Strategic Response by providers to specialty hospitals, ambulatory surgery centers, and retail clinics.

Radical innovation and disruptive technologies are frequently heralded as a solution to delivering higher quality, lower cost health care. According to the literature on disruption, local hospitals and physicians (incumbent providers) may be unable to competitively respond to such creative destruction and alter their business models for a host of reasons, thus threatening their future survival. However, strategic management theory and research suggest that, under certain conditions, incumbent providers may be able to weather the discontinuities posed by the disrupters. This article analyzes 3 disruptive innovations in service delivery: single-specialty hospitals, ambulatory surgical centers, and retail clinics. We first discuss the features of these innovations to assess how disruptive they are. We then draw on the literature on strategic adaptation to suggest how incumbents develop competitive responses to these disruptive innovations that assure their continued survival. These arguments are then evaluated in a field study of several urban markets based on interviews with both incumbents and entrants. The interviews indicate that entrants have failed to disrupt incumbent providers primarily as a result of strategies pursued by the incumbents. The findings cast doubt on the prospects for these disruptive innovations to transform health care

Networks of quantum nanorings: programmable spintronic devices

An array of quantum rings with local (ring by ring) modulation of the spin orbit interaction (SOI) can lead to novel effects in spin state transformation of electrons. It is shown that already small (3x3, 5x5) networks are remarkably versatile from this point of view: Working in a given network geometry, the input current can be directed to any of the output ports, simply by changing the SOI strengths by external gate voltages. Additionally, the same network with different SOI strengths can be completely analogous to the Stern-Gerlach device, exhibiting spatial-spin entanglement.Comment: 4 pages, 3 figures, accepted by Nano Letter

Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

BACKGROUND: The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. METHODS: A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. RESULTS: Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. CONCLUSION: Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice

Strangeness enhancement at mid-rapidity in Pb-Pb collisions at 158 GeV/c

$K^{0}_{s}$, $\Lambda$, $\Xi$, $\Omega$ and negative particle yields and transverse mass spectra have been measured at central rapidity in Pb-Pb and p-Pb collisions at 158 $A$ GeV/$c$. The yields in Pb-Pb interactions % are presented as a function of the collision centrality and compared with those obtained from p-Pb collisions. Strangeness enhancement in Pb-Pb relative to p-Pb collisions increases with the strangeness content of the particle. Going from p-Pb to Pb-Pb, the strange particle yields increase faster than linearly with the number of participants $N_{part}$ up to $N_{part} \approx 100$, thereafter the increase becomes %linear with $N_{part}$. Yields are studied as a function of the number of nucleons participating in the collision $N_{part}$, which is estimated with the Glauber model. From p-Pb to Pb-Pb collisions the particle yields per participant increase substantially. The enhancement is more pronounced for multistrange particles, and exceeds an order of magnitude for the $\Omega$. For a number of participants, $N_{part}$, greater than $100$, however, all yields per participant appear to be constant

Wpływ kształtu profilu otunelowania śmigła na siłę ciągu

The theory of cooperation with the propeller nozzle is currently being developed as applied to air drives. In the present study attempted to synthesize a new aerodynamic profile for powertrain hovercraft. We analyzed several well-known theoretical solutions aerodynamic airfoils. On the basis of the results, we designed new aerodynamic profile. The new airfoil, which has improved properties in the fields of small and medium speed.Teoria współpracy z dyszy ze śmigłem lub wentylatorem jest obecnie szeroko rozwijana w zastosowaniu do napędów lotniczych. W niniejszym opracowaniu podjęto próbę syntezy nowego profilu aerodynamicznego dla zespołu napędowego poduszkowca. Przeanalizowaliśmy teoretycznie kilka dobrze znanych rozwiązań profili aerodynamicznych. Na podstawie tych wyników opracowaliśmy nowy profil aerodynamiczny. Nowy profil ma lepsze właściwości w zakresie małych i średnich prędkości. Autorzy przedstawiają teoretyczne wyniki testów porównawczych wybranych profili z nowym profilem Ilot-HR. Nowy tunel wykazuje lepsze właściwości oporowe w porównaniu z dyszą 19A