A Web-Based Flexible Communication System in Radiology

A web-based system for rapid multidirectional communication has been created in the Radiology department at San Francisco General Hospital. The system allows messaging among radiology attendings, residents, and technologists, as well as other members of the hospital community, such as Emergency Department physicians and nurses. Instead of being tied to a particular workflow, this system provides a flexible communication infrastructure which can be easily adapted for different functions and user roles. The system has so far been configured to successfully support the standard “wet reading” workflow, to support marking and tracking of critical results, as well as multiple educational and quality improvement workflows. In the 19 months of operation, the system has gained over 1,800 users (virtually all providers at our institution), it has been accessed by radiologists over 39,000 times and by non-radiologists over 34,000 times. It has become an integral part of the radiology department operations and non-radiology clinical workflows. Unlike most existing softwares, our system is not a task-specific application, but a multipurpose communication system. It is able to effectively accommodate multiple workflows and user roles through configuration (without additional programming). This flexibility has helped this system to be rapidly and widely adopted within our enterprise. The extended reach of the system enables improved monitoring and documentation of workflows, helping with management decision making, and quality assurance. We report a successful radiology communication system based on the principles of flexibility and inclusiveness of users inside and outside the radiology department

Advertising, product quality, and complex evolving marketing systems

The paper analyses the advertising as power vs. advertising as information controversy as well as its recent empirical testing. It is stressed that this distinction focuses too much on the interaction between consumer and manufacturer while ignoring the retailer as an important stake-holder. To compensate for this lack, a complex marketing system perspective is introduced in which consumer, retailer, and manufacturer interact. However, these complex marketing systems might drift towards market equilibria which are against the consumer interests: that is, firmsmight lock out brands from the market by means of trade and sales promotions and then use advertising to protect their position. Consequently brands of better quality and/or innovative brands are barred from trade shelves

Increasing Dominance - the Role of Advertising, Pricing and Product Design

Despite the empirical relevance of advertising strategies in concentrated markets, the economics literature is largely silent on the effect of persuasive advertising strategies on pricing, market structure and increasing (or decreasing) dominance. In a simple model of persuasive advertising and pricing with differentiated goods, we analyze the interdependencies between ex-ante asymmetries in consumer appeal, advertising and prices. Products with larger initial appeal to consumers will be advertised more heavily but priced at a higher level - that is, advertising and price discounts are strategic substitutes for products with asymmetric initial appeal. We find that the escalating effect of advertising dominates the moderating effect of pricing so that post-competition market shares are more asymmetric than pre-competition differences in consumer appeal. We further find that collusive advertising (but competitive pricing) generates the same market outcomes, and that network effects lead to even more extreme market outcomes, both directly and via the effect on advertising

Universal Rights and Wrongs

This paper argues for the important role of customers as a source of competitive advantage and firm growth, an issue which has been largely neglected in the resource-based view of the firm. It conceptualizes Penrose’s (1959) notion of an ‘inside track’ and illustrates how in-depth knowledge about established customers combines with joint problem-solving activities and the rapid assimilation of new and previously unexploited skills and resources. It is suggested that the inside track represents a distinct and perhaps underestimated way of generating rents and securing long-term growth. This also implies that the sources of sustainable competitive advantage in important respects can be sought in idiosyncratic interfirm relationships rather than within the firm itself

Association between PCSK9 levels and markers of inflammation, oxidative stress, and endothelial dysfunction in a population of nondialysis chronic kidney disease patients

Proprotein convertase subtilisin/kexin 9 (PCSK9) plays an important role in lipid metabolism while available literature regarding its involvement in the pathogenesis of atherosclerosis and in the expression of genes associated with apoptosis and inflammation is constantly increasing. Patients with chronic kidney disease (CKD) experience disproportionately increased cardiovascular morbidity and mortality due to dyslipidemia, accelerated atherosclerosis, inflammation, oxidative stress, and other risk factors. In the present cross-sectional study, we investigated the possible association of serum PCSK9 levels with markers of inflammation, oxidative stress, and endothelial damage in patients with CKD. Patients and Methods. Ninety-two patients with CKD stages II-ΙV (eGFR CKD-EPI 47.3±25.7 ml/min/1.73 m2, mean age 66 years, 51 men) were included in the study. Plasma PCSK9 levels were correlated with comorbidities (arterial hypertension, diabetes mellitus, and history of cardiovascular disease), renal function indices (eGFR, proteinuria–UPR/24 h), lipid parameters (LDL-cholesterol, HDL-cholesterol, triglycerides, Lp(a), APO-A1, and APO-B), and soluble biomarkers of inflammation, oxidative stress, and endothelial damage (hs-CRP, fibrinogen, 8-epiPGF2a, ox-LDL, IL-6, TNF-α, sICAM-1, and sVCAM-1). Results. The mean plasma value of PCSK9 was 278.1 ng/ml. PCSK9 levels showed direct correlation with serum triglycerides (p=0.03), Lp(a) (p=0.01), and sICAM-1 levels (p=0.03). There was no significant correlation between PCSK9 levels and indices of the renal function, other lipid profile parameters, inflammatory markers, or comorbidities. Multiple regression analysis showed a significant effect of Lp(a) on PCSK9 levels, and for each unit of higher Lp(a), an increase by 3.082 is expected (95% CI: 0.935-5.228, p=0.006). At the same time, patients receiving statins are expected to have on average 63.8 ng/ml higher PCSK9 values compared to patients not receiving statins (95% CI: 14.6-113.5, p=0.012). Conclusion. Plasma levels of PCSK9 in nondialysis CKD patients are correlated with endothelial dysfunction and lipid metabolism parameters. Statin intake increases PCSK9 levels significantly in this patient population. PCSK9 levels are not correlated with the severity of kidney disease. Major prospective studies are necessary to investigate the role of PCSK9 in the atherosclerotic cardiovascular outcome in CKD

Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001

<p>Abstract</p> <p>Background</p> <p>In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV) given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV) at 18 months of age. This study presents carriage serotypes following this schedule.</p> <p>Methods</p> <p>We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs) in 2003 and 2005. Nasal secretions were collected and processed according to published methods.</p> <p>Results</p> <p>902 children (mean age 25 months) living in 29 communities in 2003 and 818 children (mean age 35 months) in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order) 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 μg/mL) strains (15% overall) was detected in serotypes (descending order) 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 μg/mL) strains (5% overall), was detected in serotypes (descending order) 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C.</p> <p>Conclusion</p> <p>Pneumococcal carriage remains high (~80%) in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined years were 16F, 19A, 11A, 6C and 23B. Antimicrobial non-susceptibility was detected in these and 17 additional serotypes. Shifts in serotype-specific carriage suggest a need more research to clarify the association between pneumococcal vaccination and carriage at the serotype level.</p

Drucker\u27s Insights on Market Orientation and Innovation: Implications for Emerging Areas in High-Technology Marketing

In 1954, Drucker boldly declared that organizations have only two basic functions, marketing and innovation. While true for any organization, this insight is particularly pertinent for technology-based businesses. The complicated environment surrounding high-tech companies creates a great need for sophisticated marketing, yet these companies continue to have under-developed competencies in marketing and in understanding customer needs. In its first two sections, this essay explores Drucker’s insights with respect to two particularly salient issues for high-tech companies: developing and implementing a market orientation, and sustained break-through innovations. We review Drucker’s insights and synthesize them with the scholarly research on these issues. In the third section, we discuss three emerging areas in high-tech marketing where academics and managers could build on Drucker’s insight to guide future research and practice: market-driving, customer co-creation, and corporate social responsibility. The illustrative examples provided by these emerging areas highlight that even today, Drucker’s writings continue to offer remarkable guidance to scholars and managers who are willing to take the time to reflect, understand, and incorporate these insights in the unique context of high-tech industries

Revisiting the five-facet structure of mindfulness

The current study aimed to replicate the development of the Five-Facet Mindfulness Questionnaire (FFMQ) in a sample of 399 undergraduate students. We factor analyzed the Mindful Attention and Awareness Questionnaire (MAAS), the Freiburg Mindfulness Scale, the Southampton Mindfulness Questionnaire (SMQ), the Cognitive Affective Mindfulness Scale Revised (CAMS-R), and the Kentucky Inventory of Mindfulness Skills (KIMS), but also extended the analysis by including a conceptually related measure, the Philadelphia Mindfulness Scale (PHLMS), and a conceptually unrelated measure, the Langer Mindfulness Scale (LMS). Overall, we found a partial replication of the five-factor structure, with the exception of non-reacting and non-judging which formed a single factor. The PHLMS items loaded as expected with theoretically related factors, whereas the LMS items emerged as separate factor. Finally, we found a new factor that was mostly defined by negatively worded items indicating possible item wording artifacts within the FFMQ. Our conceptual validation study indicates that some facets of the FFMQ can be recovered, but item wording factors may threaten the stability of these facets. Additionally, measures such as the LMS appear to measure not only theoretically, but also empirically different constructs

Factors affecting innovation and imitation of ICT in the agrifood sector

Diffusion of innovations has gained a lot of attention and concerns different scientific fields. Many studies, which examine the determining factors of technological innovations in the agricultural and agrifood sector, have been conducted using the widely used Technology Accepted Model, for a random sample of farmers or firms engaged in agricultural sector. In the present study, a holistic examination of the determining factors that affect the propensity of firms to innovate or imitate, is conducted. The diffusion of ICT tools of firms which are engaged in the NACE 02/03 as well as in the NACE 10/11 classifications for 49 heterogeneous national markets is examined, using the Bass model. The innovation parameter is positively associated with rural income, female employment, export activity and education of farmers, while the imitation parameter is increased in countries whose societies are characterized by uncertainty avoidance

O Efeito da Sinalização de Qualidade no Contexto de Serviços

Signaling theory states that signals are firms’ actions that communicate information about the quality of a product. The main purpose of this research is to investigate the effect of signal quality in a service context, through the investigation of the signaling effects of price and responsiveness in a service context. Perceived behavior control, regarded as an individual's perception of the ability to perform a behavior, was proposed as a moderator between signaling variables and perceived quality. Two experimental studies with factorial and inter-subject designs were conducted in order to test the hypotheses formulated from the literature review. Results from both experiments show that signaling quality through price and responsiveness can affect perceived quality. The second experiment supports the hypothesis of perceived behavior control moderation between price as a signaling variable and perceived quality, but not between responsiveness and perceived quality. These results and their implications are discussed in the final section of the paper