Customer relationship management (CRM ) : Administración de las relaciones con el cliente

Tesina (Maestro en Informática Administrativa) U.A.N.L.

Compliance measurement-guided medication management programs in hypertension : a systematic review

Objectif principal: Il n’est pas démontré que les interventions visant à maîtriser voire modérer la médicamentation de patients atteints d’hypertension peuvent améliorer leur gestion de la maladie. Cette revue systématique propose d’évaluer les programmes de gestion contrôlée de la médicamentation pour l’hypertension, en s’appuyant sur la mesure de l’observance des traitements par les patients (CMGM). Design: Revue systématique. Sources de données: MEDLINE, EMBASE, CENTRAL, résumés de conférences internationales sur l’hypertension et bibliographies des articles pertinents. Méthodes: Des essais contrôlés randomisés (ECR) et des études observationnelles (EO) ont été évalués par 2 réviseurs indépendants. L’évaluation de la qualité (de ce matériel) a été réalisée avec l’aide de l’outil de Cochrane de mesure du risque de biais, et a été estimée selon une échelle à quatre niveaux de qualité Une synthèse narrative des données a été effectuée en raison de l'hétérogénéité importante des études. Résultats: 13 études (8 ECR, 5 EO) de 2150 patients hypertendus ont été prises en compte. Parmi elles, 5 études de CMGM avec l’utilisation de dispositifs électroniques comme seule intervention ont relevé une diminution de la tension artérielle (TA), qui pourrait cependant être expliquée par les biais de mesure. L’amélioration à court terme de la TA sous CMGM dans les interventions complexes a été révélée dans 4 études à qualité faible ou modérée. Dans 4 autres études sur les soins intégrés de qualité supérieure, il n'a pas été possible de distinguer l'impact de la composante CMGM, celle-ci pouvant être compromise par des traitements médicamenteux. L’ensemble des études semble par ailleurs montrer qu’un feed-back régulier au médecin traitant peut être un élément essentiel d’efficacité des traitements CMGM, et peut être facilement assuré par une infirmière ou un pharmacien, grâce à des outils de communication appropriés. Conclusions: Aucune preuve convaincante de l'efficacité des traitements CMGM comme technologie de la santé n’a été établie en raison de designs non-optimaux des études identifiées et des ualités méthodologiques insatisfaisantes de celles-ci. Les recherches futures devraient : suivre les normes de qualité approuvées et les recommandations cliniques actuelles pour le traitement de l'hypertension, inclure des groupes spécifiques de patients avec des problèmes d’attachement aux traitements, et considérer les résultats cliniques et économiques de l'organisation de soins ainsi que les observations rapportées par les patients.

Follow-up of three large community-based programs to reduce anaemia among children 24-59 months in Ghana, Malawi and Tanzania

L'anémie de l'enfant reste un problème d'importance pour la santé mondiale, malgré les décennies de recherche visant à comprendre son étiologie et à développer des interventions efficaces pour réduire sa prévalence et ses conséquences. Bien que les facteurs de risque individuels de l'anémie soient connus, y compris les facteurs liés à la malnutrition et à la morbidité, l'interaction entre lesdits facteurs est moins documentée dans des contextes où les enfants sont fréquemment exposés à plusieurs facteurs en même temps. Cette étude vise à documenter les efforts de lutte contre l'anémie du programme MICAH qui a été mis en oeuvre au Ghana, au Malawi et en Tanzanie. Ensuite, en utilisant les données relatives à la fois au processus et à l'évaluation colligées au cours du programme, elle vise à mieux comprendre les facteurs de risque d'anémie chez les jeunes enfants dans ces contextes et à comprendre comment les relations entre ces facteurs peuvent avoir changé au fil du temps lors de l'intervention. Spécifiquement, cette étude vérifie s‘il y a des preuves d'une réduction de la vulnérabilité des enfants aux facteurs de risque associés à l'anémie dans chaque contexte. Un examen de la documentation a été réalisé afin de caractériser le contexte du programme et des interventions, leur l'intensité et étendue. Les données transversales sur la nutrition et l'état de santé des enfants âgés de 24 à 59 mois (N = 2405) obtenues en 2000 et 2004 à partir des enquêtes d'évaluation du programme MICAH au Ghana, au Malawi et en Tanzanie, ont été utilisées pour décrire la prévalence de l'anémie. Les modèles polynomiaux de régression logistique et linéaire ont été utilisés pour estimer les risques d'anémie légère et d'anémie modérée / sévère et les niveaux d‘hémoglobine associés à des groupes de variables. Les estimations du risque attribuable à une population (RAP) ont aussi été calculées. Une anémie (Hb <110 g/L) a touché au moins 60% des enfants dans les trois pays; l'anémie modérée / sévère (<100 g/L) constituait la majorité des cas. Une forte diminution de l'anémie a été observée entre 2000 et 2004 au Ghana, mais seulement une légère baisse au Malawi et en Tanzanie. Le risque d'anémie modérée / sévère était associé au retard de croissance chez les enfants du Ghana (OR 2,68, IC 95% 1,70-4,23) et du Malawi (OR 1,71; 1,29-2,27) mais pas de la Tanzanie (OR 1,29; 0,87- 1,92). Le paludisme et les maladies récentes étaient associées à une hémoglobine plus basse. Une atténuation de cette association en 2004 a été observée seulement au Malawi pour le paludisme et au Ghana pour les maladies récentes. Le risque d'anémie modérée / sévère était 44% moindre chez les enfants âgés de 48 à 59 mois comparativement aux enfants de 24 à 35 mois dans les trois pays et cela n'a pas changé entre 2000 et 2004. Les RAP estimés ont montré qu‘environ un cinquième des cas d‘anémie modérée à sévère était attribuable au retard de croissance au Ghana et Malawi, mais pas en Tanzanie. Des RAP moindres et dépendants des contextes ont été trouvés pour le paludisme et les maladies récentes. Dans ces zones d‘intervention intégrées de santé et de nutrition la relation de certains facteurs de risque à l'anémie se modifia avec le temps. Le retard de croissance est resté toutefois un facteur de risque indépendant et non mitigé de l'anémie. Une réduction efficace des causes de la malnutrition chronique est nécessaire afin de réduire la vulnérabilité des enfants et de garantir un impact maximum des programmes de lutte contre l'anémie. Une mitigation de l'impact du paludisme peut par contre être visée dans les régions endémiques.

Insights from youth workers regarding young people's engagement in out-of-school-time youth development programs

L’objectif de cette étude exploratoire était de mieux comprendre, du point de vue des animateurs/animatrices qui oeuvrent auprès des jeunes, le phénomène de l’engagement des jeunes dans les programmes parascolaires. Des entretiens qualitatifs ont été entrepris à cette fin avec six animateur(trices). Plusieurs obstacles à l’engagement ont été identifiés, la plupart étant extérieurs aux jeunes. Quelques actions et attitudes spécifiques des animateur(trices) ont été relevées comme importantes pour aider les jeunes à surmonter ces obstacles. De plus, la structure et le contenu du programme, ainsi que l’environnement de groupe, jouent des rôles primordiaux. Les dimensions soulevées par les animateur(trices) ont permis d’enrichir et rendre plus holistique un modèle d’engagement qui a été développé à partir d’une recension des écrits dans ce domaine. Finalement, les implications pour la formation des animateurs(trices) et pour la structure des programmes pour les jeunes ont été explorées.

The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation

Background: Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential. METHODS: To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations. CONCLUSIONS: In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields.

Internet Banking and Customer Acceptance: The Indian Scenario

Indian economy is witnessing stellar growth over the last few years. There have been rapid developments in infrastructural and business front during the growth period.Internet adoption among Indians has been increasing over the last one decade.Indian banks have also risen to the occasion by offering new channels of delivery to their customers.Internet banking is one such new channel which has become available to Indian customers.Customer acceptance for internet banking has been good so far.In this study the researcher tried to conduct a qualitative and quantitative investigation of internet banking customer acceptance among Indians. The researcher tried to identify important factors that affect customer's behavioral intention for internet banking .The researcher also proposes a research model which has extended from Technology Acceptance Model for predicting internet banking acceptance.The findings of the study would be useful for Indian banks in planning and upgrading their internet banking service.Banks could increase internet banking adoption by making their customer awareness about the usefulness of the service.It is seen that from the study that the variable perceived usefulness has a positive influence on internet banking use,therefore internet banking acceptance would increase when customers find it more usefulness.Banks should plan their marketing campaigns taking into consideration this factor.Proper marketing communications which would increase consumer awareness would result in better acceptance of internet banking.The variable perceived ease of use had a positive influence on internet banking use.That means customers would increase internet banking usage when they find it easier to use.Banks should therefore try to develop their internet banking site and interface easier to use.Banks could also consider providing practical training sessions for customers at their branches on usage of internet banking interface.

Market Orientation in Indian Seafood Processing Firms

This thesis studied the impact of market orietnation on business performance, in the seafood industry, which is a unique situation wherein the firms were all 100% export oriented. The study was able to prove that in the context of the seafood indsutry, implementation of market orientation principles will lead to increase in business performance. The business performance variables were measured under two heads, namely economic performance and non-economic performance. Market orientation in Indian seafood firms was significantly and postiively related to both the performance measures. Under the non-economic performance, were the customer and employee consequences.Again market orientation was positively and significantly related to both the consequences.Thus, the implication arising from the study is this: market orientation in Indian seafood processing firms increases their business performance. The implementation of market orientation will help the seafood firms in gaining competitve advantages in exporting. This in turn will result in increased exports and the position of Indian seafood in the global market will be strengthened. It will thus become a leading player in the global fish trade. Next, the focus was on the effect of the antecedents on the market orientation of a firm. It was seen that several factors were antecedents to the adoption of market orientation principles. They include top management emphasis, conflict, centralization and reward system. It is noted that top management emphasis and support is vital to the market orientation programme. The top management needs to adopt market oriented behaviour and reinforce the need for being market oriented, for it to percolate down the line.Interdepartmental conflict is seen to affect market orientation positively. A large percent of the Indian seafood firms are traditionally family-owned companies, rather than professionally managed firms. This would result in promulgation of old ideas of management whereby, conflict was seen as a healthy exercise, which helped to build up each department's efficiency. But, this view in the long run proves to be detrimental to the firm's performance and must therefore be kept to a bare minimum, if any.Decentralisation of decision making facilitates the participation of the lower level employees and builds up their motivational levels and commitment to the firm. Thus employees are encouraged to make their own decisions, so that they can deal with customers faster and more efficiently. Reward systems help improve an employee's morale, provide encouragement and helps inculcate commitment and loyalty. It improves the employee's self worth and fulfills his need for achievement. A satisfied employee works better, produces more output and needs less supervision, and is happy, thereby reducing costs to the company for replacement and retraining, if the employee quits.Competitive intensity plays a moderating role on the market orientation business performance. Thus in times of greater competition, the relationship between market orientation and business performance grows stronger. Thus, this thesis was successful in investigating a positive relationship between business performance and market orientation.

Queues with Customer Induced Interruption

In this thesis we have introduced and studied the notion of self interruption of service by customers. Service interruption in queueing systems have been extensively discussed in literature (see, Krishnamoorthy, Pramod and Chakravarthy [38]) for the most recent survey. So far all work reported deal with cases in which service interruptions are generated by sources other than customers. However, there are situations where interruptions are due to the customers rather than the system. Such situations are especially arise at doctors clinic, banks, reservation counter etc. Our attempt is to quantify a few of such problems. Systematically we have proceed from single server queue (in Chapter 2) to multi-server queues (Chapter 3). In Chapte 4, we have studied a very general multiserver queueing model with service interruption and protection of service phases. We also introduced customer interruption in a retrial setup (in Chapter 5). All models (from Chapter 2 to Chapter 4) that were analyzed involve 'non-preemptive priority' for interrupted customers where as in the model discussed in Chapter 5 interruption of service by customers is not encouraged. So the interrupted customers cannot access the server as long as there are primary customers in the system. In Chapter 5 we have obtained an explicit expression for the stability condition of the system. In all models analyzed in this thesis, we have assumed that no more than one interruption is allowed for a customer while in service. Since the models are not analytically tractable, a large number of numerical illustrations were given in each chapter it illustrate the working of the systems. We can extend the models discussed in this thesis to several directions. For example some of the models can be analyzed with both server induced and customer induced interruptions the results for which are not available till date. Another possible extension of work is to the case where there is no bound on the number of interruptions a customer is permitted to have before service completion. More complex is the case where a customer is permitted to have a nite number (K ≥ 2) of We can extend the models discussed in this thesis to several directions.

Customer perceptions of Banking Products and Services in Kerala with reference to Specific Customer Segments in the Urban Area

As of 1999. the state of Kerala has 3210 offices of scheduled commercial banks (SCBS). In all, there are 48 commercial banks operating in Kerala, which includes PSBs, OPBs, NPBS. FBs, and Gramin Banks. The urban areas give a complete picture of the competition in the present day banking scenario with the presence of all bank groups. Semi-urban areas of Kerala have 2196 and urban areas have 593 as on March 1995.“ The study focuses on the selected segments ofthe urban customers in Kerala which is capable of giving the finer aspects of variation in customer behaviour in the purchase of banking products and services. Considering the exhaustive nature of such an exercise, all the districts in the state have not been brought under the purview of the study. Instead. three districts with largest volume of business in terms of deposits, advances, and number of offices have been short listed as representative regions for a focused study. The study focuses on the retail customer segment and their perceptions on the various products or services offered to them. Non Resident Indians (NRIs), and Traders and Small—ScaIe Industries segments have also been included in the study with a view to obtain a comparative picture with respect to perception on customer satisfaction and service quality dimensions and bank choice behaviour. The research is hence confined to customer behaviour and the implications for possible strategies for segmentation within the retail segment customers

Modeling of ALFA Programs Using PVS Theorem Prover

In Safety critical software failure can have a high price. Such software should be free of errors before it is put into operation. Application of formal methods in the Software Development Life Cycle helps to ensure that the software for safety critical missions are ultra reliable. PVS theorem prover, a formal method tool, can be used for the formal verification of software in ADA Language for Flight Software Application (ALFA.). This paper describes the modeling of ALFA programs for PVS theorem prover. An ALFA2PVS translator is developed which automatically converts the software in ALFA to PVS specification. By this approach the software can be verified formally with respect to underflow/overflow errors and divide by zero conditions without the actual execution of the code.

Modeling of ALFA Programs Using PVS Theorem Prover

In Safety critical software failure can have a high price. Such software should be free of errors before it is put into operation. Application of formal methods in the Software Development Life Cycle helps to ensure that the software for safety critical missions are ultra reliable. PVS theorem prover, a formal method tool, can be used for the formal verification of software in ADA Language for Flight Software Application (ALFA.). This paper describes the modeling of ALFA programs for PVS theorem prover. An ALFA2PVS translator is developed which automatically converts the software in ALFA to PVS specification. By this approach the software can be verified formally with respect to underflow/overflow errors and divide by zero conditions without the actual execution of the code

Cumulative Approach to Customer Satisfaction with Respect to Compact Segment Car Users

Earlier studies on measurement of customer satisfaction are based on either transaction specific or overall approaches. The transaction specific approach evaluates customer satisfaction with single components in the whole purchase process but the overall satisfaction was based on all the encounters or experiences to the customer throughout the purchase process. Consumers will comment on particular events of their purchase process when asked about transaction-specific satisfaction and they will comment their overall impression and general experiences in overall satisfaction (Bitner & Hubbert 1994) Through a critical review on the literature, it has been identified a new approaches to customer satisfaction, say, cumulative approaches that can be more useful than overall and transaction specific approaches for strategic decision making (Fornell et al 1996). The cumulative approach to customer satisfaction doesn’t study earlier due to the difficulty in operationalization of the concept. But the influencers of customer satisfaction are context specific and the prevailing models doesn’t give the sources of variations in the satisfaction, the importance of cumulative approaches to customer satisfaction has emerges that lights to a new research. The current study has focused to explore the influencers of overall customer satisfaction to form individual elements that can be used to identify the cumulative customer satisfaction.

Das Kontextmarketing im mobilen Customer Relationship Management

Zusammenfassung Mobile Telekommunikationstechnologien verändern den Alltag, ihre Benutzer und die Geschäftswelt. Im Zuge der Mobilität haben die Nutzer von mobilen Übertragungstechnologien ein hohes Kommunikationsbedürfnis in jeglicher Situation entwickelt: Sie wollen überall und jederzeit kommunizieren und informiert sein. Dies ist auch darauf zurückzuführen, dass ein Wandel der Individualisierung – von der Person zur Situation – stattgefunden hat. Im Rahmen der Untersuchung gehen wir auf diese entscheidenden Veränderung ein und analysieren die Potenziale des Kontextmarketing im mobilen Customer Relationship Management anhand der Erringung von Wettbewerbsvorteilen durch Situationsfaktoren. Daneben zeigen wir mögliche Geschäftsmodelle und Wertschöpfungsketten auf. Abgerundet wird die Arbeit durch die Darstellung möglicher personenbezogener, technischer und rechtlicher Restriktionen.