Synthesizing ENABLE-AGE Research Findings to Suggest Evidence-Based Home and Health Interventions

ABSTRACT

As the quest for knowledge translation from research to practice and policy contexts is growing stronger, researchers need to develop strategies for synthesizing research findings. Since home environments constitute an important context for the delivery of health care and social services to older adults and people aging with disabilities, research in this field can serve as an example for such endeavors. Using 35 original publications and one unpublished doctoral dissertation based on the European ENABLE-AGE Project, we aimed to demonstrate a systematic approach to synthesize research findings generated by large research projects as the basis for evidence-based interventions. The synthesized findings highlighted the complex interactions between objective and perceived aspects of housing and aspects of health in very old age, impacting on, for example, residential decision making. Independence in daily activity is influenced by the sociocultural care and service context. A familiar and safe neighborhood, a social network, and a good supply of services are important to perceptions of participation. Going further, we suggest housing-related interventions that address problems and challenges related to ongoing demographic changes. This article contributes to the development of strategies for knowledge translation, connecting research and practice and policy contexts struggling to meet the societal challenges that accompany population aging.     

Gender and health among older people: What is the role of social policies?

The study investigated how social policies moderate the association between gender and health among older people across European countries. The study is the first to take a comprehensive view on the role of social policies in connection with gender inequality in health among older Europeans. The association between gender and poor self‐rated health and limiting long‐standing illness was investigated in a multilevel framework. Cross‐level interaction effects showed that more generous minimum pensions, higher spending on eldercare and a higher degree of eldercare formalisation are associated with relatively better health among women, while more generous standard pensions are associated with relatively better health among men. The conclusion is that policies directed towards older people are not gender neutral; rather they are likely to affect men and women differently. By shaping the distribution of resources as well as of unpaid work, social policies can contribute to either strengthening or weakening the link between gender and health.     

Covariance structure approximation via gLasso in high-dimensional supervised classification

Recent work has shown that the Lasso-based regularization is very useful for estimating the high-dimensional inverse covariance matrix. A particularly useful scheme is based on penalizing the ?₁ norm of the off-diagonal elements to encourage sparsity. We embed this type of regularization into high-dimensional classification. A two-stage estimation procedure is proposed which first recovers structural zeros of the inverse covariance matrix and then enforces block sparsity by moving non-zeros closer to the main diagonal. We show that the block-diagonal approximation of the inverse covariance matrix leads to an additive classifier, and demonstrate that accounting for the structure can yield better performance accuracy. Effect of the block size on classification is explored, and a class of asymptotically equivalent structure approximations in a high-dimensional setting is specified. We suggest a variable selection at the block level and investigate properties of this procedure in growing dimension asymptotics. We present a consistency result on the feature selection procedure, establish asymptotic lower an upper bounds for the fraction of separative blocks and specify constraints under which the reliable classification with block-wise feature selection can be performed. The relevance and benefits of the proposed approach are illustrated on both simulated and real data.     

Designing the Entrepreneurial University: The Interpretation of a Global Idea

Becoming an entrepreneurial university has been identified as the solution to the problems facing contemporary higher education systems. The idea of becoming an entrepreneurial university can be seen as the result of a more globalised higher education sector where the domestic and institution-specific characteristics of universities are downplayed in favour of a more uniform idea of what a university should do and how it should be organized. This article contributes to this scholarly discussion by analysing how efforts to transform universities into “more complete organisations” are understood and interpreted in terms of organisational structures.     

Strategies for business model innovation: How firms reel in migrating value

This paper brings together firm-level research on business models and industry-level research on value migration to examine patterns of business model innovation. We draw on qualitative data from 14 cases and 68 interviews in the computer and telecommunications industries to demonstrate how business model innovation is sensitive to industry-wide forces of value migration. Based on our analysis we conclude that when value is rapidly migrating across industries and between firms, proactively substituting key elements of the primary business model provides a better fit with the new value landscape than launching secondary business models in parallel. We suggest four underlying mechanisms that link business model innovation, value migration and subsequent outcomes. Unpacking business model innovation allows us to discuss contingencies for the main business model strategies, specifically in terms of limitations to—and opportunities of—changing the primary business model and the practice of parallel business models.     

A decision-theoretic approach to subset selection

The multiple decision problem of selecting a random non-empty subset of populations, out of k populations, that are close in some sense to the best population is considered in a decision-theoretic framework. Uniformly optimal procedures for non-negative semi-additive loss are derived. A class of likelihood-ratio type of procedures is shown to be admissible for monotone additive loss.     

From the employment office to the social welfare office: Social assistance recipiency among first-time unemployed in Sweden

Social assistance receipt among first-time unemployed in Sweden is investigated by analysing data files obtained by merging register data from the city of Goteborg. First-time unemployed males were observed during 1993 and 1994 and were followed in the register of social assistance recipients for 18 months after the debut. Many of the newly unemployed had no access to unemployment compensation. Slightly more than one out of five newly unemployed became social assistance recipients. Lengthy periods of unemployment combined with no access to unemployment compensation signify a high risk of becoming a social assistance recipient. This risk varies a great deal with age, citizenship, human capital and job search activity of the unemployed.     

Using queueing models to estimate system capacity

The true capacity of a production or service system is often difficult to estimate with sufficient accuracy. The two main methodological approaches to capacity measurement described in the literature – measurements based on engineering and physical factors and measurement based on time studies – are both characterised by conceptual as well as practical shortcomings. This paper provides analyses on how capacity measurement can be approached using queueing models, thereby eliminating some major drawbacks of other approaches. The core idea is to use the theoretical relation among arrival rate, service rate and queueing time; because the arrival rate and queueing time can both be measured objectively in an empirical sense, these measures can be used to estimate the true service rate of the system. The suggested method is completely insensitive to the proportional relationship between design and effective capacity, and it cannot cause any behavioural problems during measurement since it does not require direct observation of the system itself. Particularly appealing is the potential for practical application to many contexts in many industries. The validity of the approach is discussed.     

Market research with the aid of a smartphone application – a case study

We discuss using the presumed ‘wisdom of the crowd’ to reduce the bullwhip effect in supply chains by enhancing the accuracy of demand forecast. Our case study describes a joint project of a leading European technology company (We chose RAGD as a pseudonym for the company throughout the study.) and the University of Kassel on a smartphone application for end customers to gather early information for this producer’s forecast. Our results confirm the ‘wisdom of the crowd’ hypothesis: A group of experts, in our case technicians who install and maintain RAGD-products, is capable of anticipating market fluctuations six weeks in advance. This only holds true if the ‘crowd’ of technicians is large enough. Our business climate index outperforms the company forecast in the first six months, when on average 22 technicians took part per week. We discuss successes and limitations of the cooperation and provide recommendations for similar projects.