920 resultados para Self-Regulated Strategy Development


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Työn tarkoituksena oli löytää Asiakkuuksienhallintastrategian käyttöönoton ongelmakohtia asiakkuuksienhallintaan erikoistuneen konsulttiyrityksen asiakasyrityksen taholta. Lisäksi työssä etsitään ratkaisuja asiakkuusteorian viemiseksi käytäntöön. Työn anti on asiakkuusstrategian käytäntöön panon ongelmakohtien paikallistaminen, prosessin vaiheiden kuvaaminen sekä asiakkuuksienhallinnan tutkiminen lähtökohtana asiakkaalle tuotettu arvo. Asiakkuusstrategian implementoinnin ongelmakohtien ja kriittisten menestystekijöiden kuvaus ja vertailu käsitellään empiirisessä osassa suhteuttaen teoriaosuuden materiaaliin. CRM Group:n kannalta työ mahdollistaa osaltaan asiakasprojektien kehitystyön.Kirjallisuusosan pohjalta implementoinnin kannalta kriittisiksi menestystekijöiksi nousivat tietoteknisten ratkaisujen sulauttaminen osaksi asiakkuusstrategiaa tukevia toimintoja, aidon synergian löytäminen asiakas – toimittaja –suhteeseen sekä asiakkuusstrategiaa kehittävän organisaation sisäinen resursointi ja henkilöstön sitouttaminen.

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Tele- ja dataviestinnän yhdistyminen digitaaliseen sisältöön luo uusia palveluideoita sekä mobiili- että internetverkkoihin. Nämä palvelut kehitetään usein erikseen, jolloin saman sisällön käyttäminen eri pääsymenetelmin ei ole mahdollista. Sisältömuunnos on mahdollista sisällön ja muotoilun eriyttämisellä, joka puolestaan vaatii informaatioyksiköiden merkkauksen sisältöä kuvaavilla lisätiedoilla. Tässä diplomityössä tutkitaan Extensible Markup Languagen (XML) käyttöä yhdistyneiden palvelujen sisältömuunnoksessa. Nykyisiä ja tulevia palveluita ja verkkoja tarkastellaan sekä sisällön että liiketoiminnan kannalta. Lisäksi esitellään lyhyesti omia ajatuksia ja käsityksiä yhdistyneistä palveluista ja informaation täsmällisyydestä. Työn käytännön osuudessa kuvataan itse suunniteltu palvelualusta sekä esitellään sen avulla rakennettuja sovelluksia

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NlmCategory="UNASSIGNED">This Perspective discusses the pertinence of variable dosing regimens with anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (nAMD) with regard to real-life requirements. After the initial pivotal trials of anti-VEGF therapy, the variable dosing regimens pro re nata (PRN), Treat-and-Extend, and Observe-and-Plan, a recently introduced regimen, aimed to optimize the anti-VEGF treatment strategy for nAMD. The PRN regimen showed good visual results but requires monthly monitoring visits and can therefore be difficult to implement. Moreover, application of the PRN regimen revealed inferior results in real-life circumstances due to problems with resource allocation. The Treat-and-Extend regimen uses an interval based approach and has become widely accepted for its ease of preplanning and the reduced number of office visits required. The parallel development of the Observe-and-Plan regimen demonstrated that the future need for retreatment (interval) could be reliably predicted. Studies investigating the observe-and-plan regimen also showed that this could be used in individualized fixed treatment plans, allowing for dramatically reduced clinical burden and good outcomes, thus meeting the real life requirements. This progressive development of variable dosing regimens is a response to the real-life circumstances of limited human, technical, and financial resources. This includes an individualized treatment approach, optimization of the number of retreatments, a minimal number of monitoring visits, and ease of planning ahead. The Observe-and-Plan regimen achieves this goal with good functional results. Translational Relevance: This perspective reviews the process from the pivotal clinical trials to the development of treatment regimens which are adjusted to real life requirements. The article discusses this translational process which- although not the classical interpretation of translation from fundamental to clinical research, but a subsequent process after the pivotal clinical trials - represents an important translational step from the clinical proof of efficacy to optimization in terms of patients' and clinics' needs. The related scientific procedure includes the exploration of the concept, evaluation of security, and finally proof of efficacy.

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The protozoan Leishmania mexicana parasite causes chronic non-healing cutaneous lesions in humans and mice with poor parasite control. The mechanisms preventing the development of a protective immune response against this parasite are unclear. Here we provide data demonstrating that parasite sequestration by neutrophils is responsible for disease progression in mice. Within hours of infection L. mexicana induced the local recruitment of neutrophils, which ingested parasites and formed extracellular traps without markedly impairing parasite survival. We further showed that the L. mexicana-induced recruitment of neutrophils impaired the early recruitment of dendritic cells at the site of infection as observed by intravital 2-photon microscopy and flow cytometry analysis. Indeed, infection of neutropenic Genista mice and of mice depleted of neutrophils at the onset of infection demonstrated a prominent role for neutrophils in this process. Furthermore, an increase in monocyte-derived dendritic cells was also observed in draining lymph nodes of neutropenic mice, correlating with subsequent increased frequency of IFNγ-secreting T helper cells, and better parasite control leading ultimately to complete healing of the lesion. Altogether, these findings show that L. mexicana exploits neutrophils to block the induction of a protective immune response and impairs the control of lesion development. Our data thus demonstrate an unanticipated negative role for these innate immune cells in host defense, suggesting that in certain forms of cutaneous leishmaniasis, regulating neutrophil recruitment could be a strategy to promote lesion healing.

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Adipose tissue (AT) is distributed as large differentiated masses, and smaller depots covering vessels, and organs, as well as interspersed within them. The differences between types and size of cells makes AT one of the most disperse and complex organs. Lipid storage is partly shared by other tissues such as muscle and liver. We intended to obtain an approximate estimation of the size of lipid reserves stored outside the main fat depots. Both male and female rats were made overweight by 4-weeks feeding of a cafeteria diet. Total lipid content was analyzed in brain, liver, gastrocnemius muscle, four white AT sites: subcutaneous, perigonadal, retroperitoneal and mesenteric, two brown AT sites (interscapular and perirenal) and in a pool of the rest of organs and tissues (after discarding gut contents). Organ lipid content was estimated and tabulated for each individual rat. Food intake was measured daily. There was a surprisingly high proportion of lipid not accounted for by the main macroscopic AT sites, even when brain, liver and BAT main sites were discounted. Muscle contained about 8% of body lipids, liver 1-1.4%, four white AT sites lipid 28-63% of body lipid, and the rest of the body (including muscle) 38-44%. There was a good correlation between AT lipid and body lipid, but lipid in"other organs" was highly correlated too with body lipid. Brain lipid was not. Irrespective of dietary intake, accumulation of body fat was uniform both for the main lipid storage and handling organs: large masses of AT (but also liver, muscle), as well as in the"rest" of tissues. These storage sites, in specialized (adipose) or not-specialized (liver, muscle) tissues reacted in parallel against a hyperlipidic diet challenge. We postulate that body lipid stores are handled and regulated coordinately, with a more centralized and overall mechanisms than usually assumed.

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INTRODUCTION: Congenital hypogonadotropic hypogonadism (CHH) is a rare, genetic, reproductive endocrine disorder characterized by absent puberty and infertility. Limited information is available on the psychosocial impact of CHH and psychosexual development in these patients. AIM: The aim of this study was to determine the impact of CHH on psychosexual development in men on long-term treatment. METHODS: A sequential mixed methods explanatory design was used. First, an online survey (quantitative) was used to quantify the frequency of psychosexual problems among CHH men. Second, patient focus groups (qualitative) were conducted to explore survey findings in detail and develop a working model to guide potential nursing and interdisciplinary interventions. MAIN OUTCOME MEASURES: Patient characteristics, frequency of body shame, difficulty with intimate relationships, and never having been sexually active were assessed. Additionally, we collected subjective patient-reported outcomes regarding the impact of CHH on psychological/emotional well-being, intimate relationships, and sexual activity. RESULTS: A total of 101 CHH men on long-term treatment (>1 year) were included for the analysis of the online survey (mean age 37 ± 11 years, range 19-66, median 36). Half (52/101, 51%) of the men had been seen at a specialized academic center and 37/101 (37%) reported having had fertility-inducing treatment. A high percentage of CHH men experience psychosexual problems including difficulty with intimate relationships (70%) and body image concerns/body shame (94/101, 93%), and the percentage of men never having been sexually active is five times the rate in a reference group (26% vs. 5.4%, P < 0.001). Focus groups revealed persisting body shame and low self-esteem despite long-term treatment that has lasting impact on psychosexual functioning. CONCLUSIONS: CHH men frequently experience psychosexual problems that pose barriers to intimate relationships and initiating sexual activity. These lingering effects cause significant distress and are not ameliorated by long-term treatment. Psychosexual assessment in CHH men with appropriate psychological support and treatment should be warranted in these patients. Dwyer AA, Quinton R, Pitteloud N, and Morin D. Psychosexual development in men with congenital hypogonadotropic hypogonadism on long-term treatment: A mixed methods study. Sex Med 2015;3:32-41.

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Sääntelyn poistuminen ja kilpailun vapautuminen ovat aiheuttaneet huomattavan toimintaympäristön muuttumisen pohjoismaisilla sähkömarkkinoilla. Pohjoismaiset sähkömarkkinalakiuudistukset poistivat muodolliset kilpailun esteet mahdollistaen näin sekä kansallisten että yhteispohjoismaisten aktiivisten sähkömarkkinoiden muodostumisen. Toimintaympäristön muuttuminen säännellystä sähkönhuoltojärjestelmästä vapaan kilpailun sähkömarkkinoiksi altisti markkinaosapuolet riskeille, joita toimialalla ei aiemmin ollut esiintynyt. Aiemmin toiminnassa esiintyneet riskit kyettiin siirtämään suoraan asiakkaille, mikä kilpaillussa toimintaympäristössä ei enää ollut samalla tavalla mahdollista. Näin uudessa toimintaympäristössä menestymisen edellytykseksi tuli aktiivinen sähkömarkkinoiden seuraaminen ja organisoitu sähkökaupan riskienhallinta. Tässä tutkimuksessa tarkastellaan riskienhallinnan toteuttamista vastapainetuotantoa omaavassa sähköyhtiössä. Liiketoimintaa uhkaavaa markkinariskiä on käsitelty tutkimuksessa taloudellisena riskinä, joka aiheutuu mistä tahansa arvon muutoksesta sähkömarkkinoilla. Sähkömarkkinoilla suurimpana riskitekijänä voidaan pitää epävarmuutta tulevasta sähkön hintatasosta, joka toteutuu aina joko lyhytaikaisena kassavirtariskinä tai pitkäaikaisena kustannusriskinä. Tuotantoa omaavan sähköyhtiön sähkökaupankäyntiin liittyy sekä toimintaa sitovia velvoitteita että myös joustavan toiminnan mahdollisuuksia. Toimitusvelvollista sähkön hankintaa ja myyntiä omaavan yhtiön sähkökaupankäyntiä rajoittaa toimitusten kiinteähintaisuus sähkön markkinahinnan vaihdellessa huomattavasti. Toisaalta kiinteähintainen sähköntoimitus toimii hintasuojauksena sähkön markkinahintaa vastaan. Tällöin keskeinen epävarmuus sähkökaupankäynnissä liittyy lyhyen ja pitkän aikavälin hintasuojauksen tasapainottamiseen ja siten hinnan vaihtelulle alttiina olevan avoimen position sulkemistason ja ajankohdan valintaan. Riskienhallinnassa ei tule pyrkiä riskien eliminoimiseen, vaan niiden sopeuttamiseen liiketoiminnan tuotto-odotuksen ja riskinsietokyvyn mukaisiksi. Keskeinen riskienhallinnan vaatimus on riskeille altistumisen mallintaminen. Tutkimuksessa määritettiin tuotantopainotteisen energiayhtiön sähkökaupankäynnille riskienhallinnan toimintaohjeistus ja ehdotettiin toimintamallia sen toteuttamiseksi. Riskipolitiikan keskeisin sisältö on määrittää riskinsietokyky liiketoiminnalle sekä toimintavaltuudet ja -puitteet operatiiviselle riskienhallinnalle. Toimintavaltuuksien ja -limiittien tehtävänä on estää riskinsietokyvyn ylittyminen. Toiminnan seuraamisen selkeyden ja läpinäkyvyyden varmistamiseksi toimintamallissa tulee olla määritettynä vastuiden eriyttäminen sekä yksityiskohtainen valvonnan ja raportoinnin toteuttaminen. Kasvanut riskienhallinnan tarve on lisännyt myös palvelun tarjontaa sähkömarkkinoilla. Sähkömarkkinoille on tullut uusia riskienhallintaan erikoistuneita toimijoita, jotka tarjoavat osaamiseensa liittyviä palveluita sekä mallintamis- ja hallintatyökaluja. Tällöin keskeinen sähkökaupan riskienhallinnan toimintamallin toteuttamiseen liittyvä valinta tulee tehdä ulkoistamisen ja omatoimisuuden välillä yrityksen omiin voimavaroihin ja strategisiin tavoitteisiin perustuen. Pieni resurssisessa ja liikevaihtoisessa sähkökaupankäynnissä ei tule pyrkiä kaikkien riskienhallinnan osaamisalueiden omatoimiseen hallintaan. Tutkimuksen perusteella tuotantopainotteisen sähköyhtiön kaupankäyntivolyymin ollessa pieni ja liiketoimintastrategian keskittyessä suojaustoimintaan pääosa sen riskienhallinnan osa-alueista kyetään hoitamaan kustannustehokkaasti ja luotettavasti omatoimisesti. Riskienhallinnan kehittäminen on jatkuva prosessi ja siten riskienhallinnan toimintamalli tulee mukauttaa niin liiketoimintastrategian kuin myös liiketoimintaympäristön muutoksiin.

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Tämän diplomityön tarkoituksena on parantaa Timberjackin ja Timberjackin toimittajien välistä yhteistyötä ja saattaa Timberjackin toimintatavat toimittajien tietoisuuteen. Aiheen laajuuden vuoksi yksittäisten aihepiirien syvällinen tutkiminen jäi vähäiseksi. Monet globaalit yhtiöt ovat nykyisin ottaneet selkeäksi strategiakseen toimintojensa ulkoistamisen ja tällöin yhtiölle itselleen jää ainoastaan lopputuotteiden kokoonpanon työvaiheet. Tämä tarkoittaa, että ulkoisilta toimittajilta ostetaan entistä enemmän komponentteja ja tuotekokonaisuuksia. Toisaalta taas harvalla toimittajalla on vielä tarvittavaa tieto-taitoa tai resursseja vastata päämiehen lisääntyviin tarpeisiin. Tämä on syy miksi suuret maailmanluokan yhtiöt panostavat nykyisin huomattavia voimavaroja toimittajaketjun kehittämiseen. Diplomityön ensimmäisessä osiossa paneudutaan teoria-asioihin, jotka tulee olla tiedossa kehitettäessä yhteistyötä toimittajien kanssa. Toisessa osassa tutkitaan Timberjackin toimintatapoja, tuotantomallia ja nykyisiä toimittajia. Nämä tiedot ovat välttämättömiä, kun luodaan kokonaiskuvaa toimittajaprosessista ja kun kehitetään uusia työkaluja helpottamaan toimittajien ja Timberjackin välistä yhteistyötä. Työn tuloksena Timberjackilla on nyt toimittajakäsikirja, joka sisältää tietoja, jotka toimittajien tulee huomioida toimiessaan Timberjackin kanssa ja myös ohjeita siitä, kuinka toimittajat voivat kehittää omia prosessejaan.

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Terminal differentiation of B cells depends on two interconnected survival pathways, elicited by the B-cell receptor (BCR) and the BAFF receptor (BAFF-R), respectively. Loss of either signaling pathway arrests B-cell development. Although BCR-dependent survival depends mainly on the activation of the v-AKT murine thymoma viral oncogene homolog 1 (AKT)/PI3-kinase network, BAFF/BAFF-R-mediated survival engages non-canonical NF-κB signaling as well as MAPK/extracellular-signal regulated kinase and AKT/PI3-kinase modules to allow proper B-cell development. Plasma cell survival, however, is independent of BAFF-R and regulated by APRIL that signals NF-κB activation via alternative receptors, that is, transmembrane activator and CAML interactor (TACI) or B-cell maturation (BCMA). All these complex signaling events are believed to secure survival by increased expression of anti-apoptotic B-cell lymphoma 2 (Bcl2) family proteins in developing and mature B cells. Curiously, how lack of BAFF- or APRIL-mediated signaling triggers B-cell apoptosis remains largely unexplored. Here, we show that two pro-apoptotic members of the 'Bcl2 homology domain 3-only' subgroup of the Bcl2 family, Bcl2 interacting mediator of cell death (Bim) and Bcl2 modifying factor (Bmf), mediate apoptosis in the context of TACI-Ig overexpression that effectively neutralizes BAFF as well as APRIL. Surprisingly, although Bcl2 overexpression triggers B-cell hyperplasia exceeding the one observed in Bim(-/-)Bmf(-/-) mice, Bcl2 transgenic B cells remain susceptible to the effects of TACI-Ig expression in vivo, leading to ameliorated pathology in Vav-Bcl2 transgenic mice. Together, our findings shed new light on the molecular machinery restricting B-cell survival during development, normal homeostasis and under pathological conditions. Our data further suggest that Bcl2 antagonists might improve the potency of BAFF/APRIL-depletion strategies in B-cell-driven pathologies.

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Tutkielman tavoitteena on tutkia kansainvälisen liiketoimintastrategian kehittämiseen liittyviä osa-alueita ja tarjota ehdotuksia Kemira Agro Oy:lle liiketoimintastrategian kehittämiseksi. Tutkielman teoreettisessa osassa analysoidaan liiketoimintastrategian osa-alueita. Tutkielman empiirisessä osassa liiketoimintastrategian osa-alueet analysoidaan Kemira Agro Oy:n Kiinan liiketoimintastrategian kannalta ja esitetään ehdotuksia liiketoimintastrategian kehittämiseksi. Tutkielma on normatiivinen case-tutkimus. Tutkielma on jaettu teoreettiseen ja empiiriseen osaan. Empiirisessä osassa tutkimuskohteina on Suomessa tehdyt vapaamuotoiset haastattelut ja Kiinassa puoli-strukturoituina toteutetut haastattelut. Tutkimus määrittää Kiinan vaikeaksi markkina-alueeksi, joka kuitenkin tarjoaa suuria kasvumahdollisuuksia. Tutkielman tutkimustuloksissa ehdotetaan markkinointitoimenpiteiden lisäämistä sekä tutkimaan mahdollisuutta oman jakelukanavan luomiseen ja tuotevalikoiman laajentamiseen sekä korostetaan segmentoinnin tärkeyttä.

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The main objective of this dissertation is to create new knowledge on an administrative innovation, its adoption, diffusion and finally its effectiveness. In this dissertation the administrative innovation is approached through a widely utilized management philosophy, namely the total quality management (TQM) strategy. TQM operationalizes a self-assessment procedure, which is based on continual improvement principles and measuring the improvements. This dissertation also captures the theme of change management as it analyzes the adoption and diffusion of the administrative innovation. It identifies innovation characteristics as well as organisational and individual factors explaining the adoption and implementation. As a special feature, this study also explores the effectiveness of the innovation based on objective data. For studying the administrative innovation (TQM model), a multinational Case Company provides a versatile ground for a deep, longitudinal analysis. The Case Company started the adoption systematically in the mid 1980s in some of its units. As part of their strategic planning today, the procedure is in use throughout the entire global company. The empirical story begins from the innovation adoption decision that was made in the Case Company over 22 years ago. In order to be able to capture the right atmosphere and backgrounds leading to the adoption decision, key informants from that time were interviewed, since the main target was to clarify the dynamics of how an administrative innovation develops. In addition, archival material was collected and studied, available memos and data relating to the innovation, innovation adoption and later to the implementation contained altogether 20500 pages of documents. A survey was furthermore conducted at the end of 2006 focusing on questions related to the innovation, organization and leadership characteristics and the response rate totalled up to 54%. For measuring the effectiveness of the innovation implementation, the needed longitudinal objective performance data was collected. This data included the profit unit level experience of TQM, the development of the self assessment scores per profit unit and performance data per profit unit measured with profitability, productivity and customer satisfaction. The data covered the years 1995-2006. As a result, the prerequisites for the successful adoption of an administrative innovation were defined, such as the top management involvement, support of the change agents and effective tools for implementation and measurement. The factors with the greatest effect on the depth of the implementation were the timing of the adoption and formalization. The results also indicated that the TQM model does have an effect on the company performance measured with profitability, productivity and customer satisfaction. Consequently this thesis contributes to the present literature (i) by taking into its scope an administrative innovation and focusing on the whole innovation implementation process, from the adoption, through diffusion until its consequences, (ii) because the studied factors with an effect on the innovation adoption and diffusion are multifaceted and grouped into individual, organizational and environmental factors, and a strong emphasis is put on the role of the individual change agents and (iii) by measuring the depth and consistency of the administrative innovation. This deep analysis was possible due to the availability of longitudinal data with triangulation possibilities.

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Among the various strategies to reduce the incidence of non-communicable diseases reduction of sodium intake in the general population has been recognized as one of the most cost-effective means because of its potential impact on the development of hypertension and cardiovascular diseases. Yet, this strategic health recommendation of the WHO and many other international organizations is far from being universally accepted. Indeed, there are still several unresolved scientific and epidemiological questions that maintain an ongoing debate. Thus what is the adequate low level of sodium intake to recommend to the general population and whether national strategies should be oriented to the overall population or only to higher risk fractions of the population such as salt-sensitive patients are still discussed. In this paper, we shall review the recent results of the literature regarding salt, blood pressure and cardiovascular risk and we present the recommendations recently proposed by a group of experts of Switzerland. The propositions of the participating medical societies are to encourage national health authorities to continue their discussion with the food industry in order to reduce the sodium intake of food products with a target of mean salt intake of 5-6 grams per day in the population. Moreover, all initiatives to increase the information on the effect of salt on health and on the salt content of food are supported.

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This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.

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We address the challenges of treating polarization and covalent interactions in docking by developing a hybrid quantum mechanical/molecular mechanical (QM/MM) scoring function based on the semiempirical self-consistent charge density functional tight-binding (SCC-DFTB) method and the CHARMM force field. To benchmark this scoring function within the EADock DSS docking algorithm, we created a publicly available dataset of high-quality X-ray structures of zinc metalloproteins ( http://www.molecular-modelling.ch/resources.php ). For zinc-bound ligands (226 complexes), the QM/MM scoring yielded a substantially improved success rate compared to the classical scoring function (77.0% vs 61.5%), while, for allosteric ligands (55 complexes), the success rate remained constant (49.1%). The QM/MM scoring significantly improved the detection of correct zinc-binding geometries and improved the docking success rate by more than 20% for several important drug targets. The performance of both the classical and the QM/MM scoring functions compare favorably to the performance of AutoDock4, AutoDock4Zn, and AutoDock Vina.

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In the context of globalized competition among territories, cities, regions and countries have to find new ways to be attractive to companies, investors, tourists and residents. In that perspective, major sports events (such as the Olympic Games or the FIFA World Cup) are often seen as a lever for territorial development. Based on that idea, many sports events hosting strategies have emerged in the 1980s and 1990s. However, the growing competition in the sports events' market and the gigantism of those major events, forced some territories to turn to smaller events. This necessary resize of their strategy raises the question of their capacity to meet the initial objectives, which aim usually at developing the economy and promoting the image of the host destination. This essay sketches out the evolution of a sports events hosting strategy in a city that does not have the resources (either financial, human or in terms of infrastructures) to attract major international sports events. The challenges they have to face and a possible solution based on the event portfolio perspective are discussed through the article.