Associations between perceived discrimination and health status among frequent Emergency Department users

Objective: Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users' perceptions of discrimination and to test whether they were associated with increased vulnerability. Methods: In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer's exact tests, Mann-Whitney U-tests)

Validation of French and German versions of a Perceived Neighborhood Social Cohesion questionnaire among young Swiss males, and its relationship with substance use

This study main purpose was the validation of both French and German versions of a Perceived Neighborhood Social Cohesion Questionnaire. The sample group comprised 5065 Swiss men from the "Cohort Study on Substance Use Risk Factors." Multigroup Confirmatory factor analysis showed that a three-factor model fits the data well, which substantiates the generalizability of Perceived Neighborhood Social Cohesion Questionnaire factor structure, regardless of the language. The Perceived Neighborhood Social Cohesion Questionnaire demonstrated excellent homogeneity (α = 95) and split-half reliability (r = .96). The Perceived Neighborhood Social Cohesion Questionnaire was sensitive to community size and participants' financial situation, confirming that it also measures real social conditions. Finally, weak but frequent correlations between Perceived Neighborhood Social Cohesion Questionnaire and alcohol, cigarette, and cannabis dependence were measured.

Governance mode vs. governance fit: Performance implications of make-or-ally choices for product innovation in the worldwide aircraft industry, 1942-2000

We examine the impact of governance mode and governance fit on performance in make-or-ally decisions. We argue that while horizontal collaboration and autonomous governance have direct and countervailing performance implications, the alignment of make-or-ally choices with the focal firm's resource endowment and the activity's resource requirements leads to better performance. Data on the aircraft industry show that relative to aircraft developed autonomously, collaborative aircraft exhibit greater sales but require longer time-to-market. However, governance fit increases unit sales and reduces time-to-market. We contribute to the alliance and economic organization literatures. (Copyright © 2013 John Wiley & Sons, Ltd.)

Brand ideas: narrar historias mediante la vida de la marca. ¿Cómo se generan los conceptos creativos que otorgan significado y forma a las marcas?

El present projecte analitza la creació i el desenvolupament dels conceptes que donen forma a les marques des d'un punt de vista creatiu. El treball proposa l'estudi del concepte de les brand idees com a resposta a l'evolució que han seguit les marques per aconseguir comunicar la seva essència. La finalitat de l'escrit és disseccionar les dues parts principals del procés creatiu d'una marca, les big ideas i les brand ideas, per trobar la forma més adequada de transmetre l'essència de les marques durant un recorregut de diversos anys. Un escenari que ens ensenyarà si aquest procés és tan nou com es creu, si realment les marques apliquen aquestes teories i els diferents elements a tenir en compte per fer créixer una marca des del punt de vista de la comunicació creativa.

Care delivery value chains for ophthalmic clinics in Switzerland

Perceived patient value is often not aligned with the emerging expenses for health care services. In other words, the costs are often supposed as rising faster than the actual value for the patients. This fact is causing major concerns to governments, health plans, and individuals. Attempts to solve the problem have habitually been on the operational effectiveness side: increasing patient volume, minimizing costs, rationing, or closing hospitals, usually resulting in a zero-sum game. Only few approaches come from the strategic positioning side and "competition" among hospitals is still perceived rather as a danger than as a chance to create a positive-sum game and stimulate patient value. In their 2006 book, "Redefining Health Care", the renowned Harvard strategy professor Michael E. Porter and hospital management expert Professor Elizabeth Olmsted Teisberg approach the challenge from the positive-sum perspective: they propose to form Integrated Practice Units (IPUs) and manage hospitals in a modern, patient value oriented way. They argue that creating value-based competition on results should have the same effect on the health care sector like transparency and competition turned other industries with out-dated management models (like recently the inert telecommunication industry) into highly competitive and customer value creating businesses. The objective of this paper is to elaborate Care Delivery Value Chains for Integrated Practice Units in ophthalmic clinics and gather a first feedback from Swiss hospital managers, ophthalmologists, and patients, if such an approach could be a realistic way to improve health care management. First, Porter's definition of competitiveness (distinction between operational effectiveness and strategic positioning) is explained. Then, the Care Delivery Value Chain is introduced as a key element for understanding value-based management, followed by three practice examples for ophthalmic clinics. Finally, recommendations are given how the Care Delivery Value Chain can be managed efficiently and how the obstacles of becoming a patient-oriented organization can be overcome. The conclusion is that increased transparency and value-based competition on results has the potential to change the mindset of hospital managers-which will align patient value with the emerging health care expenses. Early adapters of this management approach will gain a competitive advantage. [Author, p. 6]

Extension and evaluation of JXTA protocols for supporting reliable P2P distributed computing

Peer-reviewed

Liiketoimintatiedon merkitys ja -hallinta yritysjohdon päätöksenteon tukena, case: kunnallinen energiayhtiö

Yritykset toimivat yhä enemmän dynaamisessa ja jatkuvasti muuttuvassa yritysympäristössä, joka asettaa erittäin suuria haasteita yritysjohdolle, tilanteet ovat yhä vaikeammin ennustettavissa ja päätöksenteosta on tullut entistä haasteellisempaa. Nykypäivän kilpailuympäristössä yritykset hakevat kilpailuetua tiedon avulla. Yritysten käytettävissä olevan tiedon määrä on jatkuvassa kasvussa ja oleellisen tiedon erottaminen epäoleellisesta on yhä vaativampaa. Yritystä on vaikea johtaa tehokkaasti, jos yrityksessä ei ole käytössä oikeanlaista tietoa oikeaan aikaan oikeilla ihmisillä. Työn tavoitteena oli tutkia sitä, että millaista informaatiota ja tietoa tulisi kohdeyrityksen johdolla olla nykyhetkellä yrityksen toiminnan ohjaamiseen, suunnitteluun ja päätöksenteon tueksi. Tutkimusta on tarkasteltu johdon laskentatoimen näkökulmasta ja työssä on keskitytty teorian ja empirian pohjalta kohdeyrityksen johdon strategisen päätöksenteon pohjalla olevan oleellisen liiketoimintatiedon kartoittamiseen ja sen hallintaan. Yritysten toimiessa informaatioähky yhteiskunnassa, liiketoimintatiedon hallinnalla voidaan saavuttaa merkittävää kilpailuetua. Liiketoimintatiedon hallinta on käytäntöjä, toimintoja ja prosesseja, joilla yrityksen tärkeää liiketoimintatietoa hankitaan, jalostetaan ja jaetaan sekä liiketoiminnan johtamista että päätöksentekoa varten. Liiketoimintatiedon hallinnan yhtenä tietolähteenä toimii yrityksen sisäinen tietopääoma, joka tehokkaasti yhdisteltynä yrityksen ulkopuoliseen tietoon mahdollistaa yritysjohdolle laadukkaamman ja kokonaisvaltaisemman tiedon saamisen päätöksenteon tueksi. Tutkituissa yrityksissä käytettiin päätöksenteon tukena erittäin paljon taloudellisia tunnuslukuja, ns. kovia mittareita. Hiljaisia ja heikkoja signaaleja pidettiin myös tärkeinä, mutta ongelmana koettiin niiden havaitseminen, keruu ja raportointi. Yrityksen sisältä ja yrityksen ulkopuolelta raportoitavat tiedot tulisi jatkossa kohdistua enemmän tulevaisuuteen kuin menneisyyteen.

Creating Global Competitive Advantage by Global Product Technology Transfers

Globalization is the trend which is realized in all areas in today’s business world. Pressure for cost reduction, changes in market situation and available scale economies have changed business environment more global than ever. To respond to new situation, companies are establishing global strategies. In this thesis, available global competitive advantages in electrical machine industry are studied in context of gaining them by global technology transfers. In theory part, establishing global strategy and competitive advantage is considered with connection to global sourcing and supply chain management. Additionally, market development in 21st century and its impact on global strategies is studied. In practice, global manufacturing is enabled by technology transfer projects. Smooth and fast project implementation enables faster and more flexible production ramp up. By starting the production available competitive advantages can be realized. In this thesis the present situation of technology transfer projects and the risks and advantages related to global manufacturing are analyzed. The analysis of implemented technology transfer projects indicates that project implementation is in good level. For further development of project execution 10 minor suggestions could be presented with two major ones: higher level standardization and development of product information model to support better global manufacturing.

Extension of the impedance field method to the noise analysis of a semiconductor junction: Analytical approach

We present an analytical procedure to perform the local noise analysis of a semiconductor junction when both the drift and diffusive parts of the current are important. The method takes into account space-inhomogeneous and hot-carriers conditions in the framework of the drift-diffusion model, and it can be effectively applied to the local noise analysis of different devices: n+nn+ diodes, Schottky barrier diodes, field-effect transistors, etc., operating under strongly inhomogeneous distributions of the electric field and charge concentration

Extension of the impedance field method to the noise analysis of a semiconductor junction: Analytical approach

We present an analytical procedure to perform the local noise analysis of a semiconductor junction when both the drift and diffusive parts of the current are important. The method takes into account space-inhomogeneous and hot-carriers conditions in the framework of the drift-diffusion model, and it can be effectively applied to the local noise analysis of different devices: n+nn+ diodes, Schottky barrier diodes, field-effect transistors, etc., operating under strongly inhomogeneous distributions of the electric field and charge concentration

O Quadrante de Ruetsap e a anti-ciência, tecnologia e inovação

The concept of research and the controversy among classical models for C, T & I, outdated by the development of knowledge and Post-modern society needs were revisited through the (3) Quadrants advanced by Donald Stokes in the mid-nineties. The scientific community to fit into these Quadrants was faced with many difficulties and reacted by issuing pseudo-facts, accepted by under-prepared technocrats as viable justifications for conducting research in face of these new paradigms. In a poor country full of contrast and needs such as Brazil, this attitude satisfies the bureaucracy and academic elite, but frustrates government and society, that do not get, in the expected measure, the benefits of their commitment with the Teaching, Research and Extension Sectors mainly embedded in the Public University system. An extension, in fact a contradictory approach, to Pasteur's Quadrant, is proposed to characterize this situation: The Syndrome of Ruetsap's Quadrant.

Theoretical background for market emergence framework : Case: Electricity Distribution Industry

Both the competitive environment and the internal structure of an industrial organization are typically included in the processes which describe the strategic management processes of the firm, but less attention has been paid to the interdependence between these views. Therefore, this research focuses on explaining the particular conditions of an industry change, which lead managers to realign the firm in respect of its environment for generating competitive advantage. The research question that directs the development of the theoretical framework is: Why do firms outsource some of their functions? The three general stages of the analysis are related to the following research topics: (i) understanding forces that shape the industry, (ii) estimating the impacts of transforming customer preferences, rivalry, and changing capability bases on the relevance of existing assets and activities, and emergence of new business models, and (iii) developing optional structures for future value chains and understanding general boundaries for market emergence. The defined research setting contributes to the managerial research questions “Why do firms reorganize their value chains?”, “Why and how are decisions made?” Combining Transaction Cost Economics (TCE) and Resource-Based View (RBV) within an integrated framework makes it possible to evaluate the two dimensions of a company’s resources, namely the strategic value and transferability. The final decision of restructuring will be made based on an analysis of the actual business potential of the outsourcing, where benefits and risks are evaluated. The firm focuses on the risk of opportunism, hold-up problems, pricing, and opportunities to reach a complete contract, and finally on the direct benefits and risks for financial performance. The supplier analyzes the business potential of an activity outside the specific customer, the amount of customer-specific investments, the service provider’s competitive position, abilities to revenue gains in generic segments, and long-term dependence on the customer.

On the structure of cooperative and competitive solutions for a generalized assignment game

We study cooperative and competitive solutions for a many- to-many generalization of Shapley and Shubik (1972)'s assignment game. We consider the Core, three other notions of group stability and two al- ternative definitions of competitive equilibrium. We show that (i) each group stable set is closely related with the Core of certain games defined using a proper notion of blocking and (ii) each group stable set contains the set of payoff vectors associated to the two definitions of competitive equilibrium. We also show that all six solutions maintain a strictly nested structure. Moreover, each solution can be identified with a set of ma- trices of (discriminated) prices which indicate how gains from trade are distributed among buyers and sellers. In all cases such matrices arise as solutions of a system of linear inequalities. Hence, all six solutions have the same properties from a structural and computational point of view.

Digital social media: An interactive technology incorporated as a competitive advantage for business

In a more transparent and dynamic world, in which consumers trust other consumers more for advice and recommendations on products and services, the continuity of organizations appears to be associated with socialization, the sharing of interests and the interaction with the audience. This is associated with the incorporation of digital technologies to business, specifically the use of social media. Consequently, it is timely and interesting to explore the phenomenon of virtual socialization, although it is a littlestudied field and what is needed is an innovative and theoretical approach based upon theories of marketing and communication. Expertise in these areas is present in all organizations and their performance is important for appropriate development of them. This work is a qualitative analysis about the behavior, reactions and attitudes of individuals to organizations, in order to understand the social factors that contribute to sustainable competitive advantages of organizations which can support strategic and future actions. We conclude that relevant factors associated with the tacit knowledge of the organization, specifically to learning and social interaction of the organization and their knowledge of virtual communities. The higher the coexistence of factors, the more difficult is the replication and greater will be the hypothesis of sustainable competitive advantage.