacitación de personal en distintas áreas productivas, de transporte y de financiamiento de las empresas encuestadas de Ecuador, México, Uruguay, Chile, Perú y Paraguay, en sus políticas de promoción de exportaciones.

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This research is based on a unique and extensive database which tracks the employment, payroll and sales of individual Polish firms for the period 1990 to 1995. This allowed the authors to calculate the birth, survival and growth rates for different categories of enterprises (state-owned, cooperative, private, foreign-owned and privatised after 1990) and regions. These data match data collected in the United States, making it possible to compare the Polish situation with that of the state of Michigan. Analysis of the data and lessons from the Poland-Michigan comparisons provide a solid basis for the formulation of new policy recommendations for Poland. Allowing for certain important differences, Poland would still seem to need a higher rate of births of new companies. New small private companies and companies with foreign capital can be seen as the main source of job creation and economic revitalisation. To strengthen positive trends in the economy, Poland should create a model of institutional support for both potential entrepreneurs and foreign investors.

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Patients with skin nodules characterized by the infiltrate of pleomorphic small/medium T lymphocytes are currently classified as "primary cutaneous CD4+ small-/medium-sized pleomorphic T-cell lymphoma" (SMPTCL) or as T-cell pseudolymphoma. The distinction is often arbitrary, and patients with similar clinicopathologic features have been included in both groups. We studied 136 patients (male:female = 1:1; median age: 53 years, age range: 3-90 years) with cutaneous lesions that could be classified as small-/medium-sized pleomorphic T-cell lymphoma according to current diagnostic criteria. All but 3 patients presented with solitary nodules located mostly on the head and neck area (75%). Histopathologic features were characterized by nonepidermotropic, nodular, or diffuse infiltrates of small- to medium-sized pleomorphic T lymphocytes. A monoclonal rearrangement of the T-cell receptor-gamma gene was found in 60% of tested cases. Follow-up data available for 45 patients revealed that 41 of them were alive without lymphoma after a median time of 63 months (range: 1-357 months), whereas 4 were alive with cutaneous disease (range: 2-16 months). The incongruity between the indolent clinical course and the worrying histopathologic and molecular features poses difficulties in classifying these cases unambiguously as benign or malignant, and it may be better to refer to them with a descriptive term such as "cutaneous nodular proliferation of pleomorphic T lymphocytes of undetermined significance," rather than forcing them into one or the other category. On the other hand, irrespective of the name given to these equivocal cutaneous lymphoid proliferations, published data support a nonaggressive therapeutic strategy, particularly for patients presenting with solitary lesions.

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BACKGROUND: Solitary skin nodules composed of pleomorphic T lymphocytes are often the source of diagnostic problems. OBJECTIVE: To characterize the clinicopathological features, prognosis and optimal treatment modalities of patients with solitary lymphoid nodules of small- to medium-sized pleomorphic T lymphocytes. METHODS: Twenty-six patients were analysed for clinical, histopathological, immunophenotypical, molecular and follow-up data. Results: Lesions were located mainly on the head and neck (n = 16; 61.5%) or trunk (n = 8; 30.8%). Histopathology showed non-epidermotropic nodular or diffuse infiltrates of small- to medium-sized pleomorphic T lymphocytes. Monoclonality was found by PCR in 54.2% of cases (n = 13/24). After a mean follow-up of 79.7 months, a local recurrence could be observed only in 1 patient. CONCLUSIONS: Our patients have a specific cutaneous lymphoproliferative disorder characterized by reproducible clinicopathological features. The incongruity between the indolent clinical course and the worrying histopathological features poses difficulties in classifying these cases unambiguously as benign or malignant. We suggest to describe these lesions as 'solitary small- to medium-sized pleomorphic T-cell nodules of undetermined significance'. Irrespective of the name given to these equivocal cutaneous lymphoid proliferations, follow-up data support a non-aggressive therapeutic strategy.

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This paper describes the role of small and medium-sized urban centers in Switzerland. Switzerland is a highly urbanized country where small and medium-sized urban centers play an important role in ensuring a balanced national urban system. Besides the four largest metropolitan regions (Zurich, Geneva, Basel and Bern), small and medium-sized towns function as central places for a wider, often extensive hinterland. They provide opportunities for living and working and they connect rural and mountain regions to national and international networks. Using secondary statistics and a case study, the paper shows that small and medium-sized urban centers are home to significant concentrations of export-oriented industries. Firms in these value-adding secondary sectors are rooted in these places and benefit from strong local embeddedness while also being oriented towards global markets. Small and medium-sized urban centers also profit from their strong local identities. While these places face various challenges, they function as important pillars in creating a balanced regional development pattern. Swiss regional development policy follows the goal of polycentric spatial development and it employs various instruments that aim to ensure a balanced urban system.

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Small and medium-sized firms are a prevalent organizational form in Germany. Their importance for the German economy is indisputable. Most of them are global market leaders in their niches and are considered to be a force for innovation in the German economy. The ability to be innovative in niche markets has been identified as the antecedent of their strong, or even dominant, competitive positions in their industries. The driver of this innovation success may well be the family, which distinguishes family firms from non-family firms. Nils Kraiczy analyzes if a family influences innovation in a family firm and if this influence has only positive effects. The dissertation focuses on the impact of top management teams on innovations interacting with family firm-specific characteristics. The author shows the complexity of family influence by presenting different effects of each investigated family firm-specific characteristic on the relationship between top management team behavior and innovation.

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Overcoming a crisis situation in which the socioemotional wealth (SEW) of a family is at risk can be threatened by a lack of formal crisis procedures, which can increase the probability of organizational decline. Thus, not being prepared for a crisis situation may be a critical factor in the long-term survival of family firms. From a corporate governance perspective, supervisory boards may achieve higher levels of crisis readiness. Applying the resourced-based view and SEW theory, we analyze the relationship between family ownership and formalized crisis procedures in 150 small and medium-sized German firms. Our results show that formalized crisis procedures decrease as family ownership increases. Including supervisory boards in our analysis, we find a significant moderating effect of supervisory boards on the relationship between family ownership and formalized crisis procedures. Specifically, our results suggest that family firms with supervisory boards show similar levels of formalized crisis procedures as non-family firms with supervisory boards. In contrast, family firms without supervisory boards exhibit lower levels of formalized crisis procedures compared with non-family firms without supervisory boards. We also discuss managerial implications, limitations, and future research.

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Globalized interurban competition is affecting cities of various sizes and locations. Small and medium-sized cities have to find ways to position themselves in global markets by formulating locational policies. This paper outlines an analytical framework of locational policies that cities adopt in order to increase their competitiveness. By comparing two European small and mediumsized cities (Lucerne and Ulm), we examine manifestations of locational policies and compare if these policies are being diverse or resemble each other. We found that strategies of both cities are sharing the intentions to be competitive, but their policy choices differ because the economic and political context is enabling or restricting certain kinds of locational policies. Furthermore, the findings point to the high explanatory power of municipal tax autonomy when studying locational policies.

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This paper focuses on the impact of Indonesia's economic crisis on small and medium-sized enterprises (SMEs). It shows how the performance of SMEs during the crisis varied widely even in the same industrial subsector, and found that the factors most affecting performance have been market orientation and the linkages that the SMEs have formed with the buyers of their products. Well-performing SMEs were found to have utilized putting-out linkages with wholesalers which enabled them to switch to products having better markets. On the other hand, the SMEs which had subcontracting linkages with assemblers or contracting linkages with user-factories (with the exception of SMEs having export-oriented linkages) suffered badly in the crisis because of specificity of products with little room for switching. The paper also found that exposure to debt due to borrowing for investment has been another factor affecting performance, but that enterprise size has had no linear correlation with performance.

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The backdrop of actual problematic about the implementation of Information Technology (IT) services management in Small and Medium Enterprises (SMEs) will be described. It will be exposed the reasons why reaching a maturity/capability level through well-known standards or the implementation of good software engineering practices by means of IT infrastructure Library are really difficult to achieve by SMEs. Also, the solutions to the exposed problems will be explained. Also master thesis goals are presented in terms of: purpose, research questions, research goals, objectives and scope. Finally, thesis structure is described.