Study Regarding Implementation of a Uniform Statewide System to Allow for Electronic Transactions for the Registration and Titling of Motor Vehicles

LEGISLATIVE STUDY – The 83rd General Assembly of the Iowa Legislature, in Senate File 2273, directed the Iowa Department of Transportation (DOT) to conduct a study of how to implement a uniform statewide system to allow for electronic transactions for the registration and titling of motor vehicles. PARTICIPANTS IN STUDY – As directed by Senate File 2273, the DOT formed a working group to conduct the study that included representatives from the Consumer Protection Division of the Office of the Attorney General, the Department of Public Safety, the Department of Revenue, the Iowa State County Treasurer’s Association, the Iowa Automobile Dealers Association, and the Iowa Independent Automobile Dealers Association. CONDUCT OF THE STUDY – The working group met eight times between June 17, 2010, and October 1, 2010. The group discussed the costs and benefits of electronic titling from the perspectives of new and used motor vehicle dealers, county treasurers, the DOT, lending institutions, consumers and consumer protection, and law enforcement. Security concerns, legislative implications, and implementation timelines were also considered. In the course of the meetings the group: 1. Reviewed the specific goals of S.F. 2273, and viewed a demonstration of Iowa’s current vehicle registration and titling system so participants that were not users of the system could gain an understanding of its current functionality and capabilities. 2. Reviewed the results of a survey of county treasurers conducted by the DOT to determine the extent to which county treasurers had processing backlogs and the extent to which county treasurers limited the number of dealer registration and titling transactions that they would process in a single day and while the dealer waited. Only eight reported placing a limit on the number of dealer transactions that would be processed while the dealer waited (with the number ranging from one to four), and only 11 reported a backlog in processing registration and titling transactions as of June 11, 2010, with most backlogs being reported in the range of one to three days. 3. Conducted conference calls with representatives of the American Association of Motor Vehicle Administrators (AAMVA) and representatives of three states -- Kansas, which has an electronic lien and titling (ELT) program, and Wisconsin and Florida, each of which have both an ELT program and an electronic registration and titling (ERT) program – to assess current and best practices for electronic transactions. In addition, the DOT (through AAMVA) submitted a survey to all U.S. jurisdictions to determine how, if at all, other states implemented electronic transactions for the registration and titling of motor vehicles. Twenty-eight states responded to the survey; of the 28 states that responded, only 13 allowed liens to be added or released electronically, and only five indicated allowing applications for registration and titling to be submitted electronically. DOT staff also heard a presentation from South Dakota on its ERT system at an AAMVA regional meeting. ELT information that emerged suggests a multi-vendor approach, in which vendors that meet state specifications for participation are authorized to interface with the state’s system to serve as a portal between lenders and the state system, will facilitate electronic lien releases and additions by offering lenders more choices and the opportunity to use the same vendor in multiple states. The ERT information that emerged indicates a multi-interface approach that offers an interface with existing dealer management software (DMS) systems and through a separate internet site will facilitate ERT by offering access that meets a variety of business needs and models. In both instances, information that emerged indicates that, in the long-term, adoption rates are positively affected by making participation above a certain minimum threshold mandatory. 4. To assess and compare functions or services that might be offered by or through a vendor, the group heard presentations from vendors that offer products or services that facilitate some aspect of ELT or ERT. 5. To assess the concerns, needs and interest of Iowa motor vehicle dealers, the group surveyed dealers to assess registration and titling difficulties experienced by dealers, the types of DMS systems (if any) used by dealers, and the dealers’ interest and preference in using an electronic interface to submit applications for registration and titling. Overall, 40% of the dealers that responded indicated interest and 57% indicated no interest, but interest was pronounced among new car dealers (75% were interested) and dealers with a high number of monthly transactions (85% of dealers averaging more than 50 sales per month were interested). The majority of dealers responding to the dealer survey ranked delays in processing and problems with daily limits on transaction as ―minor difficulty or ―no difficulty. RECOMMENDATIONS -- At the conclusion of the meetings, the working group discussed possible approaches for implementation of electronic transactions in Iowa and reached a consensus that a phased implementation of electronic titling that addressed first electronic lien and title transactions (ELT) and electronic fund transfers (EFT), and then electronic applications for registration and titling (ERT) is recommended. The recommendation of a phased implementation is based upon recognition that aspects of ELT and EFT are foundational to ERT, and that ELT and EFT solutions are more readily and easily attained than the ERT solution, which will take longer and be somewhat more difficult to develop and will require federal approval of an electronic odometer statement to fully implement. ELT – A multi-vendor approach is proposed for ELT. No direct costs to the state, counties, consumers, or dealers are anticipated under this approach. The vendor charges participating lenders user or transaction fees for the service, and it appears the lenders typically absorb those costs due to the savings offered by ELT. Existing staff can complete the programming necessary to interface the state system with vendors’ systems. The estimated time to implement ELT is six to nine months. Mandatory participation is not recommended initially, but should be considered after ELT has been implemented and a suitable number of vendors have enrolled to provide a fair assessment of participation rates and opportunities. EFT – A previous attempt to implement ELT and EFT was terminated due to concern that it would negatively impact county revenues by reducing interest income earned on state funds collected by the county and held until the monthly transfer to the state. To avoid that problem in this implementation, the EFT solution should remain revenue neutral to the counties, by allowing fees submitted by EFT to be immediately directed to the proper county account. Because ARTS was designed and has the capacity to accommodate EFT, a vendor is not needed to implement EFT. The estimated time to implement EFT is six to nine months. It is expected that EFT development will overlap ELT development. ERT – ERT itself must be developed in phases. It will not be possible to quickly implement a fully functioning, paperless ERT system, because federal law requires that transfer of title be accompanied by a written odometer statement unless approval for an alternate electronic statement is granted by the National Highway Traffic Safety Administration (NHTSA). It is expected that it will take as much as a year or more to obtain NHTSA approval, and that NHTSA approval will require design of a system that requires the seller to electronically confirm the seller’s identity, make the required disclosure to the buyer, and then transfer the disclosure to the buyer, who must also electronically confirm the buyer’s identity and electronically review and accept the disclosure to complete and submit the transaction. Given the time that it will take to develop and gain approval for this solution, initial ERT implementation will focus on completing and submitting applications and issuing registration applied for cards electronically, with the understanding that this process will still require submission of paper documents until an electronic odometer solution is developed. Because continued submission of paper documents undermines the efficiencies sought, ―full‖ ERT – that is, all documents necessary for registration and titling should be capable of approval and/or acceptance by all parties, and should be capable of submission without transmittal or delivery of duplicate paper documents .– should remain the ultimate goal. ERT is not recommended as a means to eliminate review and approval of registration and titling transactions by the county treasurers, or to place registration and titling approval in the hands of the dealers, as county treasurers perform an important role in deterring fraud and promoting accuracy by determining the genuineness and regularity of each application. Authorizing dealers to act as registration agents that approve registration and title applications, issue registration receipts, and maintain and deliver permanent metal license plates is not recommended. Although distribution of permanent plates by dealers is not recommended, it is recommended that dealers participating in ERT generate and print registration applied for cards electronically. Unlike the manually-issued cards currently in use, cards issued in this fashion may be queried by law enforcement and are less susceptible to misuse by customers and dealers. The estimated time to implement the electronic application and registration applied for cards is 12 to 18 months, to begin after ELT and EFT have been implemented. It is recommended that focus during this time be on facilitating transfers through motor vehicle dealers, with initial deployment focused on higher-volume dealers that use DMS systems. In the long term an internet option for access to ERT must also be developed and maintained to allow participation for lower-volume dealers that do not use a DMS system. This option will also lay the ground work for an ERT option for sales between private individuals. Mandatory participation in Iowa is not recommended initially. As with ELT, it is recommended that mandatory participation be considered after at least an initial phase of ERT has been implemented and a suitable number of dealers have enrolled to provide a fair assessment of participation rates and opportunities. The use of vendors to facilitate ERT is not initially proposed because 1) DOT IT support staff is capable of developing a system that will interact with DMS systems and will still have to develop a dealer and public interface regardless of whether a vendor acts as intermediary between the DMS systems, and 2) there is concern that the cost of the vendor-based system, which is funded by transaction-based payments from the dealer to the vendor, will be passed to the consumer in the form of additional documentation or conveyance fees. However, the DOT recommends flexibility on this point, as development and pilot of the system may indicate that a multi-vendor approach similar to that recommended for ELT may increase the adoption rate by larger dealers and may ultimately decrease the user management to be exercised by DOT staff. If vendors are used in the process, additional legislation or administrative rules may be needed to control the fees that may be passed to the consumer. No direct cost to the DOT or county treasurers is expected, as the DOT expects that it may complete necessary programming with existing staff. Use of vendors to facilitate ERT transactions by dealers using DMS systems would result in transaction fees that may ultimately be passed to consumers. LEGISLATION – As a result of the changes implemented in 2004 under Senate File 2070, the only changes to Iowa statutes proposed are to section 321.69 of the Iowa Code, ―Damage disclosure statement,and section 321.71, ―Odometer requirements.‖ In each instance, authority to execute these statements by electronic means would be clarified by authorizing language similar to that used in section 321.20, subsections ―2‖ and ―3,‖ which allows for electronic applications and directs the department to ―adopt rules on the method for providing signatures for applications made by electronic means.‖ In these sections, the authorizing language might read as follows: Notwithstanding contrary provisions of this section, the department may develop and implement a program to allow for any statement required by this section to be made electronically. The department shall adopt rules on the method for providing signatures for statements made by electronic means. Some changes to DOT administrative rules will be useful but only to enable changes to work processes that would be desirable in the long term. Examples of long term work processes that would be enabled by rule changes include allowing for signatures created through electronic means and electronic odometer certifications. The DOT rules, as currently written, do not hinder the ability to proceed with ELT, EFT, and ERT.

The statistical accuracy of surveys on business and economic perspectives: a case study

In this paper, we develop a new decision making model and apply it in political Surveys of economic climate collect opinions of managers about the short-term future evolution of their business. Interviews are carried out on a regular basis and responses measure optimistic, neutral or pessimistic views about the economic perspectives. We propose a method to evaluate the sampling error of the average opinion derived from a particular type of survey data. Our variance estimate is useful to interpret historical trends and to decide whether changes in the index from one period to another are due to a structural change or whether ups and downs can be attributed to sampling randomness. An illustration using real data from a survey of business managers opinions is discussed.

Quantitative Ultrasound of the Heel and Fracture Risk Assessment: an Updated Meta-Analysis

Objectives: Quantitative ultrasound (QUS) is an attractive method for assessing fracture risk because it is portable, inexpensive, without ionizing radiation, and available in areas of the world where DXA is not readily accessible or affordable. However, the diversity of QUS scanners and variability of fracture outcomes measured in different studies is an important obstacle to widespread utilisation of QUS for fracture risk assessment. We aimed in this review to assess the predictive power of heel QUS for fractures considering different characteristics of the association (QUS parameters and fracture outcomes measured, QUS devices, study populations, and independence from DXA-measured bone density).Materials/Methods : We conducted an inverse-variance randomeffects meta-analysis of prospective studies with heel QUS measures at baseline and fracture outcomes in their follow-up. Relative risks (RR) per standard deviation (SD) of different QUS parameters (broadband ultrasound attenuation [BUA], speed of sound &SOS;, stiffness index &SI;, and quantitative ultrasound index [QUI]) for various fracture outcomes (hip, vertebral, any clinical, any osteoporotic, and major osteoporotic fractures) were reported based on study questions.Results : 21 studies including 55,164 women and 13,742 men were included with a total follow-up of 279,124 person-years. All four QUS parameters were associated with risk of different fractures. For instance, RR of hip fracture for 1 SD decrease of BUA was 1.69 (95% CI 1.43-2.00), SOS was 1.96 (95% CI 1.64-2.34), SI was 2.26 (95%CI 1.71-2.99), and QUI was 1.99 (95% CI 1.49-2.67). Validated devices from different manufacturers predicted fracture risks with a similar performance (meta-regression p-values>0.05 for difference of devices). There was no sign of publication bias among the studies. QUS measures predicted fracture with a similar performance in men and women. Meta-analysis of studies with QUS measures adjusted for hip DXA showed a significant and independent association with fracture risk (RR/SD for BUA =1.34 [95%CI 1.22-1.49]).Conclusions : This study confirms that QUS of the heel using validated devices predicts risk of different fracture outcomes in elderly men and women. Further research and international collaborations are needed for standardisation of QUS parameters across various manufacturers and inclusion of QUS in fracture risk assessment tools. Disclosure of Interest : None declared.

Utilization of Knowledge Management in Business Process Modeling and Process Improvements

Tutkimuksen tavoitteena on tutkia telekommunikaatioalalla toimivan kohdeyrityksen ohjelmistojen toimitusprosessia° Tutkimus keskittyy mallintamaan toimitusprosessin, määrittelemään roolit ja vastuualueet, havaitsemaan ongelmakohdat ja ehdottamaan prosessille kehityskohteita. Näitä tavoitteita tarkastellaan teoreettisten prosessimallinnustekniikoiden ja tietojohtamisen SECI-prosessikehyksen läpi. Tärkein tiedonkeruun lähde oli haastatteluihin perustuva tutkimus, johon osallistuvat kaikki kohdeprosessiin kuuluvat yksiköt. Mallinnettu toimitusprosessi antoi kohdeyritykselle paremman käsityksen tarkasteltavasta prosessista ja siinä toimivien yksiköiden rooleistaja vastuualueista. Parannusehdotuksia olivat tiedonjaon kanavoinnin määritteleminen, luottamuksen ja sosiaalisten verkostojen parantaminen, ja tietojohtamisen laajamittainen implementointi.

The effects of potentiallydisruptive technology on business model - a case study of new technologies in ICT industry

This study examines how firms interpret new, potentially disruptive technologies in their own strategic context. The work presents a cross-case analysis of four potentially disruptive technologies or technical operating models: Bluetooth, WLAN, Grid computing and Mobile Peer-to-peer paradigm. The technologies were investigated from the perspective of three mobile operators, a device manufacturer and a software company in the ICT industry. The theoretical background for the study consists of the resource-based view of the firm with dynamic perspective, the theories on the nature of technology and innovations, and the concept of business model. The literature review builds up a propositional framework for estimating the amount of radical change in the companies' business model with two middle variables, the disruptiveness potential of a new technology, and the strategic importance of a new technology to a firm. The data was gathered in group discussion sessions in each company. The results of each case analysis were brought together to evaluate, how firms interpret the potential disruptiveness in terms of changes in product characteristics and added value, technology and market uncertainty, changes in product-market positions, possible competence disruption and changes in value network positions. The results indicate that the perceived disruptiveness in terms ofproduct characteristics does not necessarily translate into strategic importance. In addition, firms did not see the new technologies as a threat in terms of potential competence disruption.

Careers of Managers, Comparison between ICT and Paper Business Sectors

The purpose of this study is to increase understanding of how the managers build their early career in information and communication technology industry (ICT business sector) and pulp- and paper industry (paper business sector). The focus of the study is to explore the importance differing a business sectors have in influencing managerial careers. Business sectors can affect careers in several ways.Sectors have different history and traditions. Also the age structure of ICT personnel differs from the age structure of personnel in the paper industry. Managers in the ICT and paper sector are technically educated but in different disciplines. Differences exist also in ways of recruiting and developing commitment inpersonnel. The target group of this research, middle management engineering personnel, work in Finnish ICT and paper companies. Research data were gathered in April-December 2002 in South-Karelia by interviewing 30 managers and six directors working in three Finnish ICT companies and in three paper companies. The research issue is approached on two levels: the individual level and the organizational level. The managers related their career stories in focused interviews. Directors, representing the organizations, described the generalities of the business sector and gave background information on company policies, human relationshippractices, as well as career and human resource development. Results of the study contribute to research discussions of career, life-span reasoning, socialization and commitment. Career is conceived as a series of positions including everykind of hierarchical mobility and all kinds of positions in work. A manager's career develops in interaction with the organization and it can be seen as involving a socializing process in an organization as a consequence of experiences andchanges in positions. This research contributes to the understanding of the nature of career in the context of two business sectors. Universal career theories,for the most part, do not perceive the importance of business sector in determining career experience. This study concentrates on describing and understanding early careers in two different business areas, elements committing managers to particular business sectors and the actions of companies in that particular sector. While career research began in the middle of 1950s, the theoretical basis of career research seems to be quite fragmented still. However, a dichotomy is consistently presented between traditional, hierarchical career research and boundaryless career thinking. In this research we examine how these old and new career concepts are evidence in the ICT and paper sectors. Careers are changing from formal, hierarchy-based structures to more fluid arrangements. The new boundaryless career concept captures territory from old career thinking. Mobility between employers, networks, and changing hierarchical structures in organizations, as well as personal and family reasons are theorized to bring changes to careers patterns in the future. However, the pace of this change in careers will vary between the ICT and paper business sectors. Findings of this research indicate that business sector has an effect on how managerial careers develop. The environment where career is developed differs between ICT and paper sectors. Careers begin differently in the two environments and the speed of career progression is distinct. ICT careers are built within the business sector whereas paper careers are made inside one company. Also recruiting and socialization practices differ from one sector to the other.

Business model design: an evaluation of paper-based and computer-aided canvases

In recent years, Business Model Canvas design has evolved from being a paper-based activity to one that involves the use of dedicated computer-aided business model design tools. We propose a set of guidelines to help design more coherent business models. When combined with functionalities offered by CAD tools, they show great potential to improve business model design as an ongoing activity. However, in order to create complex solutions, it is necessary to compare basic business model design tasks, using a CAD system over its paper-based counterpart. To this end, we carried out an experiment to measure user perceptions of both solutions. Performance was evaluated by applying our guidelines to both solutions and then carrying out a comparison of business model designs. Although CAD did not outperform paper-based design, the results are very encouraging for the future of computer-aided business model design.

Business potential evaluation of wireless local area networks: Teleoperator’s view

The objective of the thesis was to evaluate business potential of wireless local area networks (WLAN, Wireless LAN). At first, the scope of business potential evaluation of technology was introduced. Next, a general framework of business potential evaluation of technology based on literature was presented. In addition, convergence of cellular networks and data networks was studied in order to get an insight of current situation of mobile telecommunications industry. Finally, wireless local area networks business potential was evaluated. A wireless local area network is a data communication system, which combines data connectivity with mobility and is implemented in unlicensed frequency bands, allowing new business opportunities to emerge. The main markets of WLAN are corporate networks, public area networks and access networks. At the moment the penetration of WLAN terminals is low which derives to low demand of wireless LAN services. In addition, unlicensed spectrum forces the teleoperators to set the service price relatively low. The business potential is in integrating wireless LANs to cellular networks and in offering value added services to end users. The future of wireless LAN is to be complementary network to cellular networks. In this vision cellular networks provide voice and low data services and broadband wireless networks enable multimedia services.

Business Benefits of Content Management

Hyvällä sisällönhallinnalla on mahdollista vaikuttaa myönteisesti liiketoiminnalliseen tulokseen, jos sisällönhallinnan eri vaikutusmahdollisuudet tunnistetaan. Kun organisaatiossa syntyvä tieto on vapaasti saatavilla, ja sitä voidaan tulkita ja hyödyntää erilaisiin tarpeisiin, tietojärjestelmän avulla voidaan vauhdittaa kehitystä ja uuden tiedon löytämistä. Tiedon keskeisin tehtävä on kehittää ja parantaa organisaation osaamista, jolloin pitää olla tietoa siitä, mitä, miksi ja kuinka tietoa on käytetty organisaatiossa. Kaiken liiketoimintaprosesseissa tuotetun tiedon kohdalla pitäisi miettiä kolmea tiedonhallinnan osa-aluetta: tiedon luontia, hallintaa ja hyödyntämistä. Tavoitteena on saavuttaa yrityksen määrämuotoisen tietopääoman paras mahdollinen hallinta.Työssä kuvataan sitä, mitä sisällönhallinta on, sen eri tasoja, sen käsitteellistä sijoittumista tietämyksenhallintaan, sisällönhallinnan järjestelmiä ja niiden merkitystä liiketoimintaprosesseissa. Lisäksi tarkastellaan niitä syitä, joiden vuoksi yritykset kiinnostuvat organisaatiossa olevan määrämuotoisen tiedon sisällönhallinnasta. Lopuksi analysoidaan, millaisia voivat olla liiketoiminnalliset, kilpailulliset tai rahalliset tavoitteet, joita asetetaan sisällönhallinnan tietojärjestelmäprojektille. Työn tueksi on haastateltu neljän suomalaisen suuryrityksen sisällönhallinnan tietojärjestelmäprojektin asiantuntijoita. Heidän kommenttejaan on analysoitu ja niiden perusteella on tehty johtopäätöksiä niistä syistä, joiden vuoksi yritykset yleensä sijoittavat resurssejaan sisällönhallintaan.

The Business Models of Telecommunications Equipment Manufacturers. Case: Cisco Systems.

Tutkielman tavoitteena oli tarkastella telekommunikaatiolaitevalmistajien liiketoimintamalleja. Tutkielma jakaantuu teoreettiseen ja empiiriseen osaan. Teoreettinen osa keskittyy lähinnä liiketoimintamallin käsitteen määrittelyyn. Olemassa olevien määritelmien, sekä liiketoimintamallin käsitteeseen läheisesti liittyvien termien, pohjalta luotiin liiketoimintamallille uusi malli. Tutkielman empiirinen osa keskittyy case-yritys Cisco Systemsin liiketoimintamallin määrittelyyn ja kehityksen kuvaamiseen. Liiketoimintamallin kehitystä seurattiin kahden vuoden ajalta perehtymällä lähinnä yrityksen lehdistötiedotteisiin, artikkeleihin ja muuhun julkiseen materiaaliin. Ciscon lisäksi empiirisessä osassa tutkittiin kahdeksan muun laitevalmistajan liiketoimintamallien kehitystä. Empiirisen osan päätavoitteena oli selvittää, miten telekommunikaatiolaitevalmistajien liiketoimintamallit kehittyvät nyt ja tulevaisuudessa.

Business models enhancing the diffusion of mobile Internet in emerging markets

Tämän tutkimuksen päätavoitteena oli selvittää, millaiset liiketoimintamallit soveltuvat mobiilin internet-liiketoiminnan harjoittamiseen kehittyvillä markkinoilla. Tavoitteena oli myös selvittää tekijöitä, jotka vaikuttavat mobiilin internetin diffuusioon. Tutkimus tehtiin käyttäen sekä kvantitatiivista että kvalitatiivista tutkimusmenetelmää. Klusterianalyysin avulla 40 Euroopan maasta muodostettiin sisäisesti homogeenisiä maaklustereita. Näiden klustereiden avulla oli mahdollista suunnitella erityyppisille markkinoille soveltuvat liiketoimintamallit. Haastatteluissa selvitettiin asiantuntijoiden näkemyksiä tekijöistä, jotka vaikuttavat mobiilin internetin diffuusioon kehittyvillä markkinoilla. Tutkimuksessa saatiin selville, että tärkeimmät liiketoimintamallin elementit kehittyvillä markkinoilla ovat hinnoittelu, arvotarjooma ja arvoverkko. Puutteellisen kiinteän verkon todettiin olevan yksi tärkeimmistä mobiilin internetin diffuusiota edistävistä tekijöistä kehittyvillä markkinoilla.

The Impact of Doing Business Regulations on Investments in ICT

null

Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing.

OBJECTIVE: To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health. DESIGN: Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. SETTING: General practices in metropolitan and rural Victoria, Australia. PARTICIPANTS: General practices with at least one interested clinician (general practitioner or nurse) and their 14-24 year old patients. INTERVENTION: This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. OUTCOME MEASURES: Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and illicit drug use, risks for sexually transmitted infection, STI, unplanned pregnancy, and road risks); and (2) change in one or more of the six health risk behaviours, at three months or at 12 months. Secondary outcomes were likelihood of future visits, trust in the clinician after exit interview, clinician detection of emotional distress and fear and abuse in relationships, and emotional distress at three and 12 months. Patient acceptability of the screening tool was also described for the intervention arm. Analyses were adjusted for practice location and billing type, patients' sex, age, and recruitment method, and past health risks, where appropriate. An intention to treat analysis approach was used, which included multilevel multiple imputation for missing outcome data. RESULTS: 42 practices were randomly allocated to intervention or comparison arms. Two intervention practices withdrew post allocation, prior to training, leaving 19 intervention (53 clinicians, 377 patients) and 21 comparison (79 clinicians, 524 patients) practices. 69% of patients in both intervention (260) and comparison (360) arms completed the 12 month follow-up. Intervention clinicians discussed more health risks per patient (59.7%) than comparison clinicians (52.7%) and thus were more likely to detect a higher proportion of young people with at least one of the six health risk behaviours (38.4% vs 26.7%, risk difference [RD] 11.6%, Confidence Interval [CI] 2.93% to 20.3%; adjusted odds ratio [OR] 1.7, CI 1.1 to 2.5). Patients reported less illicit drug use (RD -6.0, CI -11 to -1.2; OR 0·52, CI 0·28 to 0·96), and less risk for STI (RD -5.4, CI -11 to 0.2; OR 0·66, CI 0·46 to 0·96) at three months in the intervention relative to the comparison arm, and for unplanned pregnancy at 12 months (RD -4.4; CI -8.7 to -0.1; OR 0·40, CI 0·20 to 0·80). No differences were detected between arms on other health risks. There were no differences on secondary outcomes, apart from a greater detection of abuse (OR 13.8, CI 1.71 to 111). There were no reports of harmful events and intervention arm youth had high acceptance of the screening tool. CONCLUSIONS: A complex intervention, compared to a simple educational seminar for practices, improved detection of health risk behaviours in young people. Impact on health outcomes was inconclusive. Technology enabling more efficient, systematic health-risk screening may allow providers to target counselling toward higher risk individuals. Further trials require more power to confirm health benefits. TRIAL REGISTRATION: ISRCTN.com ISRCTN16059206.

Development of tender information process by business intelligence in a global company unit

The purpose of this Thesis was to study what is the present situation of Business Intelligence of the company unit. This means how efficiently unit uses possibilities of modern information management systems. The aim was to resolve how operative informa-tion management of unit’s tender process could be improved by modern information technology applications. This makes it possible that tender processes could be faster and more efficiency. At the beginning it was essential to acquaint oneself with written literature of Business Intelligence. Based on Business Intelligence theory is was relatively easy but challenging to search and discern how tender business could be improved by methods of Busi-ness Intelligence. The empirical phase of this study was executed as qualitative research method. This phase includes theme and natural interviews on the company. Problems and challenges of tender process were clarified in a part an empirical phase. Group of challenges were founded when studying information management of company unit. Based on theory and interviews, group of improvements were listed which company could possible do in the future when developing its operative processes.