820 resultados para Management by objectives.
Resumo:
The Centre for Development and Environment (CDE) has been contracted by the World Bank Group to conduct a program on capacity development in use of geospatial tools for natural resource management in Tajikistan. The program aimed to help improving natural resource management by fostering the use of geospatial tools among governmental and non-governmental institutions in Tajikistan. For this purpose a database including a Geographic Information System (GIS) has been prepared, which combines spatial data on various sectors for case study analysis related to the Community Agriculture and Watershed Management Project (CAWMP). The inception report is based on the findings resulting from the Swiss Consultant Trust Fund (CTF) financed project, specifically on the experiences from the awareness creation and training workshop conducted in Dushanbe in November 2007 and the analysis of historical land degradation trends carried out for the four CAWMP watersheds. Furthermore, also recommendations from the inception mission of CDE to Tajikistan (5-20 August 2007) and the inception report for the Swiss CTF support were considered. The inception report for the BNWPP project (The Bank-Netherlands Water Partnership Program) discusses the following project relevant issues: (1) Preliminary list of additional data layers, types of data analysis, and audiences to be covered by BNWPP grant (2) Assessing skills and equipment already available within Tajikistan, and implications for training program and specific equipment procurement plans (3) Updated detailed schedule and plans for all activities to be financed by BNWPP grant, and (4) Proposed list of contents for the final report and web-based presentations.
Resumo:
Viele Länder verankern die Versorgungs- oder Ernährungssicherheit als staatspolitisches Ziel in ihrem Grundgesetz. Neuerdings wird auch das Recht auf Nahrung und auf die Erfüllung weiterer Grundbedürfnisse aufgeführt. Das Schweizer Parlament hat darüber hinaus sogar den Grundsatz der Ernährungssouveränität im Landwirtschaftsgesetz verankert. Die zur Förderung dieser Ziele genannten Aufgaben und Eingriffsrechte des Staates sind jeweils unterschiedlich und unterschiedlich präzise formuliert. Dabei gibt es für jedes Land eigentlich nur zwei Möglichkeiten zur Ernährung: Inlandproduktion und Einfuhr. Eine zusätzliche Option ist die Bildung von Nahrungsmittelreserven zur Überbrückung von Versorgungsengpässen. Die Schweiz benützt und fördert alle drei Möglichkeiten zu ihrer Ernährungssicherheit, im Wesentlichen mit vier Politiken: Versorgungs-, Aussenwirtschafts-, Agrar- und Entwicklungspolitik. Bei Störungen sollen die durch Grenzabgaben finanzierten Pflichtlager während rund sechs Monaten die Inlandnachfrage sichern. Die Optimierung und die Abstimmung unter den verschiedenen Sektorpolitiken, welche unter Berücksichtigung der internationalen Rahmenbedingungen eine grösstmögliche Ernährungssicherheit herbeiführen, gehört zu den Kernaufgaben jedes Staates. Die Umsetzung der genannten Sektorpolitiken ist jedoch in der Praxis nicht immer kohärent, geschweige denn konfliktfrei. Dieser Artikel beschreibt zunächst die internationalen rechtlichen und ökonomischen Parameter für die Schweizer Versorgungspolitik und ihre Beziehung zur Wirtschaftsfreiheit im Allgemeinen, und speziell auf ihre Zweckmässigkeit hinsichtlich der Ernährungssicherheit. Die Analyse der Wechselwirkungen und der Konflikte bei der Umsetzung zeigt, dass die Schweizer Ernährungssicherheitspolitik (food security) in Wirklichkeit eine Politik zur einheimischen Produzentensicherheit ist (farm security). Den Abschluss bilden einige Vorschläge zur Minderung der sektorpolitischen Inkohärenzen und der festgestellten negativen Auswirkungen der Agrarpolitik auf die Schweizer und globale Ernährungssicherheit.
Resumo:
This study analyses the effects that the project management certification has on employability. This analysis started with a participative process in which various groups of experts who are involved in the certification of people were consulted. A personal interview was carried out amongst 106 professionals —certifying bodies, training institutions, the civil service, and international organisations— and amongst professional who are certified in project management by the International Project Management Association in Spain. The results show that the certification emerges as a powerful tool for improving employability. The effects are demonstrated across two complementary aspects: internal company aspects and external aspects relating to the labour market. Finally, by compiling the different agents’ opinions, a series of measures emerge for improving the accreditation processes as an employability tool and increasing the mutual learning between public and private actors.
Resumo:
Con el objetivo de consolidar los conocimientos en Sistemas de Telecomunicación, se pretende diseñar una red para la distribución de servicios avanzados, como televisión, internet de banda ancha y telefonía, mediante el uso de la tecnología FTTH. La red será totalmente pasiva, óptica, y de gran ancho de banda, Tipo PON (Passive Optical Network), de manera que el haz de luz del emisor se distribuye hacia múltiples fibras siguiendo diferentes direcciones, o las confina en el sentido opuesto usando técnicas WDM y TDMA. En primer lugar, es preciso realizar un estudio teórico sobre las características de la fibra óptica, junto con las propiedades de los elementos activos y pasivos que interactúan con ella, para poder comprender la tecnología en la que se basa y así ofrecer una solución final acorde a las necesidades que se presenten. Tras un vistazo general a la tecnología de fibra óptica, se procede a estudiar las características y topologías de las redes de acceso basadas en la misma, junto con los requisitos de cara al diseño de la redes y a la gestión de proyectos. Se definirán los objetivos de la red, ya que la complejidad de la red depende de factores como la extensión y cobertura de la misma, o el ancho de banda. Posteriormente se irá diseñando la red en una arquitectura descendente hasta destinar una única fibra óptica para cada hogar dentro de la cobertura de la red. Se detallarán todas las especificaciones necesarias para definir la red, (potencias, modulaciones y tipos de fibra) así como el instrumental y demás medios necesarios para operar con la misma. Aunque el diseño de una red FTTH contempla muchos más aspectos de los estudiados en el presente proyecto, se tomó como objetivo el diseño y planificación correspondientes a una sección de un área de escasa población donde la instalación se tomó como viable, obviando así pequeños detalles y centrándose en el despliegue de fibra óptica. Se pretende así ofrecer una solución de infraestructura doméstica de telecomunicaciones, apta para las futuras necesidades que implican la creciente demanda de servicios como internet de banda ancha o almacenamiento y procesado de aplicaciones en nube. La fibra óptica tiene mucho que ofrecer a las telecomunicaciones, y cada vez es más frecuente encontrar redes de fibra óptica como parte de un servicio de telecomunicaciones, tanto como para particulares como empresas. ABSTRACT. Aiming to strengthen knowledge in Telecommunications Systems, is intended to design a network for advanced services broadcasting, including digital TV, broadband internet and telephony, by using FTTH technology. This network will be entirely passive optic, and high bandwidth, PON type (Passive Optical Network) so that the transmitter beam is broadcasting to multiple optical fibers, branching out in different ways or joining them in the opposite. First, it is necessary to perform a theoretical study on the characteristics of the optical fiber, along with the properties of the active and passive elements that interact with it, to understand the technology that is based and offer a final solution according needs that arise. After an overview of the optical fiber technology, we proceed to study the characteristics and topologies access networks based on that, together with the requirements to face the network design and project management. System objectives will be determined, since the complexity of the network depends on factors such as the size and scope of it, or bandwidth. Later, the network will be designing in downstream architecture to deliver a single optical fiber to each household within the network area. All necessary specifications to define the network (power, modulation and fiber types) will be determined, as instruments and other means to operate it. Although FTTH network design includes many more aspects of those studied in this project, it was taken as objective the network design and planning corresponding to a section of a sparsely populated area where the facility was taken as feasible thus obviating small details and focus on the deployment of optical fiber. This is intended to provide a solution of household telecommunications infrastructure suitable for future needs involving the growing demand for services such as broadband internet or processing storage and cloud applications. The optical fiber has much to offer to telecommunications, and it is increasingly common to find fiber optic networks as part of a telecommunications service, both to individuals and businesses.
Resumo:
La creciente complejidad, heterogeneidad y dinamismo inherente a las redes de telecomunicaciones, los sistemas distribuidos y los servicios avanzados de información y comunicación emergentes, así como el incremento de su criticidad e importancia estratégica, requieren la adopción de tecnologías cada vez más sofisticadas para su gestión, su coordinación y su integración por parte de los operadores de red, los proveedores de servicio y las empresas, como usuarios finales de los mismos, con el fin de garantizar niveles adecuados de funcionalidad, rendimiento y fiabilidad. Las estrategias de gestión adoptadas tradicionalmente adolecen de seguir modelos excesivamente estáticos y centralizados, con un elevado componente de supervisión y difícilmente escalables. La acuciante necesidad por flexibilizar esta gestión y hacerla a la vez más escalable y robusta, ha provocado en los últimos años un considerable interés por desarrollar nuevos paradigmas basados en modelos jerárquicos y distribuidos, como evolución natural de los primeros modelos jerárquicos débilmente distribuidos que sucedieron al paradigma centralizado. Se crean así nuevos modelos como son los basados en Gestión por Delegación, en el paradigma de código móvil, en las tecnologías de objetos distribuidos y en los servicios web. Estas alternativas se han mostrado enormemente robustas, flexibles y escalables frente a las estrategias tradicionales de gestión, pero continúan sin resolver aún muchos problemas. Las líneas actuales de investigación parten del hecho de que muchos problemas de robustez, escalabilidad y flexibilidad continúan sin ser resueltos por el paradigma jerárquico-distribuido, y abogan por la migración hacia un paradigma cooperativo fuertemente distribuido. Estas líneas tienen su germen en la Inteligencia Artificial Distribuida (DAI) y, más concretamente, en el paradigma de agentes autónomos y en los Sistemas Multi-agente (MAS). Todas ellas se perfilan en torno a un conjunto de objetivos que pueden resumirse en alcanzar un mayor grado de autonomía en la funcionalidad de la gestión y una mayor capacidad de autoconfiguración que resuelva los problemas de escalabilidad y la necesidad de supervisión presentes en los sistemas actuales, evolucionar hacia técnicas de control fuertemente distribuido y cooperativo guiado por la meta y dotar de una mayor riqueza semántica a los modelos de información. Cada vez más investigadores están empezando a utilizar agentes para la gestión de redes y sistemas distribuidos. Sin embargo, los límites establecidos en sus trabajos entre agentes móviles (que siguen el paradigma de código móvil) y agentes autónomos (que realmente siguen el paradigma cooperativo) resultan difusos. Muchos de estos trabajos se centran en la utilización de agentes móviles, lo cual, al igual que ocurría con las técnicas de código móvil comentadas anteriormente, les permite dotar de un mayor componente dinámico al concepto tradicional de Gestión por Delegación. Con ello se consigue flexibilizar la gestión, distribuir la lógica de gestión cerca de los datos y distribuir el control. Sin embargo se permanece en el paradigma jerárquico distribuido. Si bien continúa sin definirse aún una arquitectura de gestión fiel al paradigma cooperativo fuertemente distribuido, estas líneas de investigación han puesto de manifiesto serios problemas de adecuación en los modelos de información, comunicación y organizativo de las arquitecturas de gestión existentes. En este contexto, la tesis presenta un modelo de arquitectura para gestión holónica de sistemas y servicios distribuidos mediante sociedades de agentes autónomos, cuyos objetivos fundamentales son el incremento del grado de automatización asociado a las tareas de gestión, el aumento de la escalabilidad de las soluciones de gestión, soporte para delegación tanto por dominios como por macro-tareas, y un alto grado de interoperabilidad en entornos abiertos. A partir de estos objetivos se ha desarrollado un modelo de información formal de tipo semántico, basado en lógica descriptiva que permite un mayor grado de automatización en la gestión en base a la utilización de agentes autónomos racionales, capaces de razonar, inferir e integrar de forma dinámica conocimiento y servicios conceptualizados mediante el modelo CIM y formalizados a nivel semántico mediante lógica descriptiva. El modelo de información incluye además un “mapping” a nivel de meta-modelo de CIM al lenguaje de especificación de ontologías OWL, que supone un significativo avance en el área de la representación y el intercambio basado en XML de modelos y meta-información. A nivel de interacción, el modelo aporta un lenguaje de especificación formal de conversaciones entre agentes basado en la teoría de actos ilocucionales y aporta una semántica operacional para dicho lenguaje que facilita la labor de verificación de propiedades formales asociadas al protocolo de interacción. Se ha desarrollado también un modelo de organización holónico y orientado a roles cuyas principales características están alineadas con las demandadas por los servicios distribuidos emergentes e incluyen la ausencia de control central, capacidades de reestructuración dinámica, capacidades de cooperación, y facilidades de adaptación a diferentes culturas organizativas. El modelo incluye un submodelo normativo adecuado al carácter autónomo de los holones de gestión y basado en las lógicas modales deontológica y de acción.---ABSTRACT---The growing complexity, heterogeneity and dynamism inherent in telecommunications networks, distributed systems and the emerging advanced information and communication services, as well as their increased criticality and strategic importance, calls for the adoption of increasingly more sophisticated technologies for their management, coordination and integration by network operators, service providers and end-user companies to assure adequate levels of functionality, performance and reliability. The management strategies adopted traditionally follow models that are too static and centralised, have a high supervision component and are difficult to scale. The pressing need to flexibilise management and, at the same time, make it more scalable and robust recently led to a lot of interest in developing new paradigms based on hierarchical and distributed models, as a natural evolution from the first weakly distributed hierarchical models that succeeded the centralised paradigm. Thus new models based on management by delegation, the mobile code paradigm, distributed objects and web services came into being. These alternatives have turned out to be enormously robust, flexible and scalable as compared with the traditional management strategies. However, many problems still remain to be solved. Current research lines assume that the distributed hierarchical paradigm has as yet failed to solve many of the problems related to robustness, scalability and flexibility and advocate migration towards a strongly distributed cooperative paradigm. These lines of research were spawned by Distributed Artificial Intelligence (DAI) and, specifically, the autonomous agent paradigm and Multi-Agent Systems (MAS). They all revolve around a series of objectives, which can be summarised as achieving greater management functionality autonomy and a greater self-configuration capability, which solves the problems of scalability and the need for supervision that plague current systems, evolving towards strongly distributed and goal-driven cooperative control techniques and semantically enhancing information models. More and more researchers are starting to use agents for network and distributed systems management. However, the boundaries established in their work between mobile agents (that follow the mobile code paradigm) and autonomous agents (that really follow the cooperative paradigm) are fuzzy. Many of these approximations focus on the use of mobile agents, which, as was the case with the above-mentioned mobile code techniques, means that they can inject more dynamism into the traditional concept of management by delegation. Accordingly, they are able to flexibilise management, distribute management logic about data and distribute control. However, they remain within the distributed hierarchical paradigm. While a management architecture faithful to the strongly distributed cooperative paradigm has yet to be defined, these lines of research have revealed that the information, communication and organisation models of existing management architectures are far from adequate. In this context, this dissertation presents an architectural model for the holonic management of distributed systems and services through autonomous agent societies. The main objectives of this model are to raise the level of management task automation, increase the scalability of management solutions, provide support for delegation by both domains and macro-tasks and achieve a high level of interoperability in open environments. Bearing in mind these objectives, a descriptive logic-based formal semantic information model has been developed, which increases management automation by using rational autonomous agents capable of reasoning, inferring and dynamically integrating knowledge and services conceptualised by means of the CIM model and formalised at the semantic level by means of descriptive logic. The information model also includes a mapping, at the CIM metamodel level, to the OWL ontology specification language, which amounts to a significant advance in the field of XML-based model and metainformation representation and exchange. At the interaction level, the model introduces a formal specification language (ACSL) of conversations between agents based on speech act theory and contributes an operational semantics for this language that eases the task of verifying formal properties associated with the interaction protocol. A role-oriented holonic organisational model has also been developed, whose main features meet the requirements demanded by emerging distributed services, including no centralised control, dynamic restructuring capabilities, cooperative skills and facilities for adaptation to different organisational cultures. The model includes a normative submodel adapted to management holon autonomy and based on the deontic and action modal logics.
Resumo:
En todo el mundo se ha observado un crecimiento exponencial en la incidencia de enfermedades crónicas como la hipertensión y enfermedades cardiovasculares y respiratorias, así como la diabetes mellitus, que causa un número de muertes cada vez mayor en todo el mundo (Beaglehole et al., 2008). En concreto, la prevalencia de diabetes mellitus (DM) está aumentando de manera considerable en todas las edades y representa un serio problema de salud mundial. La diabetes fue la responsable directa de 1,5 millones de muertes en 2012 y 89 millones de años de vida ajustados por discapacidad (AVAD) (OMS, 2014). Uno de los principales dilemas que suelen asociarse a la gestión de EC es la adherencia de los pacientes a los tratamientos, que representa un aspecto multifactorial que necesita asistencia en lo relativo a: educación, autogestión, interacción entre los pacientes y cuidadores y compromiso de los pacientes. Medir la adherencia del tratamiento es complicado y, aunque se ha hablado ampliamente de ello, aún no hay soluciones “de oro” (Reviews, 2002). El compromiso de los pacientes, a través de la participación, colaboración, negociación y a veces del compromiso firme, aumentan las oportunidades para una terapia óptima en la que los pacientes se responsabilizan de su parte en la ecuación de adherencia. Comprometer e involucrar a los pacientes diabéticos en las decisiones de su tratamiento, junto con expertos profesionales, puede ayudar a favorecer un enfoque centrado en el paciente hacia la atención a la diabetes (Martin et al., 2005). La motivación y atribución de poder de los pacientes son quizás los dos factores interventores más relevantes que afectan directamente a la autogestión de la atención a la diabetes. Se ha demostrado que estos dos factores desempeñan un papel fundamental en la adherencia a la prescripción, así como en el fomento exitoso de un estilo de vida sana y otros cambios de conducta (Heneghan et al., 2013). Un plan de educación personalizada es indispensable para proporcionarle al paciente las herramientas adecuadas que necesita para la autogestión efectiva de la enfermedad (El-Gayar et al. 2013). La comunicación efectiva es fundamental para proporcionar una atención centrada en el paciente puesto que influye en las conductas y actitudes hacia un problema de salud ((Frampton et al. 2008). En este sentido, la interactividad, la frecuencia, la temporalización y la adaptación de los mensajes de texto pueden promover la adherencia a un régimen de medicación. Como consecuencia, adaptar los mensajes de texto a los pacientes puede resultar ser una manera de hacer que las sugerencias y la información sean más relevantes y efectivas (Nundy et al. 2013). En este contexto, las tecnologías móviles en el ámbito de la salud (mHealth) están desempeñando un papel importante al conectar con pacientes para mejorar la adherencia a medicamentos recetados (Krishna et al., 2009). La adaptación de los mensajes de texto específicos de diabetes sigue siendo un área de oportunidad para mejorar la adherencia a la medicación y ofrecer motivación a adultos con diabetes. Sin embargo, se necesita más investigación para entender totalmente su eficacia. Los consejos de texto personalizados han demostrado causar un impacto positivo en la atribución de poder a los pacientes, su autogestión y su adherencia a la prescripción (Gatwood et al., 2014). mHealth se puede utilizar para ofrecer programas de asistencia de autogestión a los pacientes con diabetes y, al mismo tiempo, superar las dificultades técnicas y financieras que supone el tratamiento de la diabetes (Free at al., 2013). El objetivo principal de este trabajo de investigación es demostrar que un marco tecnológico basado en las teorías de cambios de conducta, aplicado al campo de la mHealth, permite una mejora de la adherencia al tratamiento en pacientes diabéticos. Como método de definición de una solución tecnológica, se han adoptado un conjunto de diferentes técnicas de conducta validadas denominado marco de compromiso de retroacción conductual (EBF, por sus siglas en inglés) para formular los mensajes, guiar el contenido y evaluar los resultados. Los estudios incorporan elementos del modelo transteórico (TTM, por sus siglas en inglés), la teoría de la fijación de objetivos (GST, por sus siglas en inglés) y los principios de comunicación sanitaria persuasiva y eficaz. Como concepto general, el modelo TTM ayuda a los pacientes a progresar a su próxima fase de conducta a través de mensajes de texto motivados específicos y permite que el médico identifique la fase actual y adapte sus estrategias individualmente. Además, se adoptan las directrices del TTM para fijar objetivos personalizados a un nivel apropiado a la fase de cambio del paciente. La GST encierra normas que van a ponerse en práctica para promover la intervención educativa y objetivos de pérdida de peso. Finalmente, los principios de comunicación sanitaria persuasiva y eficaz aplicados a la aparición de los mensajes se han puesto en marcha para aumentar la efectividad. El EBF tiene como objetivo ayudar a los pacientes a mejorar su adherencia a la prescripción y encaminarlos a una mejora general en la autogestión de la diabetes mediante mensajes de texto personalizados denominados mensajes de retroacción automáticos (AFM, por sus siglas en inglés). Después de una primera revisión del perfil, consistente en identificar características significativas del paciente basadas en las necesidades de tratamiento, actitudes y conductas de atención sanitaria, el sistema elige los AFM personalizados, los aprueba el médico y al final se transfieren a la interfaz del paciente. Durante el tratamiento, el usuario recopila los datos en dispositivos de monitorización de pacientes (PMD, por sus siglas en inglés) de una serie de dispositivos médicos y registros manuales. Los registros consisten en la toma de medicación, dieta y actividad física y tareas de aprendizaje y control de la medida del metabolismo. El compromiso general del paciente se comprueba al estimar el uso del sistema y la adherencia del tratamiento y el estado de los objetivos del paciente a corto y largo plazo. El módulo de análisis conductual, que consiste en una serie de reglas y ecuaciones, calcula la conducta del paciente. Tras lograr el análisis conductual, el módulo de gestión de AFM actualiza la lista de AFM y la configuración de los envíos. Las actualizaciones incluyen el número, el tipo y la frecuencia de mensajes. Los AFM los revisa periódicamente el médico que también participa en el perfeccionamiento del tratamiento, adaptado a la fase transteórica actual. Los AFM se segmentan en distintas categorías y niveles y los pacientes pueden ajustar la entrega del mensaje de acuerdo con sus necesidades personales. El EBF se ha puesto en marcha integrado dentro del sistema METABO, diseñado para facilitar al paciente diabético que controle sus condiciones relevantes de una manera menos intrusiva. El dispositivo del paciente se vincula en una plataforma móvil, mientras que una interfaz de panel médico permite que los profesionales controlen la evolución del tratamiento. Herramientas específicas posibilitan que los profesionales comprueben la adherencia del paciente y actualicen la gestión de envíos de AFM. El EBF fue probado en un proyecto piloto controlado de manera aleatoria. El principal objetivo era examinar la viabilidad y aceptación del sistema. Los objetivos secundarios eran también la evaluación de la eficacia del sistema en lo referente a la mejora de la adherencia, el control glucémico y la calidad de vida. Se reclutaron participantes de cuatro centros clínicos distintos en Europa. La evaluación del punto de referencia incluía datos demográficos, estado de la diabetes, información del perfil, conocimiento de la diabetes en general, uso de las plataformas TIC, opinión y experiencia con dispositivos electrónicos y adopción de buenas prácticas con la diabetes. La aceptación y eficacia de los criterios de evaluación se aplicaron para valorar el funcionamiento del marco tecnológico. El principal objetivo era la valoración de la eficacia del sistema en lo referente a la mejora de la adherencia. En las pruebas participaron 54 pacientes. 26 fueron asignados al grupo de intervención y equipados con tecnología móvil donde estaba instalado el EBF: 14 pacientes tenían T1DM y 12 tenían T2DM. El grupo de control estaba compuesto por 25 pa cientes que fueron tratados con atención estándar, sin el empleo del EBF. La intervención profesional tanto de los grupos de control como de intervención corrió a cargo de 24 cuidadores, entre los que incluían diabetólogos, nutricionistas y enfermeras. Para evaluar la aceptabilidad del sistema y analizar la satisfacción de los usuarios, a través de LimeSurvey, se creó una encuesta multilingüe tanto para los pacientes como para los profesionales. Los resultados también se recopilaron de los archivos de registro generados en los PMD, el panel médico profesional y las entradas de la base de datos. Los mensajes enviados hacia y desde el EBF y los archivos de registro del sistema y los servicios de comunicación se grabaron durante las cinco semanas del estudio. Se entregaron un total de 2795 mensajes, lo que supuso una media de 107,50 mensajes por paciente. Como se muestra, los mensajes disminuyen con el tiempo, indicando una mejora global de la adherencia al plan de tratamiento. Como se esperaba, los pacientes con T1DM recibieron más consejos a corto plazo, en relación a su estado. Del mismo modo, al ser el centro de T2DM en cambios de estilo de vida sostenible a largo plazo, los pacientes con T2DM recibieron más consejos de recomendación, en cuanto a dietas y actividad física. También se ha llevado a cabo una comparación de la adherencia e índices de uso para pacientes con T1DM y T2DM, entre la primera y la segunda mitad de la prueba. Se han observado resultados favorables para el uso. En lo relativo a la adherencia, los resultados denotaron una mejora general en cada dimensión del plan de tratamiento, como la nutrición y las mediciones de inserción de glucosa en la sangre. Se han llevado a cabo más estudios acerca del cambio a nivel educativo antes y después de la prueba, medidos tanto para grupos de control como de intervención. Los resultados indicaron que el grupo de intervención había mejorado su nivel de conocimientos mientras que el grupo de control mostró una leve disminución. El análisis de correlación entre el nivel de adherencia y las AFM ha mostrado una mejora en la adherencia de uso para los pacientes que recibieron los mensajes de tipo alertas, y unos resultados no significativos aunque positivos relacionados con la adherencia tanto al tratamiento que al uso correlacionado con los recordatorios. Por otra parte, los AFM parecían ayudar a los pacientes que no tomaban suficientemente en serio su tratamiento en el principio y que sí estaban dispuestos a responder a los mensajes recibidos. Aun así, los pacientes que recibieron demasiadas advertencias, comenzaron a considerar el envío de mensajes un poco estresante. El trabajo de investigación llevado a cabo al desarrollar este proyecto ofrece respuestas a las cuatro hipótesis de investigación que fueron la motivación para el trabajo. • Hipótesis 1 : es posible definir una serie de criterios para medir la adherencia en pacientes diabéticos. • Hipótesis 2: es posible diseñar un marco tecnológico basado en los criterios y teorías de cambio de conducta mencionados con anterioridad para hacer que los pacientes diabéticos se comprometan a controlar su enfermedad y adherirse a planes de atención. • Hipótesis 3: es posible poner en marcha el marco tecnológico en el sector de la salud móvil. • Hipótesis 4: es posible utilizar el marco tecnológico como solución de salud móvil en un contexto real y tener efectos positivos en lo referente a indicadores de control de diabetes. La verificación de cada hipótesis permite ofrecer respuesta a la hipótesis principal: La hipótesis principal es: es posible mejorar la adherencia diabética a través de un marco tecnológico mHealth basado en teorías de cambio de conducta. El trabajo llevado a cabo para responder estas preguntas se explica en este trabajo de investigación. El marco fue desarrollado y puesto en práctica en el Proyecto METABO. METABO es un Proyecto I+D, cofinanciado por la Comisión Europea (METABO 2008) que integra infraestructura móvil para ayudar al control, gestión y tratamiento de los pacientes con diabetes mellitus de tipo 1 (T1DM) y los que padecen diabetes mellitus de tipo 2 (T2DM). ABSTRACT Worldwide there is an exponential growth in the incidence of Chronic Diseases (CDs), such as: hypertension, cardiovascular and respiratory diseases, as well as diabetes mellitus, leading to rising numbers of deaths worldwide (Beaglehole et al. 2008). In particular, the prevalence of diabetes mellitus (DM) is largely increasing among all ages and constitutes a major worldwide health problem. Diabetes was directly responsible for 1,5 million deaths in 2012 and 89 million Disability-adjusted life year (DALYs) (WHO 2014). One of the key dilemmas often associated to CD management is the patients’ adherence to treatments, representing a multi-factorial aspect that requires support in terms of: education, self-management, interaction between patients and caregivers, and patients’ engagement. Measuring adherence is complex and, even if widely discussed, there are still no “gold” standards ((Giardini et al. 2015), (Costa et al. 2015). Patient’s engagement, through participation, collaboration, negotiation, and sometimes compromise, enhance opportunities for optimal therapy in which patients take responsibility for their part of the adherence equation. Engaging and involving diabetic patients in treatment decisions, along with professional expertise, can help foster a patient-centered approach to diabetes care (Martin et al. 2005). Patients’ motivation and empowerment are perhaps the two most relevant intervening factors that directly affect self-management of diabetes care. It has been demonstrated that these two factors play an essential role in prescription adherence, as well as for the successful encouragement of a healthy life-style and other behavioural changes (Heneghan et al. 2013). A personalised education plan is indispensable in order to provide the patient with the appropriate tools needed for the effective self-management of the disease (El-Gayar et al. 2013). Effective communication is at the core of providing patient-centred care since it influences behaviours and attitudes towards a health problem (Frampton et al. 2008). In this regard, interactivity, frequency, timing, and tailoring of text messages may promote adherence to a medication regimen. As a consequence, tailoring text messages to patients can constitute a way of making suggestions and information more relevant and effective (Nundy et al. 2013). In this context, mobile health technologies (mHealth) are playing significant roles in improving adherence to prescribed medications (Krishna et al. 2009). The tailoring of diabetes-specific text messages remains an area of opportunity to improve medication adherence and provide motivation to adults with diabetes but further research is needed to fully understand their effectiveness. Personalized text advices have proven to produce a positive impact on patients’ empowerment, self-management, and adherence to prescriptions (Gatwood et al. 2014). mHealth can be used for offering self-management support programs to diabetes patients and at the same time surmounting the technical and financial difficulties involved in diabetes treatment (Free et al. 2013). The main objective of this research work is to demonstrate that a technological framework, based on behavioural change theories, applied to mHealth domain, allows improving adherence treatment in diabetic patients. The framework, named Engagement Behavioural Feedback Framework (EBF), is built on top of validated behavioural techniques to frame messages, guide the definition of contents and assess outcomes: elements from the Transtheoretical Model (TTM), the Goal-Setting Theory (GST), Effective Health Communication (EHC) guidelines and Principles of Persuasive Technology (PPT) were incorporated. The TTM helps patients to progress to a next behavioural stage, through specific motivated text messages, and allow clinician’s identifying the current stage and tailor its strategies individually. Moreover, TTM guidelines are adopted to set customised goals at a level appropriate to the patient’s stage of change. The GST was used to build rules to be applied for enhancing educational intervention and weight loss objectives. Finally, the EHC guidelines and the PPT were applied to increase the effectiveness of messages. The EBF aims to support patients on improving their prescription adherence and persuade them towards a general improvement in diabetes self-management, by means of personalised text messages, named Automatic Feedback Messages (AFM). After a first profile screening, consisting in identifying meaningful patient characteristics based on treatment needs, attitudes and health care behaviours, customised AFMs are selected by the system, approved by the professional, and finally transferred into the patient interface. During the treatment, the user collects the data into a Patient Monitoring Device (PMD) from a set of medical devices and from manual inputs. Inputs consist in medication intake, diet and physical activity, metabolic measurement monitoring and learning tasks. Patient general engagement is checked by estimating the usage of the system and the adherence of treatment and patient goals status in the short and the long term period. The Behavioural Analysis Module, consisting in a set of rules and equations, calculates the patient’s behaviour. After behavioural analysis is accomplished, the AFM library and the dispatch setting are updated by the AFM Manager module. Updates include the number, the type and the frequency of messages. The AFMs are periodically supervised by the professional who also participates to the refinement of the treatment, adapted to the current transtheoretical stage. The AFMs are segmented in different categories and levels and patients can adjust message delivery in accordance with their personal needs. The EBF was integrated to the METABO system, designed to facilitate diabetic patients in managing their disease in a less intrusive approach. Patient device corresponds in a mobile platform, while a medical panel interface allows professionals to monitoring the treatment evolution. Specific tools allow professional to check patient adherence and to update the AFMs dispatch management. The EBF was tested in a randomised controlled pilot. The main objective was to examine the feasibility and acceptance of the system. Secondary objectives were also the assessment of the effectiveness of system in terms of adherence improvement, glycaemic control, and quality of life. Participants were recruited from four different clinical centres in Europe. The baseline assessment included demographics, diabetes status, profile information, knowledge about diabetes in general, usage of ICT platforms, opinion and experience about electronic devices and adoption of good practices with diabetes. Acceptance and the effectiveness evaluation criteria were applied to evaluate the performance of the technological framework. The main objective was the assessment of the effectiveness of system in terms of adherence improvement. Fifty-four patients participated on the trials. Twenty-six patients were assigned in the intervention group and equipped with mobile where the EBF was installed: 14 patients were T1DM and 12 were T2DM. The control group was composed of 25 patients that were treated through a standard care, without the usage of the EBF. Professional’s intervention for both intervention and control groups was carried out by 24 care providers, including endocrinologists, nutritionists, and nurses. In order to evaluate the system acceptability and analyse the users’ satisfaction, an online multi-language survey, using LimeSurvey, was produced for both patients and professionals. Results were also collected from the log-files generated in the PMDs, the professional medical panel and the entries of the data base. The messages sent to and from the EBF and the log-files of the system and communication services were recorded over 5 weeks of the study. A total of 2795 messages were submitted, representing an average of 107,50 messages per patient. As demonstrated, messages decrease over time indicating an overall improvement of the care plan’s adherence. As expected, T1DM patients were more loaded with short-term advices, in accordance with their condition. Similarly, being the focus of T2DM on long-term sustainable lifestyle changes, T2DM received more reminders advices, as for diet and physical activity. Favourable outcomes were observed for treatment and usage adherences of the intervention group: for both the adherence indices, results denoted a general improvement on each care plan’s dimension, such as on nutrition and blood glucose input measurements. Further studies were conducted on the change on educational level before and after the trial, measured for both control and intervention groups. The outcomes indicated the intervention group has improved its level of knowledge, while the control group denoted a low decrease. The correlation analysis between the level of adherences and the AFMs showed an improvement in usage adherence for patients who received warnings message, while non-significantly yet even positive indicators related to both treatment and usage adherence correlated with the Reminders. Moreover, the AFMs seemed to help those patients who did not take their treatment seriously enough in the beginning and who were willing to respond to the messages they received. Even though, patients who received too many Warnings, started to consider the message dispatch to be a bit stressful. The research work carried out in developing this research work provides responses to the four research hypothesis that were the motivation for the work: •Hypothesis 1: It is possible to define a set of criteria to measure adherence in diabetic patients. •Hypothesis 2: It is possible to design a technological framework, based on the aforementioned criteria and behavioural change theories, to engage diabetic patients in managing their disease and adhere to care plans. •Hypothesis 3: It is possible to implement the technological framework in the mobile health domain. •Hypothesis 4: It is possible to use the technological framework as a mobile health solution in a real context and have positive effects in terms of diabetes management indicators. The verification of each hypothesis allowed us to provide a response to the main hypothesis: The Main Hypothesis is: It is possible to improve diabetic adherence through a mHealth technological framework based on behavioural change theories. The work carried out to answer these questions is explained in this research work. The framework was developed and applied in the METABO project. METABO is an R&D project, co-funded by the European Commission (METABO 2008) that integrates mobile infrastructure for supporting the monitoring, management, and treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients.
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A working manual of clinical pathology.
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Earnings from gold mining in Australia remained tax-exempt for almost seven decades until January 1, 1991. In the early 1980s, rapid economic prosperity induced by escalated gold prices brought the Australian gold-mining industry under intense political scrutiny. Using a variant of the modified Jones model, this paper provides evidence of significant downward earnings management by Australian gold-mining firms, which is consistent with their attempts to mitigate political costs during the period from June 1985 to May 1988. In contrast, test of earnings management over a similar period in a control sample of Canadian gold-mining firms produced insignificant results. Further, empirical results are robust to several sensitivity tests performed. During the period from June 1988 to December 1990, the Australian firms were found to have engaged in economic earnings management. This is consistent with the sample firms' incentive of maximizing economic earnings immediately prior to the introduction of income tax on gold mining. The findings of this study help to understand the impact of earnings management on the efficient resource allocation in an economy. They also contribute toward understanding the linkage between regulation of accounting for special purposes and general-purpose financial. reporting.
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Uses research in a major UK company on the introduction of an electronic document management system to explore perceptions of, and attitudes to, risk. Phenomenological methods were used; with subsequent dialogue transcripts evaluated with Winmax dialogue software, using an adapted theoretical framework based upon an analysis of the literature. The paper identifies a number of factors, and builds a framework, that should support a greater understanding of risk assessment and project management by the academic community and practitioners.
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A presente dissertação trata do papel da gestão escolar no Ensino Médio, no processo de qualificação profissional dos alunos em uma escola pública estadual na periferia do município de Osasco São Paulo. Observa-se que um novo modelo de gestão na educação é discutido nos últimos anos no Brasil. Os Governos Federais junto com o Ministério da Educação têm apresentado programas sociais com o objetivo de que o jovem brasileiro possa se profissionalizar e estar apto a enfrentar um mercado de trabalho competitivo. Entre os programas do Governo destaca-se o Prouni, (Programa de Universidade para todos), representa um programa do Ministério da Educação criado em 2004 com a finalidade de conceder bolsas de ensino integral e parcial em instituições privadas de ensino superior, em cursos de graduação, destinada a estudantes brasileiros que não tenham cursado o ensino superior. Essas bolsas são concedidas aos alunos que participaram do Exame Nacional do Ensino Médio (ENEM). Em 2011, o Ministério da Educação criou o Programa Nacional de Acesso ao Ensino Técnico e Emprego (Pronatec) com o propósito de ampliar a oferta de cursos de educação profissional e tecnológica. Com esses e outros programas oferecidos pelo Governo pretende-se preparar os jovens para o mercado de trabalho. A pergunta norteadora deste estudo é: qual o papel do gestor escolar do Ensino Médio e suas ações visando a qualificação profissional do aluno? A pesquisa busca analisar a gestão escolar no Ensino Médio, tendo como foco o papel do gestor de uma escola pública no processo de escolha da qualificação profissional dos alunos do Ensino Médio. Para auxiliar o alcance desse objetivo, foram delimitados dois aspectos para estudo: a) analisar as ações e concepções políticas da gestão escolar pela percepção do corpo docente e de funcionários da escola; b) analisar as ações da gestão escolar visando à qualificação profissional por meio da visão de alunos em curso e de egressos. Trata-se de uma pesquisa que será qualitativa exploratória- descritiva. A pesquisa documental e as entrevistas semiestruturadas fazem parte da coleta de dados que irão subsidiar a análise final. A contribuição científica e social que se discute neste trabalho é a reflexão sobre a gestão da escola no Ensino Médio no processo de qualificação profissional dos alunos.
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A challenge for developing countries is to become part of the global economy. Their economic well being is dependent on their ability to attain the levels of technological development which could make them globally competitive. Infrastructural and educational problems pose immediate barriers which should be addressed as these countries embark on projects to enhance their technological base. The technology selected should be appropriate for the country's level of development and expertise. The implementation of that technology will place a new set of demands on managers and workers. This paper describes an investigation of perceptions of technology management in South Africa, a country which is developed in certain areas, but which remains desperately poor in other respects. South Africa's politics and history have always confronted managers with unique demands. The paper examines the perceptions of 132 South African managers regarding technology management by studying the relationship between the importance of different factors in managing new technology, and the extent to which a manager can control them. An importance-control grid framework is used to isolate individual parameters and to assess these in relation to the complexity of a manager's environment. The research highlights imbalances between importance and control, and suggests reasons therefor. Some broader implications for managers are also discussed. © 2002 Elsevier Science Ltd. All rights reserved.
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This special issue of the Journal of the Operational Research Society is dedicated to papers on the related subjects of knowledge management and intellectual capital. These subjects continue to generate considerable interest amongst both practitioners and academics. This issue demonstrates that operational researchers have many contributions to offer to the area, especially by bringing multi-disciplinary, integrated and holistic perspectives. The papers included are both theoretical as well as practical, and include a number of case studies showing how knowledge management has been implemented in practice that may assist other organisations in their search for a better means of managing what is now recognised as a core organisational activity. It has been accepted by a growing number of organisations that the precise handling of information and knowledge is a significant factor in facilitating their success but that there is a challenge in how to implement a strategy and processes for this handling. It is here, in the particular area of knowledge process handling that we can see the contributions of operational researchers most clearly as is illustrated in the papers included in this journal edition. The issue comprises nine papers, contributed by authors based in eight different countries on five continents. Lind and Seigerroth describe an approach that they call team-based reconstruction, intended to help articulate knowledge in a particular organisational. context. They illustrate the use of this approach with three case studies, two in manufacturing and one in public sector health care. Different ways of carrying out reconstruction are analysed, and the benefits of team-based reconstruction are established. Edwards and Kidd, and Connell, Powell and Klein both concentrate on knowledge transfer. Edwards and Kidd discuss the issues involved in transferring knowledge across frontières (borders) of various kinds, from those borders within organisations to those between countries. They present two examples, one in distribution and the other in manufacturing. They conclude that trust and culture both play an important part in facilitating such transfers, that IT should be kept in a supporting role in knowledge management projects, and that a staged approach to this IT support may be the most effective. Connell, Powell and Klein consider the oft-quoted distinction between explicit and tacit knowledge, and argue that such a distinction is sometimes unhelpful. They suggest that knowledge should rather be regarded as a holistic systemic property. The consequences of this for knowledge transfer are examined, with a particular emphasis on what this might mean for the practice of OR Their view of OR in the context of knowledge management very much echoes Lind and Seigerroth's focus on knowledge for human action. This is an interesting convergence of views given that, broadly speaking, one set of authors comes from within the OR community, and the other from outside it. Hafeez and Abdelmeguid present the nearest to a 'hard' OR contribution of the papers in this special issue. In their paper they construct and use system dynamics models to investigate alternative ways in which an organisation might close a knowledge gap or skills gap. The methods they use have the potential to be generalised to any other quantifiable aspects of intellectual capital. The contribution by Revilla, Sarkis and Modrego is also at the 'hard' end of the spectrum. They evaluate the performance of public–private research collaborations in Spain, using an approach based on data envelopment analysis. They found that larger organisations tended to perform relatively better than smaller ones, even though the approach used takes into account scale effects. Perhaps more interesting was that many factors that might have been thought relevant, such as the organisation's existing knowledge base or how widely applicable the results of the project would be, had no significant effect on the performance. It may be that how well the partnership between the collaborators works (not a factor it was possible to take into account in this study) is more important than most other factors. Mak and Ramaprasad introduce the concept of a knowledge supply network. This builds on existing ideas of supply chain management, but also integrates the design chain and the marketing chain, to address all the intellectual property connected with the network as a whole. The authors regard the knowledge supply network as the natural focus for considering knowledge management issues. They propose seven criteria for evaluating knowledge supply network architecture, and illustrate their argument with an example from the electronics industry—integrated circuit design and fabrication. In the paper by Hasan and Crawford, their interest lies in the holistic approach to knowledge management. They demonstrate their argument—that there is no simple IT solution for organisational knowledge management efforts—through two case study investigations. These case studies, in Australian universities, are investigated through cultural historical activity theory, which focuses the study on the activities that are carried out by people in support of their interpretations of their role, the opportunities available and the organisation's purpose. Human activities, it is argued, are mediated by the available tools, including IT and IS and in this particular context, KMS. It is this argument that places the available technology into the knowledge activity process and permits the future design of KMS to be improved through the lessons learnt by studying these knowledge activity systems in practice. Wijnhoven concentrates on knowledge management at the operational level of the organisation. He is concerned with studying the transformation of certain inputs to outputs—the operations function—and the consequent realisation of organisational goals via the management of these operations. He argues that the inputs and outputs of this process in the context of knowledge management are different types of knowledge and names the operation method the knowledge logistics. The method of transformation he calls learning. This theoretical paper discusses the operational management of four types of knowledge objects—explicit understanding; information; skills; and norms and values; and shows how through the proposed framework learning can transfer these objects to clients in a logistical process without a major transformation in content. Millie Kwan continues this theme with a paper about process-oriented knowledge management. In her case study she discusses an implementation of knowledge management where the knowledge is centred around an organisational process and the mission, rationale and objectives of the process define the scope of the project. In her case they are concerned with the effective use of real estate (property and buildings) within a Fortune 100 company. In order to manage the knowledge about this property and the process by which the best 'deal' for internal customers and the overall company was reached, a KMS was devised. She argues that process knowledge is a source of core competence and thus needs to be strategically managed. Finally, you may also wish to read a related paper originally submitted for this Special Issue, 'Customer knowledge management' by Garcia-Murillo and Annabi, which was published in the August 2002 issue of the Journal of the Operational Research Society, 53(8), 875–884.
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Prior research has shown that loan loss provisions are primarily used as a tool for earnings management and capital management by listed banks. Effective 2005 all listed companies in the European Union (EU) are required to comply with International Financial Reporting Standards (IFRS). Adherence to IFRS, it is claimed, should enhance transparency of reporting practices relative to local General Accepted Accounting Principles (GAAP). The overall objective of this paper is to examine the impact of the implementation of IFRS on the use of loan loss provisions (LLPs) to manage earnings and capital. We use a sample of 91 EU listed commercial banks covering a period of 10 years (before and after implementation of IFRS). Since early adopters may have different incentives and motivations relative to those who adopt mandatorily, we dichotomize our sample into early and late adopters. Overall, we find that earnings management (using loan loss provisions) for both early and late adopters while significant over the estimation window is significantly reduced after implementation of IFRS. We also find that, for risky banks, earnings management behavior is more pronounced when compared to the less risky banks, but is significantly reduced in the post IFRS period. Capital management behavior by bank managers is not significant in both pre and post IFRS regimes. Overall, we conclude that the implementation of IFRS in the EU appears to have improved earnings quality by mitigating the tendency of bank managers of listed commercial banks to engage in earnings management using loan loss provisions.
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This paper aims to contribute to the debate on the role of knowledge management in supply chain management by reviewing the published literature. A total of 58 selected referred journal articles were systematically analyzed. This review identifies various theoretical and methodological characteristics of the way in which knowledge management applications are proposed in the supply chain context. The review shows that little evidence exists of the positive relation between the use of IT solutions and firms’ performance. Some issues remain unexplored such as the problem of knowledge obsolescence in supply chain management. A deeper understanding of the knowledge accumulation process could give new insights. The paper concludes with some future directions for theory construction and empirical research.
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A műhelytanulmány célja, hogy megalapozzon egy, a lean menedzsment és a szervezeti kultúra kapcsolatát vizsgáló empirikus kutatást. Máig ritka a szűken vett témában született publikációk száma, ezért tanulmányunkban olyan forrásokat dolgozunk fel, amelyek a lean menedzsmenten túl a termelésmenedzsment más koncepcióit, gyakorlatait (minőségmenedzsment és a fejlett termelési rendszerek), az általuk elérhető teljesítmény és a szervezeti kultúra kapcsolatát értelmezi, vagy vizsgálja. A források módszeres áttekintésével azonosítjuk a kutatásokat indokoló tényezőket, az érintett termelésmenedzsment koncepciók értelmezéseit, a szervezeti kultúra értelmezéséket és a kutatási eredményeket. Mindezek alapján bemutatjuk, hogy melyek lehetnek azok a kérdések, melyek egy, a szervezeti kultúra és a lean menedzsment kapcsolatát vizsgáló empirikus kutatás során figyelmet érdemelnek. Bemutatjuk továbbá, hogy milyen egyéb tényezőkre kell figyelemmel lenni egy ilyen kutatás tervezése során. Önmagában a lean menedzsment, mint téma újszerű a szervezeti kultúrával kapcsolatos kutatások területén. Ezen túl a nagymintás és az angolszász területeken kívül eső kutatások kecsegtetnek jelentős új ismerettel. További újdonságot jelente a termelésmenedzsment koncepció és a szervezeti kultúra kapcsolatának megragadásán túl a kapcsolat természetének (a hatás irányának) feltárása. ______ The aim of this paper is to provide a solid base for a study that would examine the relationship between lean management and organizational culture. Since there are only limited number of publications in this topic, in our study we examined publications, which interpreted or examined the relationship among organizational culture, organizational performance and - beyond lean management - any operations management concepts or practices (but mainly quality management and advanced manufacturing technologies). Rigorously reviewing the selected sources, we identified the main questions justifying the researches, interpretations of the involved operations management concepts, interpretations of organization culture, and research results. Based on our review, we highlight those questions that are worth to examine within a research targeting to study the relationship between the organizational culture and lean management. Moreover, we identified other important factors to be considered when designing such research. Lean management by itself a novelty in the research field related to organizational culture. Moreover, large sample studies conducted outside the Anglo-Saxon territory likely to bring notable novelty. Further new knowledge may emerge if beyond capturing the existence of relationship among organizational culture and any operations management concept the nature of the relationship (the direction of the influence) was also investigated.