« Utilisation des services de santé chez les personnes âgées : association avec la maladie chronique et l’incapacité »

Diverses publications soulignent l'augmentation de l'espérance de vie et avec elle, le vieillissement mondial de la population. Ce processus se poursuivra à l'avenir, ainsi que son influence sur l’incidence et la prévalence de l'incapacité. Chez les personnes âgées, l’incapacité, les maladies chroniques et leur association constituent un sujet important dans le domaine de la santé publique en raison de l'effet qu'ils ont sur la demande des services de santé. Le but de ce mémoire est d’examiner quelle est la contribution respective des maladies chroniques et de l'incapacité dans l'utilisation des services de santé chez les personnes âgées et de leur interaction. Il s’agit de savoir si l'association entre la maladie chronique et l'utilisation des services de santé est modifiée par l’incapacité prenant en compte les caractéristiques de l'individu et son environnement. Ce travail est basé sur le modèle comportemental proposé par Andersen et Newman et le modèle du processus d’incapacité de Verbrugge et Jette. Pour répondre à l’objectif, nous utilisons les données du projet de recherche “ FRéLE ” (Fragilité, une étude longitudinale de ses expressions), réalisé durant la période 2010 -2013 auprès d’un échantillon de 1643 personnes âgées vivant dans la communauté au Québec. L’incapacité est évaluée à l’aide de deux indicateurs : les AVQ et les AVD. Les maladies chroniques sont mesurées par l’indice fonctionnel de comorbidité (IFC). La dépression est évaluée selon les critères de l’échelle de dépression gériatrique (EDG). L’état cognitif est mesuré par l'évaluation cognitive de Montréal (MoCA). Les facteurs de prédisposition comportent l’âge, le sexe, l’ethnicité et le niveau scolaire. Les facteurs facilitateurs incluent le revenu et le réseau social, ce dernier étant mesure par la présence ou non d’une personne de soutien et son lien avec la personne âgée. Divers modèles de régression sont adoptés pour identifier les facteurs statistiquement significatifs du modèle comportemental d’Andersen et Newman et du modèle du processus d’incapacité de Verbrugge et Jette. Nos résultats ont montré que, si le rôle des prédicteurs de l’utilisation varie en fonction du type de services de santé utilisé, l’utilisation s’accroît principalement avec le nombre de maladies chroniques. En ce qui concerne l’interaction entre la maladie chronique et l’incapacité, nos résultats ont révélé que l’interaction n’est statistiquement significative pour aucun des services analysés. Compte tenu de la diversité et les besoins de la population âgée, caractérisée par une prévalence élevée de maladies chroniques et d'incapacités, l’étude des facteurs impliqués dans l'utilisation des services de santé sera utile pour la mise en œuvre d’une offre de services, plus conforme aux besoins de cette population

« Utilisation des services de santé chez les personnes âgées : association avec la maladie chronique et l’incapacité »

Diverses publications soulignent l'augmentation de l'espérance de vie et avec elle, le vieillissement mondial de la population. Ce processus se poursuivra à l'avenir, ainsi que son influence sur l’incidence et la prévalence de l'incapacité. Chez les personnes âgées, l’incapacité, les maladies chroniques et leur association constituent un sujet important dans le domaine de la santé publique en raison de l'effet qu'ils ont sur la demande des services de santé. Le but de ce mémoire est d’examiner quelle est la contribution respective des maladies chroniques et de l'incapacité dans l'utilisation des services de santé chez les personnes âgées et de leur interaction. Il s’agit de savoir si l'association entre la maladie chronique et l'utilisation des services de santé est modifiée par l’incapacité prenant en compte les caractéristiques de l'individu et son environnement. Ce travail est basé sur le modèle comportemental proposé par Andersen et Newman et le modèle du processus d’incapacité de Verbrugge et Jette. Pour répondre à l’objectif, nous utilisons les données du projet de recherche “ FRéLE ” (Fragilité, une étude longitudinale de ses expressions), réalisé durant la période 2010 -2013 auprès d’un échantillon de 1643 personnes âgées vivant dans la communauté au Québec. L’incapacité est évaluée à l’aide de deux indicateurs : les AVQ et les AVD. Les maladies chroniques sont mesurées par l’indice fonctionnel de comorbidité (IFC). La dépression est évaluée selon les critères de l’échelle de dépression gériatrique (EDG). L’état cognitif est mesuré par l'évaluation cognitive de Montréal (MoCA). Les facteurs de prédisposition comportent l’âge, le sexe, l’ethnicité et le niveau scolaire. Les facteurs facilitateurs incluent le revenu et le réseau social, ce dernier étant mesure par la présence ou non d’une personne de soutien et son lien avec la personne âgée. Divers modèles de régression sont adoptés pour identifier les facteurs statistiquement significatifs du modèle comportemental d’Andersen et Newman et du modèle du processus d’incapacité de Verbrugge et Jette. Nos résultats ont montré que, si le rôle des prédicteurs de l’utilisation varie en fonction du type de services de santé utilisé, l’utilisation s’accroît principalement avec le nombre de maladies chroniques. En ce qui concerne l’interaction entre la maladie chronique et l’incapacité, nos résultats ont révélé que l’interaction n’est statistiquement significative pour aucun des services analysés. Compte tenu de la diversité et les besoins de la population âgée, caractérisée par une prévalence élevée de maladies chroniques et d'incapacités, l’étude des facteurs impliqués dans l'utilisation des services de santé sera utile pour la mise en œuvre d’une offre de services, plus conforme aux besoins de cette population

Identifying New Business Opportunities and Customer Value Creation: Case Vuosaari

Previously conducted research projects in the field of logistics services have emphasized the importance of value added services in customer value creation. Through value added services companies can extend their service portfolio and gain higher customer satisfaction and loyalty. In more general level service marketing has been recognized to be challenging due the intangible nature of services. This has caused issues in pricing and value perceptions. To tackle these issues scholars have suggested well–managed customer reference marketing practices. The main goal of this research work is to identify shortages in the current service offering. Additionally, the focus is on, how these shortages can be fixed. Due the low capacity utilization of warehouse premises, there is a need to find the main factors, which are causing or affecting on the current situation. The research aims to offer a set of alternatives how to come over these issues. All the potential business opportunities are evaluated and the promising prospects are discussed. The focus is on logistics value added services and how those effect on route decisions in logistics. Simultaneously the aim is to create a holistic understanding of how added value and offered services effect on logistics centralization. Moreover, customer value creation and customer references’ effectiveness in logistics service marketing are emphasized in this project. Logistics value added services have a minor effect on logistics decision. Routes are chosen on a low–cost basis. However, it is challenging to track down logistics costs and break those down into different phases. Customer value as such is a difficult concept. This causes challenges when services are sold with value–based principles. Customer references are useful for logistics service providers and this should be exploited in marketing. Those reduce the perceived risk and give credibility to the service provider.

Análise dos prejuízos financeiros da indústria brasileira de aviação civil : influência das forças competitivas de Porter

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Civil e Ambiental, 2016.

El museo de la arepa

El Museo de la Arepa es un restaurante que estará ubicado en la localidad de La Candelaria en la ciudad de Bogotá, con un enfoque de autoservicio que ofrece arepas típicas colombianas en cinco variedades distintas, cada una de las cuales representa una región del país. Sera constituida a través de la Sociedad por Acciones Simplificada S.A.S. El proyecto nace de la iniciativa de dos familias y de sus gustos gastronómicos y tradiciones familiares. Queremos crear un espacio de ocio dedicado a la cultura y a la cocina y que resalte uno de los productos insignias, símbolo de nuestra identidad colombiana e icono de nuestra gastronomía: la arepa. Queremos convertirnos en la mejor opción para comer arepas en Bogotá y ofrecerle a nuestros comensales, además de un producto delicioso y de la mejor calidad, un lugar de esparcimiento diferente en el que se encuentren con el arte local de esta zona por medio de exposiciones de artistas urbanos, presentaciones musicales y de danza y una conceptualización tipo museo del lugar. Nos encontramos en una etapa de consolidación y se espera realizar la apertura del restaurante en enero de 2017. Actualmente, se está realizando la búsqueda del establecimiento donde nos ubicaremos en La Candelaria entre los barrios La Catedral y la Concordia.

Motivating techniques within Irish and American manufacturing and service companies in the Northwest of Ireland

In today’s world, many companies are concentrating on both their technology and human resources to provide them with their competitive advantage. Hence, understanding what motivates people is particularly important for managers in order to develop and sustain a competitive edge. As a result, numerous theories have been advanced to help our understanding of the subject matter and from these theories many motivational methods have evolved to enhance motivation within the workplace. In addition, research has been conducted on the various types of motivational techniques utilised by companies within Ireland. However, very little research has been completed within specific geographical regions in Ireland concerning the types of motivational techniques implemented at different job levels and their impact on employees work performance. Thus the objective of this research was to identify the motivational techniques utilised at different job levels within large manufacturing and service companies in the Northwest of Ireland and examine how these techniques influence the performance levels of employees. Furthermore, the study examined if these companies have changed from traditional ways of motivating employees to newer techniques. The research methodologies used to undertake the research included interviews with the HR managers and questionnaires completed by different employees at various job levels within the participating companies. Overall the conclusions were varied. Many different types of motivation techniques were found within the study’s participating companies. Irish companies are improving their motivational techniques, however most of these techniques are only used within higher job levels. In contrast to their American counterparts, a variety of motivational techniques are utilised and implemented at all job levels. On a more positive note, the majority of these motivational techniques do increase performance levels at all job levels. From the extensive primary and secondary research conducted, the thesis concludes by offering a number of recommendations to assist companies in further development of their motivational techniques for all job levels. These recommendations hope to augment the success of companies through an enhanced motivated workforce.

Reasons for deploying an e-reader loan service at the UOC Library

The presentation will focus on the reasons for deploying an e-reader loan service at a virtual university library as a part of an e-learning support system to aid user mobility, concentration of documentary and electronic resources, and ICT skills acquisition, using the example of the UOC pilot project and its subsequent consolidation. E-reader devices at the UOC are an extension of the Virtual Campus. They are offered as a tool to aid user mobility, access to documentary and electronic resources, and development of information and IT skills. The e-reader loan service began as a pilot project in 2009 and was consolidated in 2010. The UOC Library piloted the e-reader loan service from October to December 2009. The pilot project was carried out with 15 devices and involved 37 loans. The project was extended into 2010 with the same number of devices and 218 loans (October 2010). In 2011 the e-reader loan service is to involve 190 devices, thus offering an improved service. The reasons for deploying an e-reader loan service at the UOC are the following: a) to offer library users access to the many kinds of learning materials available at the UOC through a single device that facilitates student study and learning; b) to enhance access to and use of the e-book collections subscribed to by the UOC Library; c) to align with UOC strategy on the development of learning materials in multiple formats, and promote e-devices as an extension of the UOC Virtual Campus, and d) to increase UOC Library visibility within and beyond the institution. The presentation will conclude with an analysis of the key issues to be taken into account at a university library: the e-reader market, the unclear business and license model for e-book contents, and the library's role in promoting new reading formats to increase use of e-collections.

Developing of Service Platform Thinking in Modern Electricity Distribution Business

Palvelukehitystoiminta sitoo huomattavan määrän resursseja ja on pitkäkestoista toimintaa. Innovatiivisuuteen tähtäämällä ja systemaattisella tuotekehitystyöllä yritys parantaa jatkuvuutta omassa liiketoiminnassaan. Alusta-ajattelu tuo uuden ulottuvuuden tuotteiden ja palveluiden kehitykseen. Alustan kehittäminen tukemaan tuote- ja palvelukehitystoimintaa ja yksinkertaistamaan tuote/palvelurakenteita antaa yrityksissä lisäpotentiaalia esimerkiksi lyhentyneiden kehitysaikojen, paremman kompleksisuuden hallinnan ja kustannustehokkuuden nousun myötä. Toimintojen tehostuminen yritystasolla saa aikaan mahdollisuuksien lisääntymisen nykyisillä liiketoimintasektoreilla. Palvelualustan kehityksellä päästään palvelurakenteen mallintamisen kautta parempaan liiketoiminnan hallitsemiseen ja systemaattisempaan tuotekehityksen läpivientiin. Palvelualustan yhtenä tärkeimpänä hyötynä on, että palvelun rakenteellisuus saadaan kuvattua alustaan. Lisäksi on tärkeää määritellä vastuutukset alustan kehityksessä, sekä pystyä mallintamaan informaation kulku (rajapinnat) prosesseissa.

Service Concept Development - An Appoach for Professional Service Firm

Specific demand for service concept creation has come about from industrial organizations’ desire to find new and innovative ways to differentiate their offering by increasing the level of customer services. Providers of professional services have also demanded new concepts and approaches for their businesses as these industries have become increasingly competitive. Firms are now seeking better ways to understand and segment their customers, to ensure the delivery of quality services and strengthen their position in aggressively competitive markets. This thesis is intended to provide management consulting companies with a new work method that enables service concept creation in a business-to-business environment. The model defines the service concept as a combination of delivered value and the target customers; the third-dimension operating model is brought to the new system in testing of the service concept creation guidelines in the target organization. For testing, service concepts for a management consulting company are created. Service concepts are designed to serve as a solid foundation for further service improvements. Recommendations and proposals for further action related to service development in the target organization are presented, and recommendations to further improve the model created are given.

Developing a new service business model for an industrial supplier

Project business companies are moving towards solution offering in order to avoid discontinuity of project business and to gain other advantages. An option to implement solution business could be BOOT (Build-Own-Operate-Transfer) business model where a company is given the responsibilities to design, finance, build, own, operate and maintain for example production facilities of a client. The contract is made for 10-30 years, the client pays the solution during this period of time and after contract termination the facilities are transferred to the ownership of the client. The purpose of this study was to provide knowledge about BOOT business model for the company in question and its employees and to create a settlement of the advantages, disadvantages and risks of it. Furthermore, one of the main objectives was to create a description of the network needed to run a BOOT project. The objectives were met through a literature study and an explorative case study with appropriate interviews. Based on this study, the company should be able to evaluate the applicability of BOOT business model to their business environment better.

Productizing professional consultancy services modularly through service blueprinting: Case QPR Software

Services are getting more complex and difficult to manage, but much less attention and resources are directed towards service development than product development both in literature and business life. The paper sheds light on how productization together with modularization and service blueprinting would help make consultancy services more manageable, scalable and efficient while retaining their customer focus. The research was qualitative and based on active research and participant observation. A theoretical framework was constructed on the basis of relevant literature and was then evaluated in two steps: first the overall framework was evaluated by mirroring it to a real life case at QPR Software. Then a service blueprint was created of a selected service, and its benefits and challenges were evaluated. The framework reflected the case company's situation well. Service blueprinting proved to be a valuable tool for facilitating discussion and knowledge sharing. The characteristics of consultancy services provide many challenges for productization. They are highly heterogeneous and people-centric whereas productization is based on standardizing the offering, the delivery processes and managing the service's tangible properties. The research indicated that by modularizing services, both customer focus and standardization can be achieved by creating variety.

Exploring the value creation in service ecosystem context: the case of the information technology sector

This thesis examines customer value creation in a service ecosystem context. The objective of this thesis is to develop a comprehensive view of value creation processes in a service ecosystem context and an understanding on the roles of the stakeholders involved in these processes, focusing on the information technology industry. The novelty of the two central concepts of this thesis, systemic customer value and service ecosystem, as well as the gap in the literature of empirical research on value creation in an ecosystem-level, opened an interesting research topic. The empirical study is conducted as a single case analysis, utilizing Group Decision Support System (GDSS) and also Analytic Hierarchy Process (AHP). The findings suggest that customer value is created by a complex combination of interactions among different actors of the ecosystem. Thus, value is not created by a single offering directed to the customer, but by an integration of services from different parts of the ecosystem as well as the active participation of customer in this process.

Industrial solution business – transition from product to solution offering

The business logic in the manufacturing industry has changed in the 21st century. In the current industrial market, manufacturers are driven to provide more comprehensive offerings that go beyond the traditional product-orientation by providing capacity and availability for their customers. From incidental merchandise, services have become the core of manufacturers’ offerings with long-lasting service agreements over the life-cycles of their products. This change is driven both by the need of providers to grow and gain competitive advantage and by increased customer demand caused by customers’ outsourcing trends. The three key drivers for manufacturers’ service strategies are outsourcing trends, saturation of the installed base, and commoditization in product markets. Thus, manufacturers focus on providing industrial solutions which are delivered through relational processes with customers by using solution-driven business models. In the management of marketing activities, this can be regarded as closer customer relationships, service-dominant business logic, and collaboration in solving customers’ problems. However, there are few studies on comprehensive conceptualizations of a solution offering that include different elements and their roles, especially in the context of capital goods industry. Also the transition process needs further studies in a real life context. This study explores the transition process of an industrial company from product to solution business and, as an aid to managing the solution business, explicates the structure and management of an industrial solution offering. There are two themes, the industrial transition process and industrial solution offering. Regarding the industrial transition process, the aim is to understand the supplier view on the process and its execution and to determine the challenges related to the transition process. The industrial solution offering is discussed by its elements and characteristics, as well as management. Furthermore, a special type of build-own-operate-transfer business model is presented and its suitability in the industrial context analyzed. The study includes findings achieved by qualitative methods and from four case companies. Based on the results, it is tentatively suggested that in the industrial solution business, the transition from product to solution business is not a linear project but an evolving process that varies according to customer needs, which suggests that companies need to possess an ability to develop new business models for different customer needs. The industrial solution offering is dynamic as it evolves in collaboration according to the prevailing and latent customer needs, which suggest restructuring of the organization from a product-centric to a customer-centric one. Furthermore, based on the findings, the concept of industrial solutions is defined as an ongoing relational process to satisfy a customer’s particular business or operational requirements, and the concept of industrial solution offering as an entity comprising the customized goods, services, collaboration, and finance needed to fulfill the industrial solution. Finally, the study offers several managerial implications for industrial managers involved in the transition and management of the solution business and its offering.

Productizing of advanced service for power plants

Työn tavoitteena on kehittää ABB:lle palvelutuote, jota voidaan tarjota voimalaitosasiakkaille. Uuden palvelutuotteen tulee vastata ABB:n uuden strategian linjauksiin. Palvelulla tarjotaan asiakkaille 1.1.2015 voimaan tulleen energiatehokkuuslain määrittelemien pakollisten toimenpiteiden suoritusta. Työssä kerätään, käsitellään ja analysoidaan tietoa voimalaitosasiakkaille suunnatun palvelun tuotteistamisprosessin päätöksenteon tueksi. Palvelutuotteen kehittämistä varten tutkitaan ABB:n nykyisiä palvelutuotteita, osaamista ja referenssi projekteja, energiatehokkuuslakia, voimalaitosten energiatehokkuus-potentiaalia ja erilaisia energiakatselmusmalleja. Päätöksenteon tueksi tehdään referenssiprojektina energia-analyysi voimalaitokselle, jossa voimalaitoksesta tehdään ipsePRO simulointiohjelmalla mallinnus. Mallinnuksen ja koeajojen avulla tutkitaan voimalaitoksen minimikuorman optimointia. Markkinatutkimuksessa selvitetään lainsäädännön vaikutusta, nykyistä markkinatilannetta, potentiaalisia asiakkaita, kilpailijoita ja ABB:n mahdollisuuksia toimia alalla SWOT–analyysin avulla. Tutkimuksen tulosten perusteella tehdään päätös tuotteistaa voimalaitoksille palvelutuote, joka sisältää kaikki toimet energiatehokkuuslain asettamien vaatimusten täyttämiseen yrityksen energiakatselmuksen vastuuhenkilön, energiakatselmuksen ja kohdekatselmuksien teon osalta. Lisäksi työn aikana Energiavirasto myönsi ABB:lle pätevyyden toimia yrityksen energiakatselmuksen vastuuhenkilönä, mikä on edellytyksenä palvelun tarjoamiselle.