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Machine-learning prediction for hospital length of stay using a French medico-administrative database
No full textInternational audience"Introduction: Prolonged Hospital Length of Stay (PLOS) is an indicator of deteriorated efficiency in Quality of Care. One goal of public health management is to reduce PLOS by identifying its most relevant predictors. The objective of this study is to explore Machine Learning (ML) models that best predict PLOS.Methods: Our dataset was collected from the French Medico-Administrative database (PMSI) as a retrospective cohort study of all discharges in the year 2015 from a large university hospital in France (APHM). The study outcomes were LOS transformed into a binary variable (long vs. short LOS) according to the 90th percentile (14 days). Logistic regression (LR), classification and regression trees (CART), random forest (RF), gradient boosting (GB) and neural networks (NN) were applied to the collected data. The predictive performance of the models was evaluated using the area under the ROC curve (AUC).Results: Our analysis included 73,182 hospitalizations, of which 7,341 (10.0%) led to PLOS. The GB classifier was the most performant model with the highest AUC (0.810), superior to all the other models (all p-values <0.0001). The performance of the RF, GB and NN models (AUC ranged from 0.808 to 0.810) was superior to that of the LR model (AUC = 0.795); all p-values <0.0001. In contrast, LR was superior to CART (AUC = 0.786), p < 0.0001. The variable most predictive of the PLOS was the destination of the patient after hospitalization to other institutions. The typical clinical profile of these patients (17.5% of the sample) was the elderly patient, admitted in emergency, for a trauma, a neurological or a cardiovascular pathology, more often institutionalized, with more comorbidities notably mental health problems, dementia and hemiplegia.Discussion: The integration of ML, particularly the GB algorithm, may be useful for health-care professionals and bed managers to better identify patients at risk of PLOS. These findings underscore the need to strengthen hospitals through targeted allocation to meet the needs of an aging population."<br /
Militer de l’intérieur : Les stratégies des réseaux professionnels LGBT
No full textInternational audienceEn dépit de l’essor des politiques diversité en France depuis les années 2000, peu d’entreprises et d’administrations se sont saisies des questions de lutte contre l’homophobie et la transphobie. Fondé sur une analyse textuelle et longitudinale d’archives complétée par des entretiens, l’article examine les stratégies de cinq réseaux internes portés par des « salarié·e·s militant·e·s », engagé·e·s de manière visible pour la cause lgbt sur leur lieu de travail. Ces réseaux internes de grandes entreprises ou d’administrations développent eux-mêmes des ressources et des services de prévention et de sensibilisation, et utilisent comme levier la réputation des employeurs à propos de leur engagement pour la diversité. Ces acteurs peuvent, à mesure qu’ils acquièrent une visibilité et une légitimité dans leur organisation, étendre le champ de leurs revendications et le périmètre de leurs actions, dénonçant de plus en plus vigoureusement l’inaction de leur employeur face aux discriminations à l’encontre des minorités sexuelles et de genre. Même s’ils proposent des actions modérées ou réformistes, ces réseaux participent à transformer de l’intérieur les politiques de ressources humaines.""Despite the development of diversity policies in France since the 2000s, few companies and public administrations have taken up issues related to the fight against homophobia and transphobia. Based on a textual and longitudinal analysis of archives, supplemented by interviews, this article examines the strategies of five internal networks made up of “activist employees,” who are openly committed to the lgbtq cause in their workplaces. These networks within corporations or public administrations develop prevention and awareness resources and services, and use their employers’ avowed commitment to diversity as leverage. As these actors gain visibility and legitimacy in their workplaces, they can extend the scope of their demands and actions, and denounce the inaction of their employers more and more vocally in the face of discrimination against sexual and gender minorities. Even if these networks propose moderate or reformist actions, they participate in transforming human resources policies from within.<br /
En ces temps troublés, ne vous laissez pas aveugler par vos croyances
No full textInternational audience"Il y a soixante ans, la crise des missiles de Cuba a failli plonger le monde dans la guerre nucléaire. Derrière cette crise : de l’incertitude, de la surprise et des croyances bien ancrées, altérant les prises de décision. Quelles leçons en tirer pour les dirigeants et leur organisation?"<br/
Where Relational Commons Take Place : The City and its Social Infrastructure as Sites of Commoning
No full textInternational audience"Commons enjoy recognition as an alternative to the dichotomy of state and market. In contrast to liberal market theorists who frame the commons as resource-based, we build on alternative and critical conceptions that describe the commons as processual, social, and inherently relational. Our analysis adds to these accounts an articulation of the contemporary commons as “social infrastructure” in the urban spatial conditions where the social processes of commoning take place. We argue that the relational features of urban commons depend on social interactions and cross-sector partnerships in physical places that promote social cohesion, suggesting that the urban commons fold together the spatial and social in hitherto undertheorized ways. To theorize this relationship, we articulate the idea of the relational urban commons as sites of social interaction and relationship building—social infrastructure. This conceptualization suggests that the commons can be governed indirectly by enabling access, participation, and partnerships across sectors, fostering mixed uses and the provision of maintenance and repair. As a result, the commons are both maintained by and conducive to place-based cross-sector partnerships, anchored in place in ways that transcend resources, issues, and ownership.
Nexus among blockchain visibility, supply chain integration and supply chain performance in the digital transformation era
No full textInternational audiencePurpose Digital transformation (DT) in the semiconductor industry goes beyond traditional business operations and supply chain management (OSCM) to the digital world. Despite significant developments in recent years, blockchain implementations for OSCM remain relatively underdeveloped in the semiconductor industry. Therefore, this research aims to examine the relationships between blockchain visibility, supply chain integration (SCI) and supply chain performance (SCP) in the era of DT in Malaysia's semiconductor industry to shed light on this emerging area. Design/methodology/approach A convenience sampling of 71 operations and supply chain managers attached to semiconductor manufacturing firms in Malaysia were invited to participate in a survey. In assessing blockchain visibility within the industry, key terms namely business intelligence gathering, information exchange, information technology (IT) and knowledge of asset status, were conceptualised from the literature review. The questionnaires developed to collect data were validated by industry and academic experts. Findings The results from the analysis confirmed that SCI mediates the link between blockchain visibility (information exchange, business intelligence gathering and knowledge asset status) and SCP. Likewise, the importance-performance matrix analysis (IPMA) outcomes revealed that IT played a minor role. The results suggested that semiconductor manufacturers should pay less attention to IT since this was identified as having the least priority towards improvement. Practical implications The outcomes from this research enable policymakers to strategise and integrate blockchain technology in the era of DT to ensure sustainable SCM in the semiconductor industry in Malaysia. Originality/value The research bridge the knowledge gap by revealing the value that blockchain visibility can facilitate SCP and explore SCI as the prevailing factor and demonstrates how Resource-Based Theory and Network Theory can be applied in this study.<br /
On the robustness of higher order attitudes to ambiguity framing
No full textIn a context-free preference situation, we conduct a laboratory experiment in which we test higher order ambiguity attitudes (order 2, order 3, and order 4) using a simple model with two states of nature (good and bad). We compare ambiguity attitudes when the random variable capturing ambiguity is introduced on the probability associated with the good state of nature versus the bad state of nature. In addition, in the case of order 3, we compare ambiguity attitudes when the random variable capturing ambiguity is presented as two harms (as usual in decision theory) versus one harm and one favor. We first establish the theoretical prediction of a general consistency of ambiguity attitudes. Ceteris paribus, these attitudes should remain invariant with respect to (i) the state of nature to which ambiguity is associated, and to (ii) the type of the change (harm or favor) in the probability to which ambiguity is associated. Our empirical results systematically contradict this formal prediction pointing to the behavioral importance of ambiguity framing
Emigration and External Imbalances in Sub-Saharan Africa: Do Migrants' Skills Matter?
No full textInternational audienceThe external deficits in SSA countries are a major concern and may be connected to emigration from these countries to advanced economies. According to the life cycle theory, by decreasing labour force, emigration induces a fall in savings and a deterioration in the external balance in the countries of origin. Migrants' remittances may dampen or even counterbalance this effect, depending on migrants' skills that matter for their propensity to remit. Empirical investigation for SSA countries over the period 1990–2014 shows that low-skilled emigration improves the current account balance, whereas high-skilled emigration worsens it because highly skilled emigrants have higher saving potential but tend to remit less than low-skilled ones. Therefore, incentives for the financing of home economies by skilled migrants would be beneficial
Attitudes and intentions toward masstige strategies: A cross-cultural study of French and Chinese consumers
No full textInternational audienceThe present research investigates how masstige strategies affect consumers' attitudes toward masstige and their intention to purchase masstige brands. An exploratory qualitative study and two experimental designs compared the response of consumers from two nationalities-Chinese and Franch. Chinese consumers generally express a more positive attitude and higher purchase intention toward masstige than French. The article further disentangles the role of the masstige strategy (accessory vs. sub-brand) by accounting for self-construal. Chinese consumers recognize the prestige of the parent brand in masstige sub-brands more than French consumers, and exhibited a more positive attitude and higher purchase intention toward said sub-brands. Meanwhile, French consumers were more accepting of masstige in the form of new product lines, such as accessories. From a managerial standpoint, companies need to tailor their masstige messaging to different consumer targets: for instance, by emphasizing durability and status for Chinese consumers, but intrinsic luxury values for French consumers
Natural disasters and voter gratitude: What is the role of prevention policies?
No full textNatural disasters and related prevention policies can affect voter decisions. In this study, we analyze how the occurrence of natural disasters changes voters' behavior at municipal elections and how prevention policies can mitigate the impact of such catastrophic events on budget accounts and might potentially be rewarded by citizens in upcoming elections. We exploit original data on French municipalities where incumbents sought reelection between 2008 and 2020. To estimate the probability of re-election at the municipal level in the event of a natural disaster we apply a Heckman model based strategy to avoid selection bias. We find that the occurrence of natural disasters significantly decreases the chances of reelection of incumbent mayors. However, although we show that natural hazard prevention plans significantly mitigate the impact of catastrophic events on budget accounts, citizens do not reward such prevention policies in upcoming elections. We confirm the hypothesis of myopia: voters reward incumbents for delivering investment spending or decreasing debt but not for investing in spending on disaster preparedness
Ethics and Technique in Welfare Economics: How Welfarism Evolves in the Making
No full textInternational audienceUnder welfarism, assertions such as “this social state is better than an alternative” or “this policy should be enacted” are based on the assumption that social welfare ultimately depends only on the well-being of individuals. A normative analysis of welfarism seeks to provide a transparent description of the basis upon which welfarism makes its value judgments, which is equivalent to an investigation into its choice of a preferred notion of well-being. Such an investigation, this paper claims, can take two forms, which we should distinguish: the ethical analysis of welfarism is concerned with the appeal to a given ethical theory of well-being; and the technical analysis of welfarism concerns the specific measure of individual utility that in practice is used to measure social welfare. Reviewing a series of claims which bear on how these two versions of welfarism are articulated (the standard, proxy, evidential and tension claims), the paper explores the differences between the ethical and technical approaches in the normative interpretation of welfarist assertions.Dans le cadre d’étude welfariste, des affirmations telles que « cet état social est meilleur que tel autre état social » ou « cette politique devrait être promulguée » reposent sur l’hypothèse que le bien-être social ne dépend que du bien-être des individus et de rien d’autre. Une analyse normative du welfarisme vise à fournir une description transparente des jugements de valeur impliqués dans ces évaluations et ces recommandations, ce qui revient à s’interroger en particulier sur la notion du bien-être qui a été retenue. Cette enquête normative peut prendre deux formes et cet article défend l’idée qu’il convient de les distinguer : l’analyse éthique du welfarisme concerne le recours à une théorie éthique donnée du bien-être ; et l’analyse technique du welfarisme concerne la mesure de l’utilité individuelle qui est utilisée en pratique pour mesurer ce bien-être social. L’article passe en revue successivement quatre points de vue types portant sur l’articulation de ces deux versions du welfarisme : le point de vue standard, de l’approximation, de la preuve et de la tension. En étudiant l’interprétation normative des affirmations welfaristes, il explore les différences qui émergent entre les approches éthique et technique