Computer Supported Strategic Management

This paper presents an overview of the essential components of effective strategic management and a detailed description of the methodology for leading an organization through the strategic management process. This process can be extremely time consuming and can easily fall victim to pep rally thinking, rather than producing useful critical evaluation.The authors have successfully used GroupSystems software, one of a limited number of software products designed to support meetings, to significantly reduce the amoimt of time required for meetings and to improve the level of independent, unbiased input from participants. The parallel processing afforded by the software typically reduced meeting time from one-third to one-half that of face-to-face meetings, and the input anonymity feature of the software encouraged insightful candor from participants. The GroupSystems seuip for each of the computer-supported meetings is detailed to illustrate how software of this type can be used to make strategic management efforts more successful. (GroupSystems is a registered trademark of Ventana Corporation, Tucson, Arizona.

The Acquisition Process Map: Blueprint for a Successful Deal

Paul Mallette, Ph.D., is associate professor of strategic management, Department of Management, Colorado State University, Fort Collins, CO 80523. Karen L. Fowler, Ph.D., is professor of strategic management, Department of Management, University of Northern Colorado, Greeley, CO 80639. Cheri Hayes, MBA, is a merger and acquisitions specialists with Union Carbide Corporation, Danbury, CT 06817

Clostridium difficile infection in the United States: A national study assessing preventive practices used and perceptions of practice evidence

We surveyed 571 US hospitals about practices used to prevent Clostridium difficile infection (CDI). Most hospitals reported regularly using key CDI prevention practices, and perceived their strength of evidence as high. The largest discrepancy between regular use and perceived evidence strength occurred with antimicrobial stewardship programs.Infect. Control Hosp. Epidemiol. 2015;36(8):969–971</jats:p

Differences in Veterans' and Nonveterans' End-of-Life Preferences: A Pilot Study

Background: Investigators conducting focus groups on end-of-life preferences noted that veterans voiced opinions that strongly differed from those of nonveterans. Objective: The objective of this study was to further explore differences between veterans' and nonveterans' end-of-life preferences. Methods: Ten focus groups and a pilot survey were conducted. Setting and sample: The focus groups consisted of Arab Muslims, Arab Christians, Hispanics, blacks, and whites stratified by gender (n = 73). Fifteen male veterans were included across all five racial groups. Measures: A moderator discussion guide was used to lead the focus groups and a pilot survey asked about demographic information and end-of-life preferences. Results: Veterans were more likely to be married (p < 0.05) and less connected to their cultural group (p < 0.05) than nonveterans. The focus group results indicated that veterans in this study were more likely to oppose the use of heroic measures compared to nonveterans. More so than nonveterans, veterans felt that their doctors should be frank and open (p < 0.05) were strongly in favor of do-not-resuscitate (DNR) orders (p < 0.10), yet were less likely to have a proxy (p < 0.10) or durable power of attorney p < 0.01). Comparing end-of-life preferences, veterans felt less strongly than nonveterans about remembering personal accomplishments (p < 0.05), being listened to (p < 0.05), being with friends (p < 0.01), or being comfortable with their nurse (p < 0.05), but did want to be around their pets at the end of life p < 0.10). Implications: The Department of Veterans Affairs is in a unique position to improve endof- life care for veterans. Providing end-of-life care that is congruent with the veteran's wishes can improve satisfaction and increase cost effectiveness by eliminating unacceptable services.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63253/1/jpm.2006.9.1099.pd

A framework for assessing the lifetime economic burden of congenital cytomegalovirus in the United States

Background: In the United States (US), congenital cytomegalovirus infection (cCMVi) is a major cause of permanent disabilities and the most common etiology of non-genetic sensorineural hearing loss. Evaluations of prevention strategies will require estimates of the economic implications of cCMVi. We aimed to develop a conceptual framework to characterize the lifetime economic burden of cCMVi in the US and to use that framework to identify data gaps. Methods: Direct health care, direct non-health care, indirect, and intangible costs associated with cCMVi were considered. An initial framework was constructed based on a targeted literature review, then validated and refined after consultation with experts. Published costs were identified and used to populate the framework. Data gaps were identified. Results: The framework was constructed as a chance tree, categorizing clinical event occurrence to form patient profiles associated with distinct economic trajectories. The distribution and magnitude of costs varied by patient life stage, cCMVi diagnosis, severity of impairment, and developmental delays/disabilities. Published studies could not fully populate the framework. The literature best characterized direct health care costs associated with the birth period. Gaps existed for direct non-health care, indirect, and intangible costs, as well as health care costs associated with adult patients and those severely impaired. Conclusions: Data gaps exist concerning the lifetime economic burden of cCMVi in the US. The conceptual framework provides the basis for a research agenda to address these gaps. Understanding the full lifetime economic burden of cCMVi would inform clinicians, researchers, and policymakers, when assessing the value of cCMVi interventions

Predictors of poor sleep quality among head and neck cancer patients

Objectives/Hypothesis: The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. Study Design: This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Methods: Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Results: Both baseline (67.1) and 1-year postdiagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer ( P < .05). Smoking, problem drinking, and female sex were marginally significant ( P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Conclusions: Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life. Laryngoscope, 2010Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75789/1/20924_ftp.pd

An academic hospitalist model to improve healthcare worker communication and learner education: Results from a quasi‐experimental study at a veterans affairs medical center

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102160/1/jhm2105.pd

Comprehensive functional characterization of murine infantile Batten disease including Parkinson-like behavior and dopaminergic markers

Infantile neuronal ceroid lipofuscinosis (INCL, Infantile Batten disease) is a neurodegenerative lysosomal storage disease caused by a deficiency in palmitoyl protein thioesterase-1 (PPT1). The PPT1-deficient mouse (Cln1−/−) is a useful phenocopy of human INCL. Cln1−/− mice display retinal dysfunction, seizures, motor deficits, and die at ~8 months of age. However, little is known about the cognitive and behavioral functions of Cln1−/− mice during disease progression. In the present study, younger (~1–2 months of age) Cln1−/− mice showed minor deficits in motor/sensorimotor functions while older (~5–6 months of age) Cln1−/− mice exhibited more severe impairments, including decreased locomotor activity, inferior cued water maze performance, decreased running wheel ability, and altered auditory cue conditioning. Unexpectedly, certain cognitive functions such as some learning and memory capabilities seemed intact in older Cln1−/− mice. Younger and older Cln1−/− mice presented with walking initiation defects, gait abnormalities, and slowed movements, which are analogous to some symptoms reported in INCL and parkinsonism. However, there was no evidence of alterations in dopaminergic markers in Cln1−/− mice. Results from this study demonstrate quantifiable changes in behavioral functions during progression of murine INCL and suggest that Parkinson-like motor/sensorimotor deficits in Cln1−/− mice are not mediated by dopamine deficiency

An introduction to Elinor Glyn : her life and legacy

This special issue of Women: A Cultural Review re-evaluates an author who was once a household name, beloved by readers of romance, and whose films were distributed widely in Europe and the Americas. Elinor Glyn (1864–1943) was a British author of romantic fiction who went to Hollywood and became famous for her movies. She was a celebrity figure of the 1920s, and wrote constantly in Hearst's press. She wrote racy stories which were turned into films—most famously, Three Weeks (1924) and It (1927). These were viewed by the judiciary as scandalous, but by others—Hollywood and the Spanish Catholic Church—as acceptably conservative. Glyn has become a peripheral figure in histories of this period, marginalized in accounts of the youth-centred ‘flapper era’. Decades on, the idea of the ‘It Girl’ continues to have great pertinence in the post-feminist discourses of the twenty-first century. The 1910s and 1920s saw the development of intermodal networks between print, sound and screen cultures. This introduction to Glyn's life and legacy reviews the cross-disciplinary debate sparked by renewed interest in Glyn by film scholars and literary and feminist historians, and offers a range of views of Glyn's cultural and historical significance and areas for future research

Neuromodulation and the role of electrodiagnostic techniques

Electrodiagnostic techniques have been utilized in surgery since the early 1960s. These techniques have been primarily used in neurosurgery; however, with the introduction of neuromodulation for voiding dysfunction, these techniques have now found their way into the field of female pelvic medicine. This article will review techniques applicable to evaluate pelvic floor function as it relates to neuromodulation. It will also review the literature describing how these techniques are used to help determine appropriate candidates as well as improve surgical outcomes. A PubMed search was conducted using the terms neuromodulation, Interstim, electrodiagnosis, electrodiagnostic techniques, electromyography with limits to the pelvic floor, and voiding dysfunction. Eight articles and three abstracts were found that directly related to the use of electrodiagnostic techniques as they apply to neuromodulation. Electrodiagnostic techniques may play a role in helping predict appropriate candidates for neuromodulation as well as improve surgical outcomes