“Emotional Exhaustion and Perceived Corporate Social Responsibility: A Case Study of a Port Logistics Organization”

In an era of economic crisis, and at the shadow of major ethical scandals in organizations, Corporate Social Responsibility (CSR) strategy has emerged as a crucial element to reestablish the bond between corporations and all other stakeholders such as the local community, society and labor force. Crisis makes employees more stressful, since they work on unwarranted jobs causing them emotional exhaustion. This study aims to examine the association between employee emotional exhaustion and perceived corporate social responsibility (CSR). For this purpose, this study conducted a survey which examines if CSR (ethical, social, environmental dimensions) is negatively related to emotional exhaustion of employees on a sample of 93 employees of a port logistics management services organization. A structured questionnaire was developed in order to measure emotional exhaustion and employee perceptions about CSR activities. Building on the claim that employee perceptions of CSR activities may significantly related to emotional state, this paper examines three CSR dimensions (social, ethical and environmental) and emotional exhaustion. The results of this study indicate that environmental CSR exerts a negative significant effect on Emotional exhaustion. These finding will be of great value as they can contribute on understanding the impact of environmental CSR on emotional exhaustion with detrimental effects on employees’ productivity, job performance, and creativity. The importance of CSR environmental aspects and the relative strategies guiding CSR impact on emotional exhaustion affecting job-related outcomes are also discussed

Resource modeling of mmwave transceivers for wireless communications at the chip scale

Wireless Network-on-Chip (WNoC), where communications takes place at the chip scale between integrated antennas and transceivers and using the chip package as propagation medium, shows promise in addressing the challenges of wireline Network-on-Chip (NoC) in modern multicore processors. Two of the most important aspects of this new paradigm are area and power consumption, which are heavily limited by the evident constraints of the chip scenario. Hence, to understand the value of the WNoC idea, it is imperative to have area and power models of the transceivers used in the communication. Such models, however, are largely missing because RF designers are typically bound to a strict set of specifications relative to the frequency band or output power, among others, in stark contrast to the WNoC scenario which does not impose such limitations. In this context, the present thesis lays down the first steps towards the modeling of wireless transceivers for WNoC communication using a bottom-up approach, component by component, using (i) known design rules, (ii) existing surveys for certain subsystems such as the data converters or power amplifiers, and (iii) relevant specific designs from the literature. The developed models allow to sweep key input parameters such as the frequency, the channel losses, the modulation rate for two low-order modulations, OOK and QPSK, paving the way to the exploration of WNoC architectures for future multicore processing systems

Cost-effectiveness analysis of coronary artery bypass grafting vs of pump coronary artery bypass

Introduction In a span of two decades, coronary artery bypass grafting (CABG) has become the most common major operative procedure performed in Europe and the United States. Nevertheless, there is incontrovertible evidence that various damaging effects of cardiopulmonary bypass occur. The organs most affected by cardiopulmonary bypass are the heart, brain, lung and kidney. Although in the majority of patients the adverse effects of cardiopulmonary bypass are minor and reversible, these effects may be of major importance, irreversible, and even fatal. Therefore it is reasonable to assume that avoiding cardiopulmonary bypass may be advantageous for certain subgroups of people, especially those with high-risk conditions for conventional CABG surgery. In recent years myocardial revascularization on the beating heart without cardiopulmonary bypass has gained increasing popularity attempting to decrease procedural mortality and morbidity and therefore increase value by lowering procedural “cost” to the patient. Aim This study attempts to answer one question: Which is the in-hospital Direct Cost and midterm Outcome of OPCAB versus CABG? Method This study was carried out in one contemporary Cardio surgery Center of Athens between 01/03/1999 and 01/014/2000. One hundred two patients undergoing first-time coronary artery bypass grafting were enrolled in the study. Group A (CABG) underwent conventional myocardial revascularization with normothermic cardiopulmonary bypass and cardioplegic arrest of the heart, whereas group B (OPCAB) underwent beating heart revascularization. Because the preoperative characteristics have important economic and medical implications as determinants of cost, exclusion criteria included impaired left ventricular function (ejection fraction 130μmol/L), combined valve surgery, respiratory impairment, previous stroke and coagulopathy. The clinical and demographic characteristics for the patients are summarized in Table 1. Table 1: Preoperative demographics and clinical characteristics Factor CABG OPCAB P Value Age (yr) 66±7 65±8 0,62 Male (n) 37 52 0,48 Diabetes (n) 15 20 0,78 Hypertension (n) 18 32 0,98 Smoking (n) 25 40 0,77 Prior MI (n) 16 30 0,67 Family history (n) 10 15 0,45 LVEF 44,2±7,6 46,2±10,1 0,96 Angina (n) 3,25±0,63 3,5±0,70 0,82 Hypercholesterolemia 30 40 0,66 MI: Myocardial infarction, LVEF: Left ventricular ejection fraction Variable and fixed direct costs were obtained for each group during operative and postoperative care including the following elements: medical tests, medications, materials, labour, bed occupancy cost and medical equipment depreciation. In addition the surgical and anesthetic expenses were included. The economic issue was explored through the application of cost effectiveness analysis. We calculated the true economic cost by applying prices to patient-specific resource consumption and we estimated the hospital charges and the insurance’s retrenchments. In order to assess the early clinical effectiveness of the two methods we set the following in-hospital endpoints: death, post-procedural complication rate (arrhythmia, stroke, perioperative myocardial infarction, hemorrhagic, pulmonary, infection) and for the midterm outcome patients followed-up for 12 months after their discharge. Results The normality of the distribution was inspected in order to compare mean values and total quantitative variables for the two procedures. This was made possible with the application of the analysis of variance (ANOVA). The independence of quantitative variables was carried out with the statistical test of X square. The in-hospital mortality was not significantly different between the two groups (CABG 2% vs OPCAB 2%, p=0.89). Four patients in each group had a perioperative myocardial infarction. Among them, two patients required treatment with an intraaortic balloon pump. Six patients in CABG group and two patients in OPCAB group had a cerebrovascular accident (transient ischemic attack). OPCAB group had significantly fewer postoperative complication rate than CABG group (CABG 47.6% vs OPCAB 18.3%, p=0.001). Time spent in the intensive care unit following surgery averaged 22.5±2.12 hours for OPCAB method and 24.48±6.8 hours for traditional bypass patients. Postoperative length of stay in the hospital was 6.58±1.04days for the CABG group and 4.93±0.93days for the OPCAB group of patients. The in-hospital cost for the CABG was 3.364.006±442.790drs per patient while for OPCAB group was 2.288.406drs±315.597drs (p1μήνα) 16 30 0.67 Οικογενειακό ιστορικό 10 15 0.45 Δυσλιπιδαιμία 30 40 0.66 Στηθάγχη (CCS) 3.25 ± 0.63 3.5 ± 0.70 0.82 Κλάσμα εξώθησης 44.2 ± 7.6 46.2 ± 10.1 0.96 Αριθμός νοσούντων αγγείων 2.6 ± 0.8 2.6 ± 0.8 0.87 CCS: ταξινόμηση της στηθάγχης κατά Canadian Cardiovascular Society, Δυσλιπιδαιμία: Ολική Χοληστερόλη >240mg.dl-1, Υπέρταση: Αρτηριακή πίεση>180/100mmHg Για τον υπολογισμό του νοσοκομειακού κόστους αποτιμήθηκαν οι εξής παράμετροι: οι ιατρικές εξετάσεις, τα φάρμακα, τα υλικά, η εργασία του προσωπικού ανά κατηγορία, τα νοσήλια, τα γενικά έξοδα και οι αποσβέσεις του βιοϊατρικού εξοπλισμού. Ως μέθοδος οικονομικής ανάλυσης επιλέχθηκε η ανάλυση κόστους αποτελεσματικότητας. Προσδιορίστηκε η διαφορά μεταξύ νοσοκομειακού κόστους και νοσοκομειακής χρέωσης στις παραπάνω παραμέτρους και εκτιμήθηκαν οι περικοπές των ασφαλιστικών οργανισμών. Για τον έλεγχο των θεραπευτικών αποτελεσμάτων των δύο παρεμβάσεων εκτιμήθηκαν ως δείκτες αποτελεσματικότητας η ενδονοσοκομειακή θνητότητα και το ποσοστό των επιπλοκών. Επίσης, οι ασθενείς παρακολουθήθηκαν για 12 μήνες μετά την έξοδό τους από το νοσοκομείο. Ελέχθηκε η κανονικότητα της κατανομής και έγινε σύγκριση των μέσων τιμών των ποσοτικών μεταβλητών και για τις δύο παρεμβάσεις, με την εφαρμογή της στατιστικής δοκιμασίας ανάλυσης της διασποράς μίας κατεύθυνσης (ANOVA). Ο έλεγχος της ανεξαρτησίας των ποιοτικών μεταβλητών έγινε με τη στατιστική δοκιμασία Χ τετράγωνο. Το μέσο νοσοκομειακό κόστος της CABG ήταν 3.364.006±442.790δρχ ανά περίπτωση ασθενούς, ενώ για την OPCAB ήταν 2.288.406±315.597δρχ. (p=0.0001). Οι αντίστοιχες νοσοκομειακές χρεώσεις ήταν 2.000.000δρχ, με αποτέλεσμα το νοσοκομείο να εισπράττει μόνο το 60% του συνολικού κόστους της CABG, ενώ για την OPCAB μέθοδο εισπράττει το 85%. Για την CABG η μέση διάρκεια νοσηλείας ήταν 6.58±1.04 ημέρες, ενώ για την OPCAB 4.93±0.93 ημέρες (p<0.0001). Από αυτές οι 1.02±0.28 ημέρες αφορούσαν στη νοσηλεία του ασθενή σε Μονάδα εντατικής θεραπείας για την CABG και οι 5.5±0.89 ημέρες στη νοσηλεία του σε νοσηλευτικό τμήμα. Αντίστοιχα, για την OPCAB οι 0.94±0.08 ημέρες ώρες αφορούσαν στη νοσηλεία του ασθενή σε Μονάδα εντατικής θεραπείας και οι 3.92±0.91 ημέρες στη νοσηλεία του σε νοσηλευτικό τμήμα. Η OPCAB μέθοδος παρουσίασε μικρότερα ποσοστά άμεσων μετεγχειρητικών επιπλοκών (CABG 47.6% έναντι OPCAB 18.3%, p=0.001), ενώ η ενδονοσοκομειακή θνητότητα δε παρουσίασε στατιστικώς σημαντική διαφορά μεταξύ των δύο παρεμβάσεων (CABG 2% έναντι OPCAB 2%, p=0.89). Η ετήσια παρακολούθηση των ασθενών έδειξε σχεδόν ίδια αποτελεσματικότητα για τις δύο παρεμβάσεις. Συγκεκριμένα, 95% των ασθενών της CABG μεθόδου έναντι 94.9% της OPCAB δεν παρουσίασε κανένα σύμπτωμα. Η ετήσια επιβίωση δεν παρουσίασε στατιστικώς σημαντική διαφορά μεταξύ των δύο πληθυσμών (CABG 95.5% έναντι OPCAB 96.5%, p=0.50). Τα αποτέλεσματα της μελέτης, τα οποία συμπίπτουν με τα αποτελέσματα των κυριοτέρων διεθνών μελετών σύγκρισης των δύο μεθόδων, δείχνουν ότι το κόστος αντιμετώπισης της στεφανιαίας νόσου παρεμβατικά, και στην Ελλάδα είναι υψηλό. Παρ’ όλα αυτά, λαμβάνοντας υπόψη τα θεραπευτικά και οικονομικά δεδομένα της μελέτης η παρεμβατική μέθοδος OPCAB διατηρεί τα πλεονεκτήματα της κλασικής μεθόδου CABG όσον αφορά τη βραχυπρόθεσμη επιβίωση και την απουσία συμπτωμάτων, αλλά φαίνεται να παρουσιάζει μικρότερα ποσοστά άμεσων μετεγχειρητικών επιπλοκών, να περιορίζει τη χρήση των υγειονομικών πόρων και να δείχνει μικρότερο κόστος έναντι της κλασικής μεθόδου CABG

Primary Care Doctors’ Assessment of and Preferences on Their Remuneration

Despite numerous studies on primary care doctors’ remuneration and their job satisfaction, few of them have quantified their views and preferences on certain types of remuneration. This study aimed at reporting these views and preferences on behalf of Greek doctors employed at public primary care. We applied a 13-item questionnaire to a random sample of 212 doctors at National Health Service health centers and their satellite clinics. The results showed that most doctors deem their salary lower than work produced and lower than that of private sector colleagues. Younger respondents highlighted that salary favors dual employment and claim of informal fees from patients. Older respondents underlined the negative impact of salary on productivity and quality of services. Both incentives to work at border areas and choose general practice were deemed unsatisfactory by the vast majority of doctors. Most participants desire a combination of per capita fee with fee-for-service; however, 3 clusters with distinct preferences were formed: general practitioners (GPs) of higher medical grades, GPs of the lowest medical grade, residents and rural doctors. Across them, a descending tolerance to salary-free schemes was observed. Greek primary care doctors are dissatisfied with the current remuneration scheme, maybe more than in the past, but notably the younger doctors are not intended to leave it. However, Greek policy makers should experiment in capitation for more tolerable to risk GPs and introduce pay-for-performance to achieve enhanced access and quality. These interventions should be combined with others in primary care’s new structure in an effort to converge with international standards

Association between subjective descriptors of coronary pain and disease characteristics: A pilot study in a Hellenic rural population

Purpose: We explored whether the way Hellenic patients describe their cardiac chest pain (verbal descriptions of the nature, intensity, temporal quality, location and radiation) associates with the diagnosis [acute myocardial infarction (AMI) versus unstable angina (UA)] as well as with the location of the coronary lesions. Methods: A cross-sectional correlational design was employed to study 80 consecutive coronary care patients (44 with AMI, 36 with UA) from northwestern Hellas. Results: Pain intensity did not differ significantly between AMI and UA, in contrast to treatment-seeking behaviour and accompanying symptoms (p ≤ 0.03). Of AMI patients, women used more often the word &quot;pain&quot; (p = 0.011), and indicated pain at the left shoulder (p = 0.004). AMI patients used fewer words (p = 0.03), and experienced pain at the back of the neck (p = 0.03) and of the left arm (p = 0.02) less often. The descriptions &quot;knob&quot;, &quot;constriction&quot; and &quot;drill&quot; were more prevalent in UA patients (p &lt; 0.01). The description &quot;drill&quot; discriminated between diagnostic groups in a multivariate model (p = 0.03). Associations between the infarct and pain location (p ≤ 0.03), and the use of some sensory descriptors (p ≤ 0.02) were detected. Pain locations associated with ECG findings (p ≤ 0.005). Conclusions: Subjective acute coronary pain descriptions and pain characteristics may associate with the pathophysiological processes in coronary syndromes. © 2007 Elsevier Ltd. All rights reserved

Greek Physicians&apos; Perceptions on Generic Drugs in the Era of Austerity

properly cited. Purpose. To assess the beliefs and preferences of Greek physicians, regarding generic drugs, in the years of financial crisis. Setting. Multicentered, nationwide survey. Material and Methods. A custom questionnaire based on former similar studies was developed and administered to Greek physicians. The variable &quot;perception on generics&quot; was constructed after an exploratory study and the instrument was validated by conventional and Rasch analysis methods. 22 items formed 5 subscales that constructed the variable in question. Results. 908 physicians successfully participated in the study (response rate: 80%). Mean total scores to the instrument were 60.63 ± 12.12 for men and significantly less (58.24 ± 11.73) for women (p = 0.04). Greek physicians were not persuaded on the potential economic gain (45.79 ± 10.53); moreover they identified that Greek authorities cannot address the increased pharmacovigilance mandates. Physicians working in Athens and those working in surgical units demonstrated significantly worse scores than their colleagues from the rest of Greece and those working in Internal Medicine wards (p = 0.03). Conclusion. Our results suggest an overall poor acceptance of the national initiative on generic drugs by Greek physicians. This trial is registered with Clinicaltrials.gov identifier: NCT01855802