Social media and successful retail operations in the hyper-customisation era

It's possible to increase both customer satisfaction and profitability, but careful planning is needed, write Usha Ramanathan, Nachiappan (Nachi) Subramanian and Guy Parrot

Adherence to Cardiovascular Disease Medications: Does Patient-Provider Race/Ethnicity and Language Concordance Matter?

BACKGROUND: Patient–physician race/ethnicity and language concordance may improve medication adherence and reduce disparities in cardiovascular disease (CVD) by fostering trust and improved patient–physician communication. OBJECTIVE: To examine the association of patient race/ethnicity and language and patient–physician race/ethnicity and language concordance on medication adherence rates for a large cohort of diabetes patients in an integrated delivery system. DESIGN: We studied 131,277 adult diabetes patients in Kaiser Permanente Northern California in 2005. Probit models assessed the effect of patient and physician race/ethnicity and language on adherence to CVD medications, after controlling for patient and physician characteristics. RESULTS: Ten percent of African American, 11 % of Hispanic, 63% of Asian, and 47% of white patients had same race/ethnicity physicians.24% of Spanish-speaking patients were linguistically concordant with their physicians. African American (46%), Hispanic (49%) and Asian (52%) patients were significantly less likely than white patients (58%) to be in good adherence to all of their CVD medications (p<0.001). Spanish-speaking patients were less likely than English speaking patients to be in good adherence (51%versus 57%, p<0.001). Race concordance for African American patients was associated with adherence to all their CVD medications (53% vs. 50%, p<0.05). Language concordance was associated with medication adherence for Spanish-speaking patients (51% vs. 45%, p<0.05). CONCLUSION: Increasing opportunities for patient– physician race/ethnicity and language concordance may improve medication adherence for African American and Spanish-speaking patients, though a similar effect was not observed for Asian patients or Englishproficient Hispanic patients

Research in Home-Care Telemedicine: Challenges in Patient Recruitment

This study reports challenges in recruiting patients for a randomized controHed trial of home-care telemedicinae. Descriptive statistics on patient eligibility for home-care telemedidne services and patient refusals for participation are provided. Frequency counts of reasons for study exclusion and participant refusal and Chi-square tests to compare race and age-related differences are given. Of 302 home-care patients reviewed, 197 (65.2%) did not meet inclusion criteria. The most common reasons for study exclusion were patients either needing \u3c2 visits per month (n = 59, 30%) or \u3e3 skilled nurse visits per week (n = 46, 23.4%). Of the eligible patients (n = 105), 79 persons (75.2%) refused participation. The most common reasons for refusals were lack of perceived addition benefit of telemedicine (n = 27, 34.2%), and that routine health care was sufficient (n = 23, 29.1%). Higher than expected proportions of patients did not meet chosen eligibility criteria or refused to participate. These results should be helpful in designing home-care telemedidne programs and clinical trials

Impact of Crystal Parameters in XRD and DFT Measurements

The Zwitterionic property of aminoacids give molecular crystal formation through homodesmotic reaction with smaller organic molecules which can undergo hydrogen bonding interactions. Alpha hydroxyl phenyl acetic acid known as mandelic acid (MA) was added with essential amino acid, L-phenylalanine (LPA) resulted in the formation of molecular crystal with P21 space group otho rhombic crystal containing four units (namely one MA, two LPA and one water) bis-L –phenyl alanine mandelate (BLPAMA) by slow evaporation method. The single crystal obtained was subjected to characterisation studies. Recrystallised BLPAMA using methanol, subjected to slow evaporation method resulted in the formation of non centerosymmetric C2 point group monoclinic single crystal of R-phenylalanine-S-mandelate (RPASMA) confirmed with XRD study. The theoretical DFT study of RPASMA using Gaussian 09 software to study the non-covalent interactions with MO6,6-31++G(d,p) showed encouraging results for the formation of low energy gap, highly reactive RPASMA. The H-bonding in the crystal confirmed by DFT study showed the existence of three units – MA, H and LPA in the crystal. Compared the experimental and theoretical crystal parameters of the reactants (MA, LPA) and product (RPASMA) for the thermo chemical properties, intermolecular hydrogen bonding existing between MA and LPA stabilises the structure of the formed RPASMA crystal resulting in the small difference in energy gap observed from HOMO-LUMO studies indicate the highly reactive character of RPASMA

Research in Home-Care Telemedicine: Challenges in Patient Recruitment

This study reports challenges in recruiting patients for a randomized controlled trial of homecare telemedicine. Descriptive statistics on patient eligibility for home-care telemedicine services and patient refusals for participation are provided. Frequency counts of reasons for study exclusion and participant refusal and Chi-square tests to compare race and age-related differences are given. Of 302 home-care patients reviewed, 197 (65.2%) did not meet inclusion criteria. The most common reasons for study exclusion were patients either needing 3 skilled nurse visits per week (n = 46, 23.4%). Of the eligible patients (n = 105), 79 persons (75.2%) refused participation. The most common reasons for refusals were lack of perceived addition benefit of telemedicine (n = 27, 34.2%), and that routine health care was sufficient (n = 23, 29.1%). Higher than expected proportions of patients did not meet chosen eligibility criteria or refused to participate. These results should be helpful in designing home-care telemedicine programs and clinical trials.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63390/1/tmj.2004.10.155.pd

Fidelity of implementation: development and testing of a measure

<p>Abstract</p> <p>Background</p> <p>Along with the increasing prevalence of chronic illness has been an increase in interventions, such as nurse case management programs, to improve outcomes for patients with chronic illness. Evidence supports the effectiveness of such interventions in reducing patient morbidity, mortality, and resource utilization, but other studies have produced equivocal results. Often, little is known about how implementation of an intervention actually occurs in clinical practice. While studies often assume that interventions are used in clinical practice exactly as originally designed, this may not be the case. Thus, fidelity of an intervention's implementation reflects how an intervention is, or is not, used in clinical practice and is an important factor in understanding intervention effectiveness and in replicating the intervention in dissemination efforts. The purpose of this paper is to contribute to the understanding of implementation science by (a) proposing a methodology for measuring fidelity of implementation (FOI) and (b) testing the measure by examining the association between FOI and intervention effectiveness.</p> <p>Methods</p> <p>We define and measure FOI based on organizational members' level of commitment to using the distinct components that make up an intervention as they were designed. Semistructured interviews were conducted among 18 organizational members in four medical centers, and the interviews were analyzed qualitatively to assess three dimensions of commitment to use--satisfaction, consistency, and quality--and to develop an overall rating of FOI. Mixed methods were used to explore the association between FOI and intervention effectiveness (inpatient resource utilization and mortality).</p> <p>Results</p> <p>Predictive validity of the FOI measure was supported based on the statistical significance of FOI as a predictor of intervention effectiveness. The strongest relationship between FOI and intervention effectiveness was found when an alternative measure of FOI was utilized based on individual intervention components that had the greatest variation across medical centers.</p> <p>Conclusions</p> <p>In addition to contextual factors, implementation research needs to consider FOI as an important factor in influencing intervention effectiveness. Our proposed methodology offers a systematic means for understanding organizational members' use of distinct intervention components, assessing the reasons for variation in use across components and organizations, and evaluating the impact of FOI on intervention effectiveness.</p

Outcomes Associated with a Home Care Telehealth Intervention

To determine whether adding telehealth technology to traditional home care services increases health-related quality of life (HRQOL) and home care satisfaction, and decreases resource utilization among home care patients. This trial included 37 home care patients receiving services in a Veterans Affairs medical center, randomized into intervention and control groups. Outcome measures included patient satisfaction and HRQOL at baseline and 6-month follow- up, and the use of inpatient and outpatient services before and during the 6-month study period. Intervention group patients reported greater improvement in the mental health component of HRQOL, (t = 2.27; df = 15; p = 0.04). Satisfaction with the telehealth equipment was high (means exceeded 4.0 on six measures ranging from 1–5). However, no statistically significant differences were observed between intervention and control groups in terms of changes in physical health, inpatient admissions, bed days of care, emergency department visits, or general satisfaction with home care services. Intervention group members did show a trend (p = 0.10) toward fewer overall outpatient visits (mean = 29.1; standard deviation [SD] ± 30.1) compared to those receiving traditional home care services (mean = 38.9; SD ± 28.9) The use of telehealth services as an adjunct to traditional home care is associated with greater improvements in mental health status and a trend toward lower use of inpatient and outpatient healthcare services. Further work, utilizing larger sample sizes, is needed to investigate the relationship between telehealth services, the use of healthcare resources, and other outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63227/1/tmj.2006.12.297.pd

Collaborative closed-loop supply chain framework for sustainable manufacturing: Evidence from the Indian packaging industry

Businesses reeling from the impact of COVID are struggling to achieve sustainability, amidst many other challenges, including finance and capacity shortfalls. One of the pathways to achieving 3BL in businesses is to create closed-loop supply chains (CLSC) covering the entire lifecycle of products. CLSC have proven to be important for sustainable supply chain (SC) operations, given the shortage of materials and labour globally following the COVID-19 pandemic. While it is widely acknowledged that the success of CLSC depends on successful collaboration between SC members, factors for successful CLSC collaboration are not sufficiently understood from the literature. Employing an observation-based case study and a survey of SC members, we develop our contribution in the context of an Indian packaging company, to delineate and verify a collaborative CLSC framework. The results confirm that the success of CLSC collaboration lies in the involvement and commitment of SC members. Collaboration for forward and reverse SC operations also facilitate the involvement of SC members in CLSC collaborations. Our research suggests that SC collaborations are enhanced by explicit incentive-sharing schemes and having the same SC members for both forward and reverse SC operations

Predictors and Impact of Intensification of Antihyperglycemic Therapy in Type 2 Diabetes: Translating Research into Action for Diabetes (TRIAD)

ObjectiveThe purpose of this study was to examine the predictors of intensification of antihyperglycemic therapy in patients with type 2 diabetes; its impact on A1C, body weight, symptoms of anxiety/depression, and health status; and patient characteristics associated with improvement in A1C.Research design and methodsWe analyzed survey, medical record, and health plan administrative data collected in Translating Research into Action for Diabetes (TRIAD). We examined patients who were using diet/exercise or oral antihyperglycemic medications at baseline, had A1C &gt;7.2%, and stayed with the same therapy or intensified therapy (initiated or increased the number of classes of oral antihyperglycemic medications or began insulin) over 18 months.ResultsOf 1,093 patients, 520 intensified therapy with oral medications or insulin. Patients intensifying therapy were aged 58 +/- 12 years, had diabetes duration of 11 +/- 9 years, and had A1C of 9.1 +/- 1.5%. Younger age and higher A1C were associated with therapy intensification. Compared with patients who did not intensify therapy, those who intensified therapy experienced a 0.49% reduction in A1C (P &lt; 0.0001), a 3-pound increase in weight (P = 0.003), and no change in anxiety/depression (P = 0.5) or health status (P = 0.2). Among those who intensified therapy, improvement in A1C was associated with higher baseline A1C, older age, black race/ethnicity, lower income, and more physician visits.ConclusionsTreatment intensification improved glycemic control with no worsening of anxiety/depression or health status, especially in elderly, lower-income, and minority patients with type 2 diabetes. Interventions are needed to overcome clinical inertia when patients might benefit from treatment intensification and improved glycemic control