921 resultados para Models of Knowledge Management


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Tämän tutkielman tarkoituksena on selvittää, miten tietojohtamisen konseptia voidaansoveltaa asiakassuhteiden hallinnassa. Tutkimusmenetelmänä olen käyttänyt kirjallisuustutkimusta, jota on täydennetty yhdellä tapaustutkimuksella. Tietojohtaminen voidaan jakaa kahteen osakokonaisuuteen: tietämyksen hallintaan ja tietohallintoon. Tietämyksen hallinta käsittää ihmiset ja organisaation, kun taas tietohallinto käsittää tietojärjestelmät ja sovellukset. Tätä jaottelua voidaan soveltaa myös asiakassuhteiden (asiakkuuksien) hallintaan. Asiakkuuden hallinta voidaansamaan tapaan jakaa asiakastietämyksen hallintaan ja sitä tukevaan tietohallintoon. Näin ollen tietojohtamisen kehittämiseen rakennetut mallit ja menetelmät ovat sovellettavissa myös asiakkuuden hallinnan kehittämiseen. Tietojohtamisen konseptin ja tapaustutkimuksen pohjalta johtamani asiakkuuden hallinnan konsepti poikkeaa jonkin verran yleisesti käytetyistä asiakkuuden hallinnan teoreettisista malleista. Konseptini arkkitehtuuri perustuu visioon, muutosta kuvaaviin strategioihin sekä yhteisesti sovittuihin mittareihin, joilla asiakkuuden hallinnan eriosa-alueiden tarkoituksenmukaisuutta ja tehokkuutta arvioidaan. Keskeisenä tavoitteena on varmistaa asiakastietämyksen kartuttaminen ja tehokas hyödyntäminen kaikissa asiakasrajapinnoissa. Tähän päästään yhdistämällä asiakasprosessit ja organisaation omat toimintaprosessit mahdollisimman saumattomaksi kokonaisuudeksi mm. tietohallinnon palveluja ja monikanavaisuuden ideaa hyödyntämällä. Asiakkuuden hallinnan kehittämisen kannalta on tärkeää ymmärtää, millaisia mahdollisuuksia tietojohtamisen eri mallit ja yleisemmin koko tietoyhteiskuntakehitys antavat organisaatioiden kilpailukyvyn tehostamiseen. Keskeistä on luoda edellytykset tiedon vapaalle virralle, verkostoitumiselle ja innovaatioille unohtamatta kuitenkaan analyysin ja systemaattisten toimintatapojen merkitystä yrityksen toiminnan kokonaisuudessa

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OBJECTIVES: Resuscitation in severe head injury may be detrimental when given with hypotonic fluids. We evaluated the effects of lactated Ringer's solution (sodium 131 mmol/L, 277 mOsm/L) compared with hypertonic saline (sodium 268 mmol/L, 598 mOsm/L) in severely head-injured children over the first 3 days after injury. DESIGN: An open, randomized, and prospective study. SETTING: A 16-bed pediatric intensive care unit (ICU) (level III) at a university children's hospital. PATIENTS: A total of 35 consecutive children with head injury. INTERVENTIONS: Thirty-two children with Glasgow Coma Scores of <8 were randomly assigned to receive either lactated Ringer's solution (group 1) or hypertonic saline (group 2). Routine care was standardized, and included the following: head positioning at 30 degrees; normothermia (96.8 degrees to 98.6 degrees F [36 degrees to 37 degrees C]); analgesia and sedation with morphine (10 to 30 microg/kg/hr), midazolam (0.2 to 0.3 mg/kg/hr), and phenobarbital; volume-controlled ventilation (PaCO2 of 26.3 to 30 torr [3.5 to 4 kPa]); and optimal oxygenation (PaO2 of 90 to 105 torr [12 to 14 kPa], oxygen saturation of >92%, and hematocrit of >0.30). MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure and intracranial pressure (ICP) were monitored continuously and documented hourly and at every intervention. The means of every 4-hr period were calculated and serum sodium concentrations were measured at the same time. An ICP of 15 mm Hg was treated with a predefined sequence of interventions, and complications were documented. There was no difference with respect to age, male/female ratio, or initial Glasgow Coma Score. In both groups, there was an inverse correlation between serum sodium concentration and ICP (group 1: r = -.13, r2 = .02, p < .03; group 2: r = -.29, r2 = .08, p < .001) that disappeared in group 1 and increased in group 2 (group 1: r = -.08, r2 = .01, NS; group 2: r = -.35, r2 =.12, p < .001). Correlation between serum sodium concentration and cerebral perfusion pressure (CPP) became significant in group 2 after 8 hrs of treatment (r = .2, r2 = .04, p = .002). Over time, ICP and CPP did not significantly differ between the groups. However, to keep ICP at <15 mm Hg, group 2 patients required significantly fewer interventions (p < .02). Group 1 patients received less sodium (8.0 +/- 4.5 vs. 11.5 +/- 5.0 mmol/kg/day, p = .05) and more fluid on day 1 (2850 +/- 1480 vs. 2180 +/- 770 mL/m2, p = .05). They also had a higher frequency of acute respiratory distress syndrome (four vs. 0 patients, p = .1) and more than two complications (six vs. 1 patient, p = .09). Group 2 patients had significantly shorter ICU stay times (11.6 +/- 6.1 vs. 8.0 +/- 2.4 days; p = .04) and shorter mechanical ventilation times (9.5 +/- 6.0 vs. 6.9 +/- 2.2 days; p = .1). The survival rate and duration of hospital stay were similar in both groups. CONCLUSIONS: Treatment of severe head injury with hypertonic saline is superior to that treatment with lactated Ringer's solution. An increase in serum sodium concentrations significantly correlates with lower ICP and higher CPP. Children treated with hypertonic saline require fewer interventions, have fewer complications, and stay a shorter time in the ICU.

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Lobbying by companies and the management techniques of lobbying have been fairly unknown territory. This study explains different theories related to lobbying including major political, economic and mathematical theories and their connections to lobbying. Existing lobbying networks in the European Union, especially at the European Union level, are explained. Lobbying organisations in the European Union are interconnected. Networks start at a local level, and have connections to national, European Union, international and sometimes to the global level. Relationships between business strategy and lobbying are studied with emphasis on issues management. Business strategy is often seen stemming from business environment analysis and stakeholder management. The issues management concept bridges aspects of business environment analysis and stakeholder management into a project type of management approach. The study includes two different empirical parts. A sample of public policy managers representing the European chemical industry was interviewed, and a chemical industry specific lobbying framework was built. This framework was then tested using a questionnaire sent to European public issues managers representing some of the largest European companies. Based on the results of the questionnaire, a generic framework on how large, European companies manage lobbying in general terms was developed.

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We study general models of holographic superconductivity parametrized by four arbitrary functions of a neutral scalar field of the bulk theory. The models can accommodate several features of real superconductors, like arbitrary critical temperatures and critical exponents in a certain range, and perhaps impurities or boundary or thickness effects. We find analytical expressions for the critical exponents of the general model and show that they satisfy the Rushbrooke identity. An important subclass of models exhibit second order phase transitions. A study of the specific heat shows that general models can also describe holographic superconductors undergoing first, second and third (or higher) order phase transitions. We discuss how small deformations of the HHH model can lead to the appearance of resonance peaks in the conductivity, which increase in number and become narrower as the temperature is gradually decreased, without the need for tuning mass of the scalar to be close to the Breitenlohner-Freedman bound. Finally, we investigate the inclusion of a generalized ¿theta term¿ producing Hall effect without magnetic field.

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The most general black M5-brane solution of eleven-dimensional supergravity (with a flat R4 spacetime in the brane and a regular horizon) is characterized by charge, mass and two angular momenta. We use this metric to construct general dual models of large-N QCD (at strong coupling) that depend on two free parameters. The mass spectrum of scalar particles is determined analytically (in the WKB approximation) and numerically in the whole two-dimensional parameter space. We compare the mass spectrum with analogous results from lattice calculations, and find that the supergravity predictions are close to the lattice results everywhere on the two dimensional parameter space except along a special line. We also examine the mass spectrum of the supergravity Kaluza-Klein (KK) modes and find that the KK modes along the compact D-brane coordinate decouple from the spectrum for large angular momenta. There are however KK modes charged under a U(1)×U(1) global symmetry which do not decouple anywhere on the parameter space. General formulas for the string tension and action are also given.

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Current standard treatments for metastatic colorectal cancer (CRC) are based on combination regimens with one of the two chemotherapeutic drugs, irinotecan or oxaliplatin. However, drug resistance frequently limits the clinical efficacy of these therapies. In order to gain new insights into mechanisms associated with chemoresistance, and departing from three distinct CRC cell models, we generated a panel of human colorectal cancer cell lines with acquired resistance to either oxaliplatin or irinotecan. We characterized the resistant cell line variants with regards to their drug resistance profile and transcriptome, and matched our results with datasets generated from relevant clinical material to derive putative resistance biomarkers. We found that the chemoresistant cell line variants had distinctive irinotecan- or oxaliplatin-specific resistance profiles, with non-reciprocal cross-resistance. Furthermore, we could identify several new, as well as some previously described, drug resistance-associated genes for each resistant cell line variant. Each chemoresistant cell line variant acquired a unique set of changes that may represent distinct functional subtypes of chemotherapy resistance. In addition, and given the potential implications for selection of subsequent treatment, we also performed an exploratory analysis, in relevant patient cohorts, of the predictive value of each of the specific genes identified in our cellular models.

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UOC

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UOC

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BACKGROUND: Frequent emergency department users represent a small number of patients but account for a large number of emergency department visits. They should be a focus because they are often vulnerable patients with many risk factors affecting their quality of life (QoL). Case management interventions have resulted in a significant decrease in emergency department visits, but association with QoL has not been assessed. One aim of our study was to examine to what extent an interdisciplinary case management intervention, compared to standard emergency care, improved frequent emergency department users' QoL. METHODS: Data are part of a randomized, controlled trial designed to improve frequent emergency department users' QoL and use of health-care resources at the Lausanne University Hospital, Switzerland. In total, 250 frequent emergency department users (≥5 attendances during the previous 12 months; ≥ 18 years of age) were interviewed between May 2012 and July 2013. Following an assessment focused on social characteristics; social, mental, and somatic determinants of health; risk behaviors; health care use; and QoL, participants were randomly assigned to the control or the intervention group (n=125 in each group). The final sample included 194 participants (20 deaths, 36 dropouts, n=96 in the intervention group, n=99 in the control group). Participants in the intervention group received a case management intervention by an interdisciplinary, mobile team in addition to standard emergency care. The case management intervention involved four nurses and a physician who provided counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system.

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Tutkielma tarkastelee vapaa alue konseptia osana yritysten kansainvälistä toimitusketjua. Tarkoituksena on löytää keinoja, millä tavoin vapaa alueen houkuttelevuutta voidaan lisätä yritysten näkökulmasta ja millaista liiketoimintaa yritysten on vapaa alueella mahdollista harjoittaa. Tutkielmassa etsitään tekijöitä, jotka vaikuttavat vapaa alueen menestykseen ja jotka voisivat olla sovellettavissa Kaakkois-Suomen ja Venäjän raja-alueelle ottaen huomioon vallitsevat olosuhteet ja lainsäädäntö rajoittavina tekijöinä. Menestystekijöitä ja liiketoimintamalleja haetaan tutkimalla ja analysoimalla lyhyesti muutamia olemassa olevia ja toimivia vapaa alueita. EU tullilain harmonisointi ja kansainvälisen kaupan vapautuminen vähentää vapaa alueen perinteistä merkitystä tullivapaana alueena. Sen sijaan vapaa alueet toimivat yhä enenevissä määrin logistisina keskuksina kansainvälisessä kaupassa ja tarjoavat palveluita, joiden avulla yritykset voivat parantaa logistista kilpailukykyään. Verkostoituminen, satelliitti-ratkaisut ja yhteistoiminta ovat keinoja, millä Kaakkois-Suomen alueen eri logistiikkapalvelujen tarjoajat voivat parantaa suorituskykyään ja joustavuutta kansainvälisessä toimitusketjussa.

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Tuotekehityksestä ja sen johtamisesta on tullut erittäin tärkeä osa tietoliikenneteollisuutta. Jatkuva teknologinen kehitys ja lyhentyneet tuotteiden elinkaaret ovat saaneet yritykset panostamaan tuotekehitysprosesseihin ja johtamiseen. Erityisesti nopeatempoiset ja lyhytkestoiset projektit onkin koettu ongelmallisiksi. Diplomityön tavoitteena oli tutkia teoriassa uusien tuotteiden tuotekehitystä, tuotekehitysprosesseja sekä projektijohtamista. Käytännön osuudessa oli tavoitteena kehittää kokeellinen tuotekehitysmalli nopeatempoisten ja lyhytkestoisten tuotekehitysprojektien tarpeisiin muuttuvissa ja epävarmoissa olosuhteissa. Tavoitteena oli myös käyttää ja analysoida kehitettyä kokeellista tuotekehitysmallia lyhytkestoisen tuotekehitysprojektin yhteydessä. Työn tuloksena saatiin ohjelmistotuote vaadituilla ominaisuuksilla vaaditussa ajassa ja todettiin projektissa käytetyn kokeellisen tuotekehitysmallin osoittautuneen toimivaksi. Jatkotutkimuksia tarvitaan selvittämään mallin sopivuutta ja sen kehityskohteita erilaisten tuotekehitysprojektien kohdalla.

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Introduction: Frequent emergency department (ED) users are often vulnerable patients with many risk factors affecting their quality of life (QoL). The aim of this study was to examine to what extent a case management intervention improved frequent ED users' QoL. Methods: Data were part of a randomized, controlled trial designed to improve frequent ED users' QoL at the Lausanne University Hospital. A total of 194 frequent ED users (≥ 5 attendances during the previous 12 months; ≥ 18 years of age) were randomly assigned to the control or the intervention group. Participants in the intervention group received a case management intervention (i.e. counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system). QoL was evaluated using the WHOQOL-BREF at baseline and twelve months later. Four dimensions of QoL were retained: physical health, psychological health, social relationship, and environment, with scores ranging from 0 (low QoL) to 100 (high QoL).