Recasting the Customer Experience in Today's Omni-channel Environment

Omni-channel marketing refers to the synergetic management of the available channels and customer touchpoints to enhance the customer experience and improve performance. It has become a cornerstone of marketing strategy but putting it into practice is still one of the major challenges that firms face today. In this study, we aim to understand how firms can manage all touchpoints across all channels in an integrated manner to provide a superior customer experience and gain competitive edge. To do so, we identify a number of key issues that firms must consider before they can embrace the changes that their organizations need to recast the customer experience and obtain superior performance. These include adopting a customercentric approach, unifying all touchpoints across all channels, delivering personalized customer experiences, integrating the available channels, delight customers across channels, redefining the role of the physical store and embracing mobile marketing. El marketing omnicanal se refiere a la gestión sinérgica de los canales disponibles y de los puntos de contacto con los clientes para mejorar la experiencia del cliente y mejorar el rendimiento. Se ha convertido en una piedra angular de la estrategia de marketing, pero su puesta en práctica sigue siendo uno de los principales retos a los que se enfrentan las empresas hoy en día. En este estudio, nuestro objetivo es entender cómo las empresas pueden gestionar todos los puntos de contacto en todos los canales de una manera integrada para proporcionar una experiencia superior al cliente y aumentar la ventaja competitiva. Para ello, se identifican una serie de cuestiones clave que las empresas deben tener en cuenta antes de que puedan adoptar los cambios que sus organizaciones necesitan para redefinir la experiencia del cliente y obtener un rendimiento superior. Estos incluyen la adopción de un enfoque centrado en el cliente, la unificación de todos los puntos de contacto en todos los canales, la prestación personalizada de experiencias al cliente, la integración de los canales disponibles, el deleite a los clientes en todos los canales, la redefinición del papel de la tienda física y la apuesta por el marketing móvil

Cost-effectiveness analysis of offering free leisure centre memberships to physically inactive members of the public receiving state benefits: a case study

Background We evaluated the cost-effectiveness of the Give-it-a-Go programme, which offers free leisure centre memberships to physically inactive members of the public in a single London Borough receiving state benefits. Methods A decision analytic Markov model was developed to analyse lifetime costs and quality-adjusted life-years (QALYs) of 1025 people recruited to the intervention versus no intervention. In the intervention group, people were offered 4 months of free membership at a leisure centre. Physical activity levels were assessed at 0 and 4 months using the International Physical Activity Questionnaire (IPAQ). Higher levels of physical activity were assumed to decrease the risk of coronary heart disease, stroke and diabetes mellitus type II, as well as improve mental health. Costs were assessed from a National Health Service (NHS) perspective. Uncertainty was assessed using one-way and probabilistic sensitivity analyses. Results One-hundred fifty nine participants (15.5 %) completed the programme by attending the leisure centre for 4 months. Compared with no intervention, Give it a Go increased costs by £67.25 and QALYs by 0.0033 (equivalent to 1.21 days in full health) per recruited person. The incremental costs per QALY gained were £20,347. The results were highly sensitive to the magnitude of mental health gain due to physical activity and the duration of the effect of the programme (1 year in the base case analysis). When the mental health gain was omitted from the analysis, the incremental cost per QALY gained increased to almost £1.5 million. In the probabilistic sensitivity analysis, the incremental costs per QALY gained were below £20,000 in 39 % of the 5000 simulations. Conclusions Give it a Go did not significantly increase life-expectancy, but had a positive influence on quality of life due to the mental health gain of physical activity. If the increase in physical activity caused by Give it a Go lasts for more than 1 year, the programme would be cost-effective given a willingness to pay for a QALY of £20,000

ASO author reflections: towards patient-tailored management of extremity soft tissue sarcoma

Orthopaedics, Trauma Surgery and Rehabilitatio

Effectiveness and characteristics of interventions to improve work participation in adults with chronic physical conditions: a systematic review

Purpose: Chronic physical conditions often negatively affect work participation. The objective of this systematic review is to investigate the effectiveness and characteristics of vocational rehabilitation interventions for people with a chronic physical condition. Methods: Searches in five databases up to April 2020 identified 30 studies meeting our inclusion criteria. Two reviewers independently assessed and extracted data. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) framework was used to evaluate quality of evidence for three outcome measures related to work participation. Results: All vocational rehabilitation interventions consisted of multiple components, but their characteristics varied widely. Analysis of 22 trials yielded a moderate positive effect with moderate certainty of interventions on work status; analysis of five trials with low risk of bias showed a large positive effect with moderate certainty (risk ratio 1.33 and 1.57, respectively). In addition, in eight studies we found a moderate to small positive effect with low certainty on work attitude (standardized mean difference = 0.59 or 0.38, respectively). We found no effect on work productivity in nine studies. Conclusion: The systematic review of the literature showed positive effects of vocational rehabilitation interventions on work status and on work attitude; we found no effect on work productivity.Implications for rehabilitation In rehabilitation, addressing work participation of persons with a chronic physical condition using targeted inte

Patient-Reported Outcome Measures may optimize shared decision-making for cancer risk management in BRCA mutation carriers

Purpose: The aim of this study was to compare patient-reported outcomes (PROs) of BRCA1/2 mutation carriers, either after bilateral prophylactic mastectomy (BPM) or during breast surveillance, to improve shared decision-making in their cancer risk management. Methods: Unaffected BRCA1/2 mutation carriers at least one year after BPM followed by immediate breast reconstruction (BPM-IBR) or one year under surveillance were eligible. After informed consent, the Hospital Anxiety and Depression Scale (HADS) and BREAST-Q were administered and compared between the different strategies. PROs were also compared to available normative data. Results: Ninety-six participants were analyzed in this study and showed significant differences between strategies in age, age at genetic testing, and time since BPM or starting breast surveillance. All HADS scores were below 8 suggesting no signs of anxiety or depression in both groups. Higher mean ‘Q-physical well-being’ scores were reported by the surveillance group (81.78 [CI 76.99–86.57]) than the BPM group (76.96 [CI 73.16 – 80.75]; p = 0.011). Overall, for both questionnaires better scores were seen when compared to age-matched normative data. Conclusions: No signs of anxiety or depression were seen in the surveillance or BPM-IBR group. Slightly better mean BREAST-Q scores were seen for the surveillance group in comparison to BPM-IBR, except for ‘Q-psychological well-being’. The difference in ‘Q-physical well-being’ was significantly worse for BPM-IBR. Approaches to obtain longitudinal PROs and reference values should be explored in the future, which could add value to shared decision-making in regards to breast cancer risk management in this specific patient population

Development of work participation in young adults with cerebral palsy: A longitudinal study

Objective: To document the development of work participation in young adults with cerebral palsy who are transitioning into adulthood, examine associated characteristics, and investigate work limitations and barriers among employed persons.Design: Observational longitudinal cohort study.Subjects: Seventy-four young adults with cerebral palsy of average intelligence, aged 16-20 years at baseline.Methods: Work participation in 3 categories (employed, unemployed, studying) was assessed at baseline, 2-year and 4-year follow-ups using structured interviews. At 4-year follow-up, associations of work participation with demographic and clinical characteristics were examined using multinomial logistic regression. Work limitations and barriers among employed persons were evaluated using questionnaires.Results: From age range 16-20 years to age range 20-24 years the proportions of subjects who were employed and unemployed increased from 12% to 49% and 3% to 17%, respectively; the proportion who were students decreased from 85% to 34%. In the age range 20-24 years, the employment rate of young adults with cerebral palsy was lower and the unemployment rate higher, than that of the general population. A lower level of gross motor function and younger age were associated with unemployment. Employed persons experienced few work limitations; 28% experienced situational or health barriers.Conclusion: Young adults with cerebral palsy and average intelligence are at risk of experiencing unfavourable developments in work participation. Rehabilitation services should offer support to prevent unemployment and occupational disability

Deescalating Follow-up after Hemithyroidectomy for Patients with Low-risk Papillary Thyroid Microcarcinoma

Importance: Structural recurrent disease (RD) after surgical treatment of papillary thyroid microcarcinoma (mPTC) is rare. We hypothesized that the RD rate after hemithyroidectomy in low-risk patients with mPTC is low.Objective: To assess the occurrence of RD in Dutch patients with mPTC who received surgical treatment according to the Dutch guidelines.Design, Setting, and Participants: This nationwide retrospective cohort study included all patients who had undergone surgery with a diagnosis of cN0/cNx mPTC in the Netherlands between January 2000 and December 2020 were identified from the Netherlands Cancer Registry database. Patients with preoperative lymph node metastases were excluded. Two groups were defined: group 1 (incidental), mPTC in pathology report after thyroid surgery for another indication; and group 2 (nonincidental), patients with a preoperative highly suspect thyroid nodule (Bethesda 5) or proven mPTC (Bethesda 6). Dutch guidelines state that a hemithyroidectomy is sufficient in patients with unifocal, intrathyroidal mPTC. Main Outcomes and Measures: The occurrence of RD in patients with low-risk mPTC after hemithyroidectomy.Results: In total, 1636 patients with mPTC were included. Patients had a median (IQR) follow-up time of 71 (32-118) months. Median (IQR) age at time of diagnosis was 51 (41-61) years and 1292 (79.0%) were women. Overall, RD after initial treatment was seen in 25 patients (1.5%). The median (IQR) time to RD was 8.2 (3.6-16.5) months and 22 of the 25 (88%) patients developed RD within 2 years. Recurrent disease was not significantly different between both groups (group 1, n = 15 [1.3%]; group 2, n = 10 [2.1%]; difference, 0.8%; 95% CI, -0.5% to 2.5%). Of the 484 patients with nonincidental mPTC (group 2), 246 (50.8%) patients were treated with a hemithyroidectomy and follow-up in accordance with Dutch guidelines. Lymph node metastases were found in 1 of 246 (0.4%) patients after hemithyreoidectomy, and new mPTC in the contralateral thyroid was detected in 3 of 246 (1.2%) patients. Median (IQR) follow-up of this patient group was 37 (18-71) months. The 10-year probability of RD was 1.3% for patients without vascular invasion and 24.4% for patients with vascular invasion. Conclusions and Relevance: This nationwide cohort study found that overall, RD after hemithyroidectomy for patients with low-risk mPTC was rare (&lt;2%). Based on these results, it seems reasonable to deescalate follow-up of patients with low-risk mPTC without vascular invasion after hemithyroidectomy. From a health care perspective, deescalation of follow-up may contribute to increased sustainability and accessibility to health care, both large challenges for the future..</p

A scatterometer record of sea ice extents and backscatter: 1992–2016

This paper presents the first long-term climate data record of sea ice extents and backscatter derived from intercalibrated satellite scatterometer missions (ERS, QuikSCAT and ASCAT) extending from 1992 to present date. This record provides a valuable independent account of the evolution of Arctic and Antarctic sea ice extents, one that is in excellent agreement with the passive microwave records during the fall and winter months but shows higher sensitivity to lower concentration and melting sea ice during the spring and summer months. The scatterometer record also provides a depiction of sea ice backscatter at C and Ku-band, allowing the separation of seasonal and perennial sea ice in the Arctic, and further differentiation between second year (SY) and older multiyear (MY) ice classes, revealing the emergence of SY ice as the dominant perennial ice type after the historical sea ice loss in 2007, and bearing new evidence on the loss of multiyear ice in the Arctic over the last 25 years. The relative good agreement between the backscatter-based sea ice (FY, SY and older MY) classes and the ice thickness record from Cryosat suggests its applicability as a reliable proxy in the historical reconstruction of sea ice thickness in the Arctic

Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

BACKGROUND: Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM) interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. METHODS: The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM) and the CAM Education and Research Network of Alberta (CAMera). The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. RESULTS: One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. CONCLUSION: We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of outcome measures, such as individualized and holistic measures, with attention to issues of process and context