Bronchial thermoplasty: implementing best practice in the era of cost containment.

Increasing dependence on advanced technologies in the 21st century has created a dilemma between the practice and business of medicine. From information technology to robotic surgery, new technologies have expanded treatment possibilities and have potentially improved patient outcomes and safety. Simultaneously, their escalating costs limit access for certain patients and health care facilities. Nevertheless, medical decisions should not simply be based on cost. Input from physicians and other health care specialists as well as adherence to best practice position statements, are vital to implementing truly cost-effective strategies in medicine. Bronchial thermoplasty (BT), a US Food and Drug Administration approved bronchoscopy procedure in difficult-to-control persistent asthma, is a prime example of a new technology facing cost and implementation challenges. We discuss the specific indications and contraindications for BT and review recent real-world experiences that can provide the foundation for building a comprehensive asthma program that provides BT for difficult-to-control asthma patients who fail national guideline treatment recommendations after an adequate clinical trial of one. We also offer insight into the barriers to implementing a successful BT program and strategies for overcoming them

Fairtrade towns as unconventional networks of ethical activism

The growing availability and consumption of Fairtrade products is recognised as one of the most widespread ethically inspired market developments, and as an example of activist-driven change within the wider marketing system. The Fairtrade Towns movement, now operating in over 1700 towns and cities globally, represents a comparatively recent extension of Fairtrade marketing driven by local activists seeking to promote positive change in production and consumption systems. This paper briefly explores the conventional framing of the role that ethically related activism plays in the operation of markets and in influencing market participants. It then presents key insights gathered from a grounded theory exploration of Fairtrade Towns as activist-driven marketing systems, revealing the atypical nature of the activism involved. The findings demonstrate how local activists leverage their social networks to exert pressure and generate support to promote ethical consumption. The study suggests that Fairtrade Towns offer a new role for activists as Fairtrade itself becomes more mainstream, and considers the role they are fulfilling as ‘informal’ local marketers. The marketing dynamics revealed represent a complex and distinctive form of relational activism that seeks to build Fairtrade markets and highlight their positive benefits, with potential lessons for other local ethical market-building efforts in future

Search for New Physics in Rare Top Decays: ttˉt \bar t Spin Correlations and Other Observables

In this paper we study new-physics contributions to the top-quark decay $t \to b \bar b c$. We search for ways of detecting such new physics via measurements at the LHC. As top quarks are mainly produced at the LHC in $t \bar t$ production via gluon fusion, we analyze the process $gg \to t \bar t \to (b \bar b c) (\bar b \ell \bar \nu)$. We find six observables that can be used to reveal the presence of new physics in $t \to b \bar b c$. Three are invariant mass-squared distributions involving two of the final-state particles in the top decay, and three are angular correlations between the final-state quarks coming from the $t$ decay and the $\ell^-$ coming from the $\bar t$ decay. The angular correlations are related to the $t \bar t$ spin correlation.Comment: Published versio

Expanding the Boundaries of Brand Communities : The Case of Fairtrade Towns

Purpose: This paper aims to further the authors’ understanding of brand communities, and their role in brand co-creation, through empirical and theoretical contributions derived from researching the marketing dynamics operating within a successful but atypical form of brand community, Fairtrade Towns (FTT). Design/methodology/approach: The paper reflects a pragmatic application of Grounded Theory, which captured qualitative data from key “insiders”, with a particular emphasis on FTT steering group members and their role as “prosumers”. Data were gathered via ethnographic involvement within one town and semi-structured interviews with participants in others. Findings: FTTs, as brand communities, demonstrate elements of co-creation that go beyond the dominant theories and models within the marketing literature. They operate in, and relate to, real places rather than the online environments that dominate the literature on this subject. Unusually, the interactions between brand marketers and consumers are not the primary source of co-creation in FTTs. Instead, factors usually identified as merely secondary providers of additional brand knowledge become key initiators and sources of co-creation and active “citizen marketer” engagement. Originality/value: This study demonstrates how brand co-creation can operate in physical geographical communities in ways that are formal without being managed by conventional brand managers. It conceptualises FTTs as a nested and “glocalised” brand and demonstrates how steering group members facilitate the process of co-creation as prosumers. It empirically demonstrates how FTTs have evolved to become unusually complex brand communities in terms of the variety of stakeholders and the multiplicity of brands involved, and the governance of the localised brand co-creation process

Aflatoxin Contamination and Consumer Valuation of Maize in Western Kenya

Crop Production/Industries,