Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records.

BACKGROUND: We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria. METHODS: We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content. RESULTS: All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified. CONCLUSION: If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.

Self-initiated expatriates and their career success

Purpose This paper aims to provide conceptual clarity by distinguishing self‐initiated expatriates (SIEs) from company‐assigned expatriates (AEs), and skilled migrants; most importantly, it introduces an overarching conceptual framework based on career capital theory to explain SIEs’ career success. Design/methodology/approach This conceptual framework is based on a review of the relevant literature on SIE, expatriation, career studies, cross‐cultural studies, migration, and other related areas. Findings Protean career attitude, career networks, and cultural intelligence are identified as three major types of career capital influencing SIEs career success positively; the predicting relationships between these are mediated by cultural adjustment in the host country. Cultural distance acts as the moderator, which highlights the influence of macro‐contextual factors on SIEs’ career development. Research limitations/implications The current paper applied career capital theory and did not integrate the impact of family and labour market situation on SIEs’ career development. Further research should test the proposed framework empirically, and integrate the impact of family‐ and career‐related factors into a holistic approach. Practical implications When constructing international talent acquisition and retention strategies, organizations and receiving countries should understand the different career development needs and provide SIEs with opportunities to increase career capital during expatriation. Furthermore, the current framework suggests how to adjust to the host country in order to meet career development goals. Originality/value The multi‐level and sequential framework adds value by identifying specific types of career capital for SIEs and providing a conceptual underpinning for explaining how they interact and foster SIEs’ career success. Moreover, the framework embraces SIEs from both developed and developing economies.

An initiative for participatory monitoring of large scale acquisitions: Opportunities and results thus far

Increasing commercial pressures on land are provoking fundamental and far-reaching changes in the relationships between people and land. Much knowledge on land-oriented investments projects currently comes from the media. Although this provides a good starting point, lack of transparency and rapidly changing contexts mean that this is often unreliable. The International Land Coalition, in partnership with Oxfam Novib, Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), University of Pretoria, Centre for Development and Environment of the University of Bern (CDE), and GIZ, started to compile an inventory of land-related investments. This project aims to better understand the extent, trends and impacts of land-related investments by supporting an ongoing and systematic stocktaking exercise of the various investment projects currently taking place worldwide. It involves a large number of organizations and individuals working in areas where land transactions are being made, and able to provide details of such investments. The project monitors land transactions in rural areas that imply a transformation of land use rights from communities and smallholders to commercial use, and are made both by domestic and foreign investors (private actors, governments, government-back private investors). The focus is on investments for food or agrofuel production, timber extraction, carbon trading, mineral extraction, conservation and tourism. A novel way of using ITC to document land acquisitions in a spatially explicit way and by using an approach called “crowdsourcing” is being developed. This approach will allow actors to share information and knowledge directly and at any time on a public platform, where it will be scrutinized in terms of reliability and cross checked with other sources. Up to now, over 1200 deals have been recorded across 96 countries. Details of such transactions have been classified in a matrix and distributed to over 350 contacts worldwide for verification. The verified information has been geo-referenced and represented in two global maps. This is an open database enabling a continued monitoring exercise and the improvement of data accuracy. More information will be released over time. The opportunities arise from overcoming constraints by incomplete information by proposing a new way of collecting, enhancing and sharing information and knowledge in a more democratic and transparent manner. The intention is to develop interactive knowledge platform where any interested person can share and access information on land deals, their link to involved stakeholders, and their embedding into a geographical context. By making use of new ICT technologies that are more and more in the reach of local stakeholders, as well as open access and web-based spatial information systems, it will become possible to create a dynamic database containing spatial explicit data. Feeding in data by a large number of stakeholders, increasingly also by means of new mobile ITC technologies, will open up new opportunities to analyse, monitor and assess highly dynamic trends of land acquisition and rural transformation.

Consumption Asymmetry and the Stock Market: Empirical Evidence

This paper examines whether U.S. stock-market wealth asymmetrically affects consumption. After identifying asymmetric behavior for consumption and stock market wealth, the results confirm that stock-market wealth asymmetrically affects real per capita consumption. Negative 'news' affects consumption more than positive 'news'.

Infrastructure (Rural Road) Development and Poverty Alleviation in Lao PDR

Rural road in Lao PDR defined as connecting road from village to main road, where it will lead them to market and access to other economic and social service facilities. However, due to mostly rural people accustom with subsistence farming, connecting road seems less important for rural people as their main farming produce is for own consumption rather than markets. After the introduction and implementation of New Economic Mechanism (NEM) since 1986, many rural villages have gradually developed and integrated into market system where people have significantly changed their livelihood with a better system. This progress has significantly contributed in improving income earning of people, better living standard and reduce poverty. The paper aims to illustrate the significant of rural road as connecting road from village to markets or a market access approach of farm produces. It also demonstrates through which approach, rural farmers/people could improve their income earning, develop their farming system, living standard and reduce poverty.

Skill distribution and comparative advantage: a comparison of China and India

This paper empirically examines the different comparative advantages of two emerging economic giants, China and India, in relation to the different skill distribution patterns in each country. By utilizing industry export data on China and India from 1983 to 2000, we find that a country with a greater dispersion of skills (i.e., India, especially in the earlier years) has higher exports in industries with shorter production chains, whereas a country with a more equal dispersion of skills (i.e., China, especially in the later years) is found to have higher exports in industries with longer production chains. The causal relationship is fairly robust across different specifications. This empirical evidence supports our assumption that the likely mechanism for these results is the negative impact of low-skilled workers on input quality, which accumulates and becomes larger as the length of production chains and the proportion of low-skilled workers in the economy increase.

Platforms, network effects and small business dynamics in China : case study of the Shanzhai cell phone industry

This paper seeks to argue the significance of platforms on emerging markets through a case study of the Shanzhai cell phone industry in Shenzhen, China. In this industry, value chains are being driven by both the technology platforms and the market platforms. The former include MTK baseband chipset, and so-called Shared PCBA and Shared Mould. The latter include the North Huaqiang Market and the Purchasing and Money Platform. Technology platforms greatly reduced the technological barriers to entry for independent design houses and system integrators, while market platforms markedly improved their poor marketing and purchasing abilities. Due to factors such as social networks, supporting industries, informality and platform governance, strong network effects have been exhibited in the two types of platforms, which have not only fostered numerous start-ups, but have also led to effective exploitation of emerging markets.

Hogar digital para servicios FTTH : dispositivos, tecnologías y QoE

FTTH (fibra hasta el hogar) es actualmente, junto con la banda ancha móvil, la principal evolución tecnológica en Redes y Servicios de Telecomunicaciones. Se prevé que en los próximos años, el despliegue de las redes FTTH se vea incrementado de manera significativa, gracias al interés creciente tanto de Operadores de Telecomunicaciones como de Organismos Gubernamentales. Este despliegue (que en el año 2013 ya se está haciendo realidad) llevará servicios de muy alta velocidad (superiores a 100 Mbps, incluso 1 Gbps) de manera masiva a los hogares, exigiendo nuevos requisitos y prestaciones en la red del hogar de los clientes. Se abre aquí, por tanto, un campo de exploración novedoso, incipiente y de requerimientos cada vez más exigentes. De hecho, sin duda, la red del hogar es uno de los elementos fundamentales para el éxito de las redes y servicios en FTTH. Debido a todo lo anterior, se convierte en una necesidad para el sector de las Telecomunicaciones el encontrar soluciones a los problemas anteriormente mencionados. Con objeto de contribuir al análisis de soluciones, este proyecto se enfoca en dos temas, ambos relacionados con la problemática ya mencionada en la red del hogar:  Prospección e identificación de soluciones tecnológicas avanzadas para la red del hogar. Descrito en capítulos 2, 3 y 4. En ellos se realiza un estudio detallado de la situación actual y tendencias futuras de los dispositivos utilizados en la red del hogar. Este estudio está enfocado en la distribución de señales de muy alto ancho de banda (en torno a los 100 Mbps por segundo) en el hogar.  Diseño y desarrollo de una aplicación que permita determinar la calidad de experiencia de cliente (QoE) de un servicio de televisión IP (IPTV). Descrito en capítulos 5 y 6. Se ha seleccionado este tipo de servicios debido a que son los que requieren mayores prestaciones tanto de la red de transporte como de la red del hogar y, al mismo tiempo, son los más complicados de medir debido a la fuerte componente de subjetividad del usuario final. Una red del hogar correctamente diseñada debe cumplir de manera equilibrada los requisitos demandados tanto por el operador como por el cliente o usuario final del servicio. Los requisitos del operador se centran principalmente en el control de la inversión (CAPEX) y del gasto de mantenimiento de la red del hogar (OPEX). El usuario, por otra parte, requiere sencillez en la instalación y mínimo número de elementos a instalar (cero intrusismo, ausencia de cableado). Para adaptarse a estos requerimientos, existe una serie de dispositivos y tecnologías que buscan encontrar el punto de equilibrio entre necesidades de operadores y de clientes finales. Las soluciones actualmente utilizadas pueden dividirse en soluciones cableadas e inalámbricas. También existen soluciones híbridas. Todas ellas se describen en detalle en los capítulos 3 y 4. Al final del estudio se concluye que, con la tecnología actual, es preferible el uso de soluciones cableadas tipo Ethernet o POF. Es recomendable no usar soluciones PLC de manera extensiva (G.hn puede ser una alternativa a futuro) y, en caso de no requerir cableado, utilizar WiFi 11n con frecuencias de 5 GHz, así como sus evoluciones, WiFi 11ac y 11ad. La aplicación desarrollada, explicada en los capítulos 5 y 6, permite capturar y medir en tiempo real la señal de televisión IP que se entrega al usuario. Esta aplicación estimará, a partir de dichas medidas, la calidad de la señal entregada. Para ello tendrá en cuenta el tipo de descodificador utilizado por el usuario así como la red empleada (red FTTH de Telefónica). Esta aplicación podría ser utilizada en los centros de atención técnica de las operadoras de telecomunicaciones, determinando así la relación existente entre reclamaciones recibidas y calidad de servicio medida por la aplicación. Asimismo, aparte de realizar medidas en tiempo real, la aplicación vuelca las medidas realizadas y alarmas detectadas en ficheros log, facilitando el análisis técnico de los problemas e incidencias registrados por dichos centros técnicos. Igualmente, esta aplicación puede ser utilizada para el proceso de certificación de equipamiento de red del hogar o incluso como herramienta para profundizar en parámetros teóricos y criterios de medida de calidad de servicio en IPTV. ABSTRACT. FTTH (Fiber To The Home) and mobile broadband are currently the main technological trend in the Network and Telecommunications Services area. In the next few years, the deployment of FTTH networks will experiment a significant increase, due to the growing interest of both telecommunications operators and government agencies. This deployment (that is becoming a reality) which will massively carry high-speed services to households (speeds of more than 100 Mbps, even 1 Gbps) will demand new requirements and features in the customer’s home network. It can be found here a new and emerging field of exploration, with increasingly demanding requirements. In fact, the home network is one of the key elements for the success of FTTH network and services. Due to the aforementioned, it is a necessity for the telecommunications industry to find solutions to these problems. In order to contribute into the solution analysis, this project focuses on two subjects, both related to the problems of home networking:  Exploratory research and identification of advanced technology solutions for the home network. Described in chapters 2, 3 and 4. These chapters show a detailed study of the current situation and future trends of the devices used at the home network. It focuses on the distribution of very high bandwidth signals (around 100 Mbps per second) in the customer’s home.  Design and development of an application to evaluate customer’s quality of experience (QoE) of an IP television service (IPTV). Described in chapters 5 and 6. IPTV service has been selected because it requires higher performance both from the transport and the home networks and, at the same time, it is the most difficult to measure due to the strong component of subjectivity of the end user. A correct design of the home network must meet the requirements demanded both by the network operator and the customer (end user of the service). Network operator requirements mainly focus on reduced capital expenditures (CAPEX) and operational expenditures (OPEX). Additionally, the final user requires a simple and easy installation and also the minimum number of items to install (zero intrusion, lack of wiring, etc.). Different devices and technologies seek to find a balance between these two requirements (network operators and final users requirements). Solutions available in the market can be divided into wired and wireless. There are also hybrid solutions. All of them are described thoroughly in the first part of the project. The conclusion at the end of the study recommends the use of wired technologies like Ethernet or POF. Additionally, the use of PLC is not advised (G.hn can be an alternative in the future) and, in the case of not requiring wiring, the use of 11ac and 11ad WiFi is advised. The application developed in the second part of the project allows capturing and measuring the real-time IPTV signal delivered to the user. This application will estimate the delivered signal quality from the captured measurements. For this purpose, it will also consider the type of decoder installed on the customer’s premises and the transport network (Telefonica’s FTTH network). This application could be used at the operator’s technical service centres, determining in this way the relationship between user’s complaints and the quality of service measured. Additionally, this application can write all the measurements and alarms in log files, making easier the technical analysis of problems and impairments recorded by the technical centres. Finally, the application can also be used for the certification process of home networking equipment (i.e. decoders) or even as a tool to deepen theoretical parameters and measuring criteria of quality of service in IPTV.

Energy consumption and carbon dioxide emissions in rail and road freight transport in Spain: a case study of car carriers and bulk petrochemicals

This article provides a new methodology for estimating fuel consumption and emissions by enabling a correct comparison between freight transportation modes. The approach is developed and integrated as a part of an intelligent transportation system dealing with goods movement. A key issue is related to energy consumption ratios and consequent CO2 emissions. Energy consumption ratios are often used based on transport demand. However, including other ratios based on transport supply can be useful. Furthermore, it is important to indicate which factors are associated with variations in energy consumption and emissions; especially of interest are parameters that have a higher incidence and order of magnitude, in order to fairly compare and understand the difference between transport modes and sub-modes. The study finds that the use of an energy consumption equation can improve the quality of the estimates. The study proposes that coefficients that define the energy consumption equation should be tested to determine market niches and sources of improvement in energy consumption according to the category of vehicles, fuel types used, and classes of products transported.

Modelling diffusion of photovoltaic: concepts and applications

Innovation studies have been interest of not only the scholars from various fields such as economics, management and sociology but also industrial practitioners and policy makers. In this vast and fruitful field, the theory of diffusion of innovations, which has been driven by a sociological approach, has played a vital role in our understanding of the mechanisms behind industrial change. In this paper, our aim is to give a state of art review of diffusion of innovation models in a structural and conceptual way with special reference to photovoltaic. We argue firstly, as an underlying background, how diffusion of innovations theory differs from other innovation studies. Secondly we give a brief taxonomical review of modelling methodologies together with comparative discussions. And finally we put the wealth of modelling in the context of photovoltaic diffusion and suggest some future directions.

Unit Commitment and Electricity Prices Forecasting for Market Strategy Preparation in Interconnected Systems

In this paper we present a solution for building a better strategy to take part in external electricity markets. For an optimal strategy development, both the internal system costs as well as the future values of the series of electricity prices in external markets need to be known. But in practice, the real problems that must be faced are that both future electricity prices and costs are unknown. Thus, the first ones must be modeled and forecasted and the costs must be calculated. Our methodology for building an optimal strategy consists of three steps: The first step is modeling and forecasting market prices in external systems. The second step is the cost calculation on internal system taking into account the expected prices in the first step. The third step is based on the results of the previous steps, and consists of preparing the bids for external markets. The main goal is to reduce consumers' costs unlike many others that are oriented to increase GenCo's profits.

Aplicación web de gestión financiera personal desarrollada con MEAN.JS

En este trabajo de fin de grado se llevará a cabo la elaboración de una aplicación web de gestión de gastos personales desde sus inicios, hasta su completo funcionamiento. Estas aplicaciones poseen un crecimiento emergente en el mercado, lo cual implica que la competencia entre ellas es muy elevada. Por ello el diseño de la aplicación que se va a desarrollar en este trabajo ha sido delicadamente cuidado. Se trata de un proceso minucioso el cual aportará a cada una de las partes de las que va a constar la aplicación características únicas que se plasmaran en funcionalidades para el usuario, como son: añadir sus propios gastos e ingresos mensuales, confeccionar gráficos de sus principales gastos, obtención de consejos de una fuente externa, etc… Estas funcionalidades de carácter único junto con otras más generalistas, como son el diseño gráfico en una amplia gama de colores, harán su manejo más fácil e intuitivo. Hay que destacar que para optimizar su uso, la aplicación tendrá la característica de ser responsive, es decir, será capaz de modificar su interfaz según el tamaño de la pantalla del dispositivo desde el que se acceda. Para su desarrollo, se va a utilizar una de las tecnologías más novedosas del mercado y siendo una de las más revolucionarias del momento, MEAN.JS. Con esta innovadora tecnología se creará la aplicación de gestión económica de gastos personales. Gracias al carácter innovador de aplicar esta tecnología novedosa, los retos que plantea este proyecto son muy variados, desde cómo estructurar las carpetas del proyecto y toda la parte de backend hasta como realizar el diseño de la parte de frontend. Además una vez finalizado su desarrollo y puesta en marcha se analizaran posibles mejoras para poder perfeccionarla en su totalidad. ABSTRACT In this final degree project will take out the development of a web application from its inception, until its full performance management. These applications have an emerging market growth, implying that competition between them is very high. Therefore the design of the application that will be developed in this work has been delicately care. It's a painstaking process which will provide each of the parties which will contain the application unique features that were translated into functionality for the user, such as: add their own expenses and monthly income, make graphs of your major expenses, obtaining advice from an external source, etc... These features of unique character together with other more general, such as graphic design in a wide range of colors, will make more easy and intuitive handling. It should be noted that to optimize its use, the application will have the characteristic of being responsive, will be able to modify your interface according to the size of the screen of the device from which are accessed. For its development, it is to use one of the newest technologies on the market and being one of the most revolutionary moment, MEAN. JS. The economic management of personal expenses application will be created with this innovative technology. Thanks to the innovative nature of applying this new technology, the challenges posed by this project are varied, from how to structure the folders of the project and all the backend part up to how to perform the part of frontend design. In addition once finished its development and commissioning possible improvements will analyze to be able to perfect it in its entirety.

Irrigation efficiency and water-policy implications for river-basin resilience

Rising demand for food, fiber, and biofuels drives expanding irrigation withdrawals from surface water and groundwater. Irrigation efficiency and water savings have become watchwords in response to climate-induced hydrological variability, increasing freshwater demand for other uses including ecosystem water needs, and low economic productivity of irrigation compared to most other uses. We identify three classes of unintended consequences, presented here as paradoxes. Ever-tighter cycling of water has been shown to increase resource use, an example of the efficiency paradox. In the absence of effective policy to constrain irrigated-area expansion using "saved water", efficiency can aggravate scarcity, deteriorate resource quality, and impair river basin resilience through loss of flexibility and redundancy. Water scarcity and salinity effects in the lower reaches of basins (symptomatic of the scale paradox) may partly be offset over the short-term through groundwater pumping or increasing surface water storage capacity. However, declining ecological flows and increasing salinity have important implications for riparian and estuarine ecosystems and for non-irrigation human uses of water including urban supply and energy generation, examples of the sectoral paradox. This paper briefly considers three regional contexts with broadly similar climatic and water-resource conditions – central Chile, southwestern US, and south-central Spain – where irrigation efficiency directly influences basin resilience. The comparison leads to more generic insights on water policy in relation to irrigation efficiency and emerging or overdue needs for environmental protection.

O impacto conjunto do empreendedorismo e das redes interorganizacionais sobre o desenvolvimento de inovações globais: evidências das subsidiárias estrangeiras operando no país

As subsidiárias de corporações multinacionais sofrem pressões do ambiente interno e externo. Internamente competem por recursos e reconhecimento da matriz, externamente precisam se preocupar com os concorrentes e demais forças do mercado, de maneira que para desenvolver-se a subsidiária deve explorar as oportunidades de mercado e mostrar o potencial empreendedor que possui. Essas oportunidades podem estar num produto ou processo novo ou substancialmente aprimorado no qual a subsidiária teve o auxílio de um parceiro da rede em que está inserida. Particularmente, essa pesquisa analisa as inovações desenvolvidas localmente (dentro do país hospedeiro) através das subsidiárias instaladas no país, essas inovações são passíveis de serem transferidas para as suas matrizes e então utilizadas pelas demais subsidiárias espalhadas pelo mundo, tornando-se inovações globais. O foco principal deste estudo está em compreender a influência do empreendedorismo e das redes de empresas sobre o desenvolvimento e transferência dessas inovações. Para tanto, o presente estudo analisa uma amostra de 172 subsidiárias estrangeiras que operam no Brasil, a qual foi modelada utilizando-se a técnica de equações estruturais para o teste das hipóteses, mensuração do efeito mediador e comparação multigrupos visando avaliar o efeito moderador referente ao porte das subsidiárias. Os resultados sugerem que o empreendedorismo da subsidiária exerce influência significativa sobre o desenvolvimento das parcerias e consequente enraizamento da subsidiária na rede de empresas do mercado emergente, esse enraizamento na rede é um fator determinante para o desenvolvimento de inovações na subsidiária as quais podem ser transferidas para a matriz e então tornarem-se inovações globais. A partir desses resultados, a pesquisa contribui para um maior entendimento dos direcionadores de inovação nas subsidiárias e aprofunda a discussão sobre o desenvolvimento de inovações globais, particularmente àquelas provenientes de mercados emergentes.

Economic cycles, asymmetric crises and tourism competitiveness: emerging versus mature destinations

This paper considers the influence of business cycles and economic crises on tourism destinations competitiveness. This competitiveness is measured by its share in world tourism. Analysing a period of forty years, the differential permanent or temporary effects that economic crises has on competitiveness of mature and emerging destinations are observed. Furthermore, it identifies the economic transmission mechanisms operating within this context, analysing them using the framework of the most relevant explanatory models of tourism destination competitiveness. The preliminary results obtained suggest that the effects of these shocks on competitiveness are not neutral. In mature destinations the negative effects are more persistent in highly intensive crises. In emerging destinations with a growing natural trend on tourism demand, the effects of the economic crises are softer and limited, reinforcing the process of convergence between destinations. This effect works through two basic transmission mechanisms: the reduction of internal and external tourism demand and the decrease on investment.