Limited Options to Manage Specialty Drug Spending

Outlines rising trends in costs of and spending on specialty drugs; health plans' efforts to curb specialty drug spending, including patient cost sharing and utilization management; and efforts to integrate medical and pharmaceutical coverage

Employer-Sponsored Health Insurance: Down, But Not Out

Presents findings from twelve metropolitan areas about employers' efforts to control employee healthcare costs in response to the recession and national healthcare reform by firm size. Projects employer trends through 2014, including greater cost sharing

Genetic characterization and protein profiling of green mussel (Perna viridis (Linnaeus, 1758)) and brown mussel (Perna indica Kuriakose and Nair, 1976)

The marine mussels of India are mainly of two species: Perna viridis [Linnaeus, 1758) (green mussel) and Perna indica Kuriakose and Nair (1976) [brown mussel). In addition to this, along the south west coast (Kollam coast f Kerala), a third type of mussel called parrot mussel has also been reported. The present study was undertaken for genetic characterisation and dentification of distinct stocks if any, within green as well as brown mussels, From both east and west coast, using shell morphometrics and molecular markers. Stock identification using shell morphometrics were attempted with Principal Component Analysis and Canonical Discriminant function Analysis, whereas, molecular methods used were protein electrophoresis (Native - Poly Acrylamide Gel Electrophoresis) and Randomly Amplified Polymorphic DNAPolymerase Chain Reaction (RAPD-PCR). The shell morphometrics as well as Native PAGE and RAPD-PCR profiles gave concordant results indicating high intraa species homogeneity and low level of genetic differentiation among populations of both green and brown mussels. Genetic characterisation using RAPD markers could bring out the genetic variability within both the populations. Elucidation of the genetic identity of parrot mussel as to whether it is a true hybrid of green and brown mussel, or only a colour variant of any of them was also done using RAPD, shell morphometrics, protein electrophoresis (native PAGE, SDS (Sodium Dodecyl Sulphate) PAGE and allozymes) and mitochondria1 (mt) DNA gene (Cytochrome oxidase 1) analysis. The study concluded that the parrot mussel is not a hybrid of the two, but only a colour variant of the brown mussel. An initial attempt to resolve the taxonomic ambiguity of P.indica that it is only a synonym of globally distributed Perna perna, as suggested by some of the previous workers has also been made in this study using COI regions of mt DNA. As P. indica revealed only 5% divergence from P, perna, it was concluded that P. indica need not be relegated as a synonym of P.pern

A Study On Entrepreneur As A Good Decision Maker In Changing Perspective Of Business And Economy

Change is a constant thing in the business. No business can achieve success without inculcating changes in the environment and the economy. Today entire world is facing the health crisis which has resulted in the huge changes in the business environment and global economy had slashed down badly. Though most of the small businesses are in closure stages, there are certain line of business which have gained a huge market or profits in this situation also. This may be because of the decisions taken by the organization. Entrepreneurs play a vital roleinliftingtheeconomybyimproving their business through better and best decisions. Just making decisions will not yield the results. The work of entrepreneurs starts from decision making. Converting these decisions into actions will make business achieve market leadership. This paper focuses on the role of entrepreneur as a decision maker in the changing perspective of business and economy

Surgical management of chronic fourth degree perineal tear: a single center experience

Background: The aim of this article is to present the ridge about the recognition, preoperative management, surgical technique and long term follow up of patients with chronic fourth degree perineal tear.Methods: Authors conducted a prospective study in the department of obstetrics and gynecology in SDM hospital of medical sciences from 2008 January to 2016 December. Data on age, parity, incontinence to flatus, solid or liquids stools, duration of symptoms, history of previous repair, duration of repair, post-operative stay, complications and recovery were collected and analyzed. A total of thirty cases of chronic perineal tear were studied.Results: A total of 30 patients underwent CPT repair. Average duration of surgery was 90 minutes. 27 out of 30 patients were discharged on post-operative day 10. Three patients were non-compliant to treatment. Of the total 30 patients, two patients were lost for follow up. Overall success rate was 93% including patients who underwent re-surgery for failed repair.Conclusions: The significant finding of the present study was that a secondary repair of an anal sphincter injury was not associated with an unfavorable subjective outcome in relation to symptoms of anal incontinence. A good insight of perineal and anal sphincter anatomy and adherence to the sound principles is essential. The success rate in this study is 93.3% highlighting that a diligently performed operation by a surgeon of adequate expertise likely results in satisfactory outcome

The Role and Impact of ATMs in reducing Regional Disparities to Enhance Competitive Edge for the Indian Economy

Every nation runs its economic chariot through the guidance of the banking sector. The policy makers work on the twin objectives of removing regional imbalances across the length and breadth of the country and to reach out to the underprivileged masses of the society in our country. To serve objectives with such lofty ideals, not only does profit making take a back seat, it also calls in for investment in infrastructure to enhance competitive edge to the entire sector.  The power of nationalization was seen as it emerged to shift focus from ―Class Banking‖ to ―Mass banking‖, from ―Profit Banking‖ to ―Social Banking‖ and from ―Elite Banking‖ to ―Every body‘s Banking.  Automated Teller Machines (ATM), Telephonic Customer Service (TCS), online banking and mobile banking are the most prominent ones amongst banking technological advances. Yet, has it really touched the heart and soul of the country? The measurable progress with its impressive numbers, guided by policy making at the centre, has churned out progress year after year and managed to hide a growing hole called the disparity in banking services between the urban and rural masses