Functional disability and social participation restriction associated with chronic conditions in middle-aged and older adults

Abstract : Background. We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination. Methods. Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008–2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables. Results. Five chronic conditions (arthritis, depression, diabetes, heart disease and eye disease) made the largest contributions to ADL-related and IADL-related functional disability and social participation restrictions, with variation in magnitude and ranking by age and gender. While arthritis was consistently associated with higher PARs across gender and most age groups, depression, alone and in combination with the physical chronic conditions, was associated with ADL and IADL disability as well as social participation restrictions in the younger age groups, especially among women. Compared to women, the combinations of conditions associated with higher PARs in men more often included heart disease and diabetes. Conclusions. Our findings suggest that in community dwelling middle-aged and older adults, the impact of combinations of mental and physical chronic conditions on functional disability and social participation restriction is substantial and differed by gender and age. Recognising the differences in the drivers of PAR by gender and age group will ultimately increase the efficiency of clinical and public health interventions

Drivers for international innovation activities in developed and emerging countries

This paper aims to shed light on firm specific drivers that lead firms to internationalise their innovation activities. The paper draws a comprehensive picture of driving forces by including firm capabilities, characteristics of the firm’s competitive environment and the influence of innovation obstacles in the home country. In particular, the role of the potential driving forces is tested on the probability to carry out different innovative activities abroad (R&D, design/conception of new products, manufacturing of innovative products and implementation of new processes). In a second step these driving forces are used to observe their impact on the decision to locate innovation activities in various countries and regions (China, Eastern Europe, Western Europe and North America) as well as in groups of countries with similar levels of knowledge (country clubs). The analysis is based on the Mannheim Innovation Panel survey which represents the German CIS (Community Innovation Survey) contribution. Two survey waves are combined and result in a sample of about 1400 firms. The results show that the decision to perform innovation activities abroad is mainly driven by organisational capabilities such as absorptive capacities, international experience and existing technological competences of the respective firm. Innovation barriers at the German home base such as lack of labour and high innovation costs foster the set up of later-stage innovation activities abroad while the lack of demand demonstrates a barrier to the internationalisation decision for the development and manufacturing of new products. Location decisions receive the strongest influencing effects from the international experience of the firm. Firms which innovate in developing countries seem to require a more extensive level of international experience by international R&D cooperation

Network embeddedness in exploration and exploitation joint R&D projects: a structural approach

This paper analyses how network embeddedness affects exploration and exploitation R&D project performance. By developing joint projects, partners and projects are linked to one another and form a network that generates social capital. We examine how the location, which determines the access to information and knowledge within a network of relationships, affects the performance of projects. We consider this question in the setup of exploration and exploitation projects, using a database built from an EU Framework. We find that each of the structural´ embeddedness dimensions (degree, betweenness and eigenvector centrality) have a different impact on the exploration and exploitation project performance. Our empirical analysis extends to project management literature, and social capital theory, by including the effect that the acquisition of external knowledge has on the performance of the project

Mind the gap: Balancing alliance network and technology portfolios during periods of technological uncertainty

While clique-embeddedness is generally considered to enhance firm performance, there are also reasons to expect that under conditions of technological turbulence clique-membership is less beneficial or might even become a liability. To address this, we study the innovative performance of clique members during periods of both technological change and technological stability. We find support for the idea that companies’ ability to adapt their alliance network (i.e. forming ties beyond the scope of the clique) and their ability to adapt their technology portfolios (i.e. access to novel technological knowledge) positively influences their innovative performance during technologically turbulent periods