Customer Orientation in Family Businesses

The purpose of this article is to investigate customer orientation of service employees (COSE) in family businesses. This study elaborates on the perception and importance of COSE in family-owned companies. The paper also proposes new consequences of COSE in the context of family business. The research is based on a qualitative study comprised of 13 interviews conducted on senior managers in family firms. The results are analysed using NVivo 11. This investigation confirms the relevance of the COSE construct in family businesses and the role of family influence over it. New consequences are elicited, including differentiation, customer experience, and customer well-being. The results show that practitioners consider COSE as a key element for success. This study sheds light on how COSE can be applied in a family business in order to enhance customer experience. This study expands on the potential of COSE with the use of family businesses for the first time and introduces new consequences from the original model

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Anthocyanin composition of Tempranillo, Garnacha and Cabernet Sauvignon grapes from high and low-quality vineyards over two years

The anthocyanin composition of Tempranillo, Garnacha and Cabernet Sauvignon grapes over two vintages was studied. Samples were obtained during berry ripening from two vineyards that differed by producing fruit of high and low quality. The proportions of the individual compounds remained practically constant within a single vineyard along the sampling period, the changes in the anthocyanin composition being principally quantitative. Different multivariate statistical methods snowed that the anthocyanin profile was primarily determined by variety. This genetic dependence was particularly verified when the sums of the non-acylated glucosides, the acetates and the p-coumaryl derivatives, were analysed. The mean relative content corresponding to these three anthocyanin fractions was always the same within each variety, independently either of the vineyard or the vintage year considered. Relating to the individual compounds, several permanent qualitative differences between vineyards in each variety were also found, although the difference in the total anthocyanin concentration was always much higher. © Springer-Verlag 2002

Abdominoplastia multifuncional en ancla: nuestra experiencia y nueva sistemática de abordaje en el paciente sin adelgazamiento

La dermolipectomía multifuncional en ancla es una técnica efectiva en el tratamiento del contorno corporal en pacientes que han sufrido grandes pérdidas de peso. En la actualidad, en el sistema público de salud español, no es infrecuente que el cirujano plástico deba abordar pacientes en los que no ha habido adelgazamiento alguno y que más allá del contorno corporal, requieren una reparación de la pared abdominal. Los procedimientos reconstructivos de la pared abdominal no están reñidos con un abordaje simultáneo del contorno corporal para una mejora funcional y de la calidad de vida del paciente. Exponemos nuestra experiencia con este conocido patrón de dermolipectomía en 32 casos, en los que mostramos el abordaje hecho en 3 pacientes con ausencia o fracaso en el adelgazamiento. El gran volumen intrabdominal, graso y visceral, de estos pacientes sin adelgazamiento, conlleva que puedan presentar complicaciones por alteración en la relación continente-contenido abdominal tras grandes dermolipectomías; las más frecuentes son dehiscencia de sutura, necrosis de los colgajos, alteraciones respiratorias o cierre a tensión que en último término puede desencadenar un síndrome compartimental intrabdominal. La adaptación y fisioterapia respiratoria preoperatoria del enfermo, el diseño de colgajos suprapúbicos que eviten el cierre a tensión en el punto de unión de las suturas, el no despegamiento de los colgajos y la estimación de la presión intrabdominal intraoperatoria, permiten ampliar la indicación de este patrón de dermolipectomía a pacientes en los que no ha habido adelgazamiento

Oxigenación por membrana extracorpórea (ECMO): experiencia inicial de nuestro centro en adultos con insuficiencia respiratoria aguda grave

Extracorporeal membrane oxygenation (ECMO) is a form of extracorporeal life support. An external artificial circulation or circuit carries venous blood from the patient to an oxygenator, where oxygen is added and carbon dioxide removed, then the blood is returned to the patient circulation. Depending on its configuration –venovenous (VV) or venoarterial–, ECMO is temporarily used to support respiratory function, circulation, or both. The objective of this publication is to review the initial experience at Son Espases University Hospital (Palma) using VV ECMO, unique centre in the Balearic Island with the capability of providing this therapy.La oxigenación por membrana extracorpórea (ECMO) es una forma de soporte vital extracorpóreo. Un circuito o sistema de circulación artificial externo conduce sangre venosa desde el paciente a un oxigenador, donde se añade oxígeno y se desprende dióxido de carbono, y a continuación, la sangre se devuelve a la circulación del paciente. Dependiendo de si su configuración es venovenosa (VV) o venoarterial, la ECMO se utiliza como apoyo temporal de la función respiratoria, de la función circulatoria o de ambas. El objetivo de este artículo es presentar la experiencia inicial del hospital universitario Son Espases (Palma) con el sistema ECMO VV al tratarse del único centro en las Islas Baleares capaz de ofrecer dicho tratamiento