Perceived risk and risk-relievers in online travel purchase intentions

Although the Internet offers numerous benefits, some consumers are still reluctant to purchase travel products online due to perceived risk. Travel products are associated with higher risk not only because of their tangibility, but also because they typically involve higher cost and complex choices. Additionally, the perceived risk of purchasing travel products online is magnified by privacy and risk involved. This study investigates perceived risk associated with online travel purchasing by Taiwanese consumers with a special focus on their reaction to risk-relievers provided on travel websites. Data were collected through participant observation of the searching/purchasing process of online travel products by the Taiwanese consumers. The results show some risk-relievers are considered to be more effective in reducing perceived risk related to online travel purchase. Based on this finding, it is suggested that travel websites should try and develop risk-relievers aimed at supporting consumers in the prepurchase phase in order to reduce perceived risk, which may lead to positive online travel purchasing intentions. © Taylor & Francis Group, LLC

Predictive modeling of health care expenditures for Medicare beneficiaries with Alzheimer's disease

Using the 1999-2004 Medicare Current Beneficiary Survey linked with Medicare claims, this dissertation identified the most sensitive and specific alternatives for selecting who has Alzheimer's disease (AD). This dissertation examined expenditure concentration and persistence patterns among seniors with AD, and was the first, to our knowledge, to compare the performance of different risk adjustment measures to predict overall and drug expenditures in the AD population. The use of survey-reported AD, diagnosis in medical claims, and Alzheimer-specific prescription medicine identified different subsets of seniors with AD. Per capita health expenditures ranged from $16,547 to$24,937, and drug expenditures ranged from $2,303 to$3,519, depending on how AD was defined. Using at least one of the three disease markers as our case definition, overall and drug expenditures were highly concentrated and persistent over a two-year period. Prior expenditures and comorbidities, but not functional ability, were highly predictive of the level of subsequent-year expenditures. In single-measure, diagnosis-based risk adjustment models, the Charlson Comorbidity Index outperformed the Diagnostic Cost Group-Hierarchical Condition Category used by Medicare and the Chronic Illness and Disability System-Medicare in predicting total and drug expenditures. The frailty adjuster based on limitations of activity of daily living improved overall prediction and predictive accuracy of diagnosis-based models. Only prior drug expenditures predicted drug expenditures well. Future research is needed to evaluate iv the performance of risk adjustment measures based on ambulatory pharmacy data. In conclusion, the development of a comprehensive case definition that is reasonably sensitive and specific is crucial in observational studies to identifying individuals at different phases of AD and to assessing their health care needs. With proper organization of information, risk adjustment appears promising in predicting health expenditures even in a population with substantial disabilities. Predictive models identifying seniors with AD who are at risk for higher future expenditures can help managed care organizations to mitigate costs or change care patterns through disease management, which may delay time to nursing home care. Better care coordination, such as medication management by nurses or pharmacists, is needed to improve adherence to drug therapies for concomitant conditions with AD

Linking Supply Chain Strength to Sustainable Development and Innovation: A Country-Level Analysis

The study ascertained the presence of association between supply chain efficiency and sustainable development together with innovation within a country. This study determined as well the link that bonds supply chain efficiency with environmental performance. The study clarified that supply chain efficiency affects corporate environmental processes by any means. Lastly, the study evaluated how supply chain efficiency affects social sustainability and sustainable development. The main task for gathering data was to put together all the archives of the Global Competitiveness Report and Environmental Performance Index Reports, spanning from 2005 to 2008. The Pearson Product Moment Correlation Coefficient has been computed to ascertain if there are significant bivariate relationships between the variables of interest. Sustainable development means fulfilling the present generations needs without compromising the needs of future generations. This just proved that human needs are important. Thus, it presented that sustainability relies on economic development that involves a country’s population. This also reflects that the environment has limitations in assimilating the effects of human activities (Kates et al, 2005). Environmental limitations refer to continuous effects of human activities with the use of resources and elements provided by nature, and the Earth’s capabilities of accumulating wastes and emissions (Clift 2003). Both sustainable development and innovation are significantly and positively correlated with supply chain efficiency

Economic implications of comorbid conditions among Medicaid beneficiaries with COPD

SummaryObjectivesTo characterize a comprehensive comorbidity profile and to explore the economic implications of comorbidity among patients with chronic obstructive pulmonary disease (COPD).MethodsThis retrospective cohort study analyzed medical claims from the Maryland Medicaid database. We employed a 1:2 case–control design to select COPD patients (n=1388) and demographically matched controls (n=2776) aged 40 to 64 years with 24 months of continuous enrollment. Odds ratios were employed to compare comorbidity differences, including 17 conditions defined by the Charlson Comorbidity Index (CCI) and 6 additional conditions commonly observed in COPD patients. We estimated the incremental medical utilization and medical cost by specific condition.ResultsCompared with the controls, Medicaid COPD patients had higher comorbidity burden and were more likely to have myocardial infarction, congestive heart failure, cerebrovascular disease, peptic ulcer, mild liver disease, hypertension, sleep apnea, tobacco use, and edema. COPD patients on average had 24% more medical claims (81.4 vs. 65.4, p<0.001) and were 33% more expensive than controls ($7603 vs.$5732, p<0.001). Ten conditions defined by the CCI as well as hypertension, tobacco use, and edema were associated with incremental medical utilization and cost in COPD patients; depression was associated with incremental medical utilization but not cost.ConclusionsThe high burden of comorbidity in COPD patients translates into additional medical utilization and cost. Effective disease management and treatment protocols are needed to reduce comorbidity burden. The development of a COPD-specific comorbidity measure may be used to identify high-risk subgroups and to predict utilization and cost

FACTORS AFFECTING THE TRANSFER OF INTER-ORGANIZATIONAL SYSTEMS TO CHINA: A CASE STUDY OF HIGH-TECH ENTERPRISES

Due to the huge market potentiality, profuse production resource such as workforce and land, and low production costs in China, many international high-tech enterprises are moving their production line to China. Accompanying production offshoring is the transfer of Information Technology (IT) to ensure that the production processes remain efficient and effective at home and abroad. Many enterprises however encounter problems in transferring their IT to China, especially when the IT is an inter-organizational system (IOS), which is across organizational boundaries and involves the management of relationships among participants. In order to understand how to successfully transfer IOS to China, we aim to find out key relational factors of IOS performance in China through an observation of a binary relationship built upon an e-procurement system between a Taiwanese PC ODM (Original Design Manufacturer) and its Chinese suppliers. Based on the relational view of the firm, four relational factors are proposed and examined. The results show that IOS specific investments and effective IOS governance most strongly affects the result of IOS transfer to China, whereas complementary resource endowment has least influence

Traditional Chinese Medicine ZHENG Identification Provides a Novel Stratification Approach in Patients with Allergic Rhinitis

Background. We aimed to apply the ZHENG identification to provide an easy and useful tool to stratify the patients with allergic rhinitis (AR) through exploring the correlation between the quantified scores of AR symptoms and the TCM ZHENGs. Methods. A total of 114 AR patients were enrolled in this observational study. All participants received the examinations of anterior rhinoscopy and acoustic rhinometry. Their blood samples were collected for measurement of total serum immunoglobulin E (IgE), blood eosinophil count (Eos), and serum eosinophil cationic protein (ECP). They also received two questionnaire to assess the severity scores of AR symptoms and quantified TCM ZHENG scores. Multiple linear regression analysis was used to determine explanatory factors for the score of AR manifestations. Results. IgE and ECP level, duration of AR, the 2 derived TCMZHENG scores of “Yin-Xu − Yang-Xu”, and “Qi-Xu + Blood-Xu” were 5 explanatory variables to predict the severity scores of AR symptoms. The patients who had higher scores of “Yin-Xu − Yang-Xu” or “Qi-Xu + Blood-Xu” tended to manifest as “sneezer and runner” or “blockers,” respectively. Conclusions. The TCM ZHENG scores correlated with the severity scores of AR symptoms and provided an easy and useful tool to stratify the AR patients

Negotiating The Maze: Confronting Dysphagia Together With My Stroke-Afflicted Family Member

Aim: To generate a descriptive theory grounded in the responses of family caregivers caring for their family stroke survivors with dysphagia during hospitalization. Design and Method: A qualitative study employing the grounded theory method was used. Fifteen family caregivers participated in comprehensive interviews. The interview data were analyzed using the constant comparative method. Findings: ‘Negotiating the maze: Confronting dysphagia with my stroke-afflicted family member’ was the core category guiding the care process for dysphagia family members among caregivers. After surviving stroke, the caregivers felt ‘more confusion less rejoicing’ as the antecedent condition. The following three interaction categories were identified: (1) ‘being overwhelmed by nasogastric (NG) tube issues’; (2) ‘searching for the right helper and information’; and (3) ‘food culture conflicts with the formula diet administered through the NG tube’. Additionally, ‘Maintaining positivity’ described the consequence of this process. Conclusions: This study highlights the critical perspective of family members who care for dysphagia stroke survivors in the hospital. Participants were under tremendous pressure during the disease treatment process. However, all attempted to maintain a positive attitude and treasured the chance to accompany their family members. Clinical Relevance: These findings can assist health professionals in charting the effects of dysphagia and in understanding the problems and needs according to the subjective perspectives of family caregivers. They can also provide a necessary foundation for comprehensive care interventions for family caregivers of stroke survivors with dysphagia

The Repository Chemotion: Infrastructure for Sustainable Research in Chemistry

We describe the development of a repository for chemistry research data (called Chemotion) that provides solutions for current challenges to store research data in a feasible manner, allowing the conservation of domain‐specific information in a machine‐readable format. A main advantage of the repository Chemotion is the comprehensive functionality, offering options to collect, prepare and reuse data with discipline specific methods and data processing tools. For selected analytical data, automated procedures are implemented to facilitate the curation of the data. Chemotion provides functions for a feasible data publishing process including automated Digital Object Identifier (DOI) generation and workflows for peer reviewing of the submissions, including embargo settings. The described developments were used to establish a research‐data infrastructure to build a new community‐driven repository as a comprehensive alternative to commercial databases

Ludwigia octovalvis extract improves glycemic control and memory performance in diabetic mice

Ethnopharmacological relevance Ludwigia octovalvis (Jacq.) P.H. Raven (Onagraceae) extracts have historically been consumed as a healthful drink for treating various conditions, including edema, nephritis, hypotension and diabetes. Aim of the study We have previously shown that Ludwigia octovalvis extract (LOE) can significantly extend lifespan and improve age-related memory deficits in Drosophila melanogaster through activating AMP-activated protein kinase (AMPK). Since AMPK has become a critical target for treating diabetes, we herein investigate the anti-hyperglycemic potential of LOE. Materials and methods Differentiated C2C12 muscle cells, HepG2 hepatocellular cells, streptozotocin (STZ)-induced diabetic mice and high fat diet (HFD)-induced diabetic mice were used to investigate the anti-hyperglycemic potential of LOE. The open field test and novel object recognition test were used to evaluate spontaneous motor activity and memory performance of HFD-induced diabetic mice. Results In differentiated C2C12 muscle cells and HepG2 hepatocellular cells, treatments with LOE and its active component (β-sitosterol) induced significant AMPK phosphorylation. LOE also enhanced uptake of a fluorescent glucose derivative (2-NBDG) and inhibited glucose production in these cells. The beneficial effects of LOE were completely abolished when an AMPK inhibitor, dorsomorphin, was added to the culture system, suggesting that LOE requires AMPK activation for its action in vitro. In streptozotocin (STZ)-induced diabetic mice, we found that both LOE and β-sitosterol induced an anti-hyperglycemic effect comparable to that of metformin, a drug that is commonly prescribed to treat diabetes. Moreover, LOE also improved glycemic control and memory performance of mice fed a HFD. Conclusions These results indicate that LOE is a potent anti-diabetic intervention that may have potential for future clinical applications