WorldWideScience

Sample records for health spa customers

  1. Health tourism in a Czech health spa.

    Science.gov (United States)

    Speier, Amy R

    2011-04-01

    This paper is about the changing shape of health tourism in a Czech spa town. The research focuses on balneotherapy as a traditional Czech healing technique, which involves complex drinking and bathing therapies, as it is increasingly being incorporated into the development of a Czech health tourism industry. Today, the health tourism industry in Mariánske Lázne is attempting to 'harmoniously' combine three elements--balneology, travel and business activities. One detects subtle shifts and consequent incongruities as doctors struggle for control over the medical portion of spa hotels. At the same time, marketing groups are creating new packages for a general clientele, and the implementation of these new packages de-medicalizes balneotherapy. Related to the issue of the doctor's authority in the spa, the changes occurring with the privatization of tourism entails the entrance of 'tourists' to Mariánske Lázne who are not necessarily seeking spa treatment but who are still staying at spa hotels. There is a general consensus among spa doctors and employees that balneotherapy has become commodified. Thus, while balneotherapy remains a traditional form of therapy, the commercial context in which it exists has created a new form of health tourism.

  2. Analisa Pengaruh Brand Image Terhadap Customer Loyalty Dengan Customer Satisfaction Sebagai Mediator Pada the Dreamland Luxury Villas and Spa, Bali.

    OpenAIRE

    Leliga, Felicia Juliani

    2013-01-01

    Penelitian ini dilakukan untuk mengetahui customer loyalty pada brand The Dreamland Luxury Villas and Spa, Bali melalui penilaian responden terhadap dimensi brand image yang terdiri dari brand strength, brand favorability, dan brand uniqueness, dengan menggunakan customer satisfaction sebagai variabel mediator. Dalam penelitian ini, penulis menggunakan metode kuantitatif dengan teknik partial least square (PLS). Dari hasil analisa, disimpulkan bahwa tidak ada pengaruh brand strength dan brand...

  3. Solec Spa – worldwide unique properties of Polish health resort in the service of rural medicine

    Directory of Open Access Journals (Sweden)

    Marek L Grabowski

    2018-03-01

    Full Text Available Solec Spa is health resort in south-eastern Poland. Its unique balneorehabilitation significance worldwide is determined by chloride-iodine-sodium water with a high content of hydrogen sulphide. This water, classified as highly mineralized sodium-chloride (seltzer sulphide, bromide, iodide, boron water, contains naturally approximately 0.9 g/l divalent sulphur compounds, which is the highest concentration noted among the mineral waters of the world. The effectiveness of the Solec waters is proven in: inflammatory and autoimmunological locomotor system diseases, degenerative joint disorders (osteoarthritis, post-traumatic and post-operative orthopedic diseases, skin diseases and allergic disorders. One of the main indications for balneotherapy in Solec Spa and Busko Spa is chronic brucellosis.

  4. [The topical problems of pediatric balneotherapy and the spa and health resort-based treatment of the children].

    Science.gov (United States)

    Razumov, A N; Khan, M A

    2016-01-01

    This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

  5. [Certain medico-economic prerequisites for the integration of spa and resort facilities into the system of compulsory health insurance].

    Science.gov (United States)

    Artem'eva, G B; Gekht, I A

    2013-01-01

    The involvement of spa and resort facilities in the system of compulsory health insurance is of primary importance for the improvement of medical aid provided to the population. The application of the methods for the calculation of differential expenditures on the spa and resort-based treatment and estimation of their dependence on a variety of factors may facilitate the more rational use of the available resources of compulsory health insurance.

  6. [The toxic complications of hydrogen sulfide-based balneotherapy in the spa and health resort practice].

    Science.gov (United States)

    Khodasevich, L S

    2015-01-01

    The present literature review was designed to consider the toxic complications of hydrogen sulfide-based balneotherapy encountered in the spa and health resort practice that should actually be regarded as hydrogen sulfide intoxication taking into consideration that their severity depends on the route through which the toxicant enters the body, its concentration in the therapeutic bath, and the overall duration of balneotherapy. Although such complications rarely occur in everyday practice, they may constitute a threat to the patient's health which implies the necessity of adequate measures for their prevention.

  7. Spa-goers’ Characteristics, Motivations, Preferences and Perceptions: Evidence from Elounda, Crete

    Directory of Open Access Journals (Sweden)

    Nikolaos Trihas

    2016-12-01

    Full Text Available Spa and wellness tourism is one of the fastest-growing market segments in the hospitality and tourism industry. The aim of this study is to investigate and identify spa-goers’ characteristics, motivations, preferences and perceptions, providing a better understanding of the main features of this type of tourists’ behavior and expectations from a spa and wellness centre. Primary quantitative research was conducted via a structured questionnaire in a sample of 123 spa customers at Elounda in Crete. The results of the study revealed a number of important factors that influence them when choosing a spa, namely the cleanliness and the maintenance of a spa, the staff knowledge and hygiene, the personnel behavior and courtesy, and the quality of services. In addition, the main reason for visiting the spa is for stress relief/relaxation, followed by physical health improvement and beauty treatments. Findings and discussion of this study are useful to industry practitioners (spa and wellness service providers who wish to develop appropriate marketing strategies and enhance customer satisfaction and academic researchers interested in spa and wellness tourism.

  8. Toward Mass Customization of Health Information

    Science.gov (United States)

    de la Cruz, Norberto B.; Kahn, Charles E.

    1999-01-01

    As a part of its community outreach efforts, the Medical College of Wisconsin developed the “MCW HealthLink” health information resource. The philosophy, design and implementation of the site lend well to steering future developments towards mass customization of health information.

  9. Cost-effectiveness of Spa treatment for fibromyalgia: general health improvement is not for free

    NARCIS (Netherlands)

    Zijlstra, T.R.; Braakman-Jansen, Louise Marie Antoinette; Taal, Erik; Rasker, Johannes J.; van de Laar, Mart A F J

    2007-01-01

    Objectives: To estimate the cost-effectiveness of an adjuvant treatment course of spa treatment compared with usual care only in patients with fibromyalgia syndrome (FM). - Methods: 134 patients with FM, selected from a rheumatology outpatient department and from members of the Dutch FM patient

  10. [The spa-health resort and touristic-recreational facilities of the region: the methodological aspects of their development].

    Science.gov (United States)

    Kirilina, V M; Kolesnikova, N V; Kolesnikov, N G

    2016-01-01

    The correction and optimization of the motor activity of the patients are currently the main priorities of all rehabilitative and recreational activities based at the spa and health resort facilities. The forms of such activities include walking tours and excursion trips. In other words, the excursion potential is one of the very important attributes of the recreational recourses. Under the current conditions characterized by the rapid socio-economic changes, the studies concerning the structural and functional transformation of spa and health resorts, recreational and tourist facilities acquire special importance, both from the humanitarian and economic points of view. The results of these studies may greatly contribute to the organization and the further development of rehabilitative and recreational activities based at the spa and health resort facilities, recreational and tourist centers taking into consideration their evolution. The objective of the present article is to analyze the structure and functions of the recreation and tourist centres as well as the modes of their cooperation with the spa and health resort facilities. In other words, these structures and their functions are both the object and the subject of the present study. The methodology of the study is based on the logical analysis of the development of the recreational and tourist systems in the framework of the evolutionary approach. (1) the notions of «tourist destination» and «recreation» have been substantiated; (2) the results of the studies carried out at the Institute of Physical Culture, Sports and Tourism and the Petrozavodsk State University have been used to elaborate the affiliate international Master Degree program «Project management in the tourism industry». The main emphasis in this program is placed on the necessity and methods of the improvement of recreational activities and more efficacious utilization of the climatic factors and the health resort infrastructure as

  11. What is a health worker? How spa therapists in a Norwegian health hotel understand their work.

    Science.gov (United States)

    Anderssen, Jorid

    2016-01-01

    In Norway, as in many other wealthy countries, the number of health-related services that are being offered outside of the health sector is increasing. The present paper is based on qualitative interviews that were conducted with providers of health-related services at a commercial health hotel in Norway. The hotel is marketed as a health hotel - that is, a place for people with health problems and for those who need relaxation and an escape from their stressful everyday lives. The paper discusses whether the providers of this kind of service consider it a health service or if they distinguish and distance themselves from the health system. The interviews showed that they consider themselves health workers and refer to themselves as therapists. Even though they use therapy in the health sector as a model, they distinguish themselves from therapists in the health sector. They do not want to treat what they call sick people. Most of their therapy is directed toward cultivating or improving people's bodies and souls. These service providers think that they contribute to improving their guests' health by teaching them how to take care of themselves; enjoying oneself (for instance, by receiving skin treatment or a massage) is an important aspect of good health. According to the therapists, modern-day women, in particular, are often worn-out, and they deserve, and are entitled, to enjoy themselves. In these ways, the therapists use health to legitimize their services, and they challenge the current understanding of health.

  12. [The development of the medical information system for the improvement of the quality of work of the Crimean spa and health resorts].

    Science.gov (United States)

    Ezhov, V V; Grigor'ev, P E; Mizin, V I; Andriiashek, Iu I; Gol'dberg, D L; Olenchuk, A V

    2016-01-01

    The Crimea has the enormous potential for the health promotion activities. However, neither the profile of these activities nor the demand for the socio-medical services is clearly defined for the majority of the local spa and health resort facilities. The possibilities of modern information technology are not used in the full measure either. The objective of the present work was to elaborate the new medical information system and demonstrate its effectiveness. In addition, the article describes the main advantages of the system for the optimization of healthcare in the Crimean spa and health resort facilities. We reviewed and analyzed various literature publications, legal framework, standards, regulations, guidelines, and questionnaire survey data obtain at 50 spa and health resort facilities of the Crimea. The results of the assessment indicate the necessity of the systematic approach to the analysis of the quality of medical care and the process of its further development. Statistical and mathematical methods were used to elaborate the medical information system for the optimization of the activities of the Crimean spa and health resorts. The distinctive features of the proposed information system are modularity and the possibility of flexible adjustment to the conditions of individual settings, one-step data loading with the subsequent multiple application for the formulation of documents, automated filling of records in compliance with the medical standards, and taking into consideration the possible changes in or amendments to the form of the documents. The data obtained in the course of project implementation were used for the first time in the Republic of Crimea to design, substantiate, and recommend for the practical application the algorithm for the comprehensive estimation of the results of treatment of the patients based at the spa and health resort facilities with due regard for the specific regional conditions.

  13. Treatment of knee OSTEOARTHRITIS in Spa Health resorts: where do we stand?

    Directory of Open Access Journals (Sweden)

    Salca Amalia

    2015-09-01

    Full Text Available Osteoarthrosis (OA includes degenerative joint disorders that affect articular cartilage in the first instance, followed by changes of all components of the joint. The disease is detected in a proportion of 33% by X-ray in patients aged over 60 years. Knee OA (KOA ranks first among chronic diseases from the point of view of patient disability. This article is a review of guidelines and articles regarding arthrosis, balneotherapy, and balneotherapy in KOA treatment. These were accessed on the Pubmed site in the period March-April 2015. The components of balneo-therapy to which the selected articles refer include mud packs, mineral waters, climate change. These are evaluated in association or in comparison with other methods used in the rehabilitation specialty area for the treatment of KOA: kinesitherapy, intra-articular infiltrations, hydrothermotherapy. The changes induced by these therapies on clinical evolution (pain relief, tenderness, functionality, quality of life, depression symptoms or certain serum parameters (biomarkers of oxidative stress, inflammation and cartilage destruction, vitamin D and other serum metabolites were recorded. The results of our review are consistent with the studies focused on spa modalities in all types of OA. All these data helped defining the role of balneotherapy as part of the rehabilitation program for the treatment of KOA, through the benefits specific to it. Conclusion: Balneotherapy has beneficial effects on patients with KOA, both clinically and serologic improvements. Further studies are needed to quantify these effects using KOA specific markers, to establish a hierarchy of balneotherapy methods based on their effects on KOA, as well as to refine indications depending on the stage of the disease.

  14. Business Performance of Health Spa Tourism Providers in Relation to the Structure of Employees in the Republic of Croatia.

    Science.gov (United States)

    Vrkljan, Sanela; Grazio, Simeon

    2017-12-01

    Health spa tourism services are provided in special hospitals for medical rehabilitation and health resorts, and include controlled use of natural healing factors and physical therapy under medical supervision in order to improve and preserve health. Health tourism is a service industry and therefore labor-intensive industry in which human resources are one of the key factors of business success. The aim of this study was to analyze business performance of special hospitals for medical rehabilitation and health resorts in Croatia in relation to the structure of employees, specifically the number of physicians and total medical personnel, as well as the share of physicians and medical personnel in the total number of employees. The assumption was that those who employ more physicians and medical employees are more successful. The empirical research was conducted and the assumption was tested firstly by correlation analysis and afterwards by regression analysis. The total number of employees in the researched health resorts and special hospitals amounted to 2,863, of which the share of physicians specialists accounted for almost 7%, while the share of total medical staff was almost 53%. From the results of our research, it can be concluded that special hospitals for medical rehabilitation and health resorts, which employ more physicians and medical personnel, are achieving better financial business performance. Based on the results obtained, it is possible to provide guidance for further growth and development in the direction of basing the primary offer on medical-health offer, rather than on wellness offer, which is a strong trend in the world. These findings are important for planning the health and tourism policies in Croatia and similar countries.

  15. Spa therapy (balneotherapy) relieves mental stress, sleep disorder, and general health problems in sub-healthy people

    Science.gov (United States)

    Yang, Bei; Qin, Qi-zhong; Han, Ling-li; Lin, Jing; Chen, Yu

    2018-02-01

    circumferences in women of various ages under 55 years were significantly reduced in the intervention group ( P 0.05). Spa therapy (balneotherapy) relieves mental stress, sleep disorder, general health, and reduces women's waist circumferences in sub-healthy people.

  16. Personal health records: retrieving contextual information with Google Custom Search.

    Science.gov (United States)

    Ahsan, Mahmud; Seldon, H Lee; Sayeed, Shohel

    2012-01-01

    Ubiquitous personal health records, which can accompany a person everywhere, are a necessary requirement for ubiquitous healthcare. Contextual information related to health events is important for the diagnosis and treatment of disease and for the maintenance of good health, yet it is seldom recorded in a health record. We describe a dual cellphone-and-Web-based personal health record system which can include 'external' contextual information. Much contextual information is available on the Internet and we can use ontologies to help identify relevant sites and information. But a search engine is required to retrieve information from the Web and developing a customized search engine is beyond our scope, so we can use Google Custom Search API Web service to get contextual data. In this paper we describe a framework which combines a health-and-environment 'knowledge base' or ontology with the Google Custom Search API to retrieve relevant contextual information related to entries in a ubiquitous personal health record.

  17. [The psychological security in the framework of the system of factors responsible for the effectiveness of spa and health resort-based rehabilitation].

    Science.gov (United States)

    Krasnyanskaya, T M; Tylets, V G

    The present work was designed to address the problem of ensuring the psychological security in the framework of organization of the rehabilitative treatment based at the spa and health resort facilities. We undertook the questionnaire study for which 650 subjects were recruited among those attending spa and health resort facilities of the cities of Essentuki and Kislovodsk. The participants were asked to estimate the level of their personal security and the quality of the provided means for the rehabilitative treatment and general health improvement. It was found that as many as 43% of the respondents reported the moderate level of psychological security whereas about 30% of them estimated the level of their psychological security as low. Overall, the attitude toward the available means for health improvement and rehabilitation proved extremely variable. The factorial analysis has demonstrated the highly subjective opinions of the responders as regards the provided services categorized in terms of therapeutic (mineral water, preformed physical factors, peloid and dietary therapy), health improvement (herbal medicine, therapeutic physical training, therapy, bioclimatic therapy), and recreational (animation, excursion and touristic activities) factors. The value of these factors was perceived differently by the vacationers with different feelings of psychological security. Those reporting the high level of psychological security demonstrated the positive attitude toward all factors and circumstances available for the general improvement of the health status whereas the holidaymakers reporting the moderate level of personal psychological security exhibited the non-equivalent attitude toward the provided services; namely, they highly estimated the available therapeutic factors but either underestimated the value of the constituent components of the health improving and recreational factors or demonstrated the very selective attitude toward their assessment. Generally

  18. [Efficiency of medical and economic activities of a sanatorium-and-spa facility in the active phase of the public health system reform under macroeconomic instability].

    Science.gov (United States)

    Poliakov, B A; Kizeev, M V

    2010-01-01

    Results of a comprehensive study have demonstrated that the reform of the public health system currently underway in this country provides conditions for the extension of medical care based at sanatorium-and-spa facilities with simultaneous rise in relevant expenses. Bearing in mind the unstable macroeconomic situation, this requires thorough monitoring medical and economic activities of health resorts for the purpose of enhancing cost efficiency. The goal of optimization can be achieved by increasing competitive capacity based on strict control of expenditures and income redistribution for financing the most promising projects.

  19. The total customer relationship in health care: broadening the bandwidth.

    Science.gov (United States)

    Berwick, D M

    1997-05-01

    The health care system is in the midst of a market revolution, driven by cost containment but also fully charged by the idea that competition among providers will lead to reforms that neither the government nor the professions have been able to achieve by themselves. An agenda of "reports to consumers" has been advanced as a bright new hope for improving the health care system. An alternative to this notion of consumerism is far broader--that is the concept of total relationship. In the hands of masters outside the health care domain, the total customer relationship embraces several elements that can be imported into health care and that offer more promise than "report cards," including the following: Customers as assistants in decreasing waste; Mass customization and stratification of need; Shaping demand; Immediate recovery; Delight as the objective; and Customer knowledge and innovation. A CREDO: The next phase of development of total customer relationship might well be guided by a credo including several tenets about the wisdom of those the health care system serves and the nature of its purpose: 1. In a helping profession, the ultimate judge of performance is the person helped. 2. Most people, including sick people, are reasonable most of the time. 3. Different people have different, legitimate needs. 4. Pain and fear produce anxiety in both the victim and the helper. 5. Meeting needs without waste is a strategic and moral imperative.

  20. Including customers in health service design.

    Science.gov (United States)

    Perrott, Bruce E

    2013-01-01

    This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

  1. Analiza lecznictwa uzdrowiskowego dzieci po leczeniu przeciwnowotworowym = Analysis of health spa treatment of children following cancer therapy

    Directory of Open Access Journals (Sweden)

    Agata Wawryków

    2016-02-01

                        Introduction: There is about 1200 new pediatric patients diagnosed with malignacies every year in Poland. Many of them requires a multi-stage, long-term and systematic rehabilitation after finished anti-cancer treatment. Specialized centers of physical and psychosocial rehabilitation take the main role in reducing the ate effects of anti-cancer treatment. There is only one rehabilitation center in Poland witch takes care of children with malignancies.                     Aim: The aim of this study was to analyze the health spa treatment of children after anti-cancer treatment on the example of Hematology Rehabilitation Hospital for Children "Orlik" in Kudowa Zdroj.                    Material and Methods: We studied a group of 3580 children and young adults (1865 girls and 1715 boys aged 1 to 21 years (mean age 11,53 years, median 12 years which were the patients in rehabilitation Hospital ,, Orlik" from 1 June 2007 to 31 May 2012.                    Results: In the analyzed period, in the  Hospital "Orlik" children after anti-cancer treatment accounted for about 26% of all hospitalized patients. Most of children after oncological treatment came from the Pomerania, Lower Silesia and Lublin, least - from Podlaskie, Lubuskie and Warmia - Mazury. Most of children were suffering from hematologic malignancies.                    Conclusions: Patients after cancer treatment are a small group of children hospitalized in the reporting center. Most children hospitalized in the Hospital Orlik came from leading centers in Poland oncological.

  2. Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service.

    Science.gov (United States)

    Crossno, J E; Berkins, B; Gotcher, N; Hill, J L; McConoughey, M; Walters, M

    2001-04-01

    In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas.

  3. Financial health and customer satisfaction in private health care providers in Brazil.

    Science.gov (United States)

    Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard

    2011-11-01

    This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.

  4. Spa therapy in dermatology

    Directory of Open Access Journals (Sweden)

    Najeeba Riyaz

    2011-01-01

    Full Text Available Spa therapy constitutes the use of mineral springs and thermal mud to soothe and heal various ailments. Like the mineral springs, seas and oceans are also important centers for spa therapy of which the most important is Dead Sea (DS. DS has been famous for thousands of years for its miraculous curative and cosmetic properties. Intensive research is going on using DS minerals in a wide range of dermatological conditions especially psoriasis, atopic dermatitis, vitiligo and other eczemas and several papers have been published in various international and pharmacological journals.

  5. Strand SPA & Konverentsikeskus

    Index Scriptorium Estoniae

    2008-01-01

    Strand SPA & Konverentsikeskus on Pärnu suurim äri- ja konverentsiklientidele suunatud hotell, mis klientide seas on hinnatud just selle kompleksuse tõttu, kuna kõik, mida külaline vajab ja soovib, on olemas ühe katuse all

  6. [The spa and resort-based health-promoting treatment of the vehicle drivers suffering from duodenal ulcer disease: the effectiveness and safety].

    Science.gov (United States)

    El'garov, A A; Kalmykova, M A; El'garova, R M; Betuganova, L V; El'garov, M A

    2015-01-01

    To evaluate the effectiveness and the safety of the spa and resort-based health-promoting treatment of the vehicle drivers (VD) presenting with duodenal ulcer disease. A total of 67 men suffering from duodenal ulcer disease (DUD) were allocated to two groups. The patients of group 1 (n = 35) were given the courses of balneotherapy that included bromine-iodine mineral baths with a temperature of 36-37 degrees C (8-9 procedures 10-15 min long each every second day) in combination with 8-9 peloid applications to the epigastric region (temperature 38-40 degrees C for 10-15 min every second day). The patients of group 2 (n = 32) were given the similar courses of therapy that included nitric thermal mineral baths with a temperature of 36-37 degrees C (8-9 procedures 10-15 min long each every second day) in combination with 8-9 peloid applications to the epigastric region (38-40 degrees C for 10-15 min every second day). The effectiveness and safety of these balenotherapeutic procedures for the treatment of duodenal ulcer disease in the subjects of the study and control (n = 47) groups were evaluated based on the results of the routine clinical and endoscopic examination, psychological and psychophysiological tests, and the comparative analysis of medical aid appeal-ability and disability cases during twelve months. Dynamics of clinical and instrumental characteristics (subjective, objective, clinical, endoscopic, psychophysiological) suggested the improvement of the health status in 88.6% and 84.4% of the drivers with duodenum ulcer in the two study groups respectively. Some of the patients comprising group 1 showed significant negative dynamics of the operative reaction system while the patients of group 2 demonstrated the marked improvement of the professionally significant functions and properties (PSF&P). The comparative analysis of medical aid appealability, disability cases, frequency of relapses and complications revealed the favorable clinical course of duodenal

  7. [The spa and health resort-based treatment of metabolic syndrome with the application of the therapeutic courses of different duration: the evaluation according long-term results].

    Science.gov (United States)

    Chalaya, E N; Botvineva, L A; Tsallagova, L V; Ahkubekova, N K; Efimenko, N V; Kaysinova, A S; Amiyants, V Yu; Vasin, V A

    The objective of the present study was to estimate the effectiveness of the new therapeutic modalities for the spa and health resort-based treatment of metabolic syndrome based on the results of the long-term follow-up observations. A total of 100 patients presenting with metabolic syndrome were recruited for the participation in the study. All of them underwent a shortened course of mineral water intake in the combination with the use of the herbal medicinal products. The results of the study give evidence of the more favorable changes in the clinical and instrumental characteristics of the patients with metabolic syndrome treated with the use of the proposed approach in comparison the patients treated by the conventional methods. Moreover, the beneficial effects of the proposed approach persisted during a longer period. The basal treatment given to our patients was supplemented by dietary therapy, therapeutic physical exercise, narzan baths, intake of mineral water having a temperature of 35-37 °С in conjunction with sulphate mineral water (narzan) cooled to 13-15 °С, and a phytococktail. The results of the long-term observations confirmed the enhanced effectiveness of the spa and health resort-based treatment of metabolic syndrome including the therapeutic courses with the intake of cooled narzan mineral water in the combination with phytococktails. This therapeutic modality increased the duration of the favorable changes of various parameters that characterize metabolic syndrome. Specifically, they persisted during 5-6 months after the application of the standard methods, were still apparent within 6-7 months after the two-week course of the treatment with cold narzan and phytococktails, and during 8-9 months when the duration of the treatment course was extended up to 3 weeks.

  8. Web Evaluation at the US National Institutes of Health: Use of the American Customer Satisfaction Index Online Customer Survey

    OpenAIRE

    Wood, Fred B; Siegel, Elliot R; Feldman, Sue; Love, Cynthia B; Rodrigues, Dennis; Malamud, Mark; Lagana, Marie; Crafts, Jennifer

    2008-01-01

    Background The National Institutes of Health (NIH), US Department of Health and Human Services (HHS), realized the need to better understand its Web users in order to help assure that websites are user friendly and well designed for effective information dissemination. A trans-NIH group proposed a trans-NIH project to implement an online customer survey, known as the American Customer Satisfaction Index (ACSI) survey, on a large number of NIH websites—the first “enterprise-wide” ACSI applicat...

  9. [The spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation].

    Science.gov (United States)

    Efimenko, N V; Kaĭsinova, A S

    2014-01-01

    To develop a new medical technology for the spa-and-health resort-based treatment of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation. A total of 100 patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation were available for the examination that included detailed investigations of the clinical picture, characteristics of the immune status, and psychological testing before and after a course of the spa-and-health resort-based treatment. The effectiveness of two therapeutic modalities was evaluated. One of them (control) prescribed to 50 patients consisted of standard antiulcer pharmacotherapy in combination with Essentuki Novaya drinking mineral water and carbon dioxide mineral baths, the other given to 50 patients included radon baths instead of carbon dioxide mineral baths. The combined application of drinking mineral waters, radon baths, and standard antiulcer pharmacotherapy produced the most conspicuous clinical effect in the framework of spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation as confirmed by positive dynamics of their psychoemotional status in 97.7% of the cases, regression of pain syndrome (91.5%), and improvement of humoral and cellular immunity (94%). An important result of the spa-and-health resort-based rehabilitation is the intensification of the reparative processes in gastroduodenal mucosa responsible for the healing of ulcers and erosions in 94.7% of the patients. The spa-and-health resort-based rehabilitation is a pathogenetically sound and efficacious approach to the management of the patients presenting with frequently recurring erosive and ulcerative lesions in the

  10. Spa Products as Main Orientation in Wellness Tourism in Bali

    Directory of Open Access Journals (Sweden)

    I Gusti Made Wendri

    2018-03-01

    Full Text Available Wellness Spa is developed from conventional spa in response to the influence of the present tourism trend which is much in demand of the achievement of wellness aspect of life. Wellness tourism is a subdivision of health tourism. Wellness spa is the core product for wellness tourism. In fact, to date, people’s knowledge about wellness spa is still poor. This fact has motivated the implementation of this research under the title “Spa Products as Main Orientation in Wellness Tourism in Bali”. The objective of the research is to find out what products becomes the orientation in wellness tourism in Ubud as well as in South Badung. This qualitative research uses a phenomenological approach to the study. The determination of the informants is purposively done, and the information concerning the object of the research is obtained by deep interview controlled by a checklist based on Wellness Wheel concept. The location of the research is Ubud and South Badung areas, the latter represented by Nusa Dua, Jimbaran, and Kuta. The research uses 10 informants, 5 from Ubud and 5 from South Badung. The informants include spa managers and spa therapists. The result of the research shows that such packages as Bali spa ritual package, personal growth, and eco-adventure package become the most attractive products offered by wellness tourism industry and enjoyed by the tourists for the fulfilment of the tourists' wellness needs.

  11. Customer centered health care: why managed care organizations must capitalize on new technology to build brands and customer loyalty.

    Science.gov (United States)

    Fell, D

    1998-01-01

    Now, more than ever, health care organizations are desperately trying to reach out to customers and establish stronger relationships that will generate increased loyalty and repeat business. As technology, like the Internet and related mediums, allow us to do a better job of managing information and communication, health care executives must invest the time and resources necessary to bring these new advances into the day-to-day operations of their businesses. Those that do will have a head start in building their brand and their customer loyalty.

  12. Formation of trihalomethanes as disinfection byproducts in herbal spa pools.

    Science.gov (United States)

    Fakour, Hoda; Lo, Shang-Lien

    2018-04-09

    Herbal spa treatments are favorite recreational activities throughout the world. The water in spas is often disinfected to control pathogenic microorganisms and guarantee hygiene. However, chlorinated water may cause the formation of disinfection byproducts (DBPs). Although there have been many studies on DBP formation in swimming pools, the role of organic matter derived from herbal medicines applied in herbal spa water has been largely neglected. Accordingly, the present study investigated the effect of herbal medicines on the formation of trihalomethanes (THMs) in simulated herbal spa water. Water samples were collected from a spa pool, and then, disinfection and herbal addition experiments were performed in a laboratory. The results showed that the organic molecules introduced by the herbal medicines are significant precursors to the formation of THMs in spa pool water. Since at least 50% of THMs were produced within the first six hours of the reaction time, the presence of herbal medicines in spa water could present a parallel route for THM exposure. Therefore, despite the undeniable benefits of herbal spas, the effect of applied herbs on DBP formation in chlorinated water should be considered to improve the water quality and health benefits of spa facilities.

  13. Meeting the needs of customers with health CRM.

    Science.gov (United States)

    Phillips, Jon; Panchal, Samir

    2002-01-01

    Customer relationship management (CRM) is a business strategy, supported by applications and technologies, that can fundamentally transform how healthcare delivery organizations manage patient and physician interactions, reduce cost, improve customer-facing processes, drive market and revenue growth, and manage regulatory compliance processes.

  14. Quality evaluation in health care services based on customer-provider relationships.

    Science.gov (United States)

    Eiriz, Vasco; Figueiredo, José António

    2005-01-01

    To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically. Systematic review of the literature. Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non-technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence). This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing-oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

  15. Exploring the impact of customer relational benefit on relationship commitment in health service sectors.

    Science.gov (United States)

    Weng, Rhay-Hung; Huang, Jin-An; Huang, Ching-Yuan; Huang, Shih-Chang

    2010-01-01

    An increasing number of health service sectors have begun to implement relationship marketing to try to establish long-term relationship with customers. Customer relational benefit has been an important subject for relationship marketing researchers. This study was conducted to investigate how customer relational benefit might influence relationship commitment in health service sectors. The research used a questionnaire survey that retrieved a total number of 403 valid questionnaires. The data were collected by way of personal visits and investigations of outpatients in three regional hospitals in Taiwan. After the reliability and the validity of the questionnaire sample were examined, the data were verified by using hierarchical regression analysis. Results showed that confidence benefit constituted the most pronounced factor for hospital customers. Confidence benefit, social benefit, and special treatment benefit were perceived by customers as the key factors that have a positive influence on relationship commitment. In particular, customers placing greater emphasis on confidence benefit tended to be less willing to establish relationship commitment. When health service managers develop marketing strategies using customer relational benefit, they will still need to enhance customer confidence benefit as one of the main ways of achieving future improvements. In the event where health service managers seek to install resources for establishing and maintaining a good relationship commitment with customers, the crucial factors of social and special treatment benefits should not be ignored when seeking to enhance the customers' perception of confidence benefit.

  16. An Economical Custom-Built Drone for Assessing Whale Health

    Directory of Open Access Journals (Sweden)

    Vanessa Pirotta

    2017-12-01

    Full Text Available Drones or Unmanned Aerial Vehicles (UAVs have huge potential to improve the safety and efficiency of sample collection from wild animals under logistically challenging circumstances. Here we present a method for surveying population health that uses UAVs to sample respiratory vapor, ‘whale blow,' exhaled by free-swimming humpback whales (Megaptera novaeangliae, and coupled this with amplification and sequencing of respiratory tract microbiota. We developed a low-cost multirotor UAV incorporating a sterile petri dish with a remotely operated ‘blow' to sample whale blow with minimal disturbance to the whales. This design addressed several sampling challenges: accessibility; safety; cost, and critically, minimized the collection of atmospheric and seawater microbiota and other potential sources of sample contamination. We collected 59 samples of blow from northward migrating humpback whales off Sydney, Australia and used high throughput sequencing of bacterial ribosomal gene markers to identify putative respiratory tract microbiota. Model-based comparisons with seawater and drone-captured air demonstrated that our system minimized external sources of contamination and successfully captured sufficient material to identify whale blow-specific microbial taxa. Whale-specific taxa included species and genera previously associated with the respiratory tracts or oral cavities of mammals (e.g., Pseudomonas, Clostridia, Cardiobacterium, as well as species previously isolated from dolphin or killer whale blowholes (Corynebacteria, others. Many examples of exogenous marine species were identified, including Tenacibaculum and Psychrobacter spp. that have been associated with the skin microbiota of marine mammals and fish and may include pathogens. This information provides a baseline of respiratory tract microbiota profiles of contemporary whale health. Customized UAVs are a promising new tool for marine megafauna research and may have broad application in

  17. Nature and determinants of customer expectations of service recovery in health care.

    Science.gov (United States)

    Dasu, S; Rao, J

    1999-01-01

    Service recovery refers to the service provider's response to a dissatisfied customer. This article proposes a model of customer expectations of service recovery in health care services. The model discusses two types of service recovery expectations: will and should. An exploratory study indicates that industry reputation and personal experiences drive customers' "will-expectations" of service recovery while "should-expectations" can be explained via norm, fairness, social contract and hospitality theories.

  18. Assessment of Customer Service in Academic Health Care Libraries (ACSAHL): an instrument for measuring customer service*†

    Science.gov (United States)

    Crossno, Jon E.; Berkins, Brenda; Gotcher, Nancy; Hill, Judith L.; McConoughey, Michelle; Walters, Mitchel

    2001-01-01

    Objectives: In a pilot study, the library had good results using SERVQUAL, a respected and often-used instrument for measuring customer satisfaction. The SERVQUAL instrument itself, however, received some serious and well-founded criticism from the respondents to our survey. The purpose of this study was to test the comparability of the results of SERVQUAL with a revised and shortened instrument modeled on SERVQUAL. The revised instrument, the Assessment of Customer Service in Academic Health Care Libraries (ACSAHL), was designed to better assess customer service in academic health care libraries. Methods: Surveys were sent to clients who had used the document delivery services at three academic medical libraries in Texas over the previous twelve to eighteen months. ACSAHL surveys were sent exclusively to clients at University of Texas (UT) Southwestern, while the client pools at the two other institutions were randomly divided and provided either SERVQUAL or ACSAHL surveys. Results: Results indicated that more respondents preferred the shorter ACSAHL instrument to the longer and more complex SERVQUAL instrument. Also, comparing the scores from both surveys indicated that ACSAHL elicited comparable results. Conclusions: ACSAHL appears to measure the same type of data in similar settings, but additional testing is recommended both to confirm the survey's results through data replication and to investigate whether the instrument applies to different service areas. PMID:11337948

  19. A research model of health-care competition and customer satisfaction.

    Science.gov (United States)

    Asoh, Derek A; Rivers, Patrick A

    2007-11-01

    In all industries, competition among businesses has long been encouraged as a mechanism to increase value for customers. In other words, competition ensures the provision of better products and services to satisfy the needs of customers. Various perspectives of competition, the nature of service quality, health-care system costs and customer satisfaction in health care are examined. A model of the relationship among these variables is developed. The model depicts customer satisfaction as an outcome measure directly dependent on competition. Quality of care and health-care system costs, while also directly dependent on competition, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research.

  20. The efficacy of staff training on improving internal customer satisfaction in a rural health setting.

    Science.gov (United States)

    Hartley, R; Turner, R

    1995-09-01

    The NSW Health Department is 3 years into its customer satisfaction initiative. North West Health Service, one of the largest rural health districts, was among the first centres to embrace the customer satisfaction philosophy starting with compulsory training of all staff. This paper reports on changes in staff morale (internal satisfaction) as a result of that training. The data suggest that training per se has had minimal effect and argues for management development, particularly regarding leadership, rather than fiscal skills.

  1. The Role and Importance of Spa and Wellness Tourism in Hungary's Tourism Industry

    Directory of Open Access Journals (Sweden)

    Csapó János

    2017-06-01

    Full Text Available This paper presents and highlights the role and importance of spa and wellness tourism in Hungary. Ever since tourism has played an important role in the social-economic processes of the country the leading tourism product proved to be health tourism (spa and wellness thanks to the advantageous physical geographical and social-political background. After the presentation of the country-specific theoretical system of spa and wellness, the paper examines the supply and the demand side together with competitor analysis and recent trends in spa and wellness in Hungary.

  2. Adapting customer service to consumer-directed health care.

    Science.gov (United States)

    Hammer, David C

    2006-09-01

    A growing number of hospitals are implementing new tools that provide convenient, more detailed patient access to billing information. These tools are paying off for hospitals through reduced calls to their billing offices, decreased mailing costs, and increased payments, as well as higher rates of customer satisfaction.

  3. Customers for life: marketing oral health care to older adults.

    Science.gov (United States)

    Niessen, L C

    1999-09-01

    Respect for and awareness of the needs of older patients from dental office staff will help such patients feel welcome in a practice. Marketing to older patients is built upon this foundation. In addition, there are other strategies for internal and external marketing aimed at older people. This article addresses the concept of turning aging patients into "customers for life."

  4. Aplicació Microsoft .Net : Hotel Spa

    OpenAIRE

    Marquès Palmer, Jordi

    2010-01-01

    Desenvolupament d'una aplicació amb Microsoft .NET, WCF, WPF, Linq2SQL, d'un Hotel Spa. Desarrollo de una aplicación con Microsoft .NET, WCF, WPF, Linq2SQL, de un Hotel Spa. Application development using Microsoft .NET, WCF, WPF, Linq2SQL, for a Spa Hotel.

  5. [The effectiveness of the spa and health resort-based treatment with the application of Essentuki-type drinking mineral waters for the management of non-alcoholic fatty liver disease in the patients presenting with type 2 diabetes mellitus].

    Science.gov (United States)

    Efimenko, N V; Kaĭsinova, A S; Fedorova, T E; Botvineva, L A

    2015-01-01

    The objective of the present study was to estimate the effectiveness of the spa and health resort-based treatment of non-alcoholic fatty liver disease in 40 patients at the mean age of 48,8 ± 5.7 years suffering from type 2 diabetes mellitus. All of them received combined therapy including the application of potable Essentuki-Novaya mineral water (20 patients) or Essentuki No 4 water (20 patients). This therapeutic modality resulted in positive dynamics of clinical symptoms of the disease, the functional liver tests, and parameters of intra-hepatic hemodynamics, lipid peroxidation homeostasis, and the hormonal status. It is concluded that the spa and health resort-based treatment with the application of local drinking Essentuki-type mineral waters for the management of non-alcoholic fatty liver disease in the patients presenting with type 2 diabetes mellitus leads to the improvement of the main functions of the liver, stabilizes carbohydrate and lipid metabolism, and prevents progression of the pathological process.

  6. Can Customizing an Avatar Motivate Exercise Intentions and Health Behaviors Among Those with Low Health Ideals?

    Science.gov (United States)

    Waddell, T Franklin; Sundar, S Shyam; Auriemma, Joshua

    2015-11-01

    Studies have shown that self-resembling avatars in health games and other applications can heighten exercise intentions, but objective self-awareness (OSA) theory suggests that this effect is likely to be true only for those who believe in the ideal of a healthy self. How can avatars be used to motivate those who do not hold this ideal and may not be motivated by avatars to pursue healthy activities? One possibility is to afford individuals the ability to customize their avatar, so they are not only more self-aware but also feel in control of their persona, both of which are necessary conditions for behavior change according to OSA. In order to test this prediction, participants in an online virtual environment created an avatar of the same sex or opposite sex by choosing among a small or large number of possible traits, then completed a series of items measuring self-awareness, sense of control, health-focused behavior, and ideal internalization. Results show that customizing a same-sex avatar can overcome differences in health intentions and behaviors between individuals with high and low levels of prior health-ideal internalization.

  7. Hypersensitivity pneumonitis with Mycobacterium avium complex among spa workers.

    Science.gov (United States)

    Moraga-McHaley, Stephanie Ann; Landen, Michael; Krapfl, Heidi; Sewell, C Mack

    2013-01-01

    The New Mexico Department of Health (NMDOH) investigated the cause of two cases of hypersensitivity pneumonitis (HP) in spa maintenance workers with laboratory confirmed Mycobacterium avium complex (MAC). The investigation occurred in tandem with worker protection and swimming pool regulatory investigations by the New Mexico Environment Department at the spa where the workers were employed. The investigation was conducted in order to identify unreported cases, exposure source(s), and to prevent further worker exposure. NMDOH surveyed 57 spa employees about symptoms and exposures, categorized jobs according to self-reported exposure to water, and computed odds ratios for symptom reporting by exposure category. Environmental isolates from spa water and filter swabs were cultured and compared to patient isolates by the Environmental and Applied Microbiology Team, Centers for Disease Control and Prevention (CDC). Workers with the highest exposure reported more HP-like symptoms (OR = 9.6), as did intermediate exposure workers (OR = 6.5), compared to workers with no aerosolized water exposure. Two of 13 environmental isolates were closely related to one of the patient isolates. Workers were likely exposed during spray cleaning of cartridge filters in a poorly ventilated work space. Recommendations include inhibiting organism growth in spa systems, assuring the use of respiratory protection, and adequately ventilating work spaces where filters and equipment are cleaned.

  8. Creating a Customer-Centric Experience in Health.

    Science.gov (United States)

    Rosenberg, Linda

    2015-07-01

    The Affordable Care Act means behavioral health will become part of "mainstream" health care. Here are three ways we can offer our expertise to support primary health providers in integrating behavioral health and three ways we can improve and better serve individuals as we move into the mainstream.

  9. Web evaluation at the US National Institutes of Health: use of the American Customer Satisfaction Index online customer survey.

    Science.gov (United States)

    Wood, Fred B; Siegel, Elliot R; Feldman, Sue; Love, Cynthia B; Rodrigues, Dennis; Malamud, Mark; Lagana, Marie; Crafts, Jennifer

    2008-02-15

    The National Institutes of Health (NIH), US Department of Health and Human Services (HHS), realized the need to better understand its Web users in order to help assure that websites are user friendly and well designed for effective information dissemination. A trans-NIH group proposed a trans-NIH project to implement an online customer survey, known as the American Customer Satisfaction Index (ACSI) survey, on a large number of NIH websites-the first "enterprise-wide" ACSI application, and probably the largest enterprise Web evaluation of any kind, in the US government. The proposal was funded by the NIH Evaluation Set-Aside Program for two years at a cost of US $1.5 million (US $1.275 million for survey licenses for 60 websites at US $18000 per website; US $225,000 for a project evaluation contractor). The overall project objectives were to assess the value added to the participating NIH websites of using the ACSI online survey, identify any NIH-wide benefits (and limitations) of the ACSI, ascertain any new understanding about the NIH Web presence based on ACSI survey results, and evaluate the effectiveness of a trans-NIH approach to Web evaluation. This was not an experimental study and was not intended to evaluate the ACSI survey methodology, per se, or the impacts of its use on customer satisfaction with NIH websites. The evaluation methodology included baseline pre-project websites profiles; before and after email surveys of participating website teams; interviews with a representative cross-section of website staff; observations of debriefing meetings with website teams; observations at quarterly trans-NIH Web staff meetings and biweekly trans-NIH leadership team meetings; and review and analysis of secondary data. Of the original 60 NIH websites signed up, 55 implemented the ACSI survey, 42 generated sufficient data for formal reporting of survey results for their sites, and 51 completed the final project survey. A broad cross-section of websites

  10. Web Evaluation at the US National Institutes of Health: Use of the American Customer Satisfaction Index Online Customer Survey

    Science.gov (United States)

    Siegel, Elliot R; Feldman, Sue; Love, Cynthia B; Rodrigues, Dennis; Malamud, Mark; Lagana, Marie; Crafts, Jennifer

    2008-01-01

    Background The National Institutes of Health (NIH), US Department of Health and Human Services (HHS), realized the need to better understand its Web users in order to help assure that websites are user friendly and well designed for effective information dissemination. A trans-NIH group proposed a trans-NIH project to implement an online customer survey, known as the American Customer Satisfaction Index (ACSI) survey, on a large number of NIH websites—the first “enterprise-wide” ACSI application, and probably the largest enterprise Web evaluation of any kind, in the US government. The proposal was funded by the NIH Evaluation Set-Aside Program for two years at a cost of US $1.5 million (US $1.275 million for survey licenses for 60 websites at US $18,000 per website; US $225,000 for a project evaluation contractor). Objective The overall project objectives were to assess the value added to the participating NIH websites of using the ACSI online survey, identify any NIH-wide benefits (and limitations) of the ACSI, ascertain any new understanding about the NIH Web presence based on ACSI survey results, and evaluate the effectiveness of a trans-NIH approach to Web evaluation. This was not an experimental study and was not intended to evaluate the ACSI survey methodology, per se, or the impacts of its use on customer satisfaction with NIH websites. Methods The evaluation methodology included baseline pre-project websites profiles; before and after email surveys of participating website teams; interviews with a representative cross-section of website staff; observations of debriefing meetings with website teams; observations at quarterly trans-NIH Web staff meetings and biweekly trans-NIH leadership team meetings; and review and analysis of secondary data. Results Of the original 60 NIH websites signed up, 55 implemented the ACSI survey, 42 generated sufficient data for formal reporting of survey results for their sites, and 51 completed the final project survey. A

  11. SWOT ANALYSIS OF SPA TOURISM IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Aleksandar Davchev

    2016-06-01

    Full Text Available Our time is marked by the increasingly dynamic changing environment. The new conditions in which we operate are characterized by increasing complexity and labor activities that require more responsible behavior. The rising levels of stress and the increasing lack of free time for relaxation and recreation require a new look at the possibilities for the prevention of personal health. The plane of the consumer society in which we live is increasingly shifted by aspiration and vision of an environmentally friendly lifestyle. The focus here is the implementation of a multilevel wellness concept that changes qualitatively the status quo and seeks for ways to harmonize the body with the nature. One of the options is the practice of SPA tourism in whose genesis is the multilayered beneficial impact of a series of procedures and actions. This new alternative through its economic dimensions is an attractive business niche which over time becomes an industry. The current state of the SPA tourism in Bulgaria is controversial despite existing achievements and introduced best practices. Traditions in this direction and the presence of favorable basis for its approval, however, are not sufficient to achieve stability and an upward trend in development. There are existing a number of weaknesses and negative aspects that create frustration in users, which is a real threat to its future. The proposed SWOT-analysis as part of a comprehensive and multilateral study of the state of SPA tourism in Bulgaria reveals some of the existing problems. There have been some suggestions to minimize the impact of weaknesses and eliminate the errors found in leading business organizations managing processes. A detailed analysis and evaluation of the formulated conclusions is ahead, as well as concluding on ideas to improve the state of the sector – a subject of a further investigation by the author.

  12. Adopting customers' empowerment and social networks to encourage participations in e-health services.

    Science.gov (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil; Low, Patrick Kim Cheng; Wint, Zaw; Younis, Mustafa Z

    2013-01-01

    The aim of this article is to present an e-health model that embeds empowerment and social network intervention that may extend the role of customers in health care settings. A 25-item Likert-type survey instrument was specifically developed for this study and administered to a sample of 108 participants in Indonesia from October to November 2012. The data were analyzed to provide ideas on how to move forward with the e-health initiative as a means to improve e-health services. The survey revealed that there is a high demand for customers' empowerment and involvement in social networks to improve their health literacy and customer satisfaction. Regardless of the limitations of the study, the participants have responded with great support for the abilities of the prototype systems drawn from the survey. The survey results were used as requirements to develop a system prototype that incorporates the expectations of the people. The prototype (namely Clinic 2.0) was derived from the model and confirmed from the survey. Participants were selected to use the system for three months, after which we measured its impact towards their health literacy and customer satisfaction. The results show that the system intervention through Clinic 2.0 leads to a high level of customer satisfaction and health literacy.

  13. Community-centered family health history: a customized approach to increased health communication and awareness.

    Science.gov (United States)

    O'Leary, James; Edelson, Vaughn; Gardner, Nicora; Gepp, Alejandra; Kyler, Panelpha; Moore, Penelope; Petruccio, Claudia; Williams, Marc; Terry, Sharon; Bowen, Deborah

    2011-01-01

    There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior. The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities. Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions. After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05). These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities.

  14. Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2015-07-01

    Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​

  15. Customized Care: An intervention to Improve Communication and health outcomes in multimorbidity

    Directory of Open Access Journals (Sweden)

    Marsha N. Wittink

    2016-12-01

    Conclusions: With better communication about everyday challenges, patients and PCPs can have more informed discussions about health care options that positively influence patient outcomes. We expect that Customized Care will improve patient-PCP communication about day-to-day challenges, which can lead to better health outcomes.

  16. Health Plans Can't Ignore The Customer Experience Any Longer.

    Science.gov (United States)

    Swanson, Erik

    2017-10-01

    With regulations limiting differentiation between products, health plans must rethink consumer experience to meet expectations of today's consumers, who seek convenience, quality, and speed from their health care organizations. Many plans understand they need to connect more effectively with their end customers, but technological, cultural, and other obstacles are in the way.

  17. Measuring customer preferences in the German statutory health insurance.

    Science.gov (United States)

    Pendzialek, Jonas B; Simic, Dusan; Stock, Stephanie

    2017-09-01

    This paper investigates consumer preferences in the German statutory health insurance market. It further aims to test whether preferences differ by age and health status. Evidence is provided by a discrete choice experiment conducted in 2014 using the six most important attributes in sickness fund competition and ten random generated choice sets per participant. Price is found to be the most important attribute followed by additional benefits, managed care programmes, and distance to nearest branch. Other positive attributes of sickness funds are found to balance out a higher price, which would allow a sickness fund to position itself as high quality. However, significant differences in preferences were found between age and health status group. In particular, compromised health is associated with higher preference for illness-related additional benefits and less distance to the lowest branch, but lower preference for a lower price. Based on these differences, a distinct sickness fund offer could be constructed that would allow passive risk selection.

  18. Customer Relationship Management System in Occupational Safety & Health Companies: Research on Practice and Preliminary Design Solution

    Directory of Open Access Journals (Sweden)

    Robert Fabac

    2011-10-01

    Full Text Available One of the most prominent contemporary trends in formation of companies is the approach to development of a customer-oriented company. In this matter, various versions related to the intensity of this orientation are differentiated. Customer relationship management (CRM system is a well-known concept, and its practice is being studied and improved in connection to various sectors. Companies providing services of occupational safety and health (OHS mainly cooperate with a large number of customers and the quality of this cooperation largely affects the occupational safety and health of employees. Therefore, it is of both scientific and wider social interest to study and improve the relationship of these companies with their customers. This paper investigates the practice of applying CRM in Croatian OHS companies. It identifies the existing conditions and suggests possible improvements in the practice of CRM, based on experts’ assessments using analytic hierarchy process evaluation. Universal preliminary design was created as a framework concept for the formation of a typical customer-oriented OHS services company. Preliminary design includes a structural view, which provides more details through system diagrams, and an illustration of main cooperation processes of a company with its customer.

  19. Customer Discovery as the First Essential Step for Successful Health Information Technology System Development.

    Science.gov (United States)

    Thamjamrassri, Punyotai; Song, YuJin; Tak, JaeHyun; Kang, HoYong; Kong, Hyoun-Joong; Hong, Jeeyoung

    2018-01-01

    Customer discovery (CD) is a method to determine if there are actual customers for a product/service and what they would want before actually developing the product/service. This concept, however, is rather new to health information technology (IT) systems. Therefore, the aim of this paper was to demonstrate how to use the CD method in developing a comprehensive health IT service for patients with knee/leg pain. We participated in a 6-week I-Corps program to perform CD, in which we interviewed 55 people in person, by phone, or by video conference within 6 weeks: 4 weeks in the United States and 2 weeks in Korea. The interviewees included orthopedic doctors, physical therapists, physical trainers, physicians, researchers, pharmacists, vendors, and patients. By analyzing the interview data, the aim was to revise our business model accordingly. Using the CD approach enabled us to understand the customer segments and identify value propositions. We concluded that a facilitating tele-rehabilitation system is needed the most and that the most suitable customer segment is early stage arthritis patients. We identified a new design concept for the customer segment. Furthermore, CD is required to identify value propositions in detail. CD is crucial to determine a more desirable direction in developing health IT systems, and it can be a powerful tool to increase the potential for successful commercialization in the health IT field.

  20. The use of data mining by private health insurance companies and customers' privacy.

    Science.gov (United States)

    Al-Saggaf, Yeslam

    2015-07-01

    This article examines privacy threats arising from the use of data mining by private Australian health insurance companies. Qualitative interviews were conducted with key experts, and Australian governmental and nongovernmental websites relevant to private health insurance were searched. Using Rationale, a critical thinking tool, the themes and considerations elicited through this empirical approach were developed into an argument about the use of data mining by private health insurance companies. The argument is followed by an ethical analysis guided by classical philosophical theories-utilitarianism, Mill's harm principle, Kant's deontological theory, and Helen Nissenbaum's contextual integrity framework. Both the argument and the ethical analysis find the use of data mining by private health insurance companies in Australia to be unethical. Although private health insurance companies in Australia cannot use data mining for risk rating to cherry-pick customers and cannot use customers' personal information for unintended purposes, this article nonetheless concludes that the secondary use of customers' personal information and the absence of customers' consent still suggest that the use of data mining by private health insurance companies is wrong.

  1. Harnn Natural Home Spa Business Plan

    OpenAIRE

    Kusol, Chompunuch

    2008-01-01

    Home Spa Partnership is looking for the amount of 50,000 GBP from an investor to invest in the business. The Company offers 20% of its authorised share capital for 17,500 GBP and the preference shares amounting to 32,500 GBP. This amount will be brought into the infrastructures and initial overhead cost for the start-up Thai spa business in the UK under 'Harnn Natural Home Spa' brand. The Company Home Spa Partnership was incorporated in July 2008 with issued share capital of 80,000...

  2. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Karagülle, Müfit Zeki

    2018-02-01

    This study aims to investigate whether 2-week spa therapy, as an adjunct to usual pharmacological therapy, has any beneficial effect in patients with rheumatoid arthritis (RA). In this single-blind crossover study, 50 patients were randomly assigned in a 1:1 manner to receive usual pharmacological therapy plus 2-week spa therapy or usual pharmacological therapy alone (period 1.6 months); after a 9-month washout, patients were crossed over to the opposite assignment (period 2.6 months). Spa therapy program included a daily saline balneotherapy session at 36-37 °C for 20 min except Sundays. The clinical outcomes were evaluated at baseline, after spa therapy (2 weeks) and 3 and 6 months after the spa therapy in both period and were pain (Visual Analogue Scale (VAS)), patient and physician global assessments (VAS), Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28). Spa therapy was superior to control therapy in improving all the assessed clinical outcomes at the end of the spa therapy. This superiority persisted significantly in physician global assessment ( p = 0.010) and with a trend in favor of spa group in patient global assessment ( p = 0.058), function ( p = 0.092), and disease activity ( p = 0.098) at 3 months. Statistically significant improvements were found in spa therapy compared to control in disease activity ( p = 0.006) and patient ( p = 0.020) and physician global ( p = 0.011) assessments, and a trend toward improvements in pain ( p = 0.069) and swollen joints ( p = 0.070) at 6 months. A 2-week spa therapy adjunct to usual pharmacological therapy provided beneficial clinical effects compared to usual pharmacological therapy alone, in RA patients treated with traditional disease-modifying antirheumatic drugs. These beneficial effects may last for 6 months.

  3. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Gürdal, Hatice; Karagülle, Müfit Zeki

    2016-10-01

    Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study

  4. [Nonnius and the Spa cure].

    Science.gov (United States)

    Lecomte, J; Lemli, J; Marganne, M H; Melard, M

    1996-01-01

    The 12th of July 1635, Jan van Beverwyck wrote a letter from Dordrecht to his esteemed friend Luis Nunez, in Antwerp. He asked him for indications about the cure of kidney stones of which he was suffering. He had just passed two calculi very painfully. Nunez answered on July 31. His letter summarized his own experience with this disease. In such cases, temperate diuretics and emollients are well indicated: ingestion of light decoctions of Malva and Viola, Caerefolium and Parieteria as well as Marshmallow syrup. No purge and no 'chemicals'. However, the best remedy was drinking Spa water. Usually the best way to absorb it is to come to the springs, in the Ardennes, part of the independent Principality of Liège. However, considering the horrors of the war (the Thirty Years War) endangering the country, van Beverwyck would be wise to drink imported water during 40 or 50 days, while staying home quietly, in Dordrecht. The letter points out the importance of provoked diuresis in the treatment of kidney stones. On the other hand the letter is an illustration of the continuing contacts between the United Provinces and the Spanish territories and of the commercial traffic between Antwerp, Dordrecht and Spa. The exported water was bottled from many 'pouhons'. It was acid, ferruginous, sulfurous and saturated with carbon dioxide; no pathogen germs, at least at the spring. Nunez quoted the large number of his patients cured with Spa water in Antwerp. This is an illustration of its commercial expansion even during this critical period.

  5. Application of the Health Belief Model to customers' use of menu labels in restaurants.

    Science.gov (United States)

    Jeong, Jin-Yi; Ham, Sunny

    2018-04-01

    Some countries require the provision of menu labels on restaurant menus to fight the increasing prevalence of obesity and related chronic diseases. This study views customers' use of menu labels as a preventive health behavior and applies the Health Belief Model (HBM) with the aim of determining the health belief factors that influence customers' use of menu labels. A self-administered survey was distributed for data collection. Responses were collected from 335 restaurant customers who experienced menu labels in restaurants within three months prior to the survey. The results of a structural equation model showed that all the HBM variables (perceived threats, perceived benefits, and perceived barriers of using menu labels) positively affected the customers' use of menu labels. Perceived threats were influenced by cues to action and cues to action had an indirect influence on menu label use through perceived threats. In conclusion, health beliefs were good predictors of menu label use on restaurant menus. This study validated the application of the HBM to menu labeling in restaurants, and its findings could offer guidelines for the industry and government in developing strategies to expand the use of menu labels among the public. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Developing an Innovative Customer Relationship Management Model for Better Health Examination Service

    Directory of Open Access Journals (Sweden)

    Lyu JrJung

    2014-11-01

    Full Text Available People emphasize on their own health and wish to know more about their conditions. Chronic diseases now take up to 50 percent of top 10 causes of death. As a result, the health-care industry has emerged and kept thriving. This work adopts an innovative customer-oriented business model since most clients are proactive and spontaneous in taking the “distinguished” health examination programs. We adopt the soft system dynamics methodology (SSDM to develop and to evaluate the steps of introducing customer relationship management model into a case health examination organization. Quantitative results are also presented for a case physical examination center and to assess the improved efficiency. The case study shows that the procedures developed here could provide a better service.

  7. Developing a Customer Relationship Management Model for Better Health Examination Service

    Directory of Open Access Journals (Sweden)

    Lyu Jr-Jung

    2014-11-01

    Full Text Available People emphasize on their own health and wish to know more about their conditions. Chronic diseases now take up to 50 percent of top 10 causes of death. As a result, the health-care industry has emerged and kept thriving. This work adopts a customer-oriented business model since most clients are proactive and spontaneous in taking the “distinguished” health examination programs. We adopt the soft system dynamics methodology (SSDM to develop and to evaluate the steps of introducing customer relationship management model into a case health examination organization. Quantitative results are also presented for a case physical examination center and to assess the improved efficiency. The case study shows that the procedures developed here could provide a better service.

  8. How do prostitution customers value health and position health in their discussions? Qualitative analysis of online forums.

    Science.gov (United States)

    Regushevskaya, Elena; Tuormaa, Tuija

    2014-11-01

    Information on the health values and positioning of health among prostitution customers is limited. The aim is to explore the positioning of health among prostitution customers using data from Internet forums in Finland. Qualitative study using a purposive sample of public online forums among prostitution customers in 2002-2012. Health beliefs in relation to infections and risky sexual behavior were diverse, from correct to false. Although men were aware of health risks in prostitution, it was common to have multiple sexual partners and unprotected sex. Although there were men who warned others about possible health consequences when a condom is not used, typically men were proud not to use a condom with a prostitute and found different explanations for not using a condom. Condom breakage was not an issue discussed in forums. Unexpected findings were beliefs that one fifth of the Nordic population is resistant to HIV, that the possibility of HIV transmission is exaggerated by medical specialists, and that men should control their behavior in order not to degrade prostitutes. Discussions on health service use were few. Sexual satisfaction and entertainment were the main reasons to post in the analyzed forums health discussion was not common although condom use was reported, attention to health risks was selective information on health service use was limited, which may suggest this topic was not valued among men and should be a topic of future studies. © 2014 the Nordic Societies of Public Health.

  9. How is the use of e-cigarettes sustained in the customers with serious health symptoms?

    OpenAIRE

    Ummuhan Pece Sonmez; Murat Güner; Elif Dagli; Tanzer Gezer; Fusun Yildiz; Osman Elbek; Pınar Ay; Murat Ceyhan

    2018-01-01

    Background In Turkey there are no legal sales of electronic cigarettes however illegal sales continue through internet and social media forum. The customers of these sites frequently post serious health complaints related to the use of product but do not quit. This study was carried out to understand how the e-cigarette social forum adminstrators respond to the health issues and what they recommend. Methods A survey was carried out at a social media forum with more than 60 thousan...

  10. Managing customization in health care: a framework derived from the services sector literature.

    Science.gov (United States)

    Minvielle, Etienne; Waelli, Mathias; Sicotte, Claude; Kimberly, John R

    2014-08-01

    Organizations that provide health services are increasingly in need of systems and approaches that will enable them to be more responsive to the needs and wishes of their clients. Two recent trends, namely, patient-centered care (PCC) and personalized medicine, are first steps in the customization of care. PCC shifts the focus away from the disease to the patient. Personalized medicine, which relies heavily on genetics, promises significant improvements in the quality of healthcare through the development of tailored and targeted drugs. We need to understand how these two trends can be related to customization in healthcare delivery and, because customization often entails extra costs, to define new business models. This article analyze how customization of the care process can be developed and managed in healthcare. Drawing on relevant literature from various services sectors, we have developed a framework for the implementation of customization by the hospital managers and caregivers involved in care pathways. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  11. From sulphur to perfume: spa and SPA at Monchique, Algarve.

    Science.gov (United States)

    Bastos, Cristiana

    2011-04-01

    In the thermal village of Monchique, Algarve, different streams of water-related knowledge and practices coexisted for centuries. Those waters were traditionally known as aguas santas (holy waters) and believed to have redemptive healing powers. In the seventeenth century, the Catholic church took control of the place, refashioned the bathing rituals, developed infrastructures and provided assistance to the patients, granting free treatment to the poor. In the nineteenth century, the state replaced the church and imposed that treatments should be provided by professionals trained in the scientific principles of medical hydrology. Secular and scientific as they were, clinical logbooks still allowed for the account of patients that embodied miracle-like redemptive cures 'at the third bath'. People went to Monchique both for its magic and its medicine, bringing in the body ailments achieved in their lives of hard labour. They also went there for a socialising break while healing. From mendicants to rich landowners, coming mostly from the Algarve and neighbouring Alentejo, they crowded the place in summertime. In the twentieth century, as in other places in continental Europe, the spa evolved into a highly medicalised place that qualified for medical expenses reimbursements, which implied the eclipsing--at least from representation--of its leisure component. In the twenty-first century, a new trend of consumer-centred, market-based, post-water balneology with an emphasis on wellness and leisure reinvented the spa as place for lush and diversified consumption. This article argues that the seemingly contradictory systems (markets and medicine) coexist much in the same way that magic, religion and medicine coexisted in the old water sites. The new SPAs, rather than putting an end to the old spas, have enabled them to survive by reinventing thermal sites as places of attraction and leisure.

  12. Health-Related Quality of Life among Nonprescription Medicine Customers in Malaysia.

    Science.gov (United States)

    Shafie, Asrul Akmal; Hassali, Mohamed Azmi; Mohamad Yahaya, Abdul Haniff

    2013-05-01

    To describe the health-related quality of life (HRQOL) among nonprescription medicine customers in Malaysia and the factors that affect it. A nationwide cross-sectional survey was conducted among pharmacy customers in 59 randomly selected community pharmacies in Malaysia. The self-administered questionnaire included the EuroQoL five-dimensional (EQ-5D) questionnaire, the EuroQol visual analogue scale (EQ-VAS), nonprescription medicines purchase, and demographic questions. Data were analyzed by using the multivariate analysis of variance and multiple logistic regressions. A total of 2729 customers enrolled in this study, with a mean EQ-5D questionnaire score of 0.92±0.15 and a mean EQ-VAS score of 69.92±24.80. Compared with the Malaysian adult population, nonprescription medicine customers have a lower mean EQ-5D questionnaire score (t =-4.49, Pcustomers (F 22,5286 = 2.555; Wilks' lambda = 0.979; Pcustomers is lower than that of the general Malaysian population. Lower health status was independently associated with older age, living in rural areas, having low income and education level, and purchasing blood and blood-forming medicines from community pharmacy. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. [Analysis of the effectiveness of the spa and health resort-based treatment of the patients presenting with broncho-pulmonary pathology at the southern coast of the Crimea depending on the period of flowering of Mediterranean Cypress (Cupressus sempervirens)].

    Science.gov (United States)

    Savchenko, V M; Belyaeva, S N; Govorun, M I; Pirogova, M E

    The objective of the present study was to evaluate the influence of pollen of Mediterranean Cypress (Cupressus sempervirens) on the effectiveness of the spa and health resort-based treatment (SHRT) of the patients with broncho-pulmonary pathology at the southern coast of the Crimea (SCC). This article presents the results of the analysis of the data on 122 patients presenting with broncho-pulmonary pathology who received SHRT under the conditions of the Southern Coast of the Crimea. Fifty one (41.8%) of these patients suffered from chronic obstructive pulmonary disease and 71 (58.2%) ones had bronchial asthma. The whole group was comprised of 44 men (36.1%) and 78 women (63.9%). The average (median) age of the patients was 55.8 years. All the participants of the study underwent the comprehensive examination including the general medical and physical examination, complete blood count, the study of sputum cytology and immunological properties of blood including the standard characteristics, IgE and lysozyme levels), evaluation of the respiratory and locomotor (physical) functions with the use of the 6-minute walking test. The aeropollenological study of the aerial environment of the southern coast of the Crimea in the region of Yalta showed that the «bloom» of the Mediterranean Cypress occurs during the period from February till April inclusive. The highest concentrations of cypress pollen are observed in March and early April. The overall effectiveness of SHRT for the patients with broncho-pulmonary pathology arriving for the treatment at the southern coast of the Crimea from other Crimean localities does not depend on the period of «flowering» (the presence of pollen in the air) of the Mediterranean Cypress. In these patients, the termination of the spa and health resort-based treatment during the «flowering» of the Mediterranean Cypress resulted in nothing more than a strained adaptive response manifested as the altered blood leukocyte count. Such reaction

  14. The impact of spa treatment on quality of life of elderly people

    Directory of Open Access Journals (Sweden)

    Marta Wardeńska

    2017-02-01

    Full Text Available The aim of this study was to assess the impact of the spa treatment on the quality of life of the older people. The study included 18 women and 22 men over 60 years of age. Method used was diagnostic survey - a questionnaire containing closed and open questions, on the subjective assessment of their own quality of life, as well as spa treatment and its impact on health and well-being. This study lead to a conclusion that due the spa treatment, the quality of life of patients over 60 ages expressed their subjective assessment improves. This confirms the hypothesis that older people using spa treatment are characterized by a significantly higher level of quality of life.

  15. Radioactivity of spa waters in Serbia

    International Nuclear Information System (INIS)

    Tanaskovic, I.; Eremic Savkovic, M.; Javorina, Lj.

    2011-01-01

    In this paper, the measurement results of: total alpha and beta activity, as well as specific activity of 226 Ra, 228 Ra, 40 K and conductivity of spa waters of Serbia, are presented. Spa water samples were taken in the fields of different types of geological environment. The maximum values of specific activity of 226 Ra, 228 Ra and 40 K were 0.53 Bq / l, [sr

  16. Radon and progeny sourced dose assessment of spa employees in balneological sites

    International Nuclear Information System (INIS)

    Kemal Uzun, Sefa; Demiroez, Isik

    2016-01-01

    This study was conducted in the scope of IAEA project with the name 'Establishing a Systematic Radioactivity Survey and Total Effective Dose Assessment in Natural Balneological Sites' (TUR/9/018), at the Health Physics department of Saraykoey Nuclear Research and Training Center (SANAEM). The aim of this study is estimation of radon and progeny sourced effective dose for the people who are working at the spa facilities by measuring radon activity concentration (RAC) at the ambient air of indoor spa pools and dressing rooms. As it is known, the source of the radon gas is the radium content of the earth crust. Therefore, thermal waters coming from ground may contain dissolved radon and the radon can diffuse water to air. So the ambient air of spa pools can contain serious RAC that depends on a lot of parameters. In this regard, RAC measurements were executed at the 70 spa facilities in Turkey. The measurements were done with both active and passive methods at ambient air of spa pools and dressing rooms. Thus, active measurements were carried out by using the Alphaguard R with diffusion mode during half an hour, and passive measurements were carried out by using the humidity resistive CR-39 radon detectors during 2 months. Results show that RAC values at ambient air of spa pools varies between 13 Bq m -3 and 10 kBq m -3 . Because long-term measurements are more reliable, if it is available, for dose calculations passive radon measurements (with CR-39 detectors) at ambient air of spa pools and dressing rooms were used, otherwise active measurement results were used. With the measurement by the conversion coefficients of ICRP 65 and occupational data of the employees has got from questionnaire forms, effective dose values were calculated. According to the calculations, spa employees are exposed to annual average dose between 0.05 and 29 mSv because of radon and progeny. (authors)

  17. The importance of accurate road data for spatial applications in public health: customizing a road network

    Directory of Open Access Journals (Sweden)

    Laraia Barbara A

    2009-05-01

    Full Text Available Abstract Background Health researchers have increasingly adopted the use of geographic information systems (GIS for analyzing environments in which people live and how those environments affect health. One aspect of this research that is often overlooked is the quality and detail of the road data and whether or not it is appropriate for the scale of analysis. Many readily available road datasets, both public domain and commercial, contain positional errors or generalizations that may not be compatible with highly accurate geospatial locations. This study examined the accuracy, completeness, and currency of four readily available public and commercial sources for road data (North Carolina Department of Transportation, StreetMap Pro, TIGER/Line 2000, TIGER/Line 2007 relative to a custom road dataset which we developed and used for comparison. Methods and Results A custom road network dataset was developed to examine associations between health behaviors and the environment among pregnant and postpartum women living in central North Carolina in the United States. Three analytical measures were developed to assess the comparative accuracy and utility of four publicly and commercially available road datasets and the custom dataset in relation to participants' residential locations over three time periods. The exclusion of road segments and positional errors in the four comparison road datasets resulted in between 5.9% and 64.4% of respondents lying farther than 15.24 meters from their nearest road, the distance of the threshold set by the project to facilitate spatial analysis. Agreement, using a Pearson's correlation coefficient, between the customized road dataset and the four comparison road datasets ranged from 0.01 to 0.82. Conclusion This study demonstrates the importance of examining available road datasets and assessing their completeness, accuracy, and currency for their particular study area. This paper serves as an example for assessing

  18. Radioactivity of water and air in Misasa Spa, Japan

    International Nuclear Information System (INIS)

    Morinaga, H.; Mifune, M.; Furuno, K.

    1984-01-01

    Misasa Spa is one of the most highly radioactive hot springs in Japan, the waters of which contain mainly 222 Rn (437 +- 132 Bq.litre -1 ). Radon contents of indoor air of private houses and health resort hotels (built of wood) at Misasa Spa range from 18.5 to 55.5 mBq.litre -1 and 22.2 to 129.5 mBq.litre -1 , respectively. Radon contents in the air of facilities using spring waters at Misasa Branch Hospital of Okayama University were measured to be: bathroom 807 +- 78 mBq.1 -1 , Hubbard-tank bathroom, 5306 +- 2568 mBq.litre -1 ; the drinking hall, 1491 +- 178 mBq.litre -1 . The environmental and dose rate inside private houses has been measured to be 14.0 +- 1.8 μR.h -1 . Chromosome abberations (dicentrics) in the peripheral blood lymphocytes of residents of Misasa Spa were investigated in 14 persons; the mean value of aberration frequencies were 0.21%. (author)

  19. Radioactivity and chromosome aberrations of residents of Misasa Spa

    International Nuclear Information System (INIS)

    Morinaga, Hiroshi; Mifune, Masaaki; Furuno, Katsushi

    1985-01-01

    Misasa Spa is one of the most highly radioactive hot springs in Japan, the waters of which contain mainly 222 Rn (437 ± 132 Bq/liter). Radon contents of indoor air of private houses and health resort hotels (built of wood) at Misasa Spa range from 18.5 to 55.5 mBq/liter and 22.2 to 129.5 mBq/liter, respectively. Radon contents in the air of facilities using spring waters at Misasa Branch Hospital of Okayama University were measured to be; bathroom 807 ± 78 mBq/liter; Hubbardtank bathroom 5306 ± 2568 mBq/liter; the drinking hall 1491 ± 178 mBq/liter. The environmental and dose rate inside private house's has been measured to be 14.0 ± 1.8 μR/h. Chromosome aberrations (dicentrics) in the peripheral blood lymphocytes of residents of Misasa Spa were investigated in 14 persons; the mean value of aberration frequencies were 0.21 %. (Kubozono, M.)

  20. A comparison of human elements and nonhuman elements in private health care settings: customers' perceptions and expectations.

    Science.gov (United States)

    Mohd Suki, Norazah; Chwee Lian, Jennifer Chiam; Suki, Norbayah Mohd

    2009-01-01

    In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers' perceptions and determine whether they are meeting customers' expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions-courtesy, communication, and understanding of customers of the human element-when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.

  1. 3D printing for health & wealth: Fabrication of custom-made medical devices through additive manufacturing

    Science.gov (United States)

    Colpani, Alessandro; Fiorentino, Antonio; Ceretti, Elisabetta

    2018-05-01

    Additive Manufacturing (AM) differs from traditional manufacturing technologies by its ability to handle complex shapes with great design flexibility. These features make the technique suitable to fabricate customized components, particularly answering specific custom needs. Although AM mainly referred to prototyping, nowadays the interest in direct manufacturing of actual parts is growing. This article shows the application of AM within the project 3DP-4H&W (3D Printing for Health & Wealth) which involves engineers and physicians for developing pediatric custom-made medical devices to enhance the fulfilling of the patients specific needs. In the project, two types of devices made of a two-component biocompatible silicone are considered. The first application (dental field) consists in a device for cleft lip and palate. The second one (audiological field) consists in an acoustic prosthesis. The geometries of the devices are based on the anatomy of the patient that is obtained through a 3D body scan process. For both devices, two different approaches were planned, namely direct AM and indirect Rapid Tooling (RT). In particular, direct AM consists in the FDM processing of silicone, while RT consists in molds FDM fabrication followed by silicone casting. This paper presents the results of the RT method that is articulated in different phases: the acquisition of the geometry to be realized, the design of the molds taking into account the casting feasibility (as casting channel, vents, part extraction), the realization of molds produced through AM, molds surface chemical finishing, pouring and curing of the silicone. The fabricated devices were evaluated by the physicians team that confirmed the effectiveness of the proposed procedure in fabricating the desired devices. Moreover, the procedure can be used as a general method to extend the range of applications to any custom-made device for anatomic districts, especially where complex shapes are present (as tracheal or

  2. Information System Success Model for Customer Relationship Management System in Health Promotion Centers

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae

    2013-01-01

    Objectives Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. Methods The evaluation areas of the CRM system includes three areas: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Results Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. Conclusions This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems. PMID:23882416

  3. Information system success model for customer relationship management system in health promotion centers.

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae; Choi, In Young

    2013-06-01

    Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. THE EVALUATION AREAS OF THE CRM SYSTEM INCLUDES THREE AREAS: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems.

  4. Use of a customer satisfaction survey by health care regulators: a tool for total quality management.

    Science.gov (United States)

    Andrzejewski, N; Lagua, R T

    1997-01-01

    To conduct a survey of health care providers to determine the quality of service provided by the staff of a regulatory agency; to collect information on provider needs and expectations; to identify perceived and potential problems that need improvement; and to make changes to improve regulatory services. The authors surveyed health care providers using a customer satisfaction questionnaire developed in collaboration with a group of providers and a research consultant. The questionnaire contained 20 declarative statements that fell into six quality domains: proficiency, judgment, responsiveness, communication, accommodation, and relevance. A 10% level of dissatisfaction was used as the acceptable performance standard. The survey was mailed to 324 hospitals, nursing homes, home care agencies, hospices, ambulatory care centers, and health maintenance organizations. Fifty-six percent of provider agencies responded; more than half had written comments. The three highest levels of customer satisfaction were in courtesy of regulatory staff (90%), efficient use of onsite time (84%), and respect for provider employees (83%). The three lowest levels of satisfaction were in the judgment domain; only 44% felt that there was consistency among regulatory staff in the interpretation of regulations, only 45% felt that interpretations of regulations were flexible and reasonable, and only 49% felt that regulations were applied objectively. Nine of 20 quality indicators had dissatisfaction ratings of more than 10%; these were considered priorities for improvement. Responses to the survey identified a number of specific areas of concern; these findings are being incorporated into the continuous quality improvement program of the office.

  5. A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

    Science.gov (United States)

    Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

    2013-01-01

    There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

  6. How much segmentation is needed in the health care marketplace? An exploratory study of HMO and non-HMO customers.

    Science.gov (United States)

    Tootelian, Dennis H; Mikhailitchenko, Andrey; Holst, Cindy; Gaedeke, Ralph M

    2016-01-01

    The health care landscape has changed dramatically. Consumers now seek plans whose benefits better fit their health care needs and desires for access to providers. This exploratory survey of more than 1,000 HMO and non-HMO customers found significant differences with respect to their selection processes for health plans and providers, and their expectations regarding access to and communication with health care providers. While there are some similarities in factors affecting choice, segmentation strategies are necessary to maximize the appeal of a plan, satisfy customers in the selection of physicians, and meet their expectations regarding access to those physicians.

  7. SP-A binding sites on bovine alveolar macrophages.

    Science.gov (United States)

    Plaga, S; Plattner, H; Schlepper-Schaefer, J

    1998-11-25

    Surfactant protein A (SP-A) binding to bovine alveolar macrophages was examined in order to characterize SP-A binding proteins on the cell surface and to isolate putative receptors from these cells that could be obtained in large amounts. Human SP-A, unlabeled or labeled with gold particles, was bound to freshly isolated macrophages and analyzed with ELISA or the transmission electron microscope. Binding of SP-A was inhibited by Ca2+ chelation, by an excess of unlabeled SP-A, or by the presence of 20 mg/ml mannan. We conclude that bovine alveolar macrophages expose binding sites for SP-A that are specific and that depend on Ca2+ and on mannose residues. For isolation of SP-A receptors with homologous SP-A as ligand we isolated SP-A from bovine lung lavage. SDS-PAGE analysis of the purified SP-A showed a protein of 32-36 kDa. Functional integrity of the protein was demonstrated. Bovine SP-A bound to Dynabeads was used to isolate SP-A binding proteins. From the fractionated and blotted proteins of the receptor preparation two proteins bound SP-A in a Ca2+-dependent manner, a 40-kDa protein showing mannose dependency and a 210-kDa protein, showing no mannose sensitivity. Copyright 1998 Academic Press.

  8. Radon in the spa of Bizovac

    International Nuclear Information System (INIS)

    Planinic, J.; Faj, Z.; Suveljak, B.; Radolic, V.

    1996-01-01

    The radon concentration in the air and water of the Bizovac spa was measured by the Radhome silicon detector and the average values were obtained as 70 Bq/m 3 in the indoor pool, 40 Bq/m 3 in the hotel room, 135 Bq/m 3 in the closed therapeutic bathroom, but the geothermal water had a Rn concentration of 25.3 kBq/m 3 and the potable one 2.7 kBq/m 3 . The Rn transfer factor (f) from water to air in the indoor pool and therapeutic bathroom was 10 and 40 times higher than for normal dwellings (f n =10 -4 ), respectively. The effective equivalent dose of inhaled radon for permanent personnel under the worst conditions in the spa was 5.4 mSv/y, but visitors spending two weeks in the spa could receive the dose of 77 μSv. (author). 6 refs., 1 fig

  9. Ministerial Decree of 12 May 1980 authorising Agip Nucleare S.p.a. in Rome to undertake health physics and medical supervision of protection against ionizing radiation

    International Nuclear Information System (INIS)

    1980-01-01

    Section 83 of Decree No. 185 of 13 February 1964 on protection against ionizing radiation provides that institutions previously authorised by the Minister of Labour and Social Security may, on condition that they are adequately equipped for such services, be authorised to undertake health physics and medical supervision of personnel. This Decree accordingly authorises the Agip Nucleare Company to carry out this work. (NEA) [fr

  10. Estimation of customer lifetime value of a health insurance with interest rates obeying uniform distribution

    Science.gov (United States)

    Widyawan, A.; Pasaribu, U. S.; Henintyas, Permana, D.

    2015-12-01

    Nowadays some firms, including insurer firms, think that customer-centric services are better than product-centric ones in terms of marketing. Insurance firms will try to attract as many new customer as possible while maintaining existing customer. This causes the Customer Lifetime Value (CLV) becomes a very important thing. CLV are able to put customer into different segments and calculate the present value of a firm's relationship with its customer. Insurance customer will depend on the last service he or she can get. So if the service is bad now, then customer will not renew his contract though the service is very good at an erlier time. Because of this situation one suitable mathematical model for modeling customer's relationships and calculating their lifetime value is Markov Chain. In addition, the advantages of using Markov Chain Modeling is its high degree of flexibility. In 2000, Pfeifer and Carraway states that Markov Chain Modeling can be used for customer retention situation. In this situation, Markov Chain Modeling requires only two states, which are present customer and former ones. This paper calculates customer lifetime value in an insurance firm with two distinctive interest rates; the constant interest rate and uniform distribution of interest rates. The result shows that loyal customer and the customer who increase their contract value have the highest CLV.

  11. Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.

    Science.gov (United States)

    Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana

    2004-01-01

    This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.

  12. Customer Orientation and Leadership in the Health Service Sector: The Role of Workplace Social Support

    Directory of Open Access Journals (Sweden)

    Andreina Bruno

    2017-11-01

    Full Text Available Health care is a critical context due to unpredictable situations, demanding clients, workload, and intrinsic organizational complexity. One key to improve the quality of health services is connected to the shift in organization perspective of viewing patients as active consumers rather than passive users. Therefore, higher levels of customer orientation (CO are expected to improve organizational service effectiveness. According to a cultural perspective to CO, the aim of the study was to explore how different leaders’ behaviors (task-oriented and relationship-oriented interact with CO of health organizations. Specifically, the aim of the paper was to contribute to this topic, by considering the leaders’ point of view. Since leader’s experience of CO is influenced by social processes in the work environment, workplace social support (WSS was inserted as moderator in the relationship between leader behavior and CO. A survey study was conducted among 57 Health Department directors belonging to the National Health Service in the North of Italy in 2016. Findings showed that WSS moderated the influence of leadership concern for relationship on CO. Practical implications of the study are discussed.

  13. Customer Orientation and Leadership in the Health Service Sector: The Role of Workplace Social Support.

    Science.gov (United States)

    Bruno, Andreina; Dell'Aversana, Giuseppina; Zunino, Anna

    2017-01-01

    Health care is a critical context due to unpredictable situations, demanding clients, workload, and intrinsic organizational complexity. One key to improve the quality of health services is connected to the shift in organization perspective of viewing patients as active consumers rather than passive users. Therefore, higher levels of customer orientation (CO) are expected to improve organizational service effectiveness. According to a cultural perspective to CO, the aim of the study was to explore how different leaders' behaviors (task-oriented and relationship-oriented) interact with CO of health organizations. Specifically, the aim of the paper was to contribute to this topic, by considering the leaders' point of view. Since leader's experience of CO is influenced by social processes in the work environment, workplace social support (WSS) was inserted as moderator in the relationship between leader behavior and CO. A survey study was conducted among 57 Health Department directors belonging to the National Health Service in the North of Italy in 2016. Findings showed that WSS moderated the influence of leadership concern for relationship on CO. Practical implications of the study are discussed.

  14. Weak fault detection and health degradation monitoring using customized standard multiwavelets

    Science.gov (United States)

    Yuan, Jing; Wang, Yu; Peng, Yizhen; Wei, Chenjun

    2017-09-01

    Due to the nonobvious symptoms contaminated by a large amount of background noise, it is challenging to beforehand detect and predictively monitor the weak faults for machinery security assurance. Multiwavelets can act as adaptive non-stationary signal processing tools, potentially viable for weak fault diagnosis. However, the signal-based multiwavelets suffer from such problems as the imperfect properties missing the crucial orthogonality, the decomposition distortion impossibly reflecting the relationships between the faults and signatures, the single objective optimization and independence for fault prognostic. Thus, customized standard multiwavelets are proposed for weak fault detection and health degradation monitoring, especially the weak fault signature quantitative identification. First, the flexible standard multiwavelets are designed using the construction method derived from scalar wavelets, seizing the desired properties for accurate detection of weak faults and avoiding the distortion issue for feature quantitative identification. Second, the multi-objective optimization combined three dimensionless indicators of the normalized energy entropy, normalized singular entropy and kurtosis index is introduced to the evaluation criterions, and benefits for selecting the potential best basis functions for weak faults without the influence of the variable working condition. Third, an ensemble health indicator fused by the kurtosis index, impulse index and clearance index of the original signal along with the normalized energy entropy and normalized singular entropy by the customized standard multiwavelets is achieved using Mahalanobis distance to continuously monitor the health condition and track the performance degradation. Finally, three experimental case studies are implemented to demonstrate the feasibility and effectiveness of the proposed method. The results show that the proposed method can quantitatively identify the fault signature of a slight rub on

  15. The SPA Tourism Perception in Romania

    Directory of Open Access Journals (Sweden)

    Ionica SOARE

    2014-11-01

    Full Text Available Tourism or geriatric-medical and wellness tourism are market segments that lately have registered significant increases. The need to define, organize, and promote these sectors. This item is intended to synthesize developments and challenges market growth wellness and medical tourism. For the industry spa these developments may represent an opportunity to take full advantage of wellness and medical tourism.

  16. Radon measurement in the spa of Bizovac

    International Nuclear Information System (INIS)

    Faj, Z.; Radolic, V.; Suveljak, B.; Planinic, J.

    1996-01-01

    The spa of Bizovac is located 20 km on the west of Osijek in east Croatia. Radon concentrations in the air and water of the Bizovac spa were measured by the Radhome silicon detector and the average values were obtained as 70 Bq/m 3 in the indoor pool, 40 Bq/m 3 in the hotel room and 135 Bq/m 3 in the closed therapeutic bathroom. A special experiment was performed in a closed therapeutic bathroom by three bathtubes filled up with geothermal water as well as normal (potable) one from water-supply. Using measured radon concentrations in air by Radhome detector under the mentioned conditions in the closed bathroom, radon concentrations were assessed for the geothermal water as 25.3 Bq/m 3 and 2.7 Bq/m 3 for potable water. Radon in potable water, measured by the sampling glass ampoule and scintillation cell, had the concentration of 3.5 Bq/m 3 . The radon transfer factor from water to air in the indoor pool and therapeutic bathroom was 10 and 40 times higher than for normal dwelling factor (10 -4 ), respectively. The effective dose equivalent of inhaled radon for permanent personnel under the worst conditions in the spa (closed therapeutic bathroom) was 5.4 mSv/y, but visitors spending two weeks in the Bizovac spa could receive the dose of 77 μSv. (author)

  17. Habit, custom, and power: a multi-level theory of population health.

    Science.gov (United States)

    Zimmerman, Frederick J

    2013-03-01

    In multi-level theory, individual behavior flows from cognitive habits, either directly through social referencing, rules of thumb, or automatic behaviors; or indirectly through the shaping of rationality itself by framing or heuristics. Although behavior does not arise from individually rational optimization, it generally appears to be rational, because the cognitive habits that guide behavior evolve toward optimality. However, power imbalances shaped by particular social, political, and economic structures can distort this evolution, leading to individual behavior that fails to maximize individual or social well-being. Replacing the dominant rational-choice paradigm with a multi-level theoretical paradigm involving habit, custom, and power will enable public health to engage in rigorous new areas of research. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. PREREQUISITES FOR DEVELOPMENT OF SPA TOURISM IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Manuela Vucheva

    2016-12-01

    Full Text Available The demand for spa tourism in Bulgaria has increased 3 times in the last five years. Worldwide demand for spa for travel increased 2 times since 2004. Indications show that spa tourism is developing in a positive direction, both in Bulgaria and abroad. In Bulgaria there are 25 spa destinations where there are hydromineral fields and complexes for accommodation and rest. The paper provides key conclusions in relation to the development of spa tourism in Bulgaria and recommendations for improvements in marketing and advertising and combination with other types of tourism.

  19. Case study: the health SmartLibrary experiences in web personalization and customization at the Galter health sciences library, Northwestern University.

    Science.gov (United States)

    Shedlock, James; Frisque, Michelle; Hunt, Steve; Walton, Linda; Handler, Jonathan; Gillam, Michael

    2010-04-01

    How can the user's access to health information, especially full-text articles, be improved? The solution is building and evaluating the Health SmartLibrary (HSL). The setting is the Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University. The HSL was built on web-based personalization and customization tools: My E-Resources, Stay Current, Quick Search, and File Cabinet. Personalization and customization data were tracked to show user activity with these value-added, online services. Registration data indicated that users were receptive to personalized resource selection and that the automated application of specialty-based, personalized HSLs was more frequently adopted than manual customization by users. Those who did customize customized My E-Resources and Stay Current more often than Quick Search and File Cabinet. Most of those who customized did so only once. Users did not always take advantage of the services designed to aid their library research experiences. When personalization is available at registration, users readily accepted it. Customization tools were used less frequently; however, more research is needed to determine why this was the case.

  20. Case study: the Health SmartLibrary* experiences in web personalization and customization at the Galter Health Sciences Library, Northwestern University

    Science.gov (United States)

    Shedlock, James; Frisque, Michelle; Hunt, Steve; Walton, Linda; Handler, Jonathan; Gillam, Michael

    2010-01-01

    Question: How can the user's access to health information, especially full-text articles, be improved? The solution is building and evaluating the Health SmartLibrary (HSL). Setting: The setting is the Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University. Method: The HSL was built on web-based personalization and customization tools: My E-Resources, Stay Current, Quick Search, and File Cabinet. Personalization and customization data were tracked to show user activity with these value-added, online services. Main Results: Registration data indicated that users were receptive to personalized resource selection and that the automated application of specialty-based, personalized HSLs was more frequently adopted than manual customization by users. Those who did customize customized My E-Resources and Stay Current more often than Quick Search and File Cabinet. Most of those who customized did so only once. Conclusion: Users did not always take advantage of the services designed to aid their library research experiences. When personalization is available at registration, users readily accepted it. Customization tools were used less frequently; however, more research is needed to determine why this was the case. PMID:20428276

  1. "Roman Baths" in Contemporary Spa Tourism

    Directory of Open Access Journals (Sweden)

    Vesna Merc

    2005-07-01

    Full Text Available The commercialisation of images and symbols from antiquity, so characteristic of Slovenia since its independence, has been reflected over the last decade in spa tourism as well. Since the great crises in the sixties, and especially since the eighties, fifteen Slovene natural health resorts have concentrated on developing wellness and activities programs. This change in orientation has been accompanied by renovations, an expansion of the water surfaces and capacities, and new wellbeing, wellness, spirituality and beauty programs. An analysis of Slovene spas, wellness centres and hotel web pages shows that they frequently offer rooms, usually saunas, which are imitations of the Roman baths. These rooms are usually called "Roman saunas", "Tepidarium", "Caldarium", and "Roman-Irish baths". At Terme Ptuj, Zdravilišče Laško, Šmarješke Toplice, Grand Hotel Palace in Portorož, and Terme Čatež, saunas have been built or renovated in the Roman style. This trend of Roman rooms is a novelty, less than a decade old in Slovenia. The first sauna with a Roman theme, a Roman-Irish bath, was opened in 1997 in the Health and Beauty Centre at Terme Čatež. Modern Roman saunas are very popular, found not only in Slovenia but also in other parts of Europe, especially Germany and Austria. Their popularity has spread from the areas formerly occupied by the Romans to other parts of world, for example the USA and the Republic of South Africa. An analysis of Slovene saunas and wellness centres reveals a well-established trend to recreate certain parts of the Roman baths. This is attempted not only through Roman-style decorations, but also through certain structures particular to the Roman baths, such as the caldarium, tepidarium, and in one case even a laconicum. The approach, however, is highly eclectic, blending Roman, Greek and, above all, modern elements. The purpose of such rooms is to increase the appeal of the spas, while their design is mostly based on

  2. SPA: a probabilistic algorithm for spliced alignment.

    Directory of Open Access Journals (Sweden)

    2006-04-01

    Full Text Available Recent large-scale cDNA sequencing efforts show that elaborate patterns of splice variation are responsible for much of the proteome diversity in higher eukaryotes. To obtain an accurate account of the repertoire of splice variants, and to gain insight into the mechanisms of alternative splicing, it is essential that cDNAs are very accurately mapped to their respective genomes. Currently available algorithms for cDNA-to-genome alignment do not reach the necessary level of accuracy because they use ad hoc scoring models that cannot correctly trade off the likelihoods of various sequencing errors against the probabilities of different gene structures. Here we develop a Bayesian probabilistic approach to cDNA-to-genome alignment. Gene structures are assigned prior probabilities based on the lengths of their introns and exons, and based on the sequences at their splice boundaries. A likelihood model for sequencing errors takes into account the rates at which misincorporation, as well as insertions and deletions of different lengths, occurs during sequencing. The parameters of both the prior and likelihood model can be automatically estimated from a set of cDNAs, thus enabling our method to adapt itself to different organisms and experimental procedures. We implemented our method in a fast cDNA-to-genome alignment program, SPA, and applied it to the FANTOM3 dataset of over 100,000 full-length mouse cDNAs and a dataset of over 20,000 full-length human cDNAs. Comparison with the results of four other mapping programs shows that SPA produces alignments of significantly higher quality. In particular, the quality of the SPA alignments near splice boundaries and SPA's mapping of the 5' and 3' ends of the cDNAs are highly improved, allowing for more accurate identification of transcript starts and ends, and accurate identification of subtle splice variations. Finally, our splice boundary analysis on the human dataset suggests the existence of a novel non

  3. Supersymmetry Parameter Analysis : SPA Convention and Project

    CERN Document Server

    Aguilar-Saavedra, J A; Allanach, Benjamin C; Arnowitt, R; Baer, H A; Bagger, J A; Balázs, C; Barger, V; Barnett, M; Bartl, Alfred; Battaglia, M; Bechtle, P; Belyaev, A; Berger, E L; Blair, G; Boos, E; Bélanger, G; Carena, M S; Choi, S Y; Deppisch, F; Desch, Klaus; Djouadi, A; Dutta, B; Dutta, S; Díaz, M A; Eberl, H; Ellis, Jonathan Richard; Erler, Jens; Fraas, H; Freitas, A; Fritzsche, T; Godbole, Rohini M; Gounaris, George J; Guasch, J; Gunion, J F; Haba, N; Haber, Howard E; Hagiwara, K; Han, L; Han, T; He, H J; Heinemeyer, S; Hesselbach, S; Hidaka, K; Hinchliffe, Ian; Hirsch, M; Hohenwarter-Sodek, K; Hollik, W; Hou, W S; Hurth, Tobias; Jack, I; Jiang, Y; Jones, D R T; Kalinowski, Jan; Kamon, T; Kane, G; Kang, S K; Kernreiter, T; Kilian, W; Kim, C S; King, S F; Kittel, O; Klasen, M; Kneur, J L; Kovarik, K; Kraml, Sabine; Krämer, M; Lafaye, R; Langacker, P; Logan, H E; Ma, W G; Majerotto, Walter; Martyn, H U; Matchev, K; Miller, D J; Mondragon, M; Moortgat-Pick, G; Moretti, S; Mori, T; Moultaka, G; Muanza, S; Mukhopadhyaya, B; Mühlleitner, M M; Nauenberg, U; Nojiri, M M; Nomura, D; Nowak, H; Okada, N; Olive, Keith A; Oller, W; Peskin, M; Plehn, T; Polesello, G; Porod, Werner; Quevedo, Fernando; Rainwater, D L; Reuter, J; Richardson, P; Rolbiecki, K; de Roeck, A; Weber, Ch.

    2006-01-01

    High-precision analyses of supersymmetry parameters aim at reconstructing the fundamental supersymmetric theory and its breaking mechanism. A well defined theoretical framework is needed when higher-order corrections are included. We propose such a scheme, Supersymmetry Parameter Analysis SPA, based on a consistent set of conventions and input parameters. A repository for computer programs is provided which connect parameters in different schemes and relate the Lagrangian parameters to physical observables at LHC and high energy e+e- linear collider experiments, i.e., masses, mixings, decay widths and production cross sections for supersymmetric particles. In addition, programs for calculating high-precision low energy observables, the density of cold dark matter (CDM) in the universe as well as the cross sections for CDM search experiments are included. The SPA scheme still requires extended efforts on both the theoretical and experimental side before data can be evaluated in the future at the level of the d...

  4. A model-Driven Approach to Customize the Vocabulary of Communication Boards: Towards More Humanization of Health Care.

    Science.gov (United States)

    Franco, Natália M; Medeiros, Gabriel F; Silva, Edson A; Murta, Angela S; Machado, Aydano P; Fidalgo, Robson N

    2015-01-01

    This work presents a Modeling Language and its technological infrastructure to customize the vocabulary of Communication Boards (CB), which are important tools to provide more humanization of health care. Using a technological infrastructure based on Model-Driven Development (MDD) approach, our Modelin Language (ML) creates an abstraction layer between users (e.g., health professionals such as an audiologist or speech therapist) and application code. Moreover, the use of a metamodel enables a syntactic corrector for preventing creation of wrong models. Our ML and metamodel enable more autonomy for health professionals in creating customized CB because it abstracts complexities and permits them to deal only with the domain concepts (e.g., vocabulary and patient needs). Additionally, our infrastructure provides a configuration file that can be used to share and reuse models. This way, the vocabulary modelling effort will decrease our time since people share vocabulary models. Our study provides an infrastructure that aims to abstract the complexity of CB vocabulary customization, giving more autonomy to health professionals when they need customizing, sharing and reusing vocabularies for CB.

  5. Linkages between organization climate and work outcomes: perceptual differences among health service professionals as a function of customer contact intensity.

    Science.gov (United States)

    Scotti, Dennis J; Harmon, Joel

    2014-01-01

    The delivery of high-quality service, rendered by health service professionals who interact with customers (patients), increases the likelihood that customers will form positive evaluations of the quality of their service encounters as well as high levels of customer satisfaction. Using linkage theory to develop our conceptual framework, we identify four clusters of variables which contribute to a chain of sequential events that connect organization climate to personal and operational work outcomes. We then examine the perceptual differences of service professionals, grouped by intensity of customer contact, with respect to these variables. National data for this project were obtained from multiple sources made available by the Veterans Healthcare Administration (VHA). Cross-group differences were tested using a series of variance analyses. The results indicate that level of customer-contact intensity plays a significant role in explaining variation in perceptions of support staff, clinical practitioners, and nurses at the multivariate and univariate levels of analysis. Contact intensity appears to be a core determinant of the nature of work performed by health service professionals as well as their psychological responses to organizational and customer-related dynamics. Health service professionals are important resources because of their specialized knowledge, labor expense, and scarcity. Based on findings from our research, managers are advised to survey employees' perceptions of their organizational environment and design practices that respond to the unique viewpoints of each of the professional groups identified in this study. Such tailoring should help executives maximize the value of investments in human resources by underwriting patient satisfaction and financial sustainability.

  6. Provider’s Perspectives on the Impact of Immigration and Customs Enforcement (ICE) Activity on Immigrant Health

    Science.gov (United States)

    Hacker, Karen; Chu, Jocelyn; Arsenault, Lisa; Marlin, Robert P.

    2013-01-01

    Introduction Increasing Immigration and Customs Enforcement (ICE) activities such as raids, detention and deportation may be affecting the health and well-being of immigrants. This study sought to understand the impact of ICE activities on immigrant health from the perspective of health care providers. Methods An online survey of primary care and emergency medicine providers was conducted to determine whether ICE activity was negatively affecting immigrant patients. Results Of 327 providers surveyed, 163 responded (50%) and 156 (48%) met criteria for inclusion. Seventy-five (48%) of them observed negative effects of ICE enforcement on the health or health access of immigrant patients. Forty-three providers gave examples of the impact on emotional health, ability to comply with health care recommendations and access. Conclusions Health care providers are witnessing the negative effects of ICE activities on their immigrant patients’ psychological and physical health. This should be considered an important determinant of immigrant health. PMID:22643614

  7. Streptococcus mutans SpaP binds to RadD of Fusobacterium nucleatum ssp. polymorphum.

    Science.gov (United States)

    Guo, Lihong; Shokeen, Bhumika; He, Xuesong; Shi, Wenyuan; Lux, Renate

    2017-10-01

    Adhesin-mediated bacterial interspecies interactions are important elements in oral biofilm formation. They often occur on a species-specific level, which could determine health or disease association of a biofilm community. Among the key players involved in these processes are the ubiquitous fusobacteria that have been recognized for their ability to interact with numerous different binding partners. Fusobacterial interactions with Streptococcus mutans, an important oral cariogenic pathogen, have previously been described but most studies focused on binding to non-mutans streptococci and specific cognate adhesin pairs remain to be identified. Here, we demonstrated differential binding of oral fusobacteria to S. mutans. Screening of existing mutant derivatives indicated SpaP as the major S. mutans adhesin specific for binding to Fusobacterium nucleatum ssp. polymorphum but none of the other oral fusobacteria tested. We inactivated RadD, a known adhesin of F. nucleatum ssp. nucleatum for interaction with a number of gram-positive species, in F. nucleatum ssp. polymorphum and used a Lactococcus lactis heterologous SpaP expression system to demonstrate SpaP interaction with RadD of F. nucleatum ssp. polymorphum. This is a novel function for SpaP, which has mainly been characterized as an adhesin for binding to host proteins including salivary glycoproteins. In conclusion, we describe an additional role for SpaP as adhesin in interspecies adherence with RadD-SpaP as the interacting adhesin pair for binding between S. mutans and F. nucleatum ssp. polymorphum. Furthermore, S. mutans attachment to oral fusobacteria appears to involve species- and subspecies-dependent adhesin interactions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review.

    Science.gov (United States)

    Asadollahi, Parisa; Farahani, Narges Nodeh; Mirzaii, Mehdi; Khoramrooz, Seyed Sajjad; van Belkum, Alex; Asadollahi, Khairollah; Dadashi, Masoud; Darban-Sarokhalil, Davood

    2018-01-01

    Background: Staphylococcus aureus , a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were " Staphylococcus aureus, spa typing ." Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution.

  9. State, planning and design of Jodna spa in Novi Sad

    Directory of Open Access Journals (Sweden)

    Garača Vuk

    2012-01-01

    Full Text Available The paper treats the area of Jodna spa in Novi Sad, which largely coincides with Futoški park, making with it the indissoluble unity. The main problem in the functioning of the Jodna psa is the fact that in legal sense Jodna spa does not exists, and in spatial sense there are still all of its content. The case of the paper is Jodna spa area, which includes the Special Hospital for Rheumatic Diseases, Hotel 'Park', Sports Center 'Sajmište' and Futoški park, which integrate them. The question of the Jodna spa planning, as well as the modern city recreation, spa and tourist center, is the goal of this paper. For this purpose it was necessary to show the historical background of the development of Jodna spa, to make the assessment of the state, critically analyze spatial plans which treat it and provide concrete suggestions for its design and equipping.

  10. Staphylococcus aureus spa type t437

    DEFF Research Database (Denmark)

    Glasner, C; Pluister, G; Westh, H

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) belonging to the multilocus sequence type clonal complex 59 (MLST CC59) is the predominant community-associated MRSA clone in Asia. This clone, which is primarily linked with the spa type t437, has so far only been reported in low numbers among...... included. Most isolates were shown to be monophyletic with 98% of the isolates belonging to the single MLVA complex 621, to which nearly all included isolates from China also belonged. More importantly, all MLST-typed isolates belonged to CC59. Our study implies that the European S. aureus t437 population...

  11. Plan de negocios: Samay Spa Mujer

    OpenAIRE

    Espol; García Viteri, Maria Del Carmen; Valle SÁnchez, Francisco; Pauta, MarÍa Alexandra

    2015-01-01

    Samay spa mujer, diseñado como centro de bienestar, belleza y salud de la mujer guayaquileña ejecutiva, pone a su disposición un ambiente armonioso con soluciones para mantener y mejorar su imagen personal y eliminar el estrés. lograremos que la mujer sienta bienestar, descanso, cuidado de su cuerpo, disfrute de preciosos momentos, a través d eun variado paquete de servicios con el respaldo de equipos modernos de alta tecnología de la conocida maraca española sorisa y productos esteé lauder, ...

  12. Mental health and debt collection: a story of progress? Exploring changes in debt collectors' attitudes and practices when working with customers with mental health problems, 2010-2016.

    Science.gov (United States)

    Evans, Jamie; Fitch, Christopher; Collard, Sharon; Henderson, Claire

    2018-04-27

    In recent years, the UK debt collection industry has taken steps to improve its policies and practices in relation to customers with mental health problems. Little data, however, have been collected to evidence change. This paper examines whether the reported attitudes and practices of debt collection staff when working with customers with mental health problems have changed between 2010 and 2016. This paper draws on descriptive and regression analyses of two cross-sectional surveys of debt collection staff: one conducted in 2010 and one conducted in 2016. All variables analysed show statistically significant changes between 2010 and 2016 indicative of improved reported attitudes and practices. While results suggest an improvement in attitudes and practice may have occurred between 2010 and 2016, research is required to understand this potential shift, its likely causes, and concrete impact on customers.

  13. Spa-Wellness Center as Part of the Hotel Facility

    Directory of Open Access Journals (Sweden)

    Milica Rančić

    2013-04-01

    Full Text Available Over the last decades “wellness spa” industry has experienced a boom around the world. The word “Wellness” has been formed by merging two words: “Well Being” + “fitness”, and appeared in the thirties of the last century in the United States. The primary objective of this movement is an ancient philosophy, according to which there ́s no fulfilled life without the assent of the physical and mental, also physical and spiritual. Hotel guests, today more than ever, want higher quality offer for their money. This means that wellness is today a very important criterion by which customers select hotels. For this reason it is necessary to pay great attention to the planning, design and construction of this part of the hotel facility. The subject of this paper is wellness and spa centers as part of the hotel facility. The task is to investigate and analyze elements of this space, to determine spatial areas of wellness center, as well as their relationships and spatial organization, in order to reach the goal - getting useful guidelines for planning quality wellness center. To all of this could be achieved, we must first go back to distant history where dating back the beginnings of wellness.

  14. Development of a Web-based tool to collect and display water system customer service areas for public health action.

    Science.gov (United States)

    Wong, Michelle; Wolff, Craig; Collins, Natalie; Guo, Liang; Meltzer, Dan; English, Paul

    2015-01-01

    Significant illness is associated with biological contaminants in drinking water, but little is known about health effects from low levels of chemical contamination in drinking water. To examine these effects in epidemiological studies, the sources of drinking water of study populations need to be known. The California Environmental Health Tracking Program developed an online application that would collect data on the geographic location of public water system (PWS) customer service areas in California, which then could be linked to demographic and drinking water quality data. We deployed the Water Boundary Tool (WBT), a Web-based geospatial crowdsourcing application that can manage customer service boundary data for each PWS in California and can track changes over time. We also conducted a needs assessment for expansion to other states. The WBT was designed for water system operators, local and state regulatory agencies, and government entities. Since its public launch in 2012, the WBT has collected service area boundaries for about 2300 individual PWS, serving more than 90% of the California population. Results of the needs assessment suggest interest and utility for deploying such a tool among states lacking statewide PWS service area boundary data. Although the WBT data set is incomplete, it has already been used for a variety of applications, including fulfilling legislatively mandated reporting requirements and linking customer service areas to drinking water quality data to better understand local water quality issues. Development of this tool holds promise to assist with outbreak investigations and prevention, environmental health monitoring, and emergency preparedness and response.

  15. Modified Decoding Algorithm of LLR-SPA

    Directory of Open Access Journals (Sweden)

    Zhongxun Wang

    2014-09-01

    Full Text Available In wireless sensor networks, the energy consumption is mainly occurred in the stage of information transmission. The Low Density Parity Check code can make full use of the channel information to save energy. Because of the widely used decoding algorithm of the Low Density Parity Check code, this paper proposes a new decoding algorithm which is based on the LLR-SPA (Sum-Product Algorithm in Log-Likelihood-domain to improve the accuracy of the decoding algorithm. In the modified algorithm, a piecewise linear function is used to approximate the complicated Jacobi correction term in LLR-SPA decoding algorithm. Construct the tangent by the tangency point to the function of Jacobi correction term, which is based on the first order Taylor Series. In this way, the proposed piecewise linear approximation offers almost a perfect match to the function of Jacobi correction term. Meanwhile, the proposed piecewise linear approximation could avoid the operation of logarithmic which is more suitable for practical application. The simulation results show that the proposed algorithm could improve the decoding accuracy greatly without noticeable variation of the computational complexity.

  16. spa typing for epidemiological surveillance of Staphylococcus aureus

    NARCIS (Netherlands)

    Hallin, Marie; Friedrich, Alexander W; Struelens, Marc J; Caugant, Dominique A.

    2009-01-01

    The spa typing method is based on sequencing of the polymorphic X region of the protein A gene (spa), present in all strains of Staphylococcus aureus. The X region is constituted of a variable number of 24-bp repeats flanked by well-conserved regions. This single-locus sequence-based typing method

  17. Spa and Wellness Tourism in Slovakia (A Geographical Analysis

    Directory of Open Access Journals (Sweden)

    Kasagranda Anton

    2017-06-01

    Full Text Available Spa industry is presently an inherent part of Slovak tourism. For this reason, it has become a major interest of scientific and professional literature (economics, management, sociology, or geography. The main topic of this paper is the evaluation of tourism in Slovakia through a geographic analysis. This paper briefly evaluates the development and the importance of spa, spa tourism and wellness and their main research areas and issues. Furthermore, the primary sources of tourism development, the overview of spa tourism and the wellness resorts, the accommodation establishments and the visitation rate are evaluated as well. In conclusion, functional and spatial typification of spa tourism and wellness in Slovakia is presented. The structure of the paper is designed to be appropriate for a comparison with V4 countries.

  18. Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Karagülle, Oğuz; Dişçi, Rian; Avcı, Aslıhan; Durak, İlker; Karagülle, Müfit Zeki

    2017-01-01

    Oxidative stress has been shown to play a contributory role in the pathogenesis of rheumatoid arthritis (RA). Recent studies have provided evidence for antioxidant properties of spa therapy. The purpose of this study is to investigate whether spa therapy with saline balneotherapy has any influence on the oxidant/antioxidant status in patients with RA and to assess clinical effects of spa therapy. In this investigator-blind randomized controlled trial, we randomly assigned 50 patients in a 1:1 ratio to spa therapy plus standard drug treatment (spa group) or standard drug treatment alone (control group). Spa group followed a 2-week course of spa therapy regimen consisting of a total of 12 balneotherapy sessions in a thermal mineral water pool at 36-37 °C for 20 min every day except Sunday. All clinical and biochemical parameters were assessed at baseline and after spa therapy (2 weeks). The clinical parameters were pain intensity, patient global assessment, physician global assessment, Health Assessment Questionnaire disability index (HAQ-DI), Disease Activity Score for 28-joints based on erythrocyte sedimentation rate (DAS28-4[ESR]). Oxidative status parameters were malondialdehyde (MDA), nonenzymatic superoxide radical scavenger activity (NSSA), antioxidant potential (AOP), and superoxide dismutase (SOD). The NSSA levels were increased significantly in the spa group ( p = 0.003) but not in the control group ( p = 0.509); and there was a trend in favor of spa therapy for improvements in NSSA levels compared to control ( p = 0.091). Significant clinical improvement was found in the spa group compared to the control in terms of patient global assessment ( p = 0.011), physician global assessment ( p = 0.043), function (HAQ-DI) ( p = 0.037), disease activity (DAS28-4[ESR]) (0.044) and swollen joint count (0.009), and a trend toward improvement in pain scores (0.057). Spa therapy with saline balneotherapy exerts antioxidant effect in patients with RA as reflected by the

  19. Integrating cultural values, beliefs, and customs into pregnancy and postpartum care: lessons learned from a Hawaiian public health nursing project.

    Science.gov (United States)

    Mayberry, L J; Affonso, D D; Shibuya, J; Clemmens, D

    1999-06-01

    Determining the elements of culturally competent health care is an important goal for nurses. This goal is particularly integral in efforts to design better preventive health care strategies for pregnant and postpartum women from multiple cultural and ethnic backgrounds. Learning about the values, beliefs, and customs surrounding health among the targeted groups is essential, but integrating this knowledge into the actual health care services delivery system is more difficult. The success of a prenatal and postpartum program developed for native Hawaiian, Filipino, and Japanese women in Hawaii has been attributed to the attention on training, direct care giving, and program monitoring participation by local cultural and ethnic healers and neighborhood leaders living in the community, with coordination by public health nurses. This article profiles central design elements with examples of specific interventions used in the Malama Na Wahine or Caring for Pregnant Women program to illustrate a unique approach to the delivery of culturally competent care.

  20. Disinfection of herbal spa pool using combined chlorine dioxide and sodium hypochlorite treatment.

    Science.gov (United States)

    Hsu, Ching-Shan; Huang, Da-Ji

    2015-02-01

    The presence of pathogenic microorganisms in public spa pools poses a serious threat to human health. The problem is particularly acute in herbal spas, in which the herbs and microorganisms may interact and produce undesirable consequences. Accordingly, the present study investigated the effectiveness of a combined disinfectant containing chlorine dioxide and sodium hypochlorite in improving the water quality of a public herbal spa in Taiwan. Water samples were collected from the spa pool and laboratory tests were then performed to measure the variation over time of the microorganism content (total CFU and total coliforms) and residual disinfectant content given a single disinfection mode (SDM) with disinfectant concentrations of 5.2 × 10, 6.29 × 10, 7.4 × 10, and 11.4 × 10(-5) N, respectively. Utilizing the experience gained from the laboratory tests, a further series of on-site investigations was performed using three different disinfection modes, namely SDM, 3DM (once every 3 h disinfection mode), and 2DM (once every 2 h disinfection mode). The laboratory results showed that for all four disinfectant concentrations, the CFU concentration reduced for the first 6 h following SDM treatment, but then increased. Moreover, the ANOVA results showed that the sample treated with the highest disinfectant concentration (11.4 × 10(-5) N) exhibited the lowest rate of increase in the CFU concentration. In addition, the on-site test results showed that 3DM and 2DM treatments with disinfectant concentrations in excess of 9.3 × 10 and 5.5 × 10(-5) N, respectively, provided an effective reduction in the total CFU concentration. In conclusion, the experimental results presented in this study provide a useful source of reference for spa businesses seeking to improve the water quality of their spa pools.

  1. Spa treatment of Chernobyl liquidators in Israel

    International Nuclear Information System (INIS)

    Godovich, A.; Chernovskij, A.; Lyass, F.; Shapiro, I.; Kratov, Eh.; Markarov, G.

    1997-01-01

    This paper presents the first experience gained in the use of the unique climate and spa of the Dead Sea for the treatment and rehabilitation of the Chernobyl liquidators at clinic near the city of Arad. Ninety-six patients were treated in Israel, in 40 of these radiation was the etiological factor of the disease: consequences of acute and chronic radiation disease, the astheno-neurotic syndrome, discirculatory encephalopathy, subatrophic laryngopharyngitis, and obstructive bronchitis. Eighty-eight patients had direct indications for treatment at the Dad Sea; locomotory, respiratory, and skin diseases. The course of treatment included the Dad Sea baths, mud applications, sun baths, climatotherapy, physiotherapy, massage, bioenergy therapy, inhalations, moisturizing creams, etc. An appreciable improvement with resolution of the principal symptoms was attained in 82% of patients, in 13% improvement with a significant abatement of the symptoms was achieved, whereas in 5% no apparent results were seen

  2. MANAGING CUSTOMER RELATIONSHIPS IN PRIVATE HEALTH CARE FACILITIES - A STUDY WITH REFERENCE TO GREATER NOIDA CITY OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    Arun Kumar Panda

    2011-03-01

    Full Text Available Customer relationship management (CRM which has overriding significance for any business isno less significant for hospital services. Hospitals are most important elements in any health caredelivery system. A hospital plays a major role in maintaining and restoring the health of the people.Care of the sick and injured, preventive health care, health research, and training of medical andparamedical staff are general broad functions of a hospital. It involves to the outpatient and inpatienthospital services and on many occasions emergency medical services. An important resource in ahospital is a human resource. This should be particularly emphasized. This should be particularlyemphasized in the content of a hospital since relationship of medical staff plays important role intreating patients - the hospital customers. In health care, CRM practices are essentially patient -focused strategies that involve effective management of hospital interface and interaction withpatients. Effective CRM practices in a hospital may mean providing services related information toa patient very quickly. Responding to the patent appointment and an admission requests promptly,dealing with patient queries and complaints expeditiously, exercising all kinds of flexibilities inserving patients to the patients. This research paper made an attempt to analyze the factorsinfluencing the customers to select the hospital and to suggest better ways and means to retain thecustomers. For the study, the researcher has collected data from 200 respondents of 10 privatehospitals located in Greater Noida city. For this purpose stratified random sampling method was usedto select the samples. The present study highlights the extent of utilization of the hospital services bythe selected sample respondents. It also shed light on the common problems faced by therespondents. The major features of the service sectors especially on hospital performance is projectedin order to utilize the

  3. Tourism of Krapinske Toplice Spa - present position and possibilities of Its development

    Directory of Open Access Journals (Sweden)

    Martina Jakovčić

    2003-01-01

    Full Text Available This paper presents present state of development of tourism in Krapinske Toplice Spa and possibilities of further development from the geographical point of view. Natural, socio-economical, cultural and historical components of the area are analysed. Special attention is given to development of health tourism and its impact on the development of other types of tourism. Paper explains the main reason of slower tourist development of Krapinske Toplice in comparison to other spas in the region.

  4. Customer experience

    OpenAIRE

    Koperdáková, Zuzana

    2016-01-01

    Bachelor thesis deals with the theme of customer experience and terms related to this topic. The thesis consists of three parts. The first part explains the terms generally, as the experience or customer loyalty. The second part is dedicated to medotology used for Customer Experience Management. In the third part is described application of Customer Experience Management in practice, particularly in the context Touch Point Analyses in GE Money Bank.

  5. Post-neonatal drop in alveolar SP-A expression

    DEFF Research Database (Denmark)

    Stray-Pedersen, Arne; Vege, Ashild; Stray-Pedersen, Asbjorg

    2008-01-01

    BACKGROUND: Surfactant protein A (SP-A) is synthesized in the lung and is a part of the innate immune system. The aim of this study was to evaluate the expression of SP-A in lung tissue from fetuses, infants, children and adults with special regard to sudden infant death syndrome (SIDS). METHODS......: A total of 160 cases were studied; 19 fetuses and neonates, 59 SIDS and 49 explained infant deaths below 1 year of age, 19 toddlers and 14 adults. Immunohistochemical detection of SP-A using monoclonal antibodies was performed by microscopy of lung tissue specimens collected at autopsy. A scoring system...

  6. PERFORMANCE ANALYSIS ON SPA SERVICE AT BADUNG DAN GIANYAR REGENCIES

    Directory of Open Access Journals (Sweden)

    Dewa Ayu i Laksmiadi Janapriat

    2016-03-01

    Full Text Available Over the last ten years, spa as one of the products of wellness tourism is growing very fast in Bali, necessitating the development strategy in accordance with the conditions of Bali. The rapid development momentum for the business of spa is opened in Bali, although in the external side of the business will compete with the international trade environment to take advantage and create sustainable economic growth prospects. This will be an opportunity for Bali as a destination spa in the future. In an effort to maintain and continue to develop quality as the best spa destinations in the world, we need the right strategy to make the creation and supporting product innovation spa in Bali. This study aims to create an integrated assessment of the extent of the influence of the utilization of natural resources, human resources and local knowledge of the existence and essence of spa in Bali and methods for utilizing natural resources, human resources and local knowledge of Bali on development of spa in Bali. Research design and methods of approach to the problem that are done in this study using descriptive design, where the planning and execution of research conducted in the form of field data are collected in the form of surveys, questionnaires and statistical data processing. The target population in this study is divided into three, namely: the company or a place that offers spa services, spa services supporting manufacturers and both foreign and domestic tourists who use the services of spa services in Badung and Gianyar, by assuming the two districts can represent the tourist population to Bali. Based on several case studies found that the performance of spa services in terms of utilization of natural resources, human resources, and local wisdom of Bali, particularly in terms of (1 the atmosphere (ambience, (2 equipment and design, (3 the qualifications and skills of the therapist, (4 treatment menu, and (5 the quality of services as a whole has

  7. Correlation of the sperm penetration assay (SPA and miscarriage after assisted reproduction: The potential use of spa as a new criterion for preimplantation genetic diagnosis

    Directory of Open Access Journals (Sweden)

    Gradistanac Jelena

    2011-01-01

    Full Text Available We analyzed 93 couples undergoing male screening with the Sperm Penetration Assay (SPA before in vitro fertilization and intracytoplasmic sperm injection (ICSI, to determine the accuracy of SPA for subsequent embryonic development, incidence of pregnancy and miscarriage rates (SAB. ICSI patients with the lowest SPA scores had significantly higher incidences of Sthan did patients in the other SPA groups. Sperm quality is higher with better SPA scores. Poor sperm quality has increased incidence of chromosomal abnormalities and is associated with early fetal loss. Couples with negative SPA are candidates for preimplantation genetic diagnosis, to reduce the incidence of SAB.

  8. A preliminary examination of patient loyalty: an application of the customer loyalty classification framework in the health care industry.

    Science.gov (United States)

    Heiens, R A; Pleshko, L P

    1997-01-01

    The present article applies the customer loyalty classification framework developed by Dick and Basu (1994) to the health care industry. Based on a two factor classification, consisting of repeat patronage and relative attitude, four categories of patient loyalty are proposed and examined, including true loyalty, latent loyalty, spurious loyalty, and no loyalty. Data is collected and the four patient loyalty categories are profiled and compared on the basis of perceived risk, product class importance, provider decision importance, provider awareness, provider consideration, number of providers visited, and self-reported loyalty.

  9. [Use of customer relationship management to improve healthcare for citizens. The 24h Andalusian Health Service: Healthline].

    Science.gov (United States)

    Quero, Manuel; Ramos, María Belén; López, Wilfredo; Cubillas, Juan José; González, José María; Castillo, José Luis

    2016-01-01

    Salud Responde (in English: Healthline) is a Health Service and Information Centre of the taxpayer-funded Andalusian Health System (AHS) that offers a Telephone Health Advisory Service called SA24h, among other services. The main objective of SA24h is to inform and advise citizens on health issues and the available health resources of the AHS. SA24h has a Customer Relationship Management information technology tool that organises information at various levels of specialization. Depending on the difficulty of the query, the citizen is attended by professionals with distinct profiles, providing a consensual response within the professionals working within Salud Responde or within other healthcare levels of the AHS. SA24h provided responses to 757,168 patient queries from late 2008 to the end of 01/12/2015. A total of 9.38% of the consultations were resolved by the non-health professionals working at Salud Responde. The remaining 84.07% were resolved by health staff. A total of 6.5% of users were referred to accident and emergency facilities while 88.77% did not need to attend their general practitioner within the next 24hours, thus avoiding unnecessary visits to health care facilities. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Product Customization

    DEFF Research Database (Denmark)

    Hvam, Lars; Mortensen, Niels Henrik; Riis, Jesper

    For the majority of industrial companies, customizing products and services is among the most critical means to deliver true customer value and achieve superior competitive advantage. The challenge is not to customize products and services in itself – but to do it in a profitable way...... from more than 40 product configuration projects in companies providing customer tailored products and services........ The implementation of a product configuration system is among the most powerful ways of achieving this in practice, offering a reduction of the lead time for products and quotations, faster and more qualified responses to customer inquiries, fewer transfers of responsibility and fewer specification mistakes...

  11. Searching from the Heart: The Interplay between Emotions and Customization in Online Health Information Seeking

    Science.gov (United States)

    Myrick, Jessica Gall

    2013-01-01

    The prospect of a threat to one's health or an opportunity for improved health can spark emotional reactions--the fear of an illness or the hope of a healthier life. People are increasingly turning to the Internet to search for information related to such health issues. However, the dizzying amount of online health information--some of it of…

  12. Customization Issues

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn; Brunø, Thomas Ditlev; Taps, Stig B.

    2014-01-01

    Implementation of mass customization and product configuration in companies requires fundamental considerations about how products can fulfil the demand from customers. In order to support such decision-making, a multi-level model for customization is developed. This model identifies four different...... levels of customization, ranging from the structure level at the bottom, through the performance level and the experience level, to the learning level at the top. The model also has a dual view with customers/demand at one side and product/supplier at the other side. It is a rather general model, which...... can be applied to many types of products, and typically, product designers must decide how far up in levels the customization should aim. In this paper, the four-level customization model is applied to wheel chairs....

  13. Non-spa-typeable clinical Staphylococcus aureus strains are naturally occurring protein A mutants

    DEFF Research Database (Denmark)

    Baum, Cathrin; Haslinger-Löffler, Bettina; Westh, Henrik

    2009-01-01

    Staphylococcus aureus is a major human pathogen responsible for increasing the prevalence of community- and hospital-acquired infections. Protein A (SpA) is a key virulence factor of S. aureus and is highly conserved. Sequencing of the variable-number tandem-repeat region of SpA (spa typing......) provides a rapid and reliable method for epidemiological studies. Rarely, non-spa-typeable S. aureus strains are encountered. The reason for this is not known. In this study, we characterized eight non-spa-typeable bacteremia isolates. Sequencing of the entire spa locus was successful for five strains...... and revealed various mutations of spa, all of which included a deletion of immunoglobulin G binding domain C, in which the upper primer for spa typing is located, while two strains were truly spa negative. This is the first report demonstrating that nontypeability of S. aureus by spa sequencing is due either...

  14. The paradigm of territoriality in the spa tourism: The concept of spatial indicators

    Directory of Open Access Journals (Sweden)

    Dželebdžić Omiljena

    2010-01-01

    Full Text Available The famous tradition of spa places like cultural centers and health resorts with unique potential in natural curing springs could be a solid, but not an adequate, ground for their development according to the challenges of contemporary society. The renewed interest in the territorial aspects of tourism as a response to globalization enhanced the influence of spatial factor (tourismscape on current on tourism demand. The network of flows, relationships and interactions, as the core of the territoriality concept, is not something new and unknown in regional planning but requires a new analytical tool for researching the global network connectivity. This paper analyzes the concept of territorial networking in the system of physical, functional and organizational networks as one of the crucial aspects in the development of well balanced tourism region. The consideration aim is to examine and define the relevant indicators that may specify the level of competitiveness of spa region in the global tourism market.

  15. Allegheny County Public Swimming Pool, Hot Tub, and Spa Inspections

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Public swimming pool, hot tub, and spa facilities are licensed and inspected once each year to assure proper water quality, sanitation, lifeguard coverage and...

  16. The FAA Health Awareness Program: Results of the 1998 Customer Service Assessment Survey

    National Research Council Canada - National Science Library

    Hilton, Thomas

    2000-01-01

    ... (even if they did not realize that the event was HAP-sponsored). In terms of attendance, the most popular HAP information programs were health fairs, health awareness lectures, and stress management awareness programs...

  17. The FAA Health Awareness Program: Results of the 1998 Customer Service Assessment Survey

    National Research Council Canada - National Science Library

    Hilton, Thomas

    2000-01-01

    This report presents the results of an agency-wide survey of employee health and wellness to determine workforce involvement in and satisfaction with the Federal Aviation Administration's Health Awareness Program (HAP...

  18. MANAGEMENT AND DEVELOPMENT POSSIBILITIES FOR SPA TOURISM IN SERBIA

    Directory of Open Access Journals (Sweden)

    Nemanja BERBER

    2010-06-01

    Full Text Available Two forms of tourism, which are represented to a large extent in the world, are spa and wellness tourism. In Serbia, spa and wellness tourism are not sufficiently used, although there are excellent conditions. During twenty century the state was paying more attention and money on the sea and river tourism. However, the separation of Serbia and Montenegro in two independent counties had left Serbia without an entrance to the Adriatic Sea, so development of other tourist products and destinations became an imperative for survival and existence in the tourist map of Europe and the world. The paper presents the basic aims and policies of development of spa tourism in Serbia and data obtained in the survey regarding quality of services provided in some spa towns in Serbia. Based on the results to which the research occurred, authors wished to point out main activities and tasks that the state uses in creating a development strategy of spa tourism, the programs that have already been taken, so as the influence of the economic crisis to spa tourism.

  19. Customers' perspectives on the impact of the Pathways to Work condition management programme on their health, well-being and vocational activity.

    Science.gov (United States)

    Secker, Jenny; Pittam, Gail; Ford, Fiona

    2012-11-01

    Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers' perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Perceived impacts on health and well-being included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life.

  20. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review

    Directory of Open Access Journals (Sweden)

    Parisa Asadollahi

    2018-02-01

    Full Text Available Background:Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies.Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were “Staphylococcus aureus, spa typing.”Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence.Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution.

  1. [The impact of the spa therapy on reduction of the perception of pain intensity in patients with degenerative joints and disc disease].

    Science.gov (United States)

    Kuciel-Lewandowska, Jadwiga; Paprocka-Borowicz, Małgorzata

    2015-01-01

    Degenerative joints and disc disease is accompanied by chronic pain which is the main symptom of the disease. Medical spa therapy has the task of providing comprehensive treatment embracing diseases of limbs as well as other systems and the essential role of medical treatment, in particular spa therapy, is pain relief. The aim of the study was to evaluate the effect of the spa treatment on the level of pain perception in patients with degenerative joints and disc disease. The observation embraced 120 people with degenerative joints and disc disease treated in the spa. The study included a comprehensive therapy conducted over a 21-day stays at the spa Przerzeczyn-Zdrój with the application of selected physical treatments, physiotherapy and the use of therapeutic natural resources: peloid mud and healing radon-sulphide water. Moreover, there was psychological counseling and health education conducted. The study also included observation of 21 persons from the control group. However, the patients in the control group did not benefit from balneotherapy, psychological care and education. There was a standard VAS scale for pain and non-standard questionnaire of pain assessment constructed for the study purposes. The assessment of pain using the VAS scale and questionnaire of pain assessment both in the study group and the control group were performed before and after the treatment. The results were analyzed statistically, there was Statistica program in Polish version used. In the analysis of the obtained results there were two tests scheduled: the sign test, the Wilcoxon test and descriptive statistics. As a result of the spa therapy and treatments administered on an outpatient basis there was reduction of pain intensity observed. 1. Spa therapy and outpatient treatment reduce the level of pain in patients with degenerative joints and disc disease. 2. The reduction of pain level was more effective in case of therapy conducted in the spa.

  2. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review

    Science.gov (United States)

    Asadollahi, Parisa; Farahani, Narges Nodeh; Mirzaii, Mehdi; Khoramrooz, Seyed Sajjad; van Belkum, Alex; Asadollahi, Khairollah; Dadashi, Masoud; Darban-Sarokhalil, Davood

    2018-01-01

    Background: Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were “Staphylococcus aureus, spa typing.” Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution. PMID:29487578

  3. Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials.

    Science.gov (United States)

    Pittler, M H; Karagülle, M Z; Karagülle, M; Ernst, E

    2006-07-01

    Low back pain is a major public health concern and complementary treatments are frequently used for this condition. The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain. Systematic searches were conducted on Medline, Embase, Amed Cochrane Central, the UK National Research Register and ClincalTrials.gov (all until July 2005). Hand searches were performed and experts contacted. Methodological quality was assessed using a standard scale. Five randomized clinical trials met all inclusion criteria. Quantitative data synthesis was performed. The data for spa therapy, assessed on a 100 mm visual analogue scale (VAS), suggest significant beneficial effects compared with waiting list control groups (weighted mean difference 26.6 mm, 95% confidence interval 20.4-32.8, n=442) for patients with chronic low back pain. For balneotherapy the data, assessed on a 100 mm VAS, also suggest beneficial effects compared with control groups (weighted mean difference 18.8 mm, 95% confidence interval 10.3-27.3, n=138). Even though the data are scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain. These data are not compelling but warrant rigorous large-scale trials.

  4. Neuroendocrine-immune and metabolic accompaniments of cholecystokinetic effects of balneotherapy on SPA Truskavets’

    Directory of Open Access Journals (Sweden)

    O M Marfiyan

    2015-05-01

    4Faculty of Physical Education, Health and Tourism, Kazimierz Wielki University, Bydgoszcz, Poland w.zukow@ukw.edu.pl   SUMMARY   Objective. Ability balneofactors spa Truskavets’ (Ukraine, including bioactive water Naftussya, affect Gall-bladder motility has long been known. We set a goal to identify changes related neuroendocrine-immune complex and metabolism accompanying cholecystokinetic effect of balneotherapy on spa. Results. In observation of 22 men with chronic cholecystitis in combination with pyelonephritis, found that 10-12-day course of balneotherapy (drinking of bioactive water Naftussya, application of ozokerite, mineral baths reduces Gall-bladder volume fasting by 16% (p0,05, by increasing PSD HF greater extent than LF. The basal levels of plasma cortisol decreased by 20% (p0,2 and 8% (p<0,05 respectively. Regarding immunity parameters revealed significant increase in blood CD16+ lymphocytes only (+17%, p<0,01 in the absence of changes in levels of CD3+CD4+ and CD3+CD8+ T cells and CD19+ B lymphocytes. Do not change significantly either serum Igg G, M, A, or circulating immune complexes. Finally, stated a slight but significant increase electrokinetic index cell nuclei of buccal epithelium, indicating the "rejuvenation" of the body. Conclusion: balneotherapy on spa Truskavets’ be significantly cholecystokinetic effect, combined with the activation excretory and depurative kidney functions and neutrophil bactericidal function against a background of lower levels of neuroendocrine markers of stress. Keywords: Truskavets’, balneotherapy, cholekinetic, diuresis, neuroendocrine-immune complex.

  5. Microfibril-associated Protein 4 Binds to Surfactant Protein A (SP-A) and Colocalizes with SP-A in the Extracellular Matrix of the Lung

    DEFF Research Database (Denmark)

    Schlosser, Anders; Thomsen, Theresa H.; Shipley, J. Michael

    2006-01-01

    for phagocytes. Here we describe the molecular interaction between the extracellular matrix protein microfibril-associated protein 4 (MFAP4) and SP-A. MFAP4 is a collagen-binding molecule containing a C-terminal fibrinogen-like domain and a N-terminal located integrin-binding motif. We produced recombinant MFAP4......-A composed of the neck region and carbohydrate recognition domain of SP-A indicating that the interaction between MFAP4 and SP-A is mediated via the collagen domain of SP-A. Monoclonal antibodies directed against MFAP4 and SP-A were used for immunohistochemical analysis, which demonstrates that the two...... molecules colocalize both on the elastic fibres in the interalveolar septum and in elastic lamina of pulmonary arteries of chronically inflamed lung tissue. We conclude, that MFAP4 interacts with SP-A via the collagen region in vitro, and that MFAP4 and SP-A colocates in different lung compartments...

  6. Dual Stimuli-Responsive P(NIPAAm-co-SPA Copolymers: Synthesis and Response in Solution and in Films

    Directory of Open Access Journals (Sweden)

    Oliver Grimm

    2018-06-01

    Full Text Available We present the synthesis and solution properties of dual stimuli-responsive poly(N-isopropylacrylamide-co-spiropyran acrylate (P(NIPAAm-co-SPA copolymers of varying composition prepared via nitroxide-mediated copolymerization. The resulting copolymers feature molar masses from 40,000 to 100,000 g/mol according to static light scattering and an SPA content of up to 5.3%. The latter was determined by 1H NMR spectroscopy and UV–Vis spectroscopy. These materials exhibit reversible response upon irradiation in polymeric films for a minimum of three cycles; their response in solution to both light and temperature was also investigated in an aqueous TRIS buffer (pH 8. Irradiation was carried out using LED setups with wavelengths of 365 and 590 nm. In aqueous solution, a custom-made setup using a fiber-coupled 200 W Hg(Xe lamp with 340 and 540 nm filters was used and additional heating of the copolymer solutions during irradiation allowed to study influence of the presence of either the spiropyran or merocyanine form on the cloud point temperature. Hereby, it was found that increasing the SPA content leads to a more pronounced difference between both states and decreasing cloud points in general.

  7. Electricity Customers

    Science.gov (United States)

    Residential, commercial, and industrial customers each account for roughly one-third of the nation’s electricity use. The transportation sector also accounts for a small fraction of electricity, although it could increase.

  8. The Impact of Immigration and Customs Enforcement on Immigrant Health: Perceptions of Immigrants in Everett, Massachusetts, USA

    Science.gov (United States)

    Hacker, Karen; Chu, Jocelyn; Leung, Carolyn; Marra, Robert; Pirie, Alex; Brahimi, Mohamed; English, Margaret; Beckmann, Joshua; Acevedo-Garcia, Dolores; Marlin, Robert P.

    2011-01-01

    U.S. immigrants have faced a changing landscape with regard to immigration enforcement over the last two decades. Following the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, and the creation of the Immigration and Customs Enforcement (ICE) agency after the attacks of September 11, 2001, detention and deportation activity increased substantially. As a result, immigrants today are experiencing heightened fear of profiling and deportation. Little research exists on how these activities affect the health and well-being of U.S. immigrant communities. This study sought to address this gap by using community-based participatory research to investigate the impact of enhanced immigration enforcement on immigrant health in Everett, Massachusetts, USA, a city with a large and diverse immigrant population. Community partners and researchers conducted 6 focus groups with 52 immigrant participants (documented and undocumented) in five languages in May 2009. The major themes across the groups included: 1) Fear of deportation, 2) Fear of collaboration between local law enforcement and ICE and perception of arbitrariness on the part of the former and 3) Concerns about not being able to furnish documentation required to apply for insurance and for health care. Documented and undocumented immigrants reported high levels of stress due to deportation fear, which affected their emotional well-being and their access to health services. Recommendations from the focus groups included improving relationships between immigrants and local police, educating immigrants on their rights and responsibilities as residents, and holding sessions to improve civic engagement. Immigration enforcement activities and the resulting deportation fear are contextual factors that undermine trust in community institutions and social capital, with implications for health and effective integration processes. These factors should be considered by any community seeking to

  9. The impact of Immigration and Customs Enforcement on immigrant health: perceptions of immigrants in Everett, Massachusetts, USA.

    Science.gov (United States)

    Hacker, Karen; Chu, Jocelyn; Leung, Carolyn; Marra, Robert; Pirie, Alex; Brahimi, Mohamed; English, Margaret; Beckmann, Joshua; Acevedo-Garcia, Dolores; Marlin, Robert P

    2011-08-01

    U.S. immigrants have faced a changing landscape with regard to immigration enforcement over the last two decades. Following the passage of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, and the creation of the Immigration and Customs Enforcement (ICE) agency after the attacks of September 11, 2001, detention and deportation activity increased substantially. As a result, immigrants today are experiencing heightened fear of profiling and deportation. Little research exists on how these activities affect the health and well-being of U.S. immigrant communities. This study sought to address this gap by using community-based participatory research to investigate the impact of enhanced immigration enforcement on immigrant health in Everett, Massachusetts, USA, a city with a large and diverse immigrant population. Community partners and researchers conducted 6 focus groups with 52 immigrant participants (documented and undocumented) in five languages in May 2009. The major themes across the groups included: 1) Fear of deportation, 2) Fear of collaboration between local law enforcement and ICE and perception of arbitrariness on the part of the former and 3) Concerns about not being able to furnish documentation required to apply for insurance and for health care. Documented and undocumented immigrants reported high levels of stress due to deportation fear, which affected their emotional well-being and their access to health services. Recommendations from the focus groups included improving relationships between immigrants and local police, educating immigrants on their rights and responsibilities as residents, and holding sessions to improve civic engagement. Immigration enforcement activities and the resulting deportation fear are contextual factors that undermine trust in community institutions and social capital, with implications for health and effective integration processes. These factors should be considered by any community seeking to

  10. Relationship marketing of health care plans: retaining corporate customers in a competitive environment.

    Science.gov (United States)

    Choong, P

    2000-01-01

    Corporate employers have become major purchasers of health care. They are gatekeepers who decide whether to retain or drop an insurance company from the choice set offered to employees as well as whether to include new insurers into this choice set. If marketers of health maintenance organizations are to maintain their market share in this competitive environment, they need to understand issues considered important to corporate employers. This paper identifies the key drivers of satisfaction among corporate employers and shows the impact these key drivers have on overall satisfaction. More importantly, it demonstrates both theoretically and empirically that the impact of performance attributes on satisfaction is asymmetrical. Positive performances of attributes are shown to have smaller impacts on satisfaction than negative performances. The theoretical underpinnings of these phenomena are shown to lie in prospect theory. Finally, quantitative indicators are computed to aid managerial decision-making. Marketing managers of health insurance companies will optimize returns on their investment by understanding this asymmetric effect and eliminate existing deficiencies.

  11. Natural radioactivity in mineral and spa water: the current regulatory approach in Italy

    International Nuclear Information System (INIS)

    Nuccetelli, C.; Bochicchio, F.; Ruocco, G.

    2004-01-01

    Mineral and thermal waters can contain radioactivity of natural origin which, in some cases, can lead to radiation-protection problems for both workers and consumers. In Italy, as in many other countries, the consumption of bottled mineral water is rather high and the practice of spending short stays in spas is also popular. Consumer protection against natural radioactivity in mineral water is not regulated at all and exposure from thermal waters is not treated in detail, in either the European Union or Italy. For this reason, the Italian Ministry of Health - which has the duty to authorize spa activities and the sale of mineral water on the basis of water characteristics - asked the Istituto Superiore di Sanita (the Italian National Institute of Health) to provide ad-hoc reports containing both dosimetric calculations and analysis of the radiation-protection regulations to be applied in these situations. On the basis of these reports, the Ministry of Health decided, in two statements for spa and mineral waters respectively, to indicate upper levels for natural radioactivity content. Since 2002, spa water parameters have been in force for authorization of their use and sale, and are to be promulgated by specific and more comprehensive regulations. For mineral waters used for infant feeding and drinking, levels lower than those for general public uses have been proposed, in order to take into account the higher ingestion dose coefficients for infants. At the moment, mineral water levels are not enforced as law. This paper presents the dosimetric calculation results and the Ministry of Health statements. (Author) 17 refs

  12. Customer satisfaction.

    Science.gov (United States)

    Vukmir, Rade B

    2006-01-01

    This paper seeks to present an analysis of the literature examining objective information concerning the subject of customer service, as it applies to the current medical practice. Hopefully, this information will be synthesized to generate a cogent approach to correlate customer service with quality. Articles were obtained by an English language search of MEDLINE from January 1976 to July 2005. This computerized search was supplemented with literature from the author's personal collection of peer-reviewed articles on customer service in a medical setting. This information was presented in a qualitative fashion. There is a significant lack of objective data correlating customer service objectives, patient satisfaction and quality of care. Patients present predominantly for the convenience of emergency department care. Specifics of satisfaction are directed to the timing, and amount of "caring". Demographic correlates including symptom presentation, practice style, location and physician issues directly impact on satisfaction. It is most helpful to develop a productive plan for the "difficult patient", emphasizing communication and empathy. Profiling of the customer satisfaction experience is best accomplished by examining the specifics of satisfaction, nature of the ED patient, demographic profile, symptom presentation and physician interventions emphasizing communication--especially with the difficult patient. The current emergency medicine customer service dilemmas are a complex interaction of both patient and physician factors specifically targeting both efficiency and patient satisfaction. Awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medicolegal risk and improve patient care if a tailored management plan is formulated.

  13. Prospecting for customers in the small employer market: the experience of Arizona Health Care Group.

    Science.gov (United States)

    Christianson, J B; Liu, C F; Schroeder, C M

    1994-01-01

    The findings of this study provide an interesting profile of the small employer "prospects" for prepaid health plans, where a prospect is defined as an employer that responds to a mass mailing effort with a request for information and further contact. About 60% of these prospects already have insurance, with 40% having group insurance. Therefore, a substantial portion of prospects are seeking to replace their existing health benefit package with a different one. Of those who do not offer existing insurance, the most common reason is that it is "too expensive" or the employer is "not profitable." A very small proportion do not offer insurance because they do not qualify for it due to medical underwriting considerations. Prospects tend to be larger than non-prospects in terms of sales, but employ lower wage employees, on average. About half of prospects are in service industries, a proportion typical of small employers in general. Somewhat surprisingly, most prospects have been in operation for over five years. They are not new firms attempting to establish their benefit packages. This is consistent with the findings on gross sales, suggesting that some maturity is necessary before an employer considers offering group health insurance as a benefit. The prepaid plans in this study also appeared to target established employers for their marketing efforts. In responding to questions about their attitudes towards health insurance, over one-quarter of prospects indicated that they would be unwilling to offer insurance at rates so low that they would not normally apply to the coverages offered by prepaid plans. Thus, although they were "prospects" by the study's definition, they were unlikely to eventually contract with prepaid plans. Those prospects that had offered insurance previously, but had discontinued it, tended to cite premium increases as the reason. This suggests that prospects among small employers are likely to be very price sensitive, and that further

  14. How is the use of e-cigarettes sustained in the customers with serious health symptoms?

    Directory of Open Access Journals (Sweden)

    Ummuhan Pece Sonmez

    2018-03-01

    166 headings and 9588 messages. The symptoms were reported 3 weeks to 3 months after the use of e-cigarettes. The most frequent symptoms were related to respiratory system, oral cavity and gums. 2830 of the messages were responded by an anonymous admin(s. Of these responses 48 % recommended the change of ingredients, % 24 claimed that health complaints were not related with e-cigarette use, % 13 attributed the symptoms to quitting classical cigarettes, 6 % reassured that the problem will soon disappear and recommended the continuation of e-cigarettes, 7 % proposed herbal medicine, 5 % actual pharmaceutical drugs, only 5 % to consult to a medical expert. Conclusions Members of this internet forum who used a product which is not legally available, they tended not to apply to regular health clinics in case of harmful effects. The forum administrators tried their best to sustain the addiction in spite of very serious complaints. Control over the websites and social forums must be part of the tobacco control enforcement strategies.

  15. Hedging customers.

    Science.gov (United States)

    Dhar, Ravi; Glazer, Rashi

    2003-05-01

    You are a marketing director with $5 million to invest in customer acquisition and retention. Which customers do you acquire, and which do you retain? Up to a point, the choice is obvious: Keep the consistent big spenders and lose the erratic small ones. But what about the erratic big spenders and the consistent small ones? It's often unclear whether you should acquire or retain them and at what cost. Businesses have begun dealing with unpredictable customer behavior by following the practices of sophisticated investors who own portfolios comprising dozens of stocks with different, indeed divergent, histories and prospects. Each portfolio is diversified so as to produce the investor's desired returns at the particular level of uncertainty he or she can tolerate. Customers, too, are assets--risky assets. As with stocks, the cost of acquiring them is supposed to reflect the cash-flow values they are likely to generate. The authors explain how to construct a portfolio based on the notion that a customer's risk-adjusted lifetime value depends on its anticipated effect on the riskiness of the group it is joining. They also show how this approach was used to identify the best prospects for Myron Corporation, a global leader in the personalized business-gift industry. The concept of risk-adjusted lifetime value has a transforming power: For companies that rely on it, product managers will be replaced by customer managers, and the current method of accounting for profit and loss--which is by product--will be replaced by one that determines each customer's P&L. Once adjusted for risk, those P&Ls will become the firm's key performance and operational metric.

  16. Non-spa-typeable clinical Staphylococcus aureus strains are naturally occurring protein A mutants

    DEFF Research Database (Denmark)

    Baum, Cathrin; Haslinger-Löffler, Bettina; Westh, Henrik

    2009-01-01

    Staphylococcus aureus is a major human pathogen responsible for increasing the prevalence of community- and hospital-acquired infections. Protein A (SpA) is a key virulence factor of S. aureus and is highly conserved. Sequencing of the variable-number tandem-repeat region of SpA (spa typing) prov...

  17. Use and Customization of Risk Scores for Predicting Cardiovascular Events Using Electronic Health Record Data.

    Science.gov (United States)

    Wolfson, Julian; Vock, David M; Bandyopadhyay, Sunayan; Kottke, Thomas; Vazquez-Benitez, Gabriela; Johnson, Paul; Adomavicius, Gediminas; O'Connor, Patrick J

    2017-04-24

    Clinicians who are using the Framingham Risk Score (FRS) or the American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) to estimate risk for their patients based on electronic health data (EHD) face 4 questions. (1) Do published risk scores applied to EHD yield accurate estimates of cardiovascular risk? (2) Are FRS risk estimates, which are based on data that are up to 45 years old, valid for a contemporary patient population seeking routine care? (3) Do the PCE make the FRS obsolete? (4) Does refitting the risk score using EHD improve the accuracy of risk estimates? Data were extracted from the EHD of 84 116 adults aged 40 to 79 years who received care at a large healthcare delivery and insurance organization between 2001 and 2011. We assessed calibration and discrimination for 4 risk scores: published versions of FRS and PCE and versions obtained by refitting models using a subset of the available EHD. The published FRS was well calibrated (calibration statistic K=9.1, miscalibration ranging from 0% to 17% across risk groups), but the PCE displayed modest evidence of miscalibration (calibration statistic K=43.7, miscalibration from 9% to 31%). Discrimination was similar in both models (C-index=0.740 for FRS, 0.747 for PCE). Refitting the published models using EHD did not substantially improve calibration or discrimination. We conclude that published cardiovascular risk models can be successfully applied to EHD to estimate cardiovascular risk; the FRS remains valid and is not obsolete; and model refitting does not meaningfully improve the accuracy of risk estimates. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh.

    Science.gov (United States)

    Chowdhury, Fahmida; Sturm-Ramirez, Katharine; Mamun, Abdullah Al; Iuliano, A Danielle; Bhuiyan, Mejbah Uddin; Chisti, Mohammod Jobayer; Ahmed, Makhdum; Haider, Sabbir; Rahman, Mahmudur; Azziz-Baumgartner, Eduardo

    2017-01-01

    Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.

  19. Customer portfolios

    DEFF Research Database (Denmark)

    Clarke, Ann Højbjerg; Freytag, Per Vagn; Zolkiewski, Judith

    2017-01-01

    gives managers a tool to help to cope with the dynamic aspects of the customer portfolio. Recognition of the importance of communication to the process, the development of trust and the role of legitimacy also provides areas that managers can focus upon in their relationship management processes......Purpose The purpose of this paper is to extend the discussion about customer portfolios beyond simple identification of models and how they can be used for balanced resource allocation to a discussion about how portfolios should take into account views from relationship partners and how they should...... that helps improve the understanding of how customer portfolio models can actually be applied from a relational perspective. Findings The key aspects of the conceptual framework relate to how alignment of the relationships in the portfolio is achieved. Critical to this are the interaction spaces...

  20. A quality tool for health insurers. A new scale measures "quality orientation" from the customer's point of view.

    Science.gov (United States)

    Westbrook, K W; Pedrick, D; Bush, V

    1996-01-01

    This study defines a company's quality orientation as "all process-related activities that can be discerned by customers." This even includes certain processes internal to the company that can be seen and evaluated by customers. One significant contribution this study provides is scale development centered on customer rather than employee perceptions. To generate scale items, input was gathered from experts involved in the study, senior managers employed with the target company, focus groups of employees working on the front line with customers, and users of the services. Because the sale measures customer perceptions of quality in comparison with the firm's closest competitor, it provides managers with information for benchmarking performance relative to others in the marketplace.

  1. Customer satisfaction

    DEFF Research Database (Denmark)

    Eskildsen, Jacob Kjær; Kristensen, Kai

    2007-01-01

    & Westlund, 2003) as well as the structure of the framework (Eskildsen et al., 2004). We know however very little about how the structure of the individual markets with respect to, for instance, how the transparency of products and services affects customer satisfaction. The aim of this article is to analyze...... the effect of the transparency of products and services on customer satisfaction with respect to Danish mobile phone companies, banks and supermarkets from 2004 based on the authors' experiences from the various analyses conducted within the EPSI rating initiative....

  2. Pürovel Spa & Sport / Ülli Plink

    Index Scriptorium Estoniae

    Plink, Ülli, 1973-

    2011-01-01

    Swissôtel Tallinna 11. korrusel asuvast Pürovel Spa & Sport poolt pakutavatest treeningutest ning lõõgastusprotseduuridest, samuti 8. korrusel asuvast a la carte menüü ja päevabuffega restoranist Café Swiss

  3. Customer Loyalty and Customer Relationship Management

    Science.gov (United States)

    Zhang, Pengwei; Li, Min; Jiao, Xiaojing; Zhou, Ruijin

    The contemporary company attaches great importance to marketing relationship and customer relations is the core of this relationship. Further, customer satisfaction and loyalty is the core of the customer relationship management. Sometimes, high customer satisfaction causes low profit because enterprises do not realize that strengthening the loyalty of the aimed customer is the key of customer relationship management.

  4. Performance of the score systems Acute Physiology and Chronic Health Evaluation II and III at an interdisciplinary intensive care unit, after customization

    Science.gov (United States)

    Markgraf, Rainer; Deutschinoff, Gerd; Pientka, Ludger; Scholten, Theo; Lorenz, Cristoph

    2001-01-01

    Background: Mortality predictions calculated using scoring scales are often not accurate in populations other than those in which the scales were developed because of differences in case-mix. The present study investigates the effect of first-level customization, using a logistic regression technique, on discrimination and calibration of the Acute Physiology and Chronic Health Evaluation (APACHE) II and III scales. Method: Probabilities of hospital death for patients were estimated by applying APACHE II and III and comparing these with observed outcomes. Using the split sample technique, a customized model to predict outcome was developed by logistic regression. The overall goodness-of-fit of the original and the customized models was assessed. Results: Of 3383 consecutive intensive care unit (ICU) admissions over 3 years, 2795 patients could be analyzed, and were split randomly into development and validation samples. The discriminative powers of APACHE II and III were unchanged by customization (areas under the receiver operating characteristic [ROC] curve 0.82 and 0.85, respectively). Hosmer-Lemeshow goodness-of-fit tests showed good calibration for APACHE II, but insufficient calibration for APACHE III. Customization improved calibration for both models, with a good fit for APACHE III as well. However, fit was different for various subgroups. Conclusions: The overall goodness-of-fit of APACHE III mortality prediction was improved significantly by customization, but uniformity of fit in different subgroups was not achieved. Therefore, application of the customized model provides no advantage, because differences in case-mix still limit comparisons of quality of care. PMID:11178223

  5. [Effects of drinking spa therapy on oxidative stress].

    Science.gov (United States)

    Costantino, M; Giampaolo, C; Filippelli, A

    2012-01-01

    Data of literature have shown the correlation between oxidative stress and some diseases of gastrointestinal and metabolic relevance such as diabetes mellitus, gastric cancer, gastritis, etc.. Studies have also shown that sulfurous mineral water may be useful in the treatment of gastrointestinal diseases. The aim of our research was to evaluate the antioxidant effect of sulphurous mineral water, administered by drinking method, in type 2 diabetes mellitus, a chronic disease with a high social and economic impact. The study has been performed on 57 subjects (25% women and 75% males; mean age: 60 ± 1.1 years; BMI: 27 ± 0.4) affected by type 2 Diabetes Mellitus. The subjects were divided in four groups: A (subjected to glucose-lowering diet therapy), B (subjected to antihyperglycaemic therapy), C (exposed to glucose-lowering diet therapy + drinking SPA therapy) and D (exposed to antihyperglycaemic therapy + drinking SPA therapy). Drinking SPA treatment was effected with sulphurous mineral water from Terme of Telese SpA (Benevento - Italy) and the pharmacological treatment provided the use of hypoglycemic drugs normally used in diabetic disease. After two weeks of therapy with treatments considered were evaluated fasting blood glycaemia and plasma concentration of ROMs (reactive oxygen metabolites) (d-ROMs test-Diacron International srl®-Grosseto - Italy). The results of our study have shown a significant (pfasting blood glycaemia when to hypoglycemic drugs or diet therapy was associated the sulphurous drinking SPA therapy. It was also observed a reduction of plasma ROMs levels, significant (p water, especially in combination with antidiabetic drug treatment, may be useful in type 2 diabetes mellitus for the improvement redox state of the organism.

  6. Real-life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Karagülle, Müfit Zeki

    2017-11-01

    The objective of this study is to determine the use and efficacy of spa therapy in patients with a wide spectrum of rheumatic and musculoskeletal diseases under real-life clinical practice circumstances. In this retrospective observational study at the Medical Ecology and Hydroclimatology Department of Istanbul Faculty of Medicine, the records of all adult patients with rheumatic and musculoskeletal diseases who were prescribed a spa therapy in various health resorts in Turkey between 2002 and 2012 were analyzed. Patients sojourned to and stayed at a health resort and followed a usual 2-week course of spa therapy. The patients were examined within a week before and after the spa therapy at the department by the physicians and outcome measures were pain intensity (visual analog scale, VAS), patient's general evaluation (VAS), physician's general evaluation (VAS), Health Assessment Questionnaire (HAQ), Lequesne's Functional Index (LFI), Western Ontario and McMaster Universities Index (WOMAC), Waddell Index (WI), Neck Pain and Disability Scale (NPDS), Shoulder Disability Questionnaire (SDQ), Fibromyalgia Impact Questionnaire (FIQ), and Beck's Depression Inventory (BDI). In total, 819 patients were included in the analysis. The diagnoses were 536 osteoarthritis; 115 fibromyalgia; 50 lumbar disc herniation; 34 cervical disc herniation; 23 nonspecific low back pain; 22 ankylosing spondylitis; 16 rheumatoid arthritis; 9 rotator cuff tendinitis; and 14 other conditions/diseases including scoliosis, stenosing flexor tenosynovitis, congenital hip dislocation in adult, Behçet's disease, de Quervain tendinopathy, psoriatic arthritis, osteoporosis, fracture rehabilitation, and diffuse idiopathic skeletal hyperostosis. Statistically significant decrease in pain scores was found in all patients except hip osteoarthritis ( p = 0.063) and rheumatoid arthritis ( p = 0.134) subgroups; and statistically significant improvement in function in all patients except hip osteoarthritis ( p

  7. The Customer Service Experience.

    Science.gov (United States)

    Bell, Chip R.

    2001-01-01

    Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

  8. Customer care in the NHS.

    Science.gov (United States)

    Ruddick, Fred

    2015-01-20

    Viewing individuals in need of NHS care as customers has the potential to refocus the way their care is delivered. This article highlights some of the benefits of reframing the nurse-patient relationship in terms of customer care, and draws parallels between good customer care and the provision of high quality patient care in the NHS. It explores lessons to be learned from those who have studied the customer experience, which can be adapted to enhance the customer care experience within the health service. Developing professional expertise in the knowledge and skills that underpin good-quality interpersonal encounters is essential to improve the customer experience in health care and should be prioritised alongside the development of more technical skills. Creating a culture where emotional intelligence, caring and compassion are essential requirements for all nursing staff will improve patient satisfaction.

  9. Effects of Rusanda Spa balneotherapy combined with calcipotriol on plaque psoriasis.

    Science.gov (United States)

    Golusin, Zoran; Jovanović, Marina; Magda, Natasa; Stojanović, Slobodan; Matić, Milan; Petrović, Aleksandra

    2015-11-01

    Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p balneotherapy as monotherapy in treatment of this type of psoriasis.

  10. Description of the behavior of an aquifer by using continuous radon monitoring in a thermal spa

    International Nuclear Information System (INIS)

    Sainz, Carlos; Rábago, Daniel; Fuente, Ismael; Celaya, Santiago; Quindós, Luis Santiago

    2016-01-01

    Radon ( 222 Rn) levels in air and water have been analyzed continuously for almost a year in Las Caldas de Besaya thermal spa, north Spain. Radon is a naturally occurring noble gas from the decay of radium ( 226 Ra) both constituents of radioactive uranium 238 series. It has been recognized as a lung carcinogen by the World Health Organization (WHO) and International Agency for Research on Cancer (IARC). Furthermore the Royal Decree R.D 1439/2010 of November, 2010 establishes the obligation to study occupational activities where workers and, where appropriate, members of the public are exposed to inhalation of radon in workplaces such as spas. Together with radon measures several physico-chemical parameters were obtained such as pH, redox potential, electrical conductivity and air and water temperature. The devices used for the study of the temporal evolution of radon concentration have been the RTM 2100, the Radon Scout and gamma spectrometry was complementarily used to determine the transfer factor of the silicone tubes in the experimental device. Radon concentrations obtained in water and air of the spa are high, with an average of 660 Bq/l and 2900 Bq/m 3 respectively, where water is the main source of radon in the air. Radiation dose for workers and public was estimated from these levels of radon. The data showed that the thermal processes can control the behavior of radon which can be also influenced by various physical and chemical parameters such as pH and redox potential. - Highlights: • Radon in water is the major source of indoor air radon concentration in thermal facilities. • Radon in water has been used to characterize the origin of water used for treatments in a spa. • Preliminary dose assessment from radon exposure has been performed.

  11. Description of the behavior of an aquifer by using continuous radon monitoring in a thermal spa

    Energy Technology Data Exchange (ETDEWEB)

    Sainz, Carlos, E-mail: sainzc@unican.es; Rábago, Daniel; Fuente, Ismael; Celaya, Santiago; Quindós, Luis Santiago

    2016-02-01

    Radon ({sup 222}Rn) levels in air and water have been analyzed continuously for almost a year in Las Caldas de Besaya thermal spa, north Spain. Radon is a naturally occurring noble gas from the decay of radium ({sup 226}Ra) both constituents of radioactive uranium 238 series. It has been recognized as a lung carcinogen by the World Health Organization (WHO) and International Agency for Research on Cancer (IARC). Furthermore the Royal Decree R.D 1439/2010 of November, 2010 establishes the obligation to study occupational activities where workers and, where appropriate, members of the public are exposed to inhalation of radon in workplaces such as spas. Together with radon measures several physico-chemical parameters were obtained such as pH, redox potential, electrical conductivity and air and water temperature. The devices used for the study of the temporal evolution of radon concentration have been the RTM 2100, the Radon Scout and gamma spectrometry was complementarily used to determine the transfer factor of the silicone tubes in the experimental device. Radon concentrations obtained in water and air of the spa are high, with an average of 660 Bq/l and 2900 Bq/m{sup 3} respectively, where water is the main source of radon in the air. Radiation dose for workers and public was estimated from these levels of radon. The data showed that the thermal processes can control the behavior of radon which can be also influenced by various physical and chemical parameters such as pH and redox potential. - Highlights: • Radon in water is the major source of indoor air radon concentration in thermal facilities. • Radon in water has been used to characterize the origin of water used for treatments in a spa. • Preliminary dose assessment from radon exposure has been performed.

  12. Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh

    Directory of Open Access Journals (Sweden)

    Chowdhury F

    2017-03-01

    Full Text Available Fahmida Chowdhury,1 Katharine Sturm-Ramirez,1,2 Abdullah Al Mamun,1 A Danielle Iuliano,2 Mejbah Uddin Bhuiyan,1 Mohammod Jobayer Chisti,1 Makhdum Ahmed,1 Sabbir Haider,3 Mahmudur Rahman,3 Eduardo Azziz-Baumgartner2 1Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; 2Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA; 3Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh Background: Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome.Methods: A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients’ relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome.Results: We interviewed 302 customers patronizing 76 pharmacies; 186 (62% sought care for themselves and 116 (38% sought care for a sick relative. Most customers (215; 71% were males. The majority (90% of customers sought care from the study pharmacy as their first point of care, while 18 (6% had previously sought care from another pharmacy and 11 (4% from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%, lower cost (46%, availability of medicine (33%, knowing the drug seller (20%, and convenient hours of operation (19%. The most commonly recommended drugs were

  13. The spa typing of methicillin-resistant Staphylococcus aureus isolates by High Resolution Melting (HRM) analysis.

    Science.gov (United States)

    Fasihi, Yasser; Fooladi, Saba; Mohammadi, Mohammad Ali; Emaneini, Mohammad; Kalantar-Neyestanaki, Davood

    2017-09-06

    Molecular typing is an important tool for control and prevention of infection. A suitable molecular typing method for epidemiological investigation must be easy to perform, highly reproducible, inexpensive, rapid and easy to interpret. In this study, two molecular typing methods including the conventional PCR-sequencing method and high resolution melting (HRM) analysis were used for staphylococcal protein A (spa) typing of 30 Methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered from clinical samples. Based on PCR-sequencing method results, 16 different spa types were identified among the 30 MRSA isolates. Among the 16 different spa types, 14 spa types separated by HRM method. Two spa types including t4718 and t2894 were not separated from each other. According to our results, spa typing based on HRM analysis method is very rapid, easy to perform and cost-effective, but this method must be standardized for different regions, spa types, and real-time machinery.

  14. Understanding Customers\\' Healthy Eating Behavior in Restaurants using the Health Belief Model and Theory of Planned Behavior

    OpenAIRE

    Lee, Sang Tak

    2013-01-01

    A large portion of the American public is overweight and many are classified as being obese.  Obesity and unhealthy eating behavior are partially related to the increase in our society""s consumption of foods away from home. Accordingly, the Food and Drug Administration (FDA) has suggested new menu labeling regulations to help educate customers on healthy items among menu selections. Few studies have tried to understand customers"" healthy eating behavior in restaurants. Therefore, the purpos...

  15. Impact to Tourism Industry of Massage Spa Therapy in Batangas City, Philippines

    Directory of Open Access Journals (Sweden)

    Kimmy Lei T. Atienza

    2014-10-01

    Full Text Available This study aimed to assess the benefits of massage spa therapy in tourism industry of Batangas City and their adherence to the standards to DOT on Spa operation and maintenance. The study aimed to identify the profile of massage spa in terms of type of ownership, length of years in the business, type of spa and different spa services offered; to assess the benefits of massage spa to the tourism industry; and to determine the extent of adherence of the massage spa to DOT standards about spa operation and maintenance; and propose a plan of action based on the results of the study. Descriptive method was used in the study. Results showed that the Sole Proprietorship got the highest rank in terms of type of ownership. With the length of years in service, it shows that most of spa business already exists for 4-6 years. Type of spa shows that majority of the spa business were Spa Town. With regards to different spa services, majority offers peat pulp bath and the least is sauna and steam bath. The over-all assessment of the respondents’ on the benefits of spa was agree by the result. It was also observed that all items were assessed as agree and it enhances the awareness of the tourists about the beauty of Batangas City. It was followed by provide taxes for the government, became a tourist attraction and improves socio-economic of local residents and improvement on the lifestyle both of the local residents and tourists

  16. Product customization

    DEFF Research Database (Denmark)

    Lueg, Rainer

    2015-01-01

    This case study deals with the extension, customization, and profitability of two new product lines of a bicycle manufacturer. It can serve both as a discussion basis in class as well as an exam for advanced Master students in management, marketing, and ccounting. The case illustrates how variance...... application of financial analysis can lead to dysfunctional decisions that run counter to a company’s business model....

  17. French Customs

    CERN Multimedia

    GS Department

    2010-01-01

    Please note that the French Customs (initially located in Building 904, Prévessin) are now located in Ferney-Voltaire (FR): Mrs Catherine NEUVILLE Douane de Ferney-Voltaire Rue de Genève F – 01210 Ferney-Voltaire Phone : 33 4 50 40 51 42 Email : catherine.neuville@douane.finances.gouv.fr Tom Wegelius Tel: 79947 Logistics and Site Services

  18. Effects of Rusanda Spa balneotherapy combined with calcipotriol on plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Golušin Zoran

    2015-01-01

    Full Text Available Background/Aim. Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue, balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. Methods. The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. Results. After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05. In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001. Conclusion. The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balneotherapy is more effective than topical

  19. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences.

    Science.gov (United States)

    Nazi, Kim M

    2010-01-01

    Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use.

  20. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences

    Science.gov (United States)

    2010-01-01

    Background Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. Objective This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. Methods The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Results Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. Conclusion VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use. PMID:20190065

  1. Spa Garden in Daruvar – Methods of Renewal and Reconstruction

    Directory of Open Access Journals (Sweden)

    Šćitaroci Mladen Obad

    2014-12-01

    Full Text Available Spa garden in Daruvar ‘Julius’s Park’ is the oldest spa garden in continental Croatia. The counts Jankovich and their successors created the garden during the 18th and 20th century. The garden resumed its nowadays form and surface in the time of count Julius Jankovich in the mid-19th century and it was named after him. The garden is protected as a cultural heritage. The garden’s renovation is seen as an urban, architectural and landscape unity and it attempts to affirm the missing and neglected parts of the garden, to provide technological and municipal space modernization and to make a pleasant urban garden ambiance with new facilities and high space arrangement qualities, contributing to the economic development of the local community.

  2. Actividad Físico - Deportiva en Adolescentes Consumidores de SPA

    OpenAIRE

    Tarqui Silva, Leonardo Eliecer; Universidad Estatal de Milagro - Guayaquil Ecuador

    2017-01-01

    RESUMEN El presente estudio muestra el abordaje terapéutico fundamentado en actividades físico-deportivas aplicadas como reforzador, canalizador y modificador conductual en conjunto con terapias cognitivas, socio-humanísticas, espirituales, ocupacionales, vivenciales y familiares ejecutadas en adolescentes consumidores de sustancias psicoactivas (SPA) entre las edades de 14 a 17 años en la Comunidad Terapéutica para Adolescentes Varones Hogar Crecer (CTHC), de la ciudad de Cuenca - Ecuador; o...

  3. Actividad Físico - Deportiva en Adolescentes Consumidores de SPA

    OpenAIRE

    Tarqui Silva, Leonardo Eliecer

    2017-01-01

    RESUMEN El presente estudio muestra el abordaje terapéutico fundamentado en actividades físico-deportivas aplicadas como reforzador, canalizador y modificador conductual en conjunto con terapias cognitivas, socio-humanísticas, espirituales, ocupacionales, vivenciales y familiares ejecutadas en adolescentes consumidores de sustancias psicoactivas (SPA) entre las edades de 14 a 17 años en la Comunidad Terapéutica para Adolescentes Varones Hogar Crecer (CTHC), de la ciudad de Cuenca - Ecuador; o...

  4. SPA Adición de enmiendas a suelos contaminados

    OpenAIRE

    Madejón, Paula

    2016-01-01

    SPA Adición de enmiendas a suelos contaminados.-- Información introducida en la base de datos WOCAT es una red global de gestión sostenible de tierras (SLM) que promueve la documentación, el intercambio y el uso del conocimiento para apoyar la adaptación, la innovación y la toma de decisiones en SLM.

  5. Hydrogeothermal characteristics of groundwater from Ribarska Banja spa, central Serbia

    Directory of Open Access Journals (Sweden)

    Dragišić Veselin S.

    2015-01-01

    Full Text Available Ribarska Banja spa is one of the most popular balneotherapy and recreation centers in Serbia. It features several thermal groundwater sources whose temperatures range from 26 to 54°C. The mineral content of these waters is low and their composition is of the SO4-Na or HCO3-Na type. Thermal water exploration has been conducted in the general area for many years, to assess the hydrogeothermal potential in order to extract larger amounts of thermal water for multiple uses. The hydrogeothermal system of Ribarska Banja spa was defined based on a synthesis of the results of comprehensive structural geology, geophysical, hydrogeological, hydrochemical and geothermal research. The primary groundwater reservoir of the hydrogeothermal system is comprised of tectonic zones (systems of faults and fractures within Cretaceous-Paleogene metamorphosed and non-metamorphosed rocks. The overlying hydrogeological and temperature barrier is made up of a series of low metamorphosed rocks (chlorite, chlorite-sericite schists, gabbros, etc., highly metamorphosed rocks (gneisses and Neogene clay and sand sediments. The system is recharged by infiltration of atmospheric precipitation and surface water at the highest elevations of Mt. Jastrebac. Investigations have also shown that the system’s heat source is younger granitoide intrusion spreading northwest of Ribarska Banja spa. Based on the quartz geothermometers, expected reservoir temperatures are in the range of 85-97°C that can be expected at a depth of 1.87 km. Total energy usage at Ribarska Banja spa is 31 TJ/y with thermal capacity of 1.65 MWt and utilization factor of 0.58. Geothermal gradient is 0,051°C/m, while heat flow density is 163.5 mW/m2. [Projekat Ministarstva nauke Republike Srbije, br. 43004

  6. Fibromyalgia Syndrome and Spa Therapy: Myth or Reality?

    Directory of Open Access Journals (Sweden)

    Giacomo M. Guidelli

    2012-01-01

    Full Text Available Fibromyalgia syndrome (FS is a common musculoskeletal disorder characterized by otherwise unexplained chronic widespread pain, a lowered pain threshold, high tender point counts, sleep disturbances, fatigue, headache, irritable bowel syndrome, morning stiffness, paraesthesias in the extremities, often psychological distress and depressed mood. Consequently, FS has a negative impact on working capacity, family life, social functioning and quality of life. Because of unknown etiology and not clearly understood pathogenesis, there is no standard therapy regime for FS. A variety of medical treatments, including antidepressants, opioids, analgesic or non-steroidal anti-inflammatory drugs, sedatives, muscle relaxants and antiepileptics, have been used to treat FS. Currently, no pharmacological treatment for FS is consistently successful. According to recent guidelines, the optimal treatment of FS requires a multidisciplinary approach with a combination of non-pharmacological and pharmacological treatment modalities. Spa therapy is a popular treatment for FS in many European countries, as well as in Japan and Israel. However, despite their long history and popularity spa treatments are still the subject of debate and their role in modern medicine is still not clear. The objective of this review is to summarize the currently available information on clinical effects and mechanism of action of spa therapy in FS. We also provide some suggestions for further development in this area.

  7. [Estimation of effective doses derived from radon in selected SPA centers that use geothermal waters based on the information of radon concentrations].

    Science.gov (United States)

    Walczak, Katarzyna; Zmyślony, Marek

    2013-01-01

    Geothermal waters contain, among other components, soluble radon gas. Alpha radioactive radon is a health hazard to humans, especially when it gets into the respiratory tract. SPA facilities that use geothermal water can be a source of an increased radiation dose to people who stay there. Based on the available literature concerning radon concentrations, we assessed exposure to radon among people - workers and visitors of Spa centers that use geothermal waters. Radon concentrations were analyzed in 17 geothermal centers: in Greece (3 centers), Iran (5), China (4) and India (5). Doses recived by people in the SPA were estimated using the formula that 1 hour exposure to 1 Bq/m3 of radon concentration and equilibrium factor F = 0.4 corresponds to an effective dose of 3.2 nSv. We have found that radon levels in SPAs are from a few to several times higher than those in confined spaces, where geothermal waters are not used (e.g., residential buildings). In 82% of the analyzed SPAs, workers may receive doses above 1 mSv/year. According to the relevant Polish regulations, people receiving doses higher than 1 mSv/year are included in category B of radiation exposure and require regular dosimetric monitoring. Doses received by SPA visitors are much lower because the time of their exposure to radon released from geothermal water is rather short. The analysis of radon concentration in SPA facilities shows that the radiological protection of people working with geothermal waters plays an important role. It seems reasonable to include SPA workers staying close to geotermal waters into a dosimetric monitoring program.

  8. Estimation of effective doses derived from radon in selected SPA centers that use geothermal waters based on the information of radon concentrations

    Directory of Open Access Journals (Sweden)

    Katarzyna Walczak

    2013-04-01

    Full Text Available Background: Geothermal waters contain, among other components, soluble radon gas. Alpha radioactive radon is a health hazard to humans, especially when it gets into the respiratory tract. SPA facilities that use geothermal water can be a source of an increased radiation dose to people who stay there. Based on the available literature concerning radon concentrations, we assessed exposure to radon among people - workers and visitors of Spa centers that use geothermal waters. Material and Methods: Radon concentrations were analyzed in 17 geothermal centers: in Greece (3 centers, Iran (5, China (4 and India (5. Doses recived by people in the SPA were estimated using the formula that 1 hour exposure to 1 Bq/m3 of radon concentration and equilibrium factor F = 0.4 corresponds to an effective dose of 3.2 nSv. Results: We have found that radon levels in SPAs are from a few to several times higher than those in confined spaces, where geothermal waters are not used (e.g., residential buildings. In 82% of the analyzed SPAs, workers may receive doses above 1 mSv/year. According to the relevant Polish regulations, people receiving doses higher than 1 mSv/year are included in category B of radiation exposure and require regular dosimetric monitoring. Doses received by SPA visitors are much lower because the time of their exposure to radon released from geothermal water is rather short. Conclusions: The analysis of radon concentration in SPA facilities shows that the radiological protection of people working with geothermal waters plays an important role. It seems reasonable to include SPA workers staying close to geotermal waters into a dosimetric monitoring program. Med Pr 2013;64(2:193–198

  9. Variations in spa types found in consecutive MRSA isolates from the same patients

    DEFF Research Database (Denmark)

    Boye, Kit; Westh, Henrik

    2010-01-01

    Very little is known about how the spa gene mutates over time in methicillin-resistant Staphylococcus aureus (MRSA) from the same patient. Copenhagen is an area with low prevalence of MRSA but with high variability in spa types. We collected 1536 MRSA isolates from 319 patients during a 5-year...... period and found spa type alterations in 30 MRSA isolates (2%) from 13 patients (4%). The alteration most often seen was the deletion of repeats followed by repeat duplication and point mutation....

  10. Understanding Customer Experience Throughout the Customer Journey

    NARCIS (Netherlands)

    Lemon, Katherine N.; Verhoef, Peter C.

    2016-01-01

    Understanding customer experience and the customer journey over time is critical for firms. Customers now interact with firms through myriad touch points in multiple channels and media, and customer experiences are more social in nature. These changes require firms to integrate multiple business

  11. The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness.

    Science.gov (United States)

    Oliveira-Maia, Albino J; Mendonça, Carina; Pessoa, Maria J; Camacho, Marta; Gago, Joaquim

    2016-01-01

    Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective

  12. The Mental Health Recovery Measure can be used to assess aspects of both customer-based and service-based recovery in the context of severe mental illness

    Directory of Open Access Journals (Sweden)

    Albino J Oliveira-Maia

    2016-11-01

    Full Text Available Within clinical psychiatry, recovery from severe mental illness has classically been defined according to symptoms and function (service-based recovery. However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery. Here we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from severe mental illness, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed respectively using a shortened version of the Mental Health Recovery Measure (MHRM-20 and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from severe mental illness may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for

  13. Customer complaints: a managed care firm's best weapon in CQI.

    Science.gov (United States)

    Polonski, G J

    1995-01-01

    Encouraging customer feedback and developing an automated customer complaint system are two essential steps a health plan must take if it wishes to develop a balanced relationship with the customer. The author explores how the right attitude and appropriate action can ensure that both customers and the company reap the benefits of a comprehensive customer complaint system.

  14. CoSpa: A Co-training Approach for Spam Review Identification with Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Wen Zhang

    2016-03-01

    Full Text Available Spam reviews are increasingly appearing on the Internet to promote sales or defame competitors by misleading consumers with deceptive opinions. This paper proposes a co-training approach called CoSpa (Co-training for Spam review identification to identify spam reviews by two views: one is the lexical terms derived from the textual content of the reviews and the other is the PCFG (Probabilistic Context-Free Grammars rules derived from a deep syntax analysis of the reviews. Using SVM (Support Vector Machine as the base classifier, we develop two strategies, CoSpa-C and CoSpa-U, embedded within the CoSpa approach. The CoSpa-C strategy selects unlabeled reviews classified with the largest confidence to augment the training dataset to retrain the classifier. The CoSpa-U strategy randomly selects unlabeled reviews with a uniform distribution of confidence. Experiments on the spam dataset and the deception dataset demonstrate that both the proposed CoSpa algorithms outperform the traditional SVM with lexical terms and PCFG rules in spam review identification. Moreover, the CoSpa-U strategy outperforms the CoSpa-C strategy when we use the absolute value of decision function of SVM as the confidence.

  15. Surface expression and functional characterization of recombinant SpaFED pili in Lactococcus lactis

    OpenAIRE

    Rintahaka, Johanna; Yu, Xia; Kant, Ravi; Palva, Airi; von Ossowski, Ingemar

    2014-01-01

    A noticeable genomic feature of many piliated Gram-positive bacterial species is the presence of more than one pilus-encoding operon. Paradigmatically, the gut-adapted Lactobacillus rhamnosus GG strain contains two different fimbrial operons in its genome. However, whereas one of these operons (called spaCBA) is encoding for the functionally mucus-/collagen-binding SpaCBA pilus, for the other operon (called spaFED) any native expression of the SpaFED-called pili is still the subject of some u...

  16. A pilot study to evaluate the effects of floatation spa treatment on patients with osteoarthritis.

    Science.gov (United States)

    Hill, S; Eckett, M J; Paterson, C; Harkness, E F

    1999-12-01

    To conduct a preliminary investigation of the effects on floatation spa therapy on quality of life in patients with osteoarthritis to see if controlled trials are warranted. Uncontrolled clinical trial. Private floatation spa therapy centre. Fourteen patients with chronic osteoarthritis of the weight-bearing joints, of whom four dropped out. Six weekly sessions of floatation spa therapy. SF36, AIMS2 and MYMOP quality-of-life questionnaires. All patients improved. Differences between baseline and discharge scores showed statistically significant improvement for MYMOP, but not AIMS2 or SF-36. Controlled trials of floatation spa therapy for patients with osteoarthritis are warranted.

  17. [The development of the system of medical rehabilitation based at the Russian health resort facilities: investment prospects].

    Science.gov (United States)

    Povazhnaya, E L; Gusakova, E V; Moiseenko, S V

    2018-05-21

    The present work is devoted to the prospects for attracting investments for the maintenance and development of the medical rehabilitation practices based at the Russian health resort facilities. The article describes the prerequisites for the enhancement of the investment attractiveness of the development of the system of medical rehabilitation in the said institutions including the formulation and strengthening of the legal and regulatory framework, the capacity for the organization of the second and third stages of medical rehabilitation in the existing spa and health resort facilities, the attraction of the funds of compulsory medical insurance as an additional source of the financial support. The main legal documents regulating the organization and provision of medical rehabilitation based at the spa and health resort facilities are presented. The results of the implementation of the investment concept of the development of medical rehabilitation in the framework of the system of health resort treatment as exemplified by the experience of JSC «The group of companies «Medsi» are discussed. It is shown that the development of medical rehabilitation based at the spa and health resort facilities greatly contributes to the significant expansion of the potential customer base and promotes the further growth of business scale.

  18. Determinants of customers' intention to participate in a Korean restaurant health promotion program: an application of the theory of planned behavior.

    Science.gov (United States)

    Hong, Kyungeui; Gittelsohn, Joel; Joung, Hyojee

    2010-06-01

    The purpose of this study was to investigate the effects of personal characteristics and theory of planned behavior (TPB) constructs on the intention to participate in a restaurant health promotion program. In total, 830 adults residing in Seoul were sampled by a multi-stage cluster and random sampling design. Data were collected from a structured self-administered questionnaire, which covered variables concerning demographics, health status and TPB constructs including attitude, subjective norm and perceived behavioral control. A path analysis combining personal characteristics and TPB constructs was used to investigate determinants of the customers' intention. Positive and negative attitudes, subjective norms and perceived behavioral control directly affected the intention to participate. Demographics and health status both directly and indirectly affected the intention to participate. This study identifies personal characteristics and TPB constructs that are important to planning and implementing a restaurant health promotion program.

  19. Balneotherapy (or spa therapy) for rheumatoid arthritis.

    Science.gov (United States)

    Verhagen, Arianne P; Bierma-Zeinstra, Sita M A; Boers, Maarten; Cardoso, Jefferson R; Lambeck, Johan; de Bie, Rob; de Vet, Henrica C W

    2015-04-11

    No cure for rheumatoid arthritis (RA) is known at present, so treatment often focuses on management of symptoms such as pain, stiffness and mobility. Treatment options include pharmacological interventions, physical therapy treatments and balneotherapy. Balneotherapy is defined as bathing in natural mineral or thermal waters (e.g. mineral baths, sulphur baths, Dead Sea baths), using mudpacks or doing both. Despite its popularity, reported scientific evidence for the effectiveness or efficacy of balneotherapy is sparse. This review, which evaluates the effects of balneotherapy in patients with RA, is an update of a Cochrane review first published in 2003 and updated in 2008. To perform a systematic review on the benefits and harms of balneotherapy in patients with RA in terms of pain, improvement, disability, tender joints, swollen joints and adverse events. We searched the Cochrane 'Rehabilitation and Related Therapies' Field Register (to December 2014), the Cochrane Central Register of Controlled Trials (2014, Issue 1), MEDLIINE (1950 to December 2014), EMBASE (1988 to December 2014), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to December 2014), the Allied and Complementary Medicine Database (AMED) (1985 to December 2014), PsycINFO (1806 to December 2014) and the Physiotherapy Evidence Database (PEDro). We applied no language restrictions; however, studies not reported in English, Dutch, Danish, Swedish, Norwegian, German or French are awaiting assessment. We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing and recently completed trials. Studies were eligible if they were randomised controlled trials (RCTs) consisting of participants with definitive or classical RA as defined by the American Rheumatism Association (ARA) criteria of 1958, the ARA/American College of Rheumatology (ACR) criteria of 1988 or the ACR/European League Against Rheumatism (EULAR) criteria of 2010

  20. Phenotypical analysis of the Lactobacillus rhamnosus GG fimbrial spaFED operon: surface expression and functional characterization of recombinant SpaFED pili in Lactococcus lactis.

    Directory of Open Access Journals (Sweden)

    Johanna Rintahaka

    Full Text Available A noticeable genomic feature of many piliated Gram-positive bacterial species is the presence of more than one pilus-encoding operon. Paradigmatically, the gut-adapted Lactobacillus rhamnosus GG strain contains two different fimbrial operons in its genome. However, whereas one of these operons (called spaCBA is encoding for the functionally mucus-/collagen-binding SpaCBA pilus, for the other operon (called spaFED any native expression of the SpaFED-called pili is still the subject of some uncertainty. Irrespective of such considerations, we decided it would be of relevance or interest to decipher the gross structure of this pilus type, and as well assess its functional capabilities for cellular adhesion and immunostimulation. For this, and by following the approach we had used previously to explicate the immuno-properties of SpaCBA pili, we constructed nisin-inducible expression clones producing either wild-type or SpaF pilin-deleted surface-assembled L. rhamnosus GG SpaFED pili on Lactococcus lactis cells. Using these piliated lactococcal constructs, we found that the pilin-polymerized architecture of a recombinant-produced SpaFED pilus coincides with sequence-based functional predictions of the related pilins, and in fact is prototypical of those other sortase-dependent pilus-like structures thus far characterized for piliated Gram-positive bacteria. Moreover, we confirmed that among the different pilin subunits encompassing spaFED operon-encoded pili, the SpaF pilin is a main adhesion determinant, and when present in the assembled structure can mediate pilus binding to mucus, certain extracellular matrix proteins, and different gut epithelial cell lines. However, somewhat unexpectedly, when recombinant SpaFED pili are surface-attached, we found that they could not potentiate the existing lactococcal cell-induced immune responses so elicited from intestinal- and immune-related cells, but rather instead, they could dampen them. Accordingly, we

  1. Phenotypical analysis of the Lactobacillus rhamnosus GG fimbrial spaFED operon: surface expression and functional characterization of recombinant SpaFED pili in Lactococcus lactis.

    Science.gov (United States)

    Rintahaka, Johanna; Yu, Xia; Kant, Ravi; Palva, Airi; von Ossowski, Ingemar

    2014-01-01

    A noticeable genomic feature of many piliated Gram-positive bacterial species is the presence of more than one pilus-encoding operon. Paradigmatically, the gut-adapted Lactobacillus rhamnosus GG strain contains two different fimbrial operons in its genome. However, whereas one of these operons (called spaCBA) is encoding for the functionally mucus-/collagen-binding SpaCBA pilus, for the other operon (called spaFED) any native expression of the SpaFED-called pili is still the subject of some uncertainty. Irrespective of such considerations, we decided it would be of relevance or interest to decipher the gross structure of this pilus type, and as well assess its functional capabilities for cellular adhesion and immunostimulation. For this, and by following the approach we had used previously to explicate the immuno-properties of SpaCBA pili, we constructed nisin-inducible expression clones producing either wild-type or SpaF pilin-deleted surface-assembled L. rhamnosus GG SpaFED pili on Lactococcus lactis cells. Using these piliated lactococcal constructs, we found that the pilin-polymerized architecture of a recombinant-produced SpaFED pilus coincides with sequence-based functional predictions of the related pilins, and in fact is prototypical of those other sortase-dependent pilus-like structures thus far characterized for piliated Gram-positive bacteria. Moreover, we confirmed that among the different pilin subunits encompassing spaFED operon-encoded pili, the SpaF pilin is a main adhesion determinant, and when present in the assembled structure can mediate pilus binding to mucus, certain extracellular matrix proteins, and different gut epithelial cell lines. However, somewhat unexpectedly, when recombinant SpaFED pili are surface-attached, we found that they could not potentiate the existing lactococcal cell-induced immune responses so elicited from intestinal- and immune-related cells, but rather instead, they could dampen them. Accordingly, we have now provided

  2. Custom controls

    Science.gov (United States)

    Butell, Bart

    1996-02-01

    Microsoft's Visual Basic (VB) and Borland's Delphi provide an extremely robust programming environment for delivering multimedia solutions for interactive kiosks, games and titles. Their object oriented use of standard and custom controls enable a user to build extremely powerful applications. A multipurpose, database enabled programming environment that can provide an event driven interface functions as a multimedia kernel. This kernel can provide a variety of authoring solutions (e.g. a timeline based model similar to Macromedia Director or a node authoring model similar to Icon Author). At the heart of the kernel is a set of low level multimedia components providing object oriented interfaces for graphics, audio, video and imaging. Data preparation tools (e.g., layout, palette and Sprite Editors) could be built to manage the media database. The flexible interface for VB allows the construction of an infinite number of user models. The proliferation of these models within a popular, easy to use environment will allow the vast developer segment of 'producer' types to bring their ideas to the market. This is the key to building exciting, content rich multimedia solutions. Microsoft's VB and Borland's Delphi environments combined with multimedia components enable these possibilities.

  3. A online credit evaluation method based on AHP and SPA

    Science.gov (United States)

    Xu, Yingtao; Zhang, Ying

    2009-07-01

    Online credit evaluation is the foundation for the establishment of trust and for the management of risk between buyers and sellers in e-commerce. In this paper, a new credit evaluation method based on the analytic hierarchy process (AHP) and the set pair analysis (SPA) is presented to determine the credibility of the electronic commerce participants. It solves some of the drawbacks found in classical credit evaluation methods and broadens the scope of current approaches. Both qualitative and quantitative indicators are considered in the proposed method, then a overall credit score is achieved from the optimal perspective. In the end, a case analysis of China Garment Network is provided for illustrative purposes.

  4. Are loyal customers profitable? : customer satisfaction, customer loyalty and customer profitability at the individual level

    OpenAIRE

    Helgesen, Øyvind

    2000-01-01

    Customer satisfaction is supposed to be positively related to profitability. This conception may be called “the paradigm of customer satisfaction”. Nevertheless, only a few studies have examined this fundamental relationship. Thus, evidence for this “much talked about relationship” is questioned. In this working paper the focus is on the individual customer with respect to the relationships between customer satisfaction, customer loyalty and customer profitability at the customer level. The f...

  5. Customer Clustering Based on Customer Purchasing Sequence Data

    OpenAIRE

    Yen-Chung Liu; Yen-Liang Chen

    2017-01-01

    Customer clustering has become a priority for enterprises because of the importance of customer relationship management. Customer clustering can improve understanding of the composition and characteristics of customers, thereby enabling the creation of appropriate marketing strategies for each customer group. Previously, different customer clustering approaches have been proposed according to data type, namely customer profile data, customer value data, customer transaction data, and customer...

  6. Point-of-purchase health information encourages customers to purchase vegetables: objective analysis by using a point-of-sales system.

    Science.gov (United States)

    Ogawa, Yoshiko; Tanabe, Naohito; Honda, Akiko; Azuma, Tomoko; Seki, Nao; Suzuki, Tsubasa; Suzuki, Hiroshi

    2011-07-01

    Point-of-purchase (POP) information at food stores could help promote healthy dietary habits. However, it has been difficult to evaluate the effects of such intervention on customers' behavior. We objectively evaluated the usefulness of POP health information for vegetables in the modification of customers' purchasing behavior by using the database of a point-of-sales (POS) system. Two supermarket stores belonging to the same chain were assigned as the intervention store (store I) and control store (store C). POP health information for vegetables was presented in store I for 60 days. The percent increase in daily sales of vegetables over the sales on the same date of the previous year was compared between the stores by using the database of the POS system, adjusting for the change in monthly visitors from the previous year (adjusted ∆sales). The adjusted ∆sales significantly increased during the intervention period (Spearman's ρ = 0.258, P for trend = 0.006) at store I but did not increase at store C (ρ = -0.037, P for trend = 0.728). The growth of the mean adjusted ∆sales of total vegetables from 30 days before the intervention period through the latter half of the intervention period was estimated to be greater at store I than at store C by 18.7 percentage points (95% confidence interval 1.6-35.9). Health-related POP information for vegetables in supermarkets can encourage customers to purchase and, probably, consume vegetables.

  7. Cost-effectiveness and efficacy of spa, SCCmec, and PVL genotyping of methicillin-resistant Staphylococcus aureus as compared to pulsed-field gel Electrophoresis.

    Directory of Open Access Journals (Sweden)

    Vincent Li

    Full Text Available Pulsed-field gel electrophoresis (PFGE is a valuable molecular typing assay used for methicillin-resistant Staphylococcus aureus (MRSA surveillance and genotyping. However, there are several limitations associated with PFGE. In Alberta, Canada, the significant increase in the number of MRSA isolates submitted to the Provincial Laboratory for Public Health (ProvLab for PFGE typing led to the need for an alternative genotyping method. In this study, we describe the transition from PFGE to Staphylococcus protein A (spa, Staphylococcal cassette chromosome (SCCmec, and Panton-Valentine leukocidin (PVL typing. A total of 1915 clinical MRSA isolates collected from 2005 to 2009 were used to develop and validate an algorithm for assigning PFGE epidemic types using spa, SCCmec, and PVL typing and the resulting data was used to populate a new Alberta MRSA typing database. An additional 12620 clinical MRSA isolates collected from 2010 to 2012 as part of ongoing routine molecular testing at ProvLab were characterized using the new typing algorithm and the Alberta MRSA typing database. Switching to spa, SCCmec, and PVL from PFGE typing substantially reduced hands-on and turn-around times while maintaining historical PFGE epidemic type designations. This led to an approximate $77,000 reduction in costs from 2010 to 2012. PFGE typing is still required for a small subset of MRSA isolates that have spa types that are rare, novel, or associated with more than one PFGE epidemic type.

  8. Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility

    Science.gov (United States)

    Musumeci, Alfredo; Pranovi, Giulia; Masiero, Stefano

    2018-05-01

    Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical—PCS-12—and mental health component—MCS-12) were also administered. After the 2-week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 ± 12.8 to 82.15 ± 12.7 (p < 0.05), and the PCS-12 score from 36.37 ± 8.4 to 43.61 ± 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the

  9. Talking about Customer Service.

    Science.gov (United States)

    Talley, Mary; Axelroth, Joan

    2001-01-01

    Discusses customer service in information centers and how to define it. Topics include the effects of competition, that give customers more choices; defining customers, and defining services; communications; physical environment; change, in customers and in technology; measuring customer service; and evaluating policies and procedures. (LRW)

  10. From connection to customer

    International Nuclear Information System (INIS)

    Milatz, H.; Soeters, R.

    2001-01-01

    Energy companies can no longer be certain that a customer today will remain a customer tomorrow. They have to work hard to achieve that. They are going from thinking in terms of connections to pampering their customers. Good Customer Relationship Management is a way to achieve a competitive advantage. The whole organisation has to adapt, particularly the customer orientation of employees

  11. Mass Customization Services

    DEFF Research Database (Denmark)

    Friedrich, Gerhard

    Topics of the IMCM’08 & PETO’08 and this book are: Mass customization in service, mass customizing financial services, mass customization in supply networks, implementation issues in logistics, product life cycle and mass customization. The research field of mass customization is more than 15 years...

  12. Customer Equity von KMUs

    NARCIS (Netherlands)

    Biemel, Friedhelm W.; Henseler, Jörg; Meyer, Jorn-Axel

    2003-01-01

    Customer relationships are most important assets of many SMEs. Customer Equity is the sum of the values of all customer relationships. Customer Equity will not be found in any balance sheet, nevertheless it has strategic importance. Even if companies do not want to publish their Customer Equity for

  13. 77 FR 35888 - Airworthiness Directives; PIAGGIO AERO INDUSTRIES S.p.A Airplanes

    Science.gov (United States)

    2012-06-15

    ...., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. For service.... Relevant Service Information PIAGGIO AERO INDUSTRIES S.p.A. has issued Service Bulletin No. 80- 0318, dated... Instructions of Piaggio Aero Industries S.p.A. Mandatory Service Bulletin No. 80-0318, revision 2, dated March...

  14. 'MRI-tis' in the early diagnosis of axial SpA: issues and limitations

    NARCIS (Netherlands)

    de Rycke, Leen; Maas, Mario; Tak, Paul P.; Baeten, Dominique

    2010-01-01

    Sacroiliitis on conventional radiography, a key diagnostic feature of axial spondyloarthritis (SpA), often appears only late in the disease course. With the introduction of potent biologic agents that may also be effective in early disease, diagnostic techniques that can identify SpA early in the

  15. Stiffness Customization and Patterning for Property Modulation of Silicone-Based Soft Pneumatic Actuators.

    Science.gov (United States)

    Sun, Yi; Yap, Hong Kai; Liang, Xinquan; Guo, Jin; Qi, Peng; Ang, Marcelo H; Yeow, Chen-Hua

    2017-09-01

    Soft pneumatic actuators (SPAs), as novel types of motion drivers for robotic devices, excel in many applications, such as rehabilitation and biomimicry, which demand compliance and softness. To further expand their scope of utilization, the SPAs should be customizable to meet the distinctive requirements of different applications. This article proposes a novel perspective on the SPA working mechanism based on stiffness distribution and then presents a versatile method called stiffness customization and patterning (SCP) for SPA body stiffness layout as a novel attempt to customize SPAs with distinctive properties. We fabricated a hybrid type of material combining unstretchable material and silicone with customizable aggregated elasticity. The tensile results showed that embedding unstretchable material directly increases the stiffness of the hybrid material sample, and our stress-strain model for SCP is able to adequately predict the elasticity of hybrid samples with specific material ratios. By applying this approach to bending-type SPAs, we are able to mitigate SPA buckling, a main failure mode of SPAs, and improve the SPA tip force by using hybrid material with globally increased stiffness. We also diversify bending modalities with different stiffness configurations in the hybrid material. SCP offers numerous ways to engineer SPAs for more applications.

  16. Determinants of customer satisfaction with the health care system, with the possibility to choose a personal physician and with a family doctor in a transition country.

    Science.gov (United States)

    Kersnik, J

    2001-08-01

    Many Eastern and Central European counties are reforming their health care systems. The aim of this study was to determine customer satisfaction with a reformed health care system, with the possibility of free choice of a family physician and patient satisfaction with the family physician in Slovenia and their major determinants. We used a postal survey of the patients who attended their family physician's offices during the study period. We obtained an 84% response rate. Some 72.9% of the respondents were satisfied with the current organisation of health care services, 95.5% of the respondents were satisfied with the possibility of choosing their own family physician and 58% of participants were very satisfied with the level of care received from their personal family practitioners. It was shown that higher patient satisfaction with the family physician was the most powerful predictor of patients' satisfaction with the health care system. The results show that health care reform in Slovenia has a positive impact on the consumers' perceptions of health care quality, measured in terms of consumer satisfaction with the health care system, the possibility to choose a family physician and the overall satisfaction with the family physician.

  17. HOSPITALITY ENGLISH FOR SPA THERAPISTS IN BANYAN TREE HOTELS AND RESORTS

    Directory of Open Access Journals (Sweden)

    Ratnasari Nugraheni

    2018-04-01

    Full Text Available This study is a preliminary study of research and design for hospitality English for SPA therapist in Banyan Tree Hotels and Resorts at Bintan Island. The purpose of this study is to help the English teacher to provide a successful English training since a good English proficiency used in the hospitality industry is obliged, especially for an-international-five-star-hotel-brand. The nature of the study is qualitative using R&D approach. Since this is only a preliminary study, need analysis becomes the primary focus. The data were collected through interview and observation. The participants were people who are working in SPA department in Banyan Tree Bintan, such as SPA trainer, SPA therapist, and SPA manager.

  18. Improving Internal Customer Service

    Science.gov (United States)

    1990-09-01

    34Companies are recognizing that treating customers and associates like people has a very high value" (21:20). 2 Customer service has become more that... customer service is also a strategy with the focus towards people , not product (24:1). Customers are demanding quality service for several reasons...34 (39:45). External Customers . External customers are an organization’s ultimate consumers . They purchase the end product or service an organization

  19. Customer Relationship Management

    OpenAIRE

    Abdillah, Leon

    2018-01-01

    Contents: 1) Introduction, 2) Basic Concept of CRM, 3) The Customer Service/Sales Profile, 4) Customer Relationship, 5) Planning and implementing CRM projects, 6) Developing, managing and using customer-related databases, 7) Managing and Sharing Customer Data, 8) Tools for Capturing Customer Information, 9) E-Commerce: Customer Relationships on the Internet, 10) Information Technology for CRM, 11) Sales-force automation, 12) Marketing automation, 13) Service automation, 14) Presentations, 15)...

  20. 75 FR 76038 - Zach System Corporation a Subdivision of Zambon Company, SPA Including On-Site Leased Workers of...

    Science.gov (United States)

    2010-12-07

    ... Subdivision of Zambon Company, SPA Including On-Site Leased Workers of Turner Industries and Go Johnson, La..., including on-site leased workers from Turner Industries and Go Johnson, La Porte, Texas. The Department's... investigation revealed that Zach System Corporation is a subdivision of Zambon Company, SPA, not Zach System SPA...

  1. Comparing whole-genome sequencing with Sanger sequencing for spa typing of methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Bartels, Mette Damkjær; Petersen, Andreas; Worning, Peder; Nielsen, Jesper Boye; Larner-Svensson, Hanna; Johansen, Helle Krogh; Andersen, Leif Percival; Jarløv, Jens Otto; Boye, Kit; Larsen, Anders Rhod; Westh, Henrik

    2014-12-01

    spa typing of methicillin-resistant Staphylococcus aureus (MRSA) has traditionally been done by PCR amplification and Sanger sequencing of the spa repeat region. At Hvidovre Hospital, Denmark, whole-genome sequencing (WGS) of all MRSA isolates has been performed routinely since January 2013, and an in-house analysis pipeline determines the spa types. Due to national surveillance, all MRSA isolates are sent to Statens Serum Institut, where the spa type is determined by PCR and Sanger sequencing. The purpose of this study was to evaluate the reliability of the spa types obtained by 150-bp paired-end Illumina WGS. MRSA isolates from new MRSA patients in 2013 (n = 699) in the capital region of Denmark were included. We found a 97% agreement between spa types obtained by the two methods. All isolates achieved a spa type by both methods. Nineteen isolates differed in spa types by the two methods, in most cases due to the lack of 24-bp repeats in the whole-genome-sequenced isolates. These related but incorrect spa types should have no consequence in outbreak investigations, since all epidemiologically linked isolates, regardless of spa type, will be included in the single nucleotide polymorphism (SNP) analysis. This will reveal the close relatedness of the spa types. In conclusion, our data show that WGS is a reliable method to determine the spa type of MRSA. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  2. Identification and Description of Healthcare Customer Communication Patterns Among Individuals with Diabetes in Clalit Health Services: A Retrospective Database Study.

    Science.gov (United States)

    Benis, Arriel; Harel, Nissim; Barkan, Refael; Sela, Tomer; Feldman, Becca

    2017-01-01

    HMOs record medical data and their interactions with patients. Using this data we strive to identify sub-populations of healthcare customers based on their communication patterns and characterize these sub-populations by their socio-demographic, medical, treatment effectiveness, and treatment adherence profiles. This work will be used to develop tools and interventions aimed at improving patient care. The process included: (1) Extracting socio-demographic, clinical, laboratory, and communication data of 309,460 patients with diabetes in 2015, aged 32+ years, having 7+ years of the disease treated by Clalit Healthcare Services; (2) Reducing dimensions of continuous variables; (3) Finding the K communication-patterns clusters; (4) Building a hierarchical clustering and its associated heatmap to summarize the discovered clusters; (5) Analyzing the clusters found; (6) Validating results epidemiologically. Such a process supports understanding different communication-channel usage and the implementation of personalized services focusing on patients' needs and preferences.

  3. IoT and Connected Insurance Reshaping The Health Insurance Industry. A Customer-centric “From Cure To Care” Approach

    Directory of Open Access Journals (Sweden)

    A. Silvello

    2017-12-01

    Full Text Available An increasing global population, the rise in number of chronic disease patients and the threat of global epidemics have made the way for technology as a potential answer to many of these problems. Health insurance can contribute to the resolution of some of these issues but insurers need to transition from simple “Payers” to “Players” in order to achieve that. They need to become points of reference on which the customer and the health care system can count on. This is possible and is strictly related to connected insurance and in particular to wearables and devices that are able to gather vital data from patients and share them with the care givers.

  4. King customer forever: Customer satisfaction and beyond

    Directory of Open Access Journals (Sweden)

    Myuers James

    2004-01-01

    Full Text Available "King Customer!" So proclaimed the front cover of Business Week in a 1989 issue. At about the same time, "Rediscovering the Customer" was the title of a series of company vignettes in Fortune magazine. And a Wall Street Journal article asked, "For Customers, More Than Lip Service?" Combined, these three prestigious business publications reflected a new era in business firms perceptions of their customers and the role they should play in the formulation of company strategies and priorities. Had the "Era of the Customer" finally arrived in American business? .

  5. Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns

    OpenAIRE

    Van Gucht, Dinska; Adriaens, Karolien; Baeyens, Frank

    2017-01-01

    (1) Background: Characteristics and usage patterns of vapers (e-cigarette users) have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2) Methods: Customers were questioned on their smoking history, current smoking and vaping status, reasons for vaping, perceived harmfulness, and potential health changes due to vaping; (3) Results: Almost everyone ...

  6. Pengaruh Customer Service Quality, Customer Perceived Value, Customer Satisfaction, Customer Trust Dan Switching Barriers Terhadap Customer Retention.

    OpenAIRE

    Hardjanti, Adiati; Amalia, Dinna

    2014-01-01

    Penelitian ini bertujuan untuk mengetahui pengaruh customer service quality, customer perceived value, customer satisfaction, customer trust dan switching barriers terhadap customer retention. Rancangan penelitian yang digunakan dalam penelitian ini adalah pengujian hipotesis (testing hypotesis). Pengambilan sampel dalam penelitian ini menggunakan teknik purposive sampling dan keseluruhan hipotesis diuji dengan metode structural equation modeling yang menggunakan Amos 7.0. Data dalam peneliti...

  7. COMPETITIVENESS THROUGH SUSTAINABILITY AND FINANCIAL EFFICIENCY OF SPA TOURIST DESTINATIONS

    Directory of Open Access Journals (Sweden)

    Anis Cecilia

    2010-12-01

    Full Text Available In the specific literature, success may be achieved by two important attributes: competitiveness and sustainability. Competitive advantage represents an essential criterion for surviving on the tourist market and defines the ability of one destination to use these resources effectively and in the long term. The paper work continue a study begun last year by the same authors about tourist perception of attractiveness of the two tourist SPA destinations (Buziaş and Băile Felix on a different market segment (18-35 years old people. This time, we undertake an analysis on SC Turism Felix SA in order to determine and underline the tourist competitiveness through sustainability and financial efficiency (tourism performance indicators evolution, market share, turnover, investment volume, financial returns and costs.

  8. [INDENA SPA company's patent portfolio of Ginkgo biloba preparation].

    Science.gov (United States)

    Wang, Nan; Guo, Kai; Cheng, Xin-min; Liu, Wei

    2015-10-01

    INDENA SPA Company in Italy is a multi-national company that produces and sells plant extracts. Based on its own re- search advantages in the field of Ginkgo biloba preparation, the company protects its own products market effectively through building patent portfolio around the patents of its opponent. Based on the multi-angle analysis for patent portfolio of G. biloba preparation from the aspects of application time, legal status, technical development route, and patent portfolio layout, this article provides technical reference on research and development of G. biloba preparation, and the author suggest that Chinese applicants learn techniques and layout experiences of other patents fully to enhance the level of research and patent protection level.

  9. A new silver based composite material for SPA water disinfection.

    Science.gov (United States)

    Tartanson, M A; Soussan, L; Rivallin, M; Chis, C; Penaranda, D; Lapergue, R; Calmels, P; Faur, C

    2014-10-15

    A new composite material based on alumina (Al2O3) modified by two surface nanocoatings - titanium dioxide (TiO2) and silver (Ag) - was studied for spa water disinfection. Regarding the most common microorganisms in bathing waters, two non-pathogenic bacteria Escherichia coli (Gram-negative) and Staphylococcus epidermidis (Gram positive) were selected as surrogates for bacterial contamination. The bactericidal properties of the Al2O3-TiO2-Ag material were demonstrated under various operating conditions encountered in spa water (temperature: 22-37 °C, presence of salt: CaCO3 or CaCl2, high oxygen content, etc.). Total removal of 10(8) CFU mL(-1) of bacteria was obtained in less than 10 min with 16 g L(-1) of material. Best results were observed for both conditions: a temperature of 37 °C and under aerobic condition; this latest favouring Reactive Oxygen Species (ROS) generation. The CaCO3 salt had no impact on the bactericidal activity of the composite material and CaCl2 considerably stabilized the silver desorption from the material surface thanks to the formation of AgCl precipitate. Preliminary tests of the Al2O3-TiO2-Ag bactericidal behaviour in a continuous water flow confirmed that 2 g L(-1) of material eliminated more than 90% of a 2.0 × 10(8) CFU mL(-1) bacterial mixture after one water treatment recycle and reached the disinfection standard recommended by EPA (coliform removal = 6 log) within 22 h. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. The internal and external customer focused process improvement and the performance analysis studies in health care systems

    International Nuclear Information System (INIS)

    Tekin, P.; Erol, R.

    2017-01-01

    Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals. Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having performed the respective process improvement studies. The relevant samplings of this study are modeled via the Arena Simulation Program. The data of the previous four months is used in the parameters, which are used through the modellings. The system data are entered by taking into account seasonal characteristics of the data. Findings: The analyses are made as a consequence of such study that has been addressed, it is established that the efficiency of the internal customers of the hospital increases substantially, and that the waiting durations of the dental patients decrease and in turn, the external customer satisfaction increases drastically. Research limitations/implications: Under the scope of the present study, 7 different treatment processes are analysed in a dental hospital in Cukurova Region with a significant patient potential. The treatment clinics present in the hospital are radiology, periodontology, surgery, treatment, orthodontics and prosthesis. These clinics run their own

  11. The internal and external customer focused process improvement and the performance analysis studies in health care systems

    Energy Technology Data Exchange (ETDEWEB)

    Tekin, P.; Erol, R.

    2017-07-01

    Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals. Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having performed the respective process improvement studies. The relevant samplings of this study are modeled via the Arena Simulation Program. The data of the previous four months is used in the parameters, which are used through the modellings. The system data are entered by taking into account seasonal characteristics of the data. Findings: The analyses are made as a consequence of such study that has been addressed, it is established that the efficiency of the internal customers of the hospital increases substantially, and that the waiting durations of the dental patients decrease and in turn, the external customer satisfaction increases drastically. Research limitations/implications: Under the scope of the present study, 7 different treatment processes are analysed in a dental hospital in Cukurova Region with a significant patient potential. The treatment clinics present in the hospital are radiology, periodontology, surgery, treatment, orthodontics and prosthesis. These clinics run their own

  12. Elementi koji diferenciraju ugovor o spašavanju od ugovora o tegljenju : (prikaz presude

    Directory of Open Access Journals (Sweden)

    Vesna Skorupan Wolff

    2016-07-01

    Full Text Available Brod kojem su se zaustavili porivni strojevi, a uslijed toga vjetar i morska struja nosili su ga prema obali, zatražio je uslugu tegljenja. Između stranaka je sporno radi li se u konkretnom slučaju o ugovoru o tegljenju ili ugovoru o spašavanju. Spašavanje je svaka djelatnosti kojoj je svrha spašavanje osoba, brodova i stvari s tih brodova. Bitan element pojma spašavanja jest da se osoba, odnosno stvar koja se spašava nalazi u opasnosti (opasnost po život osoba, odnosno propast stvari. Pod spašavanjem se podrazumijeva i pružanje pomoći. Ako je pomoć pružena tegljenjem, to ne znači da se radi o pravnom poslu tegljenja. U konkretnom slučaju u pitanju nije bio komercijalni posao tegljenja već posao spašavanja.

  13. The relationship between customer satisfaction and the demographic profile of participants in the exercise programs of health and fitness clubs for municipal youth and sport organizations

    Directory of Open Access Journals (Sweden)

    ALEXANDRA TRIPOLITSIOTI

    2007-01-01

    Full Text Available The objective of this study is to analyze the satisfaction of participants in the offered programs of exercise of health and fitness clubs for municipal Youth and Sport organizations. A random sample of 320 participants was selected from 18 closed halls and responded to a questionnaire that was pre-checked for reliability, validity and objectivity (Chen, 2001. The questionnaire included questions related to demographics, participant satisfaction from the exercise programs and from the level of organisation these have, the quality of equipment the athletic halls have and the variety of services offered. Data was analysed statistically to determine the relationships and differences between the mean value of the different variables. Results show that the profile of the major customer segment is women from 26 to 35 years old with University education. Also, statistical analysis shows that there are significant differences between the average values in all 5 dimensions of participant satisfaction: the prices of exercise programs, program content, the quality of hall equipment, public relations and employee performance. Also, there are statistically significant differences between the demographic variables (age, sex, income and the 5 participant satisfaction dimensions. However, the dimensions that present statistically significant differences vary according to the demographic variable analysed. This shows that municipal sports centres should differentiate their offers according to the dimensions of satisfaction that are more important for each customer segment as these are formed based on age, income or sex.

  14. Development and evaluation of an electronic health record configuration and customization laboratory course for clinical informatics students.

    Science.gov (United States)

    Mohan, Vishnu; Hersh, William R

    2013-01-01

    There is a need for informatics educational programs to develop laboratory courses that facilitate hands-on access to an EHR, and allow students to learn and evaluate functionality and configuration options. This is particularly relevant given the diversity of backgrounds of informatics students. We implemented an EHR laboratory course that allowed students to explore an EHR in both inpatient and outpatient clinical environments. The course focused on specific elements of the EHR including order set development, customization, clinical decision support, ancillary services, and billing and coding functionality. Students were surveyed at the end of the course for their satisfaction with the learning experience. We detailed challenges as well as lessons learned after analyzing student evaluations of this course. Features that promote the successful offering of an online EHR course, include (1) using more than one EHR to allow students to compare functionalities, (2) ensuring appropriate course calibration, (3) countering issues specific to EHR usability, and (4) fostering a fertile environment for rich online conversations are discussed.

  15. Performance excellence: using Lean Six Sigma tools to improve the US Army behavioral health surveillance process, boost team morale, and maximize value to customers and stakeholders.

    Science.gov (United States)

    Watkins, Eren Youmans; Kemeter, Dave M; Spiess, Anita; Corrigan, Elizabeth; Kateley, Keri; Wills, John V; Mancha, Brent Edward; Nichols, Jerrica; Bell, Amy Millikan

    2014-01-01

    Lean Six Sigma (LSS) is a process improvement, problem-solving methodology used in business and manufacturing to improve the speed, quality, and cost of products. LSS can also be used to improve knowledge-based products integral to public health surveillance. An LSS project by the Behavioral Social Health Outcomes Program of the Army Institute of Public Health reduced the number of labor hours spent producing the routine surveillance of suicidal behavior publication. At baseline, the total number of labor hours was 448; after project completion, total labor hours were 199. Based on customer feedback, publication production was reduced from quarterly to annually. Process improvements enhanced group morale and established best practices in the form of standard operating procedures and business rules to ensure solutions are sustained. LSS project participation also fostered a change in the conceptualization of tasks and projects. These results demonstrate that LSS can be used to inform the public health process and should be considered a viable method of improving knowledge-based products and processes.

  16. Customer relationship management

    OpenAIRE

    Gudeliūnas, Mindaugas

    2016-01-01

    My name is Mindaugas Gudeliūnas. My bachelors thesis topic is "Customer Relationship Management". The main goal of my work was to investigate customers relationship management and to create modern system, which is fast, easy to use and made for small business. Customer relationship management is really beneficial for a lot of companies. It can make your relationships with a customer more reliable and loyal, it can automate a lot of processes, which are related to customer management, human re...

  17. Customer relationship management system

    OpenAIRE

    Selenis, Laimonas

    2004-01-01

    Customer Relationship Management (CRM) is one of the biggest problems for many companies today. By analyzing history records (profiles) of its customers, organization can effectively adapt its business activity to users needs and create better products and services. Proper analysis of customer profiles can help to predict the behaviour of the customers. After grouping customer profiles by similar attributes, company can easier handle its interactions with similar users. Such group profiling c...

  18. Managing customer knowledge

    OpenAIRE

    2013-01-01

    M. Phil. (Information Management) Customer relationship management has been exposed as a strategic failure, unveiling only customer dissatisfaction. A new method for managing customers is consequently required. The effect of the knowledge economy has brought about a change in global orientation, in the focus on customer wants and needs to increase satisfaction. There was then a shift in focus from information to knowledge. In such an economy, the customer knowledge management strategy, as ...

  19. Effect of evidence-based approach on the customer orientation (Case study: Physicians Health Centers in Isfahan province in 2014)

    Science.gov (United States)

    Esfahani, NG; Maharati, Y

    2015-01-01

    Introduction: The purpose of this research was to examine the approach, based on evidence to customer-orientation attending physicians in the region, them being the subject collection. Research method: This is a definitive-analytic and cross-sectional configuration, which was completed in 2014. The statistical community in this research consists of 212 doctors in the healthcare hubs. The working physicians chose 200 patients by means of a simple accidental sampling. The analysis means was the researcher built survey whose efficacy and reliability were verified. In this research, the fundamental equation design and partial least square technique were applied to examine the presumptions and fitness pattern and the structural design was agreed as adequate. Findings: The outcomes showed four cases linked to the character, a behavior which was meant to treat; traditional origins of evidence were employed to retrieve data based on the reliable evidence and the shortage of limitations to the performance of client orientation strategy of evidence-based influences were meaningful. Two ranges of the doctor's information, the absence of restrictions, and the finding of the sign of dimensions about the client orientation approach were according to the evidence that had no meaningful influence. Conclusion: The utilization of evidence-based training not only increased awareness, character, and abilities of the doctors but also allowed them to answer to the requirements of clients in choosing excellent decisions and presenting a better quality of healthcare, by decreasing treatment prices for patients, bringing satisfaction of patients, and finally having a better effectiveness for patients and institutions. PMID:28316691

  20. How small business health exchanges can offer value to their future customers--and why they must.

    Science.gov (United States)

    Kingsdale, Jon

    2012-02-01

    The success of the Small Business Health Options Program (SHOP)-health insurance exchanges targeted at the small-group market and opening for business in January 2014-will depend in large part on persuading small employers and qualified health plans to participate. The most important objective will be offering employers lower-cost health plans than they have now. Other critical objectives will be offering small firms administrative efficiencies and access to choices among high-value plans that are not offered elsewhere. This article frames the challenges that exchanges will encounter in meeting these objectives. In particular, it discusses the advisability of small-business exchanges' offering an "employee choice" model (which the article describes in detail); of combining the small-business and individual exchanges to broaden product offerings and gain operational efficiencies; and of encouraging low-cost plans to enter the exchange market, perhaps by enabling Medicaid managed care plans to offer comparable commercial products, and in turn affording health plans access to a uniquely motivated market of small firms and their workers who want affordable coverage.

  1. Health insurance exchanges of past and present offer examples of features that could attract small-business customers.

    Science.gov (United States)

    Gardiner, Terry

    2012-02-01

    The Affordable Care Act calls on states to create health insurance exchanges serving small businesses by 2014. These exchanges will allow small-business owners to pool their buying power, have more choices of health plans, and buy affordable health insurance. However, creating an exchange that appeals to small-business owners poses several challenges. Past and current exchanges provide valuable insights into the role exchanges can play, services they can offer, and design features that can make them successful. For example, states should allow insurance brokers to provide employers with advice and analysis regarding plans offered in the exchanges. Exchanges should also provide services to ease enrollment, such as a single application for all of the plans they offer, and make additional benefits, such as wellness programs, available on a stand-alone basis or within insurance plans.

  2. Customer satisfaction and competencies

    DEFF Research Database (Denmark)

    Gritti, Paola; Foss, Nicolai Juul

    We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do......, loyalty is a mediator between financial and not-financial customer value and two sources of customer satisfaction, namely relationships with the front office and the branch, on the one hand, and the products offered, on the other....... this by analyzing data collected on 2,105 customers of 118 branches of one of the biggest banks of an Italian banking group. We find that customer satisfaction impacts loyalty, which in turn has a direct effect on financial and non-financial customer value/total customer value/complex customer value. Moreover...

  3. MARKETING RELATIONSHIP AND TRADING IN THE RELATIONSHIP BETWEEN SERVICE PROVIDERS, HEALTH OPERATORS AND FINAL CUSTOMER: THE SEARCH FOR AN INTEGRATING MODEL

    Directory of Open Access Journals (Sweden)

    Nilda Catalina, Tañski

    2012-01-01

    Full Text Available The marketing relationship finds similarities with the concept of cooperative bargaining, the purpose of this is to find solutions to mutual gains with long-term vision. Within this approach, we sought to build an integrative model of relationship marketing and negotiation in the relationship between service providers, health operators and final customers in the health plan market in Brazil, this relationship is complex, full of conflicts and stagnation. It was first used, first, as an exploratory research of direct observation of the phenomenon referred to relationship marketing, trading and health insurance to increase employment opportunities. Then, the method of data collection was in that environment through online questionnaires using the survey method, in the representative sector. The type of sample used, where n = 217 and the confidence level was 95%, not intentional probabilistic. In the final, it was concluded that the initially proposed model was fully accepted, taking into account the choice of methodology, then achieving the main objective of this study.

  4. Creating a successful relationship with customers.

    Science.gov (United States)

    Cotton, L; Sparrow, E

    1998-01-01

    In 1997, several employers commissioned an inpatient survey for a group of businesses that included hospitals in southeast Michigan. Its results indicated that the University of Michigan Health System (UMHS) needed to become more customer-focused. To meet this challenge, UMHS mandated that customer service to its patients and their families should be its first priority. A pilot project in the radiology department's pediatric division was established to recognize and reward employees for outstanding service to customers. The program is now used to reward employees throughout the radiology department, on the assumption that when employees feel special, so will their customers. Management's focus is on employees--they are the health system. The department also invested in employee development, a continuous training program that centers on customer service and teaches tools and skills for better communication. The goal of the development program at UMHS is to exceed the needs of its customers.

  5. Kaks kuud Kalev SPA-s / kommenteerinud Julia Kurbat, Natalia Nazarenko-Kiivikas, Margit Lipstuhl

    Index Scriptorium Estoniae

    2012-01-01

    Kahe spordiharrastaja Kaur Sau ja Kadri Sõggeli seatud eesmärkidest 2012. aastal ja kehalisest arengust treenides kaks kuud mõnes Tallinna spordiklubis. Treeningutest Kalev Spa Hotel & Water Park'i nimekandvas spordi- ja vabaajakeskuses

  6. Surfactant protein A (SP-A) inhibits agglomeration and macrophage uptake of toxic amine modified nanoparticles.

    Science.gov (United States)

    McKenzie, Zofi; Kendall, Michaela; Mackay, Rose-Marie; Whitwell, Harry; Elgy, Christine; Ding, Ping; Mahajan, Sumeet; Morgan, Cliff; Griffiths, Mark; Clark, Howard; Madsen, Jens

    2015-01-01

    The lung provides the main route for nanomaterial exposure. Surfactant protein A (SP-A) is an important respiratory innate immune molecule with the ability to bind or opsonise pathogens to enhance phagocytic removal from the airways. We hypothesised that SP-A, like surfactant protein D, may interact with inhaled nanoparticulates, and that this interaction will be affected by nanoparticle (NP) surface characteristics. In this study, we characterise the interaction of SP-A with unmodified (U-PS) and amine-modified (A-PS) polystyrene particles of varying size and zeta potential using dynamic light scatter analysis. SP-A associated with both 100 nm U-PS and A-PS in a calcium-independent manner. SP-A induced significant calcium-dependent agglomeration of 100 nm U-PS NPs but resulted in calcium-independent inhibition of A-PS self agglomeration. SP-A enhanced uptake of 100 nm U-PS into macrophage-like RAW264.7 cells in a dose-dependent manner but in contrast inhibited A-PS uptake. Reduced association of A-PS particles in RAW264.7 cells following pre-incubation of SP-A was also observed with coherent anti-Stokes Raman spectroscopy. Consistent with these findings, alveolar macrophages (AMs) from SP-A(-/-) mice were more efficient at uptake of 100 nm A-PS compared with wild type C57Bl/6 macrophages. No difference in uptake was observed with 500 nm U-PS or A-PS particles. Pre-incubation with SP-A resulted in a significant decrease in uptake of 100 nm A-PS in macrophages isolated from both groups of mice. In contrast, increased uptake by AMs of U-PS was observed after pre-incubation with SP-A. Thus we have demonstrated that SP-A promotes uptake of non-toxic U-PS particles but inhibits the clearance of potentially toxic A-PS particles by blocking uptake into macrophages.

  7. Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study

    OpenAIRE

    Koike Y; Kondo H; Kondo S; Takagi M; Kano Y

    2013-01-01

    Yoshihisa Koike,1 Hideki Kondo,2 Satoshi Kondo,1 Masayuki Takagi,1 Yoshio Kano31Department of Occupational Therapy, Prefectural University of Hiroshima, Mihara, Japan; 2Yoshiigawa Hospital, Okayama, Japan; 3Department of Occupational Therapy, Kibi International University, Takahashi, JapanPurpose: To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients.Methods: Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42&...

  8. [Balneotherapy and spa therapy of rheumatic diseases in Turkey: a systematic review].

    Science.gov (United States)

    Karagülle, M Z; Karagülle, M

    2004-02-01

    Turkey has a lot of thermal and mineral springs and is looking back on a still vivid tradition of spa therapy and balneotherapy, applied especially for the treatment of rheumatic diseases. This tradition is predominantly empiric and intuitive, however, it has assumed some important aspects of modern balneotherapeutic methods as well. This article is aimed at presenting the characteristics of traditional and modern balneological and spa therapy forms in Turkey. The studies which have been conducted between 1990 and 2000 in different spas in Turkey on the efficacy and effectiveness of spa therapy and balneotherapy for rheumatic diseases have been searched and analyzed independent of their design. A descriptive evaluation of the studies was carried out. A total of 15 published studies have been found and analyzed. The investigations have been carried out in 8 different spa resorts in Turkey. In these studies the effectiveness and efficacy of different balneological and spa therapies on a variety of rheumatic diseases (from osteoarthritis to fibromyalgia and from rheumatoid arthritis to low back pain) could be shown. Nearly all studied balneotherapeutic modalities were applied as bathing cures. Only in one study peloid therapy was applied. Balneotherapeutic therapy was applied in a modern and traditional way, and both open and stationary spa therapy forms were used at the same time. The review has shown the effectiveness of the investigated spa therapy and balneotherapy forms. It could be concluded that nearly all forms of spa therapy and balneotherapy used for the treatment of rheumatic diseases in Turkey are effective. A definitive conclusion, however, is not possible because of the heterogeneity of the study designs, methodological flaws, and the publication bias. In future good quality randomized controlled trials are needed. Copyright 2004 S. Karger GmbH, Freiburg

  9. Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial

    Science.gov (United States)

    Forestier, R; Desfour, H; Tessier, J-M; Françon, A; Foote, A M; Genty, C; Rolland, C; Roques, C-F; Bosson, J-L

    2010-01-01

    Objective To determine whether spa therapy, plus home exercises and usual medical treatment provides any benefit over exercises and usual treatment, in the management of knee osteoarthritis. Methods Large multicentre randomised prospective clinical trial of patients with knee osteoarthritis according to the American College of Rheumatology criteria, attending French spa resorts as outpatients between June 2006 and April 2007. Zelen randomisation was used so patients were ignorant of the other group and spa personnel were not told which patients were participating. The main endpoint criteria were patient self-assessed. All patients continued usual treatments and performed daily standardised home exercises. The spa therapy group also received 18 days of spa therapy (massages, showers, mud and pool sessions). Main Endpoint The number of patients achieving minimal clinically important improvement (MCII) at 6 months, defined as ≥19.9 mm on the visual analogue pain scale and/or ≥9.1 points in a normalised Western Ontario and McMaster Universities osteoarthritis index function score and no knee surgery. Results The intention to treat analysis included 187 controls and 195 spa therapy patients. At 6 months, 99/195 (50.8%) spa group patients had MCII and 68/187 (36.4%) controls (χ2=8.05; df=1; p=0.005). However, no improvement in quality of life (Short Form 36) or patient acceptable symptom state was observed at 6 months. Conclusion For patients with knee osteoarthritis a 3-week course of spa therapy together with home exercises and usual pharmacological treatments offers benefit after 6 months compared with exercises and usual treatment alone, and is well tolerated. Trial registration number NCT00348777. PMID:19734131

  10. Hotel Online Marketing: The Bugibba Hotel, Radisson Blu Resort Malta, St. Julian's, Preluna Hotel & SPA

    OpenAIRE

    Dinh Quynh, Mai

    2013-01-01

    The thesis covers the study of online marketing theory, a very popular trend of marketing nowadays, especially Search Engine Optimization (SEO) and Google Adwords Campaign in the analyses of the online marketing practices of three hotels from different areas and standards in Malta, namely The Bugibba Hotel, Preluna Hotel & SPA and Radisson Blu Resort Malta, St. Julian’s. From the analyses, the thesis aims at suggesting Preluna Hotel & SPA optimal online marketing practices and answering t...

  11. Potentials for development of spa tourism in region of Cer Mountain: Western Serbia

    Directory of Open Access Journals (Sweden)

    Grčić Mirko

    2006-01-01

    Full Text Available Because of their particularities, thermal and mineral springs at the foothill of Cer Mountain deserve special analysis. This is the reason we wrote this article, aiming to take reader's attention to the touristic potentials of the spa zone of Cer Mountain and possibilities for its perspective development. From the medical and excursion-recreational tourism point of view, there is a possibility for combining the spa tourism with the complementary values of Cer Mountain.

  12. Romanian spa tourism: a communist paradigm in a post communist era

    OpenAIRE

    George Erdeli; Ana Irina Dincă; Aurel Gheorghilas; Camelia Surugiu

    2011-01-01

    Spa tourism is one of the oldest forms of tourism which continuously evolved in time as the leisure industry paradigm and the consumers’ behavior changed. Similar to other countries in Central and Eastern Europe, spa tourism is an old phenomenon in Romania which expanded to the dimensions of a well defined tourism industry during the mass tourism period which also corresponded to the communism epoch. Although severely affected by the major political and socio-economic changes which occurred a...

  13. Customer-Oriented and Eco-friendly Networks for Health Fashionable Goods – The CoReNet Approach

    OpenAIRE

    Azevedo , Américo; Bastos , João; Almeida , António; Soares , Carlos; Magaletti , Nicola; Grosso , Enrico ,; Stellmach , Dieter; Winkler , Marcus; Fornasiero , Rosanna; Zangiacomi , Andrea; Chiodi , Andrea

    2011-01-01

    Part 3: Value Chain for Enhancing Collaborative Networks; International audience; The design, production and distribution of small series of health fashionable goods for specific target groups of wide impact in terms of market for the European industry as elderly, disables, diabetics and obese people represents a challenging opportunity for European companies which are asked to supply the demand with affordable price and eco-compatible products. Added to this challenge, textile, clothing and ...

  14. Spa Treatment (Balneotherapy) for Fibromyalgia—A Qualitative-Narrative Review and a Historical Perspective

    Science.gov (United States)

    Ablin, Jacob N.; Buskila, Dan

    2013-01-01

    Aim. To perform a narrative review of spa therapy for management of the fibromyalgia syndrome (FMS), evaluating this traditional time-honored form of therapy in a historical perspective. Methods. Medline was searched using the terms “Spa therapy,” “Balneotherapy,” and “Fibromyalgia” between 1990 (year of ACR fibromyalgia criteria publication) and April 2013. The Cochrane database was also searched. Publications relating to the implementation of spa therapy and related practices over the centuries were identified through references, searched, and reviewed. Results. Reports of balneotherapy were described from diverse locations throughout Europe and Asia, and various forms of water-related therapy have been incorporated for many musculoskeletal indications. In the management of FMS, spa therapy has generally been shown to be well accepted and moderately effective for symptom reduction. Conclusion. While achieving high-quality evidence-based conclusions is difficult for complex natural therapies such as spa therapy, the existing evidence indicates a positive effect in management of FMS. In view of the long history of this modality in the management of rheumatic pain as well as the inherent difficulties related to pharmacological treatment, the role of spa therapy should currently be recognized as part of a therapeutic program for FMS. PMID:23983795

  15. Spa Treatment (Balneotherapy for Fibromyalgia—A Qualitative-Narrative Review and a Historical Perspective

    Directory of Open Access Journals (Sweden)

    Jacob N. Ablin

    2013-01-01

    Full Text Available Aim. To perform a narrative review of spa therapy for management of the fibromyalgia syndrome (FMS, evaluating this traditional time-honored form of therapy in a historical perspective. Methods. Medline was searched using the terms “Spa therapy,” “Balneotherapy,” and “Fibromyalgia” between 1990 (year of ACR fibromyalgia criteria publication and April 2013. The Cochrane database was also searched. Publications relating to the implementation of spa therapy and related practices over the centuries were identified through references, searched, and reviewed. Results. Reports of balneotherapy were described from diverse locations throughout Europe and Asia, and various forms of water-related therapy have been incorporated for many musculoskeletal indications. In the management of FMS, spa therapy has generally been shown to be well accepted and moderately effective for symptom reduction. Conclusion. While achieving high-quality evidence-based conclusions is difficult for complex natural therapies such as spa therapy, the existing evidence indicates a positive effect in management of FMS. In view of the long history of this modality in the management of rheumatic pain as well as the inherent difficulties related to pharmacological treatment, the role of spa therapy should currently be recognized as part of a therapeutic program for FMS.

  16. spa typing and antimicrobial resistance of Staphylococcus aureus from healthy humans, pigs and dogs in Tanzania.

    Science.gov (United States)

    Katakweba, Abdul Sekemani; Muhairwa, Amandus Pachificus; Espinosa-Gongora, Carmen; Guardabassi, Luca; Mtambo, Madundo M A; Olsen, John Elmerdahl

    2016-02-28

    Staphylococcus aureus is an opportunistic pathogen causing infections in humans and animals. Here we report for the first time the prevalence of nasal carriage, spa typing and antimicrobial resistance of S. aureus in a Tanzanian livestock community. Nasal swabs were taken from 100 humans, 100 pigs and 100 dogs in Morogoro Municipal. Each swab was enriched in Mueller Hinton broth with 6.5% NaCl and subcultured on chromogenic agar for S. aureus detection. Presumptive S. aureus colonies were confirmed to the species level by nuc PCR and analysed by spa typing. Antimicrobial susceptibility patterns were determined by disc diffusion method. S. aureus was isolated from 22% of humans, 4% of pigs and 11% of dogs. A total of 21 spa types were identified: 13, 7 and 1 in human, dogs, and pigs, respectively. Three spa types (t314, t223 and t084) were shared between humans and dogs. A novel spa type (t10779) was identified in an isolate recovered from a colonized human. Antimicrobials tested revealed resistance to ampicillin in all isolates, moderate resistances to other antimicrobials with tetracycline resistance being the most frequent. S. aureus carrier frequencies in dogs and humans were within the expected range and low in pigs. The S. aureus spa types circulating in the community were generally not shared by different hosts and majority of types belonged to known clones. Besides ampicillin resistance, moderate levels of antimicrobial resistance were observed irrespective of the host species from which the strains were isolated.

  17. Spa47 is an oligomerization-activated type three secretion system (T3SS) ATPase from Shigella flexneri.

    Science.gov (United States)

    Burgess, Jamie L; Jones, Heather B; Kumar, Prashant; Toth, Ronald T; Middaugh, C Russell; Antony, Edwin; Dickenson, Nicholas E

    2016-05-01

    Gram-negative pathogens often use conserved type three secretion systems (T3SS) for virulence. The Shigella type three secretion apparatus (T3SA) penetrates the host cell membrane and provides a unidirectional conduit for injection of effectors into host cells. The protein Spa47 localizes to the base of the apparatus and is speculated to be an ATPase that provides the energy for T3SA formation and secretion. Here, we developed an expression and purification protocol, producing active Spa47 and providing the first direct evidence that Spa47 is a bona fide ATPase. Additionally, size exclusion chromatography and analytical ultracentrifugation identified multiple oligomeric species of Spa47 with the largest greater than 8 fold more active for ATP hydrolysis than the monomer. An ATPase inactive Spa47 point mutant was then engineered by targeting a conserved Lysine within the predicted Walker A motif of Spa47. Interestingly, the mutant maintained a similar oligomerization pattern as active Spa47, but was unable to restore invasion phenotype when used to complement a spa47 null S. flexneri strain. Together, these results identify Spa47 as a Shigella T3SS ATPase and suggest that its activity is linked to oligomerization, perhaps as a regulatory mechanism as seen in some related pathogens. Additionally, Spa47 catalyzed ATP hydrolysis appears to be essential for host cell invasion, providing a strong platform for additional studies dissecting its role in virulence and providing an attractive target for anti-infective agents. © 2016 The Protein Society.

  18. Health and imaging outcomes in axial spondyloarthritis

    NARCIS (Netherlands)

    Machado, P.M.

    2016-01-01

    This thesis focuses on the assessment and monitoring of health and imaging outcomes in axial spondyloarthritis (SpA) and the relationship between these outcomes. Four major contributions to the understanding and management of axial SpA were made: 1) the improvement and facilitation of the assessment

  19. MxiN Differentially Regulates Monomeric and Oligomeric Species of the Shigella Type Three Secretion System ATPase Spa47.

    Science.gov (United States)

    Case, Heather B; Dickenson, Nicholas E

    2018-04-17

    Shigella rely entirely on the action of a single type three secretion system (T3SS) to support cellular invasion of colonic epithelial cells and to circumvent host immune responses. The ATPase Spa47 resides at the base of the Shigella needle-like type three secretion apparatus (T3SA), supporting protein secretion through the apparatus and providing a likely means for native virulence regulation by Shigella and a much needed target for non-antibiotic therapeutics to treat Shigella infections. Here, we show that MxiN is a differential regulator of Spa47 and that its regulatory impact is determined by the oligomeric state of the Spa47 ATPase, with which it interacts. In vitro and in vivo characterization shows that interaction of MxiN with Spa47 requires the six N-terminal residues of Spa47 that are also necessary for stable Spa47 oligomer formation and activation. This interaction with MxiN negatively influences the activity of Spa47 oligomers while upregulating the ATPase activity of monomeric Spa47. Detailed kinetic analyses of monomeric and oligomeric Spa47 in the presence and absence of MxiN uncover additional mechanistic insights into the regulation of Spa47 by MxiN, suggesting that the MxiN/Spa47 species resulting from interaction with monomeric and oligomeric Spa47 are functionally distinct and that both could be involved in Shigella T3SS regulation. Uncovering regulation of Spa47 by MxiN addresses an important gap in the current understanding of how Shigella controls T3SA activity and provides the first description of differential T3SS ATPase regulation by a native T3SS protein.

  20. Spa typing and identification of pvl genes of meticillin-resistant Staphylococcus aureus isolated from a Libyan hospital in Tripoli.

    Science.gov (United States)

    Ahmed, Mohamed O; Baptiste, Keith E; Daw, Mohamed A; Elramalli, Asma K; Abouzeed, Yousef M; Petersen, Andreas

    2017-09-01

    The purpose of the study was to investigate the molecular characteristics of meticillin-resistant Staphylococcus aureus (MRSA) isolated from clinical sources in Tripoli, Libya. A total of 95 MRSA strains collected at the Tripoli medical Centre were investigated by spa typing and identification of the Panton-Valentine Leukocidin (pvl) genes. A total of 26 spa types were characterized and distributed among nine clonal complexes; CC5 (n=32), CC80 (n=18), CC8 (n=17) and CC22 (n=12) were the most prevalent clonal complexes. In total, 34% of the isolates were positive for PVL. This study demonstrated the presence of CA-MRSA and pvl positive strains in hospital settings and underlines the importance of using molecular typing to investigate the epidemiology of MRSA. Preventative measures and surveillance systems are needed to control and minimize the spread of MRSA in the Libyan health care system. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  1. Common Health Risks, Required Precautions of Travelers and their Customs Towards the Use of Travel Medicine Services.

    Science.gov (United States)

    Roupa, Zoe; Zikos, Dimitrios; Vasilopoulos, Aristides; Diomidous, Marianna

    2012-01-01

    There is an increasing number of people who travel around the world. Every traveler is exposed to nearly all infectious risks which may occur during his travel time. Some of the main risk factors can be water quality, temperature and high humidity and the exposure to multi-resistant microorganisms. To tackle the upcoming problem there is an imperative need to develop a new branch of medicine with the name of travel medicine. A consultation prior to departure for an upcoming trip is required, focusing to a personalized healthcare plan, based on international scientific protocols and epidemiological studies.Travelers must acquire essential information about the prevailing hygiene conditions and climatic differentiations that occur in the region. Additionally there are several health risks upon the arrival at destination. A scheduled visit to a health professional is necessary, especially in the case of travelers suffering from chronic diseases or those taking medication, while vaccination is considered essential for specific destination countries. Healthcare professionals should be able to inform travelers and evaluate their needs. According to research studies on notion and attitudes travelers' specific risks, only few of them are well-informed during a trip. While most studies indicate that travelers have some kind of pre travel medical consultation, not all of them proceed to the required vaccinations and medications. Travelling for business or leisure around the world may be unhealthy. The importance of proper preparation prior to the travel requires to be adequately informed by specialized healthcare professionals, and to receive appropriate vaccinations and medications, when required. The results of the review of notions and attitudes of travelers during the trip indicate not only the need for further development of the branch of travel medicine but especially the need for the expansion and the availability of health services.

  2. Pengaruh Customer Relationship Management (Crm) Terhadap Customer Satisfaction Dan Customer Loyalty Pada Pelanggan Matahari Department Store

    OpenAIRE

    Ham, Meyske

    2016-01-01

    This study was conducted to determine the effect Benefits of Customer Relationship Management and Customer satisfation to Customer Loyalty in Customers Matahari Department Store. Customer relationship management (CRM) is part of a marketing strategy to get satisfaction and increase customer loyalty. CRM and customer satisfaction can encourage customer loyalty where customers do not easily switch to other companies. The population is all customers Matahari Department Store, and the sample are ...

  3. Spa as Arena of Career Woman Resistance to Patriarch Domination

    Directory of Open Access Journals (Sweden)

    Bhernadetta Pravita Wahyuningtyas

    2011-04-01

    Full Text Available This study examines the career women who use the habit of treating the body through the routine of coming to spas, which aims to overcome the dominance of patriarchy. This study uses several concepts. First, muted group theory, which states that woman, is the one that silenced; so to overcome this condition, women should perform self-transformation. The transformation is aligned with the second concept, feminist existentialist, which defines the transformation as the change of a woman concept from Other to Self. The transformation can be achieved not only by working outside the domestic sphere, but also supported by a good appearance through a complete body treatment. Grooming habits acquired through socialization that derived in woman since their childhood. The socialization is about how women as a person who is considered weak by the world of patriarchal domination using the power of their beauty to master, subdue, and break the domination in her life. Then, with their good appearance, woman can express their existence in everything that they do from object become subject. Spa and the whole result of the activities contained in it then consciously become a way of resistance that being used by the career woman against the domination of patriarchy which overshadowing their lives. 

  4. The design of the spa - tourist recreational complex

    Directory of Open Access Journals (Sweden)

    Alenka Fikfak

    2012-01-01

    Full Text Available The study area lies in the central part of Bela Krajina in south-eastern Slovenia, between the town of Črnomelj and the border crossing at Vinica. It is situated in the vicinity of the Lahinja Landscape Park, where natural and cultural heritage sites interact in the interesting settings of preserved towns and villages. The urban planning concept developed at the workshop was based on the idea that the best space is one where the qualities of "empty spaces" and a fusion with the landscape are recognised. The concept was based on the design of a complex with several connecting structures. A green clearing was defined as the centre of activities, i.e. the core of the activity and pivot of life being the common point of all structures: it is empty, intended to allow for random connections, network organisation or spatial networking, where the key points in the built and natural structures are connected, hence representing the main communication hub between the individual structures. The concept complements the system with accommodation capacities, which are also located outside the spa complex, providing attractive accommodation in a natural setting.

  5. Biological properties of mud extracts derived from various spa resorts.

    Science.gov (United States)

    Spilioti, Eliana; Vargiami, Margarita; Letsiou, Sophia; Gardikis, Konstantinos; Sygouni, Varvara; Koutsoukos, Petros; Chinou, Ioanna; Kassi, Eva; Moutsatsou, Paraskevi

    2017-08-01

    Spa resorts are known for thousands of years for their healing properties and have been empirically used for the treatment of many inflammatory conditions. Mud is one of the most often used natural materials for preventive, healing and cosmetic reasons and although it has been used since the antiquity, little light has been shed on its physical, chemical and biological properties. In this study we examined the effect of mud extracts on the expression of adhesion molecules (CAMs) by endothelial cells as well as their effects on monocyte adhesion to activated endothelial cells. Most of mud extracts inhibited the expression of VCAM-1 by endothelial cells and reduced monocyte adhesion to activated endothelial cells, indicating a potent anti-inflammatory activity. Furthermore, the mud extracts were tested for their antimicrobial activity; however, most of them appeared inactive against S. aureus and S. epidermidis. One of the mud extracts (showing the best stabilization features) increased significantly the expression of genes involved in cell protection, longevity and hydration of human keratinocytes, such as, collagen 6A1, forkhead box O3, sirtuin-1, superoxide dismutase 1 and aquaporin-3. The present study reveals that mud exerts important beneficial effects including anti-inflammatory and anti-aging activity as well as moisturizing effects, implicating important cosmeceutical applications.

  6. Study of spa and geology in Nagano pref

    Energy Technology Data Exchange (ETDEWEB)

    Iijima, Namio

    1987-03-20

    After due consideration of magma activities, spars and the horizontal movement involved in the formation of the Japanese Archipelago, magma generation and plate theory under the Japanese Archipelago were studied comprehensively. Many spars in the Japanese North Alpine mountains, which are located in old rock areas, were mainly gushed out from new-period granite. Thus, they were presumed to be caused by volcanos from Hakuba-Norikura to Ontake. There are also several spas on the Central Upheaval Zone which are new lock area spas. This zone is characterized by focused volcanism which occurred during the time from the Tertiary period to the Quaternary period of the diluival epoch. Especially, the northern part of the zone has many high-temperature spas above 50/sup 0/C. Moreover, at the southern end of this zone, special geological features which prove that the Philippine plate and the Pacific plate are sunk under the Japanese Archipelago were found. It was also estimated that Nagano Prefecture has no spa caused by volcanism of acidic plutonic rocks from the the later Mesozoic era to the early Cenozoic era. (3 figs, 1 tab, 27 refs)

  7. Customer-to-customer roles and impacts in service encounters

    OpenAIRE

    Lee, Linda

    2016-01-01

    This thesis investigates customer-to-customer roles and impacts in the context of service encounters. This topic is studied from two angles: customer interactions during group service encounters and customer perceptions post service encounters. The first angle is a focus on group service encounters that addresses the lack of research on customer-to-customer interactions that occur in customer-to-customer interaction-intensive contexts. These are contexts where the interactions between custome...

  8. Mass Customization Measurements Metrics

    DEFF Research Database (Denmark)

    Nielsen, Kjeld; Brunø, Thomas Ditlev; Jørgensen, Kaj Asbjørn

    2014-01-01

    A recent survey has indicated that 17 % of companies have ceased mass customizing less than 1 year after initiating the effort. This paper presents measurement for a company’s mass customization performance, utilizing metrics within the three fundamental capabilities: robust process design, choice...... navigation, and solution space development. A mass customizer when assessing performance with these metrics can identify within which areas improvement would increase competitiveness the most and enable more efficient transition to mass customization....

  9. [Customer orientation in ambulant medicine].

    Science.gov (United States)

    Heinrich, M

    2014-07-01

    Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications. Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis. The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer. The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict. Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of

  10. Rationalization of indigenous male circumcision as a sacred religious custom: health beliefs of Xhosa men in South Africa.

    Science.gov (United States)

    Mavundla, Thandisizwe Redford; Netswera, Fulufelo Godfrey; Bottoman, Brian; Toth, Ferenc

    2009-10-01

    This article presents research findings based on the meaning of indigenous circumcision to Xhosa men in South Africa. In South Africa, male circumcision is a rite of passage from adolescence to adulthood. The country has experienced serious problems associated with the practice of this rite ranging from dehydration to death in the traditional "bush" circumcision schools. A qualitative, endogenous research "How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

  11. Understanding customer experience.

    Science.gov (United States)

    Meyer, Christopher; Schwager, Andre

    2007-02-01

    Anyone who has signed up for cell phone service, attempted to claim a rebate, or navigated a call center has probably suffered from a company's apparent indifference to what should be its first concern: the customer experiences that culminate in either satisfaction or disappointment and defection. Customer experience is the subjective response customers have to direct or indirect contact with a company. It encompasses every aspect of an offering: customer care, advertising, packaging, features, ease of use, reliability. Customer experience is shaped by customers' expectations, which largely reflect previous experiences. Few CEOs would argue against the significance of customer experience or against measuring and analyzing it. But many don't appreciate how those activities differ from CRM or just how illuminating the data can be. For instance, the majority of the companies in a recent survey believed they have been providing "superior" experiences to customers, but most customers disagreed. The authors describe a customer experience management (CEM) process that involves three kinds of monitoring: past patterns (evaluating completed transactions), present patterns (tracking current relationships), and potential patterns (conducting inquiries in the hope of unveiling future opportunities). Data are collected at or about touch points through such methods as surveys, interviews, focus groups, and online forums. Companies need to involve every function in the effort, not just a single customer-facing group. The authors go on to illustrate how a cross-functional CEM system is created. With such a system, companies can discover which customers are prospects for growth and which require immediate intervention.

  12. A checklist to assess the quality of reports on spa therapy and balneotherapy trials was developed using the Delphi consensus method: the SPAC checklist.

    Science.gov (United States)

    Kamioka, Hiroharu; Kawamura, Yoichi; Tsutani, Kiichiro; Maeda, Masaharu; Hayasaka, Shinya; Okuizum, Hiroyasu; Okada, Shinpei; Honda, Takuya; Iijima, Yuichi

    2013-08-01

    The purpose of this study was to develop a checklist of items that describes and measures the quality of reports of interventional trials assessing spa therapy. The Delphi consensus method was used to select the number of items in the checklist. A total of eight individuals participated, including an epidemiologist, a clinical research methodologist, clinical researchers, a medical journalist, and a health fitness programmer. Participants ranked on a 9-point Likert scale whether an item should be included in the checklist. Three rounds of the Delphi method were conducted to achieve consensus. The final checklist contained 19 items, with items related to title, place of implementation (specificity of spa), care provider influence, and additional measures to minimize the potential bias from withdrawals, loss to follow-up, and low treatment adherence. This checklist is simple and quick to complete, and should help clinicians and researchers critically appraise the medical and healthcare literature, reviewers assess the quality of reports included in systematic reviews, and researchers plan interventional trials of spa therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Hydrogeothermal resources in spa areas of Serbia: Main properties and possible improvement of use

    Directory of Open Access Journals (Sweden)

    Dokmanović Petar B.

    2012-01-01

    Full Text Available Geological complexity of the territory of Serbia is a world curiosity: six main geo-tectonic regions and tens sub-regions are delineated in a small area of 88,000 km2. Geologic origin and regional structure of some areas has long been the subject of discussion. Notable magmatism and associated tectonic events in the Earth's crust provided for a fairly large hydrogeothermal resource potential, which is manifested in more than 250 warm (mainly mineral springs and more than 100 hydrothermal wells. Thermal springs and wells together discharge some 5 m3/s. This potential is used in part for balneal therapy (waters differ in temperature and chemical composition in the spa areas of Serbia. The amounts of thermal water unused therapeutically or the amounts of heat energy from unused geo-thermal water may be used in almost all spas for space heating/cooling and thus increase the efficiency of the thermal water energy utilization. This also will be cost-effective, reduce emission of noxious gases, and improve the environmental-health image of the resorts. The hydrogeothermal resources are described for 29 spas with 700 l/s total discharge capacity of water temperature between 25°C and 96ºC, or an overall heat energy of 78.40 MWt. Feasibility of additional energy utilization of thermal water in spas is generally considered.

  14. The role of open-air inhalatoria in the air quality improvement in spa towns.

    Science.gov (United States)

    Burkowska-But, Aleksandra; Kalwasińska, Agnieszka; Brzezinska, Maria Swiontek

    2014-08-01

    The present study was aimed at evaluating microbiological contamination of air in Ciechocinek and Inowrocław - Polish lowland spa towns. Additionally, the impact of open-air inhalatoria on the quality of air was evaluated. Air samples were collected seasonally in the urban areas, in the recreation areas and in the vicinity of inhalatoria in both towns using impaction. The numbers of mesophilic bacteria, staphylococci, hemolytic bacteria and actinomycetes were determined on media according to the Polish Standard PN-86/Z-04111/02. The number of moulds was determined on media according to the Polish Standard PN-86/Z-04111/03. While the highest numbers of microorganisms were noted at the sites located in the urban areas, the lowest numbers were noted in the vicinity of the open-air inhalatoria. In all the investigated air samples the values of bioaerosol concentrations were below the recommended TLVs (≤ 5000 CFU×m(-3) for both bacteria and fungi in outdoor environments). Location of the sampling site was invariably a decisive factor in determining the number of microorganisms in the air. The aerosol which is formed in the open-air inhalatoria has a positive influence on microbiological air quality. Owing to a unique microclimate and low air contamination, Ciechocinek and Inowrocław comply with all necessary requirements set for health resorts specializing in treating upper respiratory tract infections.

  15. Is Mass Customization Sustainable?

    DEFF Research Database (Denmark)

    Petersen, Thomas Ditlev; Jørgensen, Kaj Asbjørn; Nielsen, Kjeld

    2011-01-01

    Mass customizers are like other companies currently experiencing an increasing customer demand for environmentally sustainable products as well as an increasingly strict legislation regarding environmental sustainability. This paper addresses the issue whether the concepts mass customization...... and sustainability are fundamentally compatible by asking the question: can a mass customized product be sustainable? Several factors could indicate that mass customized products are less sustainable than standardized products; however other factors suggest the opposite. This paper explores these factors during...... three life cycle phases for a product: Production, Use and End of Life. It is concluded that there is not an unambiguous causal relationship between mass customization and sustainability; however several factors unique to mass customized products are essential to consider during product and process...

  16. Treatment with mPEG-SPA improves the survival of corneal grafts in rats by immune camouflage.

    Science.gov (United States)

    Wang, Shuangyong; Li, Liangliang; Liu, Ying; Li, Chaoyang; Zhang, Min; Wang, Bowen; Huang, Zheqian; Gao, Xinbo; Wang, Zhichong

    2015-03-01

    We investigated the immune camouflage effects of methoxy polyethylene glycol succinimidyl propionate (mPEG-SPA) on corneal antigens and explored a novel approach for reducing corneal antigenicity, thereby decreasing corneal graft rejection. Importantly, this approach did not alter normal local immunity. Corneal grafts were treated with mPEG-SPA 5KD or 20KD (3% W/V), which could shield major histocompatibility antigen class I molecules (RT1-A) of corneal grafts. Skin grafts of Wistar rats were transplanted to SD rats. Then the splenic lymphocytes were isolated from SD rats. Subsequently, the lymphocytes were co-cultured with autologous corneal grafts or untreated corneal grafts and PEGylated grafts treated with mPEG-SPA 5KD or 20KD obtained from the counterpart skin donors, which were used as autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group, respectively. Lymphocyte proliferation was lower in mPEG-SPA 5KD group and mPEG-SPA 20KD group than in the allogeneic control. SD rats with corneal neovascularisation were used as recipients for high-risk corneal transplantation and were randomly divided into four groups: autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group. The recipients received corneal grafts from Wistar rats. Corneal graft survival was prolonged and graft rejection was reduced in the mPEG-SPA 5KD group and the mPEG-SPA 20KD group compared to the allogeneic control. Thus, we think that mPEG-SPA could immunologically camouflage corneal antigens to prolong corneal grafts survival in high-risk transplantation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Use of qualitative methods and user-centered design to develop customized health information technology tools within federally qualified health centers to keep children insured.

    Science.gov (United States)

    DeVoe, Jennifer; Angier, Heather; Likumahuwa, Sonja; Hall, Jennifer; Nelson, Christine; Dickerson, Kay; Keller, Sara; Burdick, Tim; Cohen, Deborah

    2014-01-01

    Lack of health insurance negatively impacts children's health. Despite federal initiatives to expand children's coverage and accelerate state outreach efforts, millions of US children remain uninsured or experience frequent gaps in coverage. Most current efforts to enroll and retain eligible children in public insurance programs take place outside of the health care system. This study is a partnership between patients' families, medical informaticists, federally qualified health center (FQHC) staff, and researchers to build and test information technology tools to help FQHCs reach uninsured children and those at risk for losing coverage.

  18. Role of surfactant protein A (SP-A)/lipid interactions for SP-A functions in the lung.

    Science.gov (United States)

    Casals, C

    2001-01-01

    Surfactant protein A (SP-A), an oligomeric glycoprotein, is a member of a group of proteins named collectins that contain collagen-like and Ca(2+)-dependent carbohydrate recognition domains. SP-A interacts with a broad range of amphipathic lipids (glycerophospholipids, sphingophospholipids, glycosphingolipids, lipid A, and lipoglycans) that are present in surfactant or microbial membranes. This review summarizes SP-A/lipid interaction studies regarding the lipid system used (i.e., phospholipid vesicles, phospholipid monolayers, and lipids immobilized on silica or adsorbed on a solid support). The effect of calcium, ionic strength, and pH on the binding of SP-A to lipids and the subsequent lipid aggregation process is discussed. Current evidence suggests that hydrophobic-binding forces are involved in the peripherical association of SP-A to membranes. It is also proposed that fluid and liquid-ordered phase coexistence in surfactant membranes might favor partition of SP-A into those membranes. The binding of SP-A to surfactant membranes containing hydrophobic surfactant peptides makes possible the formation of a membrane reservoir in the alveolar fluid that is protected by SP-A against inactivation and improves the rate of surfactant film formation. In addition, the interaction of SP-A with membranes might enhance the affinity of SP-A for terminal carbohydrates of glycolipids or glycoproteins on the surface of invading microorganisms.

  19. Provider Customer Service Program - Performance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is continuously analyzing performance and quality of the Provider Customer Service Programs (PCSPs) of the contractors and will be identifying trends and making...

  20. Analysis of the radioactivity in the 'Elguea' spa, Villa Clara, Cuba

    International Nuclear Information System (INIS)

    Fernandez G, I.M.; Zerquera, J.T.; Carrazana G, J.; Capote F, E.; Rodriguez C, G.

    2006-01-01

    The 'Elguea' spa, located in the north coast of the county of Villa Clara, Cuba, is considered one of those more important spas of Latin America. The waters of this spa are rich in salts of chlorine, sodium, bromine, sulfides and its contain radon. As a result of measurements of environmental gamma dose rates carried out in the area of the spa, its were considered levels of dose between 0.13 and 2.3 mSv. The obtained results motivated that it was carried out a characterization, from the radiological point of view, of the spa. This characterization is of supreme importance to be able to evaluate the impact that it has and the discharges of its waters on the environment, as well as, those dose that the population potentially affected can receive by these discharges. With this end its were carried out quantitative determinations of those existent natural more significant radionuclides in different environmental objects coming from the area of the spa and its surroundings, as well as one characterization gamma 'in situ' of the same one. The obtained results are present in this work. (Author)

  1. Assesment of customer relationship development

    OpenAIRE

    Dagmar Lesáková

    2011-01-01

    The focus of this paper is customer relationship marketing and its new trends. The particular goal of the presented research study was to identify and analyse the indicators of customer relationship development in human resources recruitment / leasing companies. Nine indicators have been explored: mission statement concerning customer commitment, customer attraction, customer commitment, development of customer value, understanding customer needs, goals for customer satisfaction, after sales ...

  2. The case for customer loyalty.

    Science.gov (United States)

    Sturm, Arthur C

    2004-09-01

    How does customer loyalty grow? Through good customer experiences. Yet some organizations seem to genuinely fail to understand that they can keep or lose a customer in the proverbial blink of an eye. And in this era of increasing customer demands across all industries, it's important that healthcare financial managers understand the correlation between customer loyalty and customer experience.

  3. Customer satisfaction research

    Energy Technology Data Exchange (ETDEWEB)

    Tormasi, T

    1987-03-01

    A review of four aspects of the Gas and Fuel Corporation of Victoria's study of customer satisfaction covers: (1) corporate goals to meet its responsibility as a public utility and operate as a successful marketing organization, (2) the history of customer satisfaction research by GFC, (3) measurements of customer satisfaction through expectations research, and (4) case studies involving domestic appliance maintenance and gas mains renewal. Continuous validation of GFC's policies and procedures is the basis for future growth and success. 3 tables.

  4. Developing customer databases.

    Science.gov (United States)

    Rao, S K; Shenbaga, S

    2000-01-01

    There is a growing consensus among pharmaceutical companies that more product and customer-specific approaches to marketing and selling a new drug can result in substantial increases in sales. Marketers and researchers taking a proactive micro-marketing approach to identifying, profiling, and communicating with target customers are likely to facilitate such approaches and outcomes. This article provides a working framework for creating customer databases that can be effectively mined to achieve a variety of such marketing and sales force objectives.

  5. Customization and Customer-Product Learning

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn

    2011-01-01

    , through the performance level and the experience level to the learning level at the top. This model has a dual view with customers/demand at one side and product/supplier at the other side. It is developed so that it can be generally applied and, typically, product designers must decide how far up...... in levels the customisation should aim. This paper sets special focus on the upper levels of customisation, especially the learning level, and it is shown that products with a large range of user-oriented functionalities often require much training to use and that customers on the other hand are sometimes...

  6. Companies and the customers who hate them.

    Science.gov (United States)

    McGovern, Gail; Moon, Youngme

    2007-06-01

    Why do companies bind customers with contracts, bleed them with fees, and baffle them with fine print? Because bewildered customers, who often make bad purchasing decisions, can be highly profitable. Most firms that profit from customers' confusion are on a slippery slope. Over time, their customer-centric strategies for delivering value have evolved into company-centric strategies for extracting it. Not surprisingly, when a rival comes along with a friendlier alternative, customers defect. Adversarial value-extracting strategies are common in such industries as cell phone service, retail banking, and health clubs. Overly complex product and pricing options, for example, may have been designed to serve various segments. But in fact they take advantage of how difficult it is for customers to predict their needs (such as how many cell phone minutes they'll use each month) and make it hard for them to choose the right product. Similarly, penalties and fees, which may have been instituted to offset the costs of undesirable customer behavior, like bouncing checks, turn out to be very profitable. As a result, companies have no incentive to help customers avoid them. Tactics like these generate bad publicity and fuel customer defections, creating opportunities for competitors. Virgin Mobile USA, for example, has lured millions of angry cell phone customers away from the incumbents by offering a straightforward plan with no hidden fees, no time-of-day restrictions, and no contracts. ING Direct, now the fourth-largest thrift bank in the United States, offers accounts with no fees, no tiered interest rates, and no minimums. In industries where squeezing value from customers is commonplace, companies that dismantle these harmful practices and design a transparent, value-creating offer can head off customer retaliation and spur rapid growth.

  7. Molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from patients with bacteremia based on MLST, SCCmec, spa, and agr locus types analysis.

    Science.gov (United States)

    Goudarzi, Mehdi; Seyedjavadi, Sima Sadat; Nasiri, Mohammad Javad; Goudarzi, Hossein; Sajadi Nia, Raheleh; Dabiri, Hossein

    2017-03-01

    The widespread emergence of methicillin resistant Staphylococcus aureus, as a common cause of nosocomial infections, is becoming a serious concern in global public health. The objective of the present study was to investigate antimicrobial susceptibility pattern, frequency of virulence genes and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated from patients with bacteremia. A total of 128 methicillin-resistant Staphylococcus aureus isolates were collected during February 2015 to January 2016. In vitro antimicrobial susceptibility of the isolates was assessed using the disk diffusion method. Conventional PCR was performed for the detection of adhesion (can, bbp, ebp, fnbB, fnbA, clfB, clfA) and toxin (etb, eta, pvl, tst) encoding genes, determining the agr type, SCCmec, MLST and spa typing of the isolates. All the methicillin-resistant Staphylococcus aureus isolates were found to be sensitive to linezolid, teicoplanin, and vancomycin. Resistance to the tested antibiotics varied from 97.7% for penicillin to 24.2% for mupirocin. The rate of multi drug resistance (MDR) in the present study was 97.7%. The most commonly detected toxin and adhesion genes were tst (58.6%), and clfB (100%), respectively. The majority of SCCmec III isolates were found in agr group I while SCCmec IV and II isolates were distributed among agr group III. Multilocus Sequence Typing (MLST) of the MRSA isolates showed five different sequence types: ST239 (43%), ST22 (39.8%), ST585 (10.9%), ST45 (3.9%) and ST240 (2.3%). All of the pvl positive strains belonged to ST22-SCCmec IV/t790 clone and were MDR. Among different 7 spa types, the most common were t790 (27.3%), t037 (21.9%), and t030 (14.1%). spa types t016, t924 and spa type t383 were reported for the first time from Asia and Iran, respectively. It was shown that spa types circulating in the studied hospitals varied which support the need to perform future surveillance studies in order to understand

  8. IMPLEMENTATION OF EU DIRECTIVES FOR CERTIFICATION OF THE STAFF IN THE SPA BUSINESS IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Petya Kutincheva

    2013-07-01

    Full Text Available Implemented was a psychometric experiment for survey the opinion of the leading experts from the 4 and 5 stars hotels and the first SPA certified MSc - SPA managers. The summarized results from the study highlight that the priorities are related to improve the quality of the services in the SPA business. We establish the acute need for increasing professional qualification of the personnel and harmonize the Bulgarian legislation with the EU directives. In this regard it is important to implement the national classificatory with new professions and unified for this purpose the theoretical categories: “Results of advanced training", "knowledge", "practical skills" and "competencies" in educational and qualification degree: “Bachelor", "MasterSc" and "PhD ".

  9. Market segment of families with children: a new stimulus for modern Czech spa industry?

    Directory of Open Access Journals (Sweden)

    Darina Jelínková

    2017-06-01

    Full Text Available The paper deals with a comprehensive range of hotel services for families with children at spa facilities of the Czech Republic, in line with current trends and requirements of this market segment. The main goal of this paper is to determine the preferences, needs and requirements of families with children in terms of amenities and services offer at spa hotels designated specifically for this target group. The secondary goal is to determine the current state of hotel services and facilities of Czech First Class hotels, which are the holders of the Baby Friendly Certificate. Subsequently, service offerings of these spa hotels are compared with the existing range of services for families with children in the selected Czech spas. In conclusion, based on the information obtained from the analyses and marketing research, a solution of the services portfolio intended for the market segment of families with children is recommended here using marketing mix as applied to tourism.

  10. spa typing and antimicrobial resistance of Staphylococcus aureus from healthy humans, pigs and dogs in Tanzania

    DEFF Research Database (Denmark)

    Katakweba, Abdul S.; Muhairwa, Amandus P.; Espinosa-Gongora, Carmen

    2016-01-01

    . aureus carrier frequencies in dogs and humans were within the expected range and low in pigs. The S. aureus spa types circulating in the community were generally not shared by different hosts and majority of types belonged to known clones. Besides ampicillin resistance, moderate levels of antimicrobial......Introduction: Staphylococcus aureus is an opportunistic pathogen causing infections in humans and animals. Here we report for the first time the prevalence of nasal carriage, spa typing and antimicrobial resistance of S. aureus in a Tanzanian livestock community. Methodology: Nasal swabs were taken...... from 100 humans, 100 pigs and 100 dogs in Morogoro Municipal. Each swab was enriched in Mueller Hinton broth with 6.5% NaCl and subcultured on chromogenic agar for S. aureus detection. Presumptive S. aureus colonies were confirmed to the species level by nuc PCR and analysed by spa typing...

  11. Romanian spa tourism: a communist paradigm in a post communist era

    Directory of Open Access Journals (Sweden)

    George Erdeli

    2011-11-01

    Full Text Available Spa tourism is one of the oldest forms of tourism which continuously evolved in time as the leisure industry paradigm and the consumers’ behavior changed. Similar to other countries in Central and Eastern Europe, spa tourism is an old phenomenon in Romania which expanded to the dimensions of a well defined tourism industry during the mass tourism period which also corresponded to the communism epoch. Although severely affected by the major political and socio-economic changes which occurred after the Revolution in 1989, this industry coexists with new emergent forms of tourism orienting, itself towards new dimensions embraced by the contemporary leisure consumerism (e.g. medical tourism, cosmetic treatments. Lying on considerable balneal and climate resources and displaying an important communist heritage both in physical terms (large and massive tourism structures and in virtual and psychological terms (social supportive ticket granting system, Romanian spa tourism faces various challenges in the attempt to adapt in a new tourism era.

  12. The Mental Health Recovery Measure can be used to assess aspects of both customer-based and service-based recovery in the context of severe mental illness

    OpenAIRE

    Albino J Oliveira-Maia; Albino J Oliveira-Maia; Albino J Oliveira-Maia; Albino J Oliveira-Maia; Carina Mendonça; Marta Camacho; Maria João Pessoa; Joaquim Gago; Joaquim Gago

    2016-01-01

    Within clinical psychiatry, recovery from severe mental illness has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs...

  13. The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness

    OpenAIRE

    Oliveira-Maia, Albino J.; Mendon?a, Carina; Pessoa, Maria J.; Camacho, Marta; Gago, Joaquim

    2016-01-01

    Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namel...

  14. Membangun Customer Loyalty Nasabah Bank melalui Customer Satisfaction

    OpenAIRE

    Sumarto, Sumarto

    2007-01-01

    In the relation between bank and its customer, the bank should to capable to fulfill need and satisfy through services and create the value to the customer. So in the compete situation, to give customer satisfaction is main duty of bank in order that the customer loyal permanently. The customer satisfaction is primary cause for building customer loyalty. More and more loyal customer to the bank, that's indicate the service superiority of its bank. Base description above this research purpose...

  15. Spa therapy: can be a valid option for treating knee osteoarthritis?

    Science.gov (United States)

    Tenti, Sara; Cheleschi, Sara; Galeazzi, Mauro; Fioravanti, Antonella

    2015-08-01

    Osteoarthritis (OA) continues to be one of the leading causes of `years lived with disability' worldwide. Symptomatic knee OA is highly prevalent among people aged 50 years and over and is destined to become an ever more important healthcare problem. Current management of knee OA includes non-pharmacological and pharmacological treatments. Spa therapy is one of the most commonly used non-pharmacological approaches for OA in many European countries, as well as in Japan and Israel. Despite its long history and popularity, spa treatment is still the subject of debate and its role in modern medicine continues to be unclear. The objective of this review is to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in knee OA. Various randomized controlled clinical trials (RCTs) were conducted to assess the efficacy and tolerability of balneotherapy and mud-pack therapy in patients with knee OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in knee OA that lasts over time, until 6-9 months after the treatment. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviate suffering in OA are not fully understood. The net benefit is probably the result of a combination of factors, among which the mechanical, thermal and chemical effects are most prominent. In conclusion, spa therapy seems to have a role in the treatment of knee OA. Additional RCTs and further studies of mechanisms of action with high methodological quality are necessary to prove the effects of spa therapy.

  16. Focusing on customer service.

    Science.gov (United States)

    1996-01-01

    This booklet is devoted to a consideration of how good customer service in family planning programs can generate demand for products and services, bring customers back, and reduce costs. Customer service is defined as increasing client satisfaction through continuous concern for client preferences, staff accountability to clients, and respect for the rights of clients. Issues discussed include the introduction of a customer service approach and gaining staff commitment. The experience of PROSALUD in Bolivia in recruiting appropriate staff, supervising staff, soliciting client feedback, and marketing services is offered as an example of a successful customer service approach. The key customer service functions are described as 1) establishing a welcoming atmosphere, 2) streamlining client flow, 3) personalizing client services, and 4) organizing and providing clear information to clients. The role of the manager in developing procedures is explored, and the COPE (Client-Oriented Provider-Efficient) process is presented as a good way to begin to make improvements. Techniques in staff training in customer service include brainstorming, role playing, using case studies (examples of which are provided), and engaging in practice sessions. Training also leads to the development of effective customer service attitudes, and the differences between these and organizational/staff-focused attitudes are illustrated in a chart. The use of communication skills (asking open-ended questions, helping clients express their concerns, engaging in active listening, and handling difficult situations) is considered. Good recovery skills are important when things go wrong. Gathering and using client feedback is the next topic considered. This involves identifying, recording, and discussing customer service issues as well as taking action on these issues and evaluating the results. The booklet ends by providing a sample of customer service indicators, considering the maintenance of a

  17. 76 FR 54403 - Airworthiness Directives; PIAGGIO AERO INDUSTRIES S.p.A Model PIAGGIO P-180 Airplanes

    Science.gov (United States)

    2011-09-01

    ... Federal holidays. For service information identified in this proposed AD, contact Piaggio Aero Industries... Service Information Piaggio Aero Industries S.p.A. has issued Mandatory Service Bulletin No. 80-0304... Accomplishment Instructions of Piaggio Aero Industries S.p.A. Mandatory Service Bulletin No. 80-0304, dated July...

  18. Molecular analysis of virulent genes (coa and spa) of staphylococcus aureus involved in natural cases of bovine mastitis

    International Nuclear Information System (INIS)

    Khan, A.; Javed, M.T.; Mahmood, F.; Hussain, R.

    2013-01-01

    The present study was undertaken to determine the distribution and genotypic characteristics of Staphylococcus aureus isolates recovered from naturally occurring mastitis in cattle and buffaloes. For this purpose a total of 1445 lactating cattle (653) and buffaloes (792) present at two experimental livestock farms Okara (Bahadarnagar) and Sahiwal (Qadiarabad), in and around district Faisalabad and slaughtered at an abattoir due to low milk yield and were screened for mastitis. California Mastitis Test (CMT) was used to detect sub clinical mastitis. The positive quarter milk samples were collected for culturing of S. aureus isolates. taphylococcus aureus isolates were identified on the basis of growth features, biochemical characteristics, coagulase test and as well as amplification of coagulase (coa) and spa (spa-X) genes specific to its virulence. S. aureus isolates (n=265) were characterized by Polymerase chain reaction to determine the frequency of coagulase (coa) and spa (spa-X) genes. From these isolates the amplification of the coagulase (coa) gene yielded three different PCR products approximately 204bp to 490bp while spa (spa-X) gene produced five different products ranging in size from 190bp to 320bp. PCR revealed that from all the coagulase positive S. aureus isolates 261(98.5%) had spa (spa-X) gene. The results of the present study indicated that S. aureus isolates recovered from bovine mastitis were genetically different within and among the various herds which may provide essential and valuable strategies to control staphylococcal infections in future. (author)

  19. Molecular analysis of virulent genes (coa and spa) of staphylococcus aureus involved in natural cases of bovine mastitis

    Energy Technology Data Exchange (ETDEWEB)

    Khan, A.; Javed, M. T.; Mahmood, F. [University of Agriculture, Faisalabad (Pakistan). Dept. of Pathology; Hussain, R. [The Islamia Univ. of Bahawalpur, Pakistan (Pakistan). Dept. of Veterinary and Animal Sciences

    2013-12-15

    The present study was undertaken to determine the distribution and genotypic characteristics of Staphylococcus aureus isolates recovered from naturally occurring mastitis in cattle and buffaloes. For this purpose a total of 1445 lactating cattle (653) and buffaloes (792) present at two experimental livestock farms Okara (Bahadarnagar) and Sahiwal (Qadiarabad), in and around district Faisalabad and slaughtered at an abattoir due to low milk yield and were screened for mastitis. California Mastitis Test (CMT) was used to detect sub clinical mastitis. The positive quarter milk samples were collected for culturing of S. aureus isolates. taphylococcus aureus isolates were identified on the basis of growth features, biochemical characteristics, coagulase test and as well as amplification of coagulase (coa) and spa (spa-X) genes specific to its virulence. S. aureus isolates (n=265) were characterized by Polymerase chain reaction to determine the frequency of coagulase (coa) and spa (spa-X) genes. From these isolates the amplification of the coagulase (coa) gene yielded three different PCR products approximately 204bp to 490bp while spa (spa-X) gene produced five different products ranging in size from 190bp to 320bp. PCR revealed that from all the coagulase positive S. aureus isolates 261(98.5%) had spa (spa-X) gene. The results of the present study indicated that S. aureus isolates recovered from bovine mastitis were genetically different within and among the various herds which may provide essential and valuable strategies to control staphylococcal infections in future. (author)

  20. Comparing Whole-Genome Sequencing with Sanger Sequencing for spa Typing of Methicillin-Resistant Staphylococcus aureus

    DEFF Research Database (Denmark)

    Bartels, Mette Damkjaer; Petersen, Andreas; Worning, Peder

    2014-01-01

    spa typing of methicillin-resistant Staphylococcus aureus (MRSA) has traditionally been done by PCR amplification and Sanger sequencing of the spa repeat region. At Hvidovre Hospital, Denmark, whole-genome sequencing (WGS) of all MRSA isolates has been performed routinely since January 2013, and ...

  1. New customer services

    DEFF Research Database (Denmark)

    Münster, Marie; Møller Andersen, Frits; Meza, Maria Josefina Figueroa

    2011-01-01

    This chapter focuses on the challenge of motivating energy service customers to make best use of available smart technologies. This can be done through economic incentives, but also through information and education, regulation and reorganisation, and by improving services or customer comfort...

  2. Encounters with immigrant customers

    DEFF Research Database (Denmark)

    Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig

    2013-01-01

    were not sufficiently assessed at the counter (n = 55, 65%), and that their latest encounter with an immigrant customer was less satisfactory than a similar encounter with an ethnic Danish customer (n = 48, 57%) (significantly more pharmacists than assistants: odds ratio, OR, 3.19; 95% confidence...

  3. Customer Relationship Management.

    Science.gov (United States)

    Fayerman, Michael

    2002-01-01

    Presents an approach increasingly employed by businesses to track and respond to their customers to provide better and faster services: customer relationship management. Discusses its applicability to the operations of higher education and institutional research and the role it plays in the knowledge management framework. (EV)

  4. REGIONAL CUSTOMS DIRECTORATES MANAGEMENT

    Directory of Open Access Journals (Sweden)

    CABA STEFAN

    2009-05-01

    Full Text Available The management of a regional customs directorate is analyzed. A new approach of the managerial system, in the European integration context, is presented. The customs system is one of the first “doors” to a new economic, social and cultural community. For

  5. Managing customer service.

    Science.gov (United States)

    Paget, Zoe

    2015-02-28

    Zoe Paget is the customer services manager at YourVets. Her role includes managing the company's call centre, social media marketing, working with the marketing department to develop customer care initiatives and reporting service levels to the company's directors. British Veterinary Association.

  6. Managing Global Customers

    NARCIS (Netherlands)

    G.S. Yip (George)

    2009-01-01

    textabstractMultinational companies need to manage their relationships with multinational customers in a globally integrated approach. This paper provides a systematic framework for developing and implementing such global customer management programmes. The paper is based on Chapter 1 of George S.

  7. British Sign Name Customs

    Science.gov (United States)

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  8. Analytics for Customer Engagement

    NARCIS (Netherlands)

    Bijmolt, Tammo H. A.; Leeflang, Peter S. H.; Block, Frank; Eisenbeiss, Maik; Hardie, Bruce G. S.; Lemmens, Aurelie; Saffert, Peter

    In this article, we discuss the state of the art of models for customer engagement and the problems that are inherent to calibrating and implementing these models. The authors first provide an overview of the data available for customer analytics and discuss recent developments. Next, the authors

  9. Impact of Customer Relationship Management on Customer Loyalty, Customer Retention and Customer Profitability for Hotelier Sector

    Directory of Open Access Journals (Sweden)

    Sandra-Dinora Orantes-Jiménez

    2017-08-01

    Full Text Available Since the entrance of strategies oriented to marketing relational in Hotelier Sector, the traditional way of travel agents and other representatives arranging hospitality services for hotel and travel reservations has changed. The strategies oriented to customer relationship management are a relatively new area of specialty loyalty marketing in the hotel and hotelier sector, with advancements being made constantly. The use of this type of strategy can allow hoteliers or companies to tailor special guest programs, services and promotions based on hotel guest preferences. The hotel can use the data collected in a program to identify the needs of particular customers across hotel chains to be able to use marketing that can be targeted at specific groups of people. It also gives hoteliers the opportunity to evaluate frequent guest programs, personalize their services and perform trend analysis. A program based in marketing relational is typically run by hotels and companies to collect guest information and transaction data for use and examining to allow hoteliers to see target groups that should be marketed too. Based on these transactions hotels are able to create and manage guest loyalty programs and reward schemes. This research approach is to appraise the impact of customer relationship management on customer profitability as mediated by customer loyalty and customer retention within the hotelier sector of Mexico, and specifically for those hoteliers classified like of three stars. A sample of 100 hotels three stars was interviewed as respondents in this study. The objective of the study was to find the impact relationship between effective customer relationship implementation, customer loyalty, and customer retention and customer profitability. The findings of the study add value to hotels three stars in Mexico, and provide some invaluable statistical results essential for hotel managers and owners to successfully enhance customer loyalty

  10. Role of surfactant protein-A (SP-A) in lung injury in response to acute ozone exposure of SP-A deficient mice

    International Nuclear Information System (INIS)

    Haque, Rizwanul; Umstead, Todd M.; Ponnuru, Padmavathi; Guo Xiaoxuan; Hawgood, Samuel; Phelps, David S.; Floros, Joanna

    2007-01-01

    Millions are exposed to ozone levels above recommended limits, impairing lung function, causing epithelial damage and inflammation, and predisposing some individuals to pneumonia, asthma, and other lung conditions. Surfactant protein-A (SP-A) plays a role in host defense, the regulation of inflammation, and repair of tissue damage. We tested the hypothesis that the lungs of SP-A(-/-) (KO) mice are more susceptible to ozone-induced damage. We compared the effects of ozone on KO and wild type (WT) mice on the C57BL/6 genetic background by exposing them to 2 parts/million of ozone for 3 or 6 h and sacrificing them 0, 4, and 24 h later. Lungs were subject to bronchoalveolar lavage (BAL) or used to measure endpoints of oxidative stress and inflammation. Despite more total protein in BAL of KO mice after a 3 h ozone exposure, WT mice had increased oxidation of protein and had oxidized SP-A dimers. In KO mice there was epithelial damage as assessed by increased LDH activity and there was increased phospholipid content. In WT mice there were more BAL PMNs and elevated macrophage inflammatory protein (MIP)-2 and monocyte chemoattractant protein (MCP)-1. Changes in MIP-2 and MCP-1 were observed in both KO and WT, however mRNA levels differed. In KO mice MIP-2 mRNA levels changed little with ozone, but in WT levels they were significantly increased. In summary, several aspects of the inflammatory response differ between WT and KO mice. These in vivo findings appear to implicate SP-A in regulating inflammation and limiting epithelial damage in response to ozone exposure

  11. CUSTOMER LOYALTY THEORETICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    Margarita IŠORAITĖ

    2016-08-01

    Full Text Available Customer loyalty - is a voluntary user solution for a long time to build relationships with the company. Loyalty is the user's desire for a long time to continue their relationship with a particular company, because loyal customers are those who purchase goods/services of the company from time to time. Loyalty can be treated as a customer desire, willingness to be a regular customer for a long time, buying and using the goods of the chosen companies by recommending them to friends and colleagues. Loyalty can be seen as a multi-dimension, covering behavioral and positional components, where positional aspect reflects customers' approach to business, while the behavioral dimension reveals a frequent and regular shopping, purchase quantity, size, range, availability, etc.

  12. Customer relationships marketing

    Directory of Open Access Journals (Sweden)

    Đorđević Bojan

    2005-01-01

    Full Text Available Market economy terms impose on modern companies the need to change their business relationships to customers. In this way has the term "customer relationship marketing", known as CRM, come into use. Customers are the most valuable asset of a company, and the wisdom and essence of CRM can be presented in two words - profitable and long-term. Modern customer is an individual. They are smart, informed, have great expectations and want only the best, and they can change their supplier by one click of the mouse. Every one of them is characterized by specific needs, and, in that sense the company must strive to satisfy them with the right offer at the right time and through the right channel. The aim of the company is to have loyal customers who will help the company make maximized profit and competitive advantage on the market.

  13. Delivering customer solutions

    International Nuclear Information System (INIS)

    Bergsma, J.

    1997-01-01

    Convergence of the energy industries began with customer's demands for the best energy choice and value. In a converged energy market customers buy year-round home comfort, rather than gas heat or electric air conditioning. Union Gas has been facilitating cogeneration development to its customers since the mid 1980's. A brief description of the corporate context of Union Gas and Centra Gas was provided. Convergence at the retail level was discussed in detail. The essence of converge at the retail level is that an energy service provider will tailor products and services to meet a customer's specific needs for choice, value and best prices. Consequently, a residential customer will have the choice to select an environmentally preferred fuel source for home comfort, plus billing options, merchandise and repair services, all for one price, and from one utility

  14. How Customers Choose Hotels

    Directory of Open Access Journals (Sweden)

    Hera Oktadiana

    2011-05-01

    Full Text Available In the advancement of hospitality industry, thus it is important for hotel sales and marketing to understand the customer behavior in order to create effective marketing. Factors that influence customer behavior as individuality consist of personal and interpersonal factors. Personal factors include the needs, wants, motivation, perception, learning, personality, lifestyle, and self-concept. Meanwhile, interpersonal factors come from culture and sub-culture, group references, customers through stages before deciding to purchase. Begin with the awareness about the needs, customers then find information about the product or service that could be used to solve the problems. After having the information, customers select the best product and service before deciding to purchase. After purchasing, the last stage is evaluation of product and service, whether it is satisfying or not.

  15. Design and health care: a study of virtual design and direct metal lasersintering of titanium alloy for the production of customized facial implants

    Directory of Open Access Journals (Sweden)

    Wilson Kindlein Junior

    2009-11-01

    Full Text Available The increase in life expectancy and a great number ofaccidents lead to higher demand for medical products,including corrective implants. Patients with tumors or traumas need to replace injured areas in order to restore their aesthetic and structural function. Currently, the available craniofacial implants present a standard geometry and seldom generate satisfactory results. Customized implants, on theother hand, are designed to conform exactly to individual patient’s anatomy. This way, the use of customized implantscan show beneficial effects to the patient and the surgicalteam. In this study, the design and manufacturing of customized implant prior to surgery were described. Implant shape and functional requirements were established by digitaldata based on CT-scans and mirroring operations. The designprocess of customized mandible prosthesis is illustrated as well as its manufacturing process (direct metal laser sinteringand quality control. Laser sintering process and its constraints for the production of customized implants in titanium alloy(Ti-6Al-4V with complex geometry and internal structures are reported.

  16. Radon exposure during treatment in some thermal spa centers in Greece

    International Nuclear Information System (INIS)

    Nikolopoulos, D.; Louizi, A.; Serefoglou, A.; Georgiou, E.; Vogiannis, E.; Halvadakis, C.

    2004-01-01

    Radon ( 222 Rn) present in the spa facilities has been identified as an agent of additional radiation burden both for bathers and the working personnel. Although some researchers have been concentrated on the health impact of radon activity transient increases due to water flow of domestically used water, limited work has been reported on this effect in spa facilities. The aim of this work was to study the exposure both of bathers and working personnel due to water flow under working conditions in some thermal spas in Greece. The spas studied were built at two locations in Greece; Lesvos Island and the city of Loutra- Edipsou. The study was performed between 1999 and 2003. Measurements involved determination of radon concentration in the waters of the thermal spas, monitoring of radon and short-lived decay product activity (both in attached and unattached form) and coarse particles (> 500 nm). Water radon concentration was measured by Alpha Guard PQ2000Pro of Genitron GmbH equipped with an appropriate unit (Aquakit). Indoor radon activity was monitored by Alpha Guard PQ2000Pro and EQF3023 of Sarad GmbH which was also used for monitoring of radon short-lived decay product activity. Coarse particle concentration measurements were performed by a GRIMM 1.104 Portable Dust Monitor. Measurements indoors were performed in the treatment room and in the reception room, if existing, under working conditions. Several procedures for bath filling and pouring out of the treatment room, during the measurements, were studied. Radon concentrations of thermal waters were found to lie in the range 1 Bq.L -1 and 304 Bq.L -1 . Some of these concentrations may be considered as elevated. Elevated (about 2-6 kBq.m -3 ) indoor radon concentrations were measured in the treatment rooms of the spas of Polichnitos, Eftalou and Loutra Edipsou. This found to be in accordance to the high radon potential of these spas, as detected out of the measurements of their thermal waters. Concentration

  17. The Impact of Customer Relationship Management to Customer Loyalty Through Customer Satisfaction in Cabal Dining Manado

    OpenAIRE

    Pandowo, Merinda; Pangemanan, Sifrid S.; Wattilete, Randy

    2013-01-01

    Customer relationship management is the one influencing customer loyalty, but to get customer loyalty we should know how to make customer satisfaction. This research is purposed to analyze the impact of customer relationship management to customer loyalty through customer satisfaction in Cabal Dining Manado. This research used the Path analysis as the method of this research. Population in this research is mainly in this research is people in Manado. The sample of this research is 100 respond...

  18. The study of the relationship between value creation and customer loyalty with the role of trust moderation and customer satisfaction in Sari hospitals.

    Science.gov (United States)

    Rahmani, Zienolabedin; Ranjbar, Mansour; Gara, Ali Asgar Nadi; Gorji, Mohammad Ali Heidari

    2017-06-01

    Healthcare providers are competitive, owing to heightened customers' awareness and expectations of health care services. The aim of this study was to determine the relationship between customer value creation and loyalty with mediator trust and customer satisfaction. This is a cross sectional survey study. Participants were 196 patients referred to private hospitals in Sari city, Iran from May to June 2014 which were selected by convenience sampling method. Data were collected using questionnaires. Data were analyzed using the structural equation modeling software Smart PLS. The results revealed a relationship between customer value creation and customer loyalty in a Sari city private hospital, and customer satisfaction and trust, mediate the relationship between customer value creation and customer loyalty. The results also revealed significant positive relationship between customer satisfaction and trust (p=0.000 r=0.585). customer satisfaction and trust mediate the relationship between customer value creation and customer loyalty.

  19. The truth about patient experience: what we can learn from other industries, and how three ps can improve health outcomes, strengthen brands, and delight customers.

    Science.gov (United States)

    Needham, Brian R

    2012-01-01

    Improving the patient experience is an issue many healthcare organizations face. However, it is the opinion of this author that the focus on patient satisfaction scores alone is short-sighted and that the most successful organizations will adopt best practices from other industries to deliver a more complete patient experience. This article presents an extensive review of best practices in customer experience from numerous customer-centric industries and postulates as to how the healthcare field might apply them. A new framework for improving patient experience is proposed--one that moves beyond the traditional focus on satisfaction scores to embrace the core differentiating characteristics of the organization.

  20. Customs control of goods

    Directory of Open Access Journals (Sweden)

    Mentor Gashi

    2015-11-01

    Full Text Available Customs control, is regulated by law in different countries. Different countries define through the law, the control of goods.. Main purpose of this paper is to analyze two types of customs controls, and their effect in reducing avoidance of duty or tax evasion which may be caused by the import of goods of certain companies. For this reason we researched which model is implemented in developing countries and what results were reached through questionnaires. In this sense the next research question, consists in defining the moment of customs control pre or post-clearance control of goods.

  1. Customer Communication Document

    Science.gov (United States)

    2009-01-01

    This procedure communicates to the Customers of the Automation, Robotics and Simulation Division (AR&SD) Dynamics Systems Test Branch (DSTB) how to obtain services of the Six-Degrees-Of-Freedom Dynamic Test System (SDTS). The scope includes the major communication documents between the SDTS and its Customer. It established the initial communication and contact points as well as provides the initial documentation in electronic media for the customer. Contact the SDTS Manager (SM) for the names of numbers of the current contact points.

  2. 75 FR 12167 - Virginia Graeme Baker Pool and Spa Safety Act; Public Accommodation

    Science.gov (United States)

    2010-03-15

    ... pool or spa that is ``open exclusively to patrons of a hotel or other public accommodations facility... Web site at http://www.cpsc.gov . B. Legal Analysis In adopting a reasonable interpretation of... ``an inn, hotel, motel, or other place of lodging, except for an establishment located within a...

  3. 76 FR 62605 - Virginia Graeme Baker Pool and Spa Safety Act; Interpretation of Unblockable Drain

    Science.gov (United States)

    2011-10-11

    ... the VGB Act defines an ``unblockable drain'' as ``a drain of any size and shape that a human body... intentions. They claim that for this reason, backup systems are necessary, and a swimming pool or spa with a... of an ``unblockable drain,'' at 16 CFR 1450.2(b) and believe it was in error. Regardless of the size...

  4. [Measurement of soil organic matter and available K based on SPA-LS-SVM].

    Science.gov (United States)

    Zhang, Hai-Liang; Liu, Xue-Mei; He, Yong

    2014-05-01

    Visible and short wave infrared spectroscopy (Vis/SW-NIRS) was investigated in the present study for measurement of soil organic matter (OM) and available potassium (K). Four types of pretreatments including smoothing, SNV, MSC and SG smoothing+first derivative were adopted to eliminate the system noises and external disturbances. Then partial least squares regression (PLSR) and least squares-support vector machine (LS-SVM) models were implemented for calibration models. The LS-SVM model was built by using characteristic wavelength based on successive projections algorithm (SPA). Simultaneously, the performance of LSSVM models was compared with PLSR models. The results indicated that LS-SVM models using characteristic wavelength as inputs based on SPA outperformed PLSR models. The optimal SPA-LS-SVM models were achieved, and the correlation coefficient (r), and RMSEP were 0. 860 2 and 2. 98 for OM and 0. 730 5 and 15. 78 for K, respectively. The results indicated that visible and short wave near infrared spectroscopy (Vis/SW-NIRS) (325 approximately 1 075 nm) combined with LS-SVM based on SPA could be utilized as a precision method for the determination of soil properties.

  5. LHC suppliers win Golden Hadron awards : Sandro Ferraris and Guiseppi Ginola from Simic SpA

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    Simic SpA (Italy) received its award for manufacturing the vacuum vessels for the superconducting dipoles. The 937 blue cylinders manufactured by Simic will provide the thermal insulation for the magnets. Measuring 15 metres in length and 1 metre in diameter, they are designed to withstand a vacuum of 10-4 Pa.

  6. Rickett’s Dry Cleaning Site, Village of Ballston Spa, NY

    Science.gov (United States)

    The Rickett’s Dry Cleaning Site is located in a mixed commercial and residential area in the village of Ballston Spa on County Route 50. The site was the location of a family owned dry cleaner/ laundromat that went out of business in 2014. The site has

  7. Objectification of a Choice of a Spa Treatment Plan for Arthritis of the Hip Joint

    Czech Academy of Sciences Publication Activity Database

    Och, F.; Medonos, J.; Hanzlíček, P.; Valenta, Zdeněk; Dvořák, V.; Zvárová, Jana

    2013-01-01

    Roč. 1, č. 1 (2013), s. 10-10 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : decision-support * spa treatment * hip arthritis * statistical analysis Subject RIV: IN - Informatics, Computer Science

  8. Solar car park in a spa town; Das Solarparkhaus an der Kurpromenade

    Energy Technology Data Exchange (ETDEWEB)

    Ernst, Willi

    2010-11-23

    Bad Lippspringe is the first spa town in the German state of Nordrhein-Westfalen that installed a solar park garage. The roof consists of semistransparent solar modules that ensure daylighting even in the winter season. There are safety nets below the modules to protect cars and persons from injuries in case of glassbreak. (orig.)

  9. Radioactivity measurements and risk assessments of spa waters in some areas in Turkey.

    Science.gov (United States)

    Duran, Selcen Uzun; Kucukomeroglu, Belgin; Damla, Nevzat; Taskin, Halim; Celik, Necati; Cevik, Uğur; Ersoy, Hakan

    2017-03-01

    The current study presents the results of the activity of radionuclides in spa waters, and evaluates their radiological influences on the population consuming these waters in the Central and Eastern Black Sea regions of Turkey. Since these waters are used for therapy and consumption purposes unconsciously, their radiological impact on the people was computed by taking into consideration the annual intake through ingestion of 226 Ra, 232 Th, 40 K, 137 Cs and 222 Rn. The mean activities were estimated to be 11.35 for gross alpha, 6.23 for gross beta, 2.96 for 226 Ra, 0.42 for 232 Th, 0.069 for 137 Cs, 0.19 for 40 K, and 267 Bq L -1 for 222 Rn, respectively. The estimated effective doses from spa water were found to be 49.77 µSv a -1 ( 226 Ra), 5.95 µSv a -1 ( 232 Th), 0.07 µSv a -1 ( 137 Cs), 0.83 µSv a -1 ( 40 K) and 56.03 µSv a -1 ( 222 Rn). These values were evaluated and compared with related verified values from literature. Also, physico-chemical characterizations of spa water samples considered in the current study were investigated. This study would be useful for consumers and official authorities for the assessment of radiation exposure risk due to usage of the considered spa waters.

  10. The system of processing and analysis of the parameters to be controlled of the 'Ukrytie' (SPA)

    International Nuclear Information System (INIS)

    Shcherbin, V.N.; Kravchuk, T.A.; Nenakhov, A.N.

    1998-01-01

    Processing system and analysis of parameters to be controlled (SPA) is an integrated system monitor control, which unites complexes of technical facilities with methods of remote control and diagnostics of object 'Ukrytie'. System executes checking, diagnosing analytical, prognostic, scholastic-simulator and scientifically-methodical functions, describing current condition of the 'Ukrytie', with the issue of possible emergency situation descriptions

  11. Constructing a Professional: Gendered Knowledge in the (Self-)Positioning of Skin and Spa Therapy Students

    Science.gov (United States)

    Bredlöv, Eleonor

    2017-01-01

    This study outlines the self-positioning of skin and spa therapy students. More specifically, it focuses how they position themselves as professionals in terms of knowledge, and how gender is at play throughout this process. Drawing on a poststructural approach, inspired by Foucault and feminist theory, regularities of description and…

  12. 76 FR 60396 - Airworthiness Directives; Piaggio Aero Industries S.p.A. Airplanes

    Science.gov (United States)

    2011-09-29

    ...., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. For service... on other P.180 aeroplanes, and Piaggio Aero Industries (PAI) had issued Service Bulletin (SB) No. 80... information by examining the MCAI in the AD docket. Relevant Service Information Piaggio Aero Industries S.p.A...

  13. 78 FR 36691 - Airworthiness Directives; Piaggio Aero Industries S.p.A Airplanes

    Science.gov (United States)

    2013-06-19

    ...., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. For service... condition, Piaggio Aero Industries (PAI) issued Service Bulletin (SB) 80-0345 to provide instructions for... in the AD docket. Relevant Service Information Piaggio Aero Industries S.p.A. has issued Mandatory...

  14. 76 FR 27872 - Airworthiness Directives; PIAGGIO AERO INDUSTRIES S.p.A Model P-180 Airplanes

    Science.gov (United States)

    2011-05-13

    ... through Friday, except Federal holidays. For service information identified in this AD, contact Piaggio... accomplishment instructions of Piaggio Aero Industries Alert Service Bulletin ASB- 80-0324, step 5, this AD.... Relevant Service Information PIAGGIO AERO INDUSTRIES S.p.A has issued Service Bulletin (Mandatory) N.: 80...

  15. 78 FR 69600 - Airworthiness Directives; Piaggio Aero Industries S.p.A Airplanes

    Science.gov (United States)

    2013-11-20

    ... p.m., Monday through Friday, except Federal holidays. For service information identified in this.... To address this potential unsafe condition, Piaggio Aero Industries (PAI) issued Service [[Page 69601... Service Information Piaggio Aero Industries S.p.A. has issued Mandatory Service Bulletin No.: 80-0381, Rev...

  16. 77 FR 27144 - Airworthiness Directives; Agusta S.p.A. Helicopters

    Science.gov (United States)

    2012-05-09

    ... Agusta, S.p.A., Via Giovanni Agusta 520, 21017 Cascina Costa di Samarate (VA), Italy, ATTN: Giovanni... written comments, data, or views. We also invite comments relating to the economic, environmental, energy.... Discussion The European Aviation Safety Agency (EASA), which is the Technical Agent for Italy, a Member State...

  17. Thompson’s Spa: The Most Famous Lunch Counter in the World

    Directory of Open Access Journals (Sweden)

    Peter Szende

    2012-09-01

    Full Text Available Thompson’s Spa in Boston was one of the most celebrated restaurant companies in America at the turn of the twentieth century. Founder Charles Eaton was a pioneer in production and service methods, who developed a variety of innovative mechanical systems. This article describes the founding, growth, and eventual decline of the company during the period 1882 to 1968.

  18. Structure of Spa15, a type III secretion chaperone from Shigella flexneri with broad specificity

    NARCIS (Netherlands)

    Eerde, André van; Hamiaux, Cyril; Pérez, Javier; Parsot, Claude; Dijkstra, Bauke W.

    2004-01-01

    Type III secretion (TTS) systems are used by many Gram-negative pathogens to inject virulence proteins into the cells of their hosts. Several of these virulence effectors require TTS chaperones that maintain them in a secretion-competent state. Whereas most chaperones bind only one effector, Spa15

  19. Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial

    NARCIS (Netherlands)

    van Tubergen, A.; Landewé, R.; van der Heijde, D.; Hidding, A.; Wolter, N.; Asscher, M.; Falkenbach, A.; Genth, E.; Thè, H. G.; van der Linden, S.

    2001-01-01

    To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean

  20. The influence of customer relationship management information on customer loyalty

    OpenAIRE

    Ignatovič, Eva

    2009-01-01

    The purpose of this master thesis is to approve that customer relationship management (CRM) has influenced on customer loyalty. In order to achieve this purpose the work was divided into four main tasks: review of the relevant literature; analyze the influence of customer relationship management on customer loyalty and approve its importance for companies, research of the concrete business-to-business (B2B) Company CRM process and its customer loyalty, and the development of the customer rela...

  1. Customer Loyalty Research : Can customer loyalty programs really build loyalty?

    OpenAIRE

    Romppanen, Maiju; Kellgren, Cecilia; Moradi, Ladan

    2007-01-01

    Background: During the last decades the efforts to foster customer relationships have become important due to increased competition in the consumer markets. One of the most popular strategies have been to introduce customer loyalty programs which are believed to enhance the customer loyalty. The popularity of the customer loyalty programs is based on the beliefs that loyal customers are lucrative and these programs would bond the customers to the company. More recently however, the discussion...

  2. When to "Fire" Customers: Customer Cost-Based Pricing

    OpenAIRE

    Jiwoong Shin; K. Sudhir; Dae-Hee Yoon

    2012-01-01

    The widespread adoption of activity-based costing enables firms to allocate common service costs to each customer, allowing for precise measurement of both the cost to serve a particular customer and the customer's profitability. In this paper, we investigate how pricing strategies based on customer cost information affects a firm's customer acquisition and retention dynamics, and ultimately its profit, using a two-period monopoly model with high- and low-cost customer segments. Although past...

  3. Customer Relationship Management in Agile Healthcare Organizations

    OpenAIRE

    Nasrabad, Rafat Rezapour

    2017-01-01

    Today, several studies in the field to identify key factors in the success and agility of health care organizations to improve their performance in the face of changes have taken place in the context of customer relationship management among them. The purpose of this study was to explore the concept of customer relationship management, goals and benefits by considering its relationship with value creation for clients and treatment. Results showed concern for organizations today, creating cust...

  4. Large Customers (DR Sellers)

    Energy Technology Data Exchange (ETDEWEB)

    Kiliccot, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2011-10-25

    State of the large customers for demand response integration of solar and wind into electric grid; openADR; CAISO; DR as a pseudo generation; commercial and industrial DR strategies; California regulations

  5. ASD Customer Satisfaction Survey

    Data.gov (United States)

    Department of Veterans Affairs — ASD implemented a customer satisfaction survey for our products and services. This feedback will provide a better understanding of how ASD products and services can...

  6. Arkitektur & Mass customization

    DEFF Research Database (Denmark)

    Ryborg Jørgensen, Thomas

    2007-01-01

    Publikationens ambition er at udrede og give indblik i produktindustriens seneste udvikling med forretnings- og produktionsstrategien Mass Customization, og dermed en indgang til de muligheder og problemer der knytter sig til implementering af disse eller tilsvarende strategier i byggebranchen, og...

  7. Utility customer issues

    International Nuclear Information System (INIS)

    Downey, W.H.

    1997-01-01

    Customer issues affected by the restructuring of the $250 billion US electric power industry were discussed. In the past the industry's vertically integrated utilities conducted their business in protected geographic markets. With deregulation and greater competition, that industry structure will change. This presentation highlighted the strategies that Unicom is using to react to the restructuring of the electric power industry. The underlying principle is for the utility to reinvent itself to change its market orientation and focus on customer services, such as reliability, responsiveness, custom tailored solutions, and guaranteed savings over time. Attempting to become total energy providers and delivering integrated solutions to meet the needs of large industrial and commercial consumers, intensive market research, improved service and installation, and sophisticated customer retention initiatives will also have to be high on the agenda

  8. Bank Customers Management System

    Directory of Open Access Journals (Sweden)

    Ebubeogu Amarachukwu Felix

    2015-08-01

    Full Text Available ABSTRACT The purpose of this project is in partial fulfilment of the requirements of Bachelor of Science Hon in Information Technology. The Design and development of this Bank customers Management system provides a more secured approach in managing bank customers information which strengthens the relationships between banks and their customers by providing the right solutions that uses a multi-level security to improve customer satisfaction. The technology used in developing this project is ASP.NET and the programming language used to develop this project is C and the IDE used is Microsoft Visual Studio 2013 professional in designing the front end while the back end uses Microsoft SQL Server 2012.

  9. A customer service journey.

    Science.gov (United States)

    VanDecandelaere, Traci

    2012-01-01

    Converting security team members from simple rule enforcers to superior customer service providers required changes in leadership attitudes, rules, training, and other security traditions, but it has paid off in staff performance and recognition, according to the author.

  10. SPA (Solus per Aqua) service industry: An entrepeneurship opportunity to beauty education department

    Science.gov (United States)

    Marwiyah, Apriyani, Delta

    2018-03-01

    Beauty industry grows vastly in the scope of regional, national, or international. Beauty industry includes Spa service. It becomes one of the choices where the urban citizen can use it to release their stress and relax their mind. This business grows as the development of technology. Spa industry should be able to provide the best service for physical and mental therapy, it will make the user of the service can be freed from their business and stress in the respective time to be healthies, more beautiful, and able to do their activity maximally. Spa treatment consists of hair creambath, facial treatment, manicure-pedicure, scrub treatment, foot spa, aromatherapy, and body treatment with traditional cosmetics which are easy to get in Indonesia. Beauty education is one of the programs in Home Economics Department of Engineering Faculty of UNNES. This program was established to produce graduates in beauty fields as Vocational High School teachers with bachelor (S1) qualification. The graduates suppose to be excellent, professional, skillful, and care to the environment, culture, and social condition around them. It prepares them as teachers of beauty (in formal and non- formal education). Besides, it also prepared them to have professional competence in production fields of beauty service with adaptive, creative, and innovative which can be entrepreneurs who are able to create job vacancies for others. Beauty education used KKNI- based curriculum, which is oriented to Industry and Working Fields with UNNES' Conservation basis. It provided the students a chance to practive their knowledge in working internship program, study field trip, and teaching practice program. The industry of Spa service provides a big chance to become an entrepreneur, create a working field, and help the government reduce unemployment number, whether from beauty education graduates or from vocational high school students

  11. Improving customer satisfaction

    OpenAIRE

    Wei, Yu

    2011-01-01

    Today, the competition among enterprises is growing in intensity and organizations of all types and sizes have increasingly come to understand the importance of customer satisfaction and good services. The purpose of this study is to investigate the present level of customer satisfaction with language training institutes and find out any possible areas of improvement. This thesis will discuss and analyze the factors that influence the customer’s level of satisfaction and assist the case compa...

  12. Customer Poaching and Advertising

    OpenAIRE

    Rosa Branca Esteves

    2007-01-01

    This article is a first look at the dynamic effects of customer poaching in homogeneous product markets, where firms need to invest in advertising to generate awareness. When a firm can recognize customers with different past purchasing histories, it may send them targeted advertiseraents with different prices. It is shown that only the firm that advertises the highest price in the first period will engage in price discrimination, and that poaching clearly benefits the discriminating firm, Th...

  13. Customer satisfaction measurement

    Directory of Open Access Journals (Sweden)

    Maričić Branko R.

    2012-01-01

    Full Text Available Customer satisfaction is important in business management as a basis for long-term profitability of a single line of products and services and the company as a whole. Customer satisfaction in modern market conditions is characterized by a large number of alternatives that can satisfy the same need or desire of consumers, and are a prerequisite for the retention, loyalty, and positive verbal communication between companies and vendors on one hand and consumers on the other. Companies are investing more and more investment and management efforts in improving customer satisfaction. Improving customer satisfaction and its measurement involves the taking of appropriate marketing strategies and tactics, as well as corrective measures. This paper presents the well-known attempts to measure customers' satisfaction at the macro and micro level of marketing analysis. The index of consumer satisfaction is an important indicator of achieved quality and market performance of companies and can be measured on a micro and macro level. National customer satisfaction indexes are useful framework for analyzing the competitiveness of national economies, industries and individual companies and are used for a variety of other aspects of observation and analysis. Standardization of consumer satisfaction indexes in different countries allows comparability of the data, giving a new quality of analysis in the era of globalization and internationalization of business.

  14. A simple and valuable approach for measuring customer satisfaction.

    Science.gov (United States)

    Kinney, William C

    2005-08-01

    To determine the financial impact of poor customer satisfaction and the value of information gained from using a 1-question customer-satisfaction survey in a medical setting. A single-question customer-satisfaction survey was collected from customers presenting to an academic otolaryngology head and neck surgery outpatient clinic. The overall response rate was 25%, overall net promoter score was 67.3%, lowest net promoter score occurred on Wednesday and Friday, overall net potential referrals were 872, and potential lost revenue from dissatisfied customers equaled US 2.3 million dollars. A single-question customer-satisfaction survey may help identify areas of customer dissatisfaction that lead to a significant source of lost revenue. The competitive forces in today's health care environment require medical practices to address issues related to customer satisfaction.

  15. Customer satisfaction and business excellence

    DEFF Research Database (Denmark)

    Kristensen, Kai; Martensen, Anne; Grønholdt, Lars

    The topic for this paper is the link between customer satisfaction and business performance, which makes it possible to use customer satisfaction measures as basis for creating business excellence. First, the paper presents microeconomic models for the relationship between customer satisfaction......, customer loyalty and performance, and optimal customer satisfaction is characterized which will help management choose the right quality parameters for improvement. Second, the paper describes empirical evidence that customer satisfaction measures, based on a modelling approach, have impact on economic...

  16. Preventing customer defection and stimulating return of the lost customers

    Directory of Open Access Journals (Sweden)

    Senić Radoslav

    2013-01-01

    Full Text Available Customers represent company's most valuable asset. Company can assure its survival, further growth and development by retaining existing, attracting new and returning lost customers. Retaining existing, loyal customers is the most profitable business activity, attracting new ones is the most expensive, while returning lost and frequently forgotten customers is a type of business activity that still generates modest interest among researchers and practitioners. So far, marketing strategies have been mainly directed towards the first two categories of customers. The objective of this paper is dedicated to customer defection and returning lost customers. Paper discusses customer relationship life-cycle and the significance of managing customer return within it, types of customer defections, the process of managing return, as well as, the reasons that led to customer defection.

  17. Determining customer satisfaction in anatomic pathology.

    Science.gov (United States)

    Zarbo, Richard J

    2006-05-01

    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  18. Customer Satisfaction in Internal Customer Service : Case: Abloy Oy Internal Customer Service

    OpenAIRE

    Turunen, Susanna

    2011-01-01

    ABSTRACT Turunen, Susanna Marita 2011. Customer Satisfaction in Internal Customer Service. Case: Abloy Oy Internal Customer Service. Master’s thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 73. Appendix 1. This thesis discusses and studies service quality and customer satisfaction in internal customer service. The main objective is to find out what the service quality level in the internal customer service at Abloy Oy is and whether there exists a diffe...

  19. Shouldn’t customers control customized product development

    NARCIS (Netherlands)

    Smets, L.P.M.; Langerak, F.; Rijsdijk, S.A.

    2013-01-01

    Nowadays, customized product development (CPD) is increasingly prevalent in business-to-business settings, which has motivated manufacturers into development approaches wherein the customer plays an active role. When the customer is merely viewed as a passive receiver of the customized product, the

  20. Customer complaints and recovery effectiveness : A customer base approach

    NARCIS (Netherlands)

    Knox, G.; van Oest, R.D.

    2014-01-01

    Although customer complaints are a well-studied aspect of business, no study has measured the impact of actual complaints and recoveries on subsequent customer purchasing. The authors develop a customer base model to investigate the effectiveness of recovery in preventing customer churn. They

  1. The study of the relationship between value creation and customer loyalty with the role of trust moderation and customer satisfaction in Sari hospitals

    Science.gov (United States)

    Rahmani, Zienolabedin; Ranjbar, Mansour; Gara, Ali Asgar Nadi; gorji, Mohammad Ali Heidari

    2017-01-01

    Background Healthcare providers are competitive, owing to heightened customers’ awareness and expectations of health care services. Objective The aim of this study was to determine the relationship between customer value creation and loyalty with mediator trust and customer satisfaction. Methods This is a cross sectional survey study. Participants were 196 patients referred to private hospitals in Sari city, Iran from May to June 2014 which were selected by convenience sampling method. Data were collected using questionnaires. Data were analyzed using the structural equation modeling software Smart PLS. Results The results revealed a relationship between customer value creation and customer loyalty in a Sari city private hospital, and customer satisfaction and trust, mediate the relationship between customer value creation and customer loyalty. The results also revealed significant positive relationship between customer satisfaction and trust (p=0.000 r=0.585). Conclusion customer satisfaction and trust mediate the relationship between customer value creation and customer loyalty. PMID:28848619

  2. 76 FR 44020 - Proposed Collection; Comment Request; Generic Clearance for Partners and Customer Satisfaction...

    Science.gov (United States)

    2011-07-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Generic Clearance for Partners and Customer Satisfaction Surveys SUMMARY: In compliance with the... Voluntary Partners and Customers Satisfaction Surveys: Extension. The information collected in these surveys...

  3. Customer Innovation Process Leadership

    DEFF Research Database (Denmark)

    Lindgren, Peter; Jørgensen, Jacob Høj; Goduscheit, René Chester

    2007-01-01

    Innovation leadership has traditionally been focused on leading the companies' product development fast, cost effectively and with an optimal performance driven by technological inventions or by customers´ needs. To improve the efficiency of the product development process focus has been on diffe......Innovation leadership has traditionally been focused on leading the companies' product development fast, cost effectively and with an optimal performance driven by technological inventions or by customers´ needs. To improve the efficiency of the product development process focus has been...... on different types of organisational setup to the product development model and process. The globalization and enhanced competitive markets are however changing the innovation game and the challenge to innovation leadership Excellent product development innovation and leadership seems not any longer to enough...... another outlook to future innovation leadership - Customer Innovation Process Leadership - CIP-leadership. CIP-leadership moves the company's innovation process closer to the customer innovation process and discusses how companies can be involved and innovate in customers' future needs and lead...

  4. Characterizing customers at medical center farmers' markets.

    Science.gov (United States)

    Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

    2014-08-01

    Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

  5. Loyalty and positive word-of-mouth: patients and hospital personnel as advocates of a customer-centric health care organization.

    Science.gov (United States)

    Ferguson, Ronald J; Paulin, Michele; Leiriao, Elizabeth

    2006-01-01

    The ability to attract and retain loyal customers depends on the successful implementation of a customer-centric strategy. Customer loyalty is an attitude about an organization and its' services that is manifested by intentions and behaviors of re-patronization and recommendation. In the context of many medical services, loyalty through repeat patronization is not pertinent, whereas loyalty through positive word-of mouth (WOM) recommendation can be a powerful marketing tool. The Shouldice Hospital, a well-known institution for the surgical correction of hernias, instituted a marketing plan to develop a stable base of patients by creating positive WOM advocacy. This study focused on the consequences of both hernia patient overall satisfaction (and overall service quality) and hospital personnel satisfaction on the level of positive WOM advocacy. Using a commitment ladder of positive WOM advocacy, respondents were divided into three categories described as passive supporters, active advocates and ambassador advocates. Patient assessments of overall satisfaction and service quality were significantly related to these progressive levels of WOM for recommending the hospital to potential patients. Similarly, the satisfaction of the hospital employees was also significantly related to these progressive levels of positive WOM about recommending the hospital to potential patients and to potential employees. High levels of satisfaction are required to create true ambassadors of a service organization.

  6. Pengaruh Customer Perceived Value Terhadap Customer Satisfaction PT. Xyz

    OpenAIRE

    Sucahyo, Martinus Wilman

    2017-01-01

    Penelitian ini membahas tentang Customer Perceived Value terhadap Customer Satisfaction PT. XYZ. Dalam penelitian ini, Customer Perceived Value diukur melalui dimensi Core Product Value, Service Value dan Relationship Value. Masing-masing dimensi ini akan diuji pengaruhnya terhadap Customer Satisfaction, baik secara simultan maupun secara parsial, serta dimensi mana yang paling berpengaruh terhadap Customer Satisfaction. Sampel penelitian berjumlah 100 pelanggan PT. XYZ. Data penelitian diola...

  7. Enhancing customer value

    International Nuclear Information System (INIS)

    Gabel, B.

    1996-01-01

    A discussion on how Westcoast Gas Services Inc., is striving to meet customer satisfaction was presented. A strategic business unit called storage, transportation and service is a customer-centered, energy service enterprise dedicated to providing value-added service. The company is placing emphasis on better coordination of sales and marketing activities, especially in areas of customer relationship management and product development. Deregulation was responsible for the changing marketplace. It resulted in increased competition, energy alliances and multi-fuel opportunities. Some of the ways Westcoast Gas Service plans to survive and prosper in this new world of competition were outlined. Among the ideas mentioned were consumer orientation, superior information about consumers and competitors, quick adaptation to changing market conditions, anticipation of consumer needs, and appropriate product development

  8. Consumer Preferences for Mass Customization

    NARCIS (Netherlands)

    B.G.C. Dellaert (Benedict); S. Stremersch (Stefan)

    2004-01-01

    textabstractIncreasingly, firms adopt mass customization, which allows consumers to customize products by self-selecting their most preferred composition of the product for a predefined set of modules. For example, PC vendors such as Dell allow customers to customize their PC by choosing the type of

  9. Emotional Satisfaction of Customer Contacts

    NARCIS (Netherlands)

    Güngör, Hüseyin

    2007-01-01

    For marketing and customer services researchers and professionals who are interested in customer contacts, customer satisfaction and loyalty issues. Contact centers are playing a pivotal role in customer services of the 21st century. Nevertheless, despite their growing importance and presence,

  10. Competitive Effects of Mass Customization

    OpenAIRE

    Oksana Loginova

    2010-01-01

    Earlier theoretical literature on mass customization maintains that customization reduces product differentiation and intensifies price competition. In contrast, operations management studies argue that customization serves primarily to differentiate a company from its competitors. Interactive involvement of the customer in product design creates an affective relationship with the firm, relaxing price competition. This paper provides a model that incorporates consumer involvement to explain t...

  11. [Quality management in a combined clinic - the quality management system according to DIN EN ISO 9001 of the The German Association of Spa Accommodation Resorts e. V. (VdKB)].

    Science.gov (United States)

    Eckert, H; Schulze, U

    2004-06-01

    The implementation of a quality system in health care organizations offers huge potentials for improvement and development. But the realization of such systems necessitates high investments, which small companies and family businesses often are unable to raise. The German Association of Spa Accommodation Resorts (VdKB) commissioned two consultants to develop a reasonably priced implementation concept of a DIN EN ISO 9001 quality system specially adjusted to small companies and family businesses in medical spa and rehabilitation services, which was successfully accredited in May 2003. This paper describes fundamental requirements in combine management systems, considers the pros and cons of management combines and demonstrates the practical realization of combine requirements on the example of the VdKB-combine system.

  12. Web Based Customized Design

    OpenAIRE

    Moi, Morten Benestad

    2013-01-01

    This thesis studies the methods needed to create a web based application to remotely customize a CAD model. This includes customizing a CAD model by using a graphical user interface to be able to remotely control the inputs to- and outputs from the model in NX, and to get the result sent back to the user. Using CAD systems such as NX requires intensive training, is often a slow process and gives a lot of room for errors. An intuitive, simple user interface will eliminate the need for CAD trai...

  13. Emotional Satisfaction of Customer Contacts

    OpenAIRE

    Güngör, Hüseyin

    2007-01-01

    For marketing and customer services researchers and professionals who are interested in customer contacts, customer satisfaction and loyalty issues. Contact centers are playing a pivotal role in customer services of the 21st century. Nevertheless, despite their growing importance and presence, contact centers are increasingly becoming the center for customer frustration, and frequently associated with negative comments in the media. Therefore, this research explores the Emotional, Cognitive, ...

  14. Building Agents to Serve Customers

    OpenAIRE

    Barbuceanu, Mihai; Fox, Mark S.; Hong, Lei; Lallement, Yannick; Zhang, Zhongdong

    2004-01-01

    AI agents combining natural language interaction, task planning, and business ontologies can help companies provide better-quality and more costeffective customer service. Our customer-service agents use natural language to interact with customers, enabling customers to state their intentions directly instead of searching for the places on the Web site that may address their concern. We use planning methods to search systematically for the solution to the customer's problem, ensuring that a r...

  15. UNDERSTANDING CUSTOMERS - PROFILING AND SEGMENTATION

    OpenAIRE

    Mircea Andrei SCRIDON

    2008-01-01

    In any industry, the first step to finding and creating profitable customers isdetermining what drives profitability. This leads to better prospecting andmore successful customer relationship management. Any company cansegment and profile their customer base to uncover those profit drivers usingthe knowledge of their customers, products, and markets. Or they can usedata-driven techniques to find natural clusters in their customer or prospectbase. Whatever the method, the process will lead to ...

  16. Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study

    Science.gov (United States)

    Koike, Yoshihisa; Kondo, Hideki; Kondo, Satoshi; Takagi, Masayuki; Kano, Yoshio

    2013-01-01

    Purpose To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients. Methods Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week). Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale. Results Significant decreases in systolic (P steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded. Conclusion The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients. PMID:23717038

  17. Clinical researches on the efficacy of spa therapy in fibromyalgia: a systematic review

    Directory of Open Access Journals (Sweden)

    Antonio Fraioli

    2013-06-01

    Full Text Available BACKGROUND: Fibromyalgia is characterized by chronic widespread pain, tenderness at muscle and tendon insertions point when digital pressure is applied, sleep disorders, chronic fatigue, depressive episodes, anxiety, and other functional somatic syndromes. OBJECTIVE: The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia. METHODS: We conducted a systematic review of the literature regarding spa therapy in the treatment of the fibromyalgia. We searched many databases for articles published between 2000 and 2012 and we selected 7 studies among 65 articles retrieved. A total of 142 patients received balneotherapy and 129 were controls. CONCLUSIONS: Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain, depression and minor symptoms.

  18. Local and spa fee on the example of Kujawsko-pomorskie municipalities

    Directory of Open Access Journals (Sweden)

    Robert Kwaśniewski

    2016-12-01

    Full Text Available The article discusses facultative public levies in the Polish tax system – ie. local and spa tax. This publication presents legal structure of both taxes in accordance with the regulations of local taxes and fees contained in the Act of 12 January 1991. It also presents the results of empirical researches that have been carried out in Kujawsko-pomorskie municipalities, where local and spa taxes occured. The basic aim of study was to determine in which municipalities these fees were in force in 2010–2014 and what income had the individual municipal governments. Completed research would answer the question, whether the analysed charges are effective from local government`s point of view. The article is based on the analysis of legal acts, available literature and using case law of administrative courts. Furthermore, the authors presented the results of empirical research taken from Ms. Iwona Majewska thesis.

  19. Insulin utilizes the PI 3-kinase pathway to inhibit SP-A gene expression in lung epithelial cells

    Directory of Open Access Journals (Sweden)

    Snyder Jeanne M

    2002-10-01

    Full Text Available Abstract Background It has been proposed that high insulin levels may cause delayed lung development in the fetuses of diabetic mothers. A key event in lung development is the production of adequate amounts of pulmonary surfactant. Insulin inhibits the expression of surfactant protein A (SP-A, the major surfactant-associated protein, in lung epithelial cells. In the present study, we investigated the signal transduction pathways involved in insulin inhibition of SP-A gene expression. Methods H441 cells, a human lung adenocarcinoma cell line, or human fetal lung explants were incubated with or without insulin. Transcription run-on assays were used to determine SP-A gene transcription rates. Northern blot analysis was used to examine the effect of various signal transduction inhibitors on SP-A gene expression. Immunoblot analysis was used to evaluate the levels and phosphorylation states of signal transduction protein kinases. Results Insulin decreased SP-A gene transcription in human lung epithelial cells within 1 hour. Insulin did not affect p44/42 mitogen-activated protein kinase (MAPK phosphorylation and the insulin inhibition of SP-A mRNA levels was not affected by PD98059, an inhibitor of the p44/42 MAPK pathway. In contrast, insulin increased p70 S6 kinase Thr389 phosphorylation within 15 minutes. Wortmannin or LY294002, both inhibitors of phosphatidylinositol 3-kinase (PI 3-kinase, or rapamycin, an inhibitor of the activation of p70 S6 kinase, a downstream effector in the PI 3-kinase pathway, abolished or attenuated the insulin-induced inhibition of SP-A mRNA levels. Conclusion Insulin inhibition of SP-A gene expression in lung epithelial cells probably occurs via the rapamycin-sensitive PI 3-kinase signaling pathway.

  20. DNAGear- a free software for spa type identification in Staphylococcus aureus

    Science.gov (United States)

    2012-01-01

    Background Staphylococcus aureus is both human commensal and an important human pathogen, responsible for community-acquired and nosocomial infections ranging from superficial wound infections to invasive infections, such as osteomyelitis, bacteremia and endocarditis, pneumonia or toxin shock syndrome with a mortality rate up to 40%. S. aureus reveals a high genetic polymorphism and detecting the genotypes is extremely useful to manage and prevent possible outbreaks and to understand the route of infection. One of current and expanded typing method is based on the X region of the spa gene composed of a succession of repeats of 21 to 27 bp. More than 10000 types are known. Extracting the repeats is impossible by hand and needs a dedicated software. Unfortunately the only software on the market is a commercial program from Ridom. Findings This article presents DNAGear, a free and open source software with a user friendly interface written all in Java on top of NetBeans Platform to perform spa typing, detecting new repeats and new spa types and synchronizing automatically the files with the open access database. The installation is easy and the application is platform independent. In fact, the SPA identification is a formal regular expression matching problem and the results are 100% exact. As the program is using Java embedded modules written over string manipulation of well established algorithms, the exactitude of the solution is perfectly established. Conclusions DNAGear is able to identify the types of the S. aureus sequences and detect both new types and repeats. Comparing to manual processing, which is time consuming and error prone, this application saves a lot of time and effort and gives very reliable results. Additionally, the users do not need to prepare the forward-reverse sequences manually, or even by using additional tools. They can simply create them in DNAGear and perform the typing task. In short, researchers who do not have commercial software will

  1. DNAGear--a free software for spa type identification in Staphylococcus aureus.

    Science.gov (United States)

    AL-Tam, Faroq; Brunel, Anne-Sophie; Bouzinbi, Nicolas; Corne, Philippe; Bañuls, Anne-Laure; Shahbazkia, Hamid Reza

    2012-11-19

    Staphylococcus aureus is both human commensal and an important human pathogen, responsible for community-acquired and nosocomial infections ranging from superficial wound infections to invasive infections, such as osteomyelitis, bacteremia and endocarditis, pneumonia or toxin shock syndrome with a mortality rate up to 40%. S. aureus reveals a high genetic polymorphism and detecting the genotypes is extremely useful to manage and prevent possible outbreaks and to understand the route of infection. One of current and expanded typing method is based on the X region of the spa gene composed of a succession of repeats of 21 to 27 bp. More than 10000 types are known. Extracting the repeats is impossible by hand and needs a dedicated software. Unfortunately the only software on the market is a commercial program from Ridom. This article presents DNAGear, a free and open source software with a user friendly interface written all in Java on top of NetBeans Platform to perform spa typing, detecting new repeats and new spa types and synchronizing automatically the files with the open access database. The installation is easy and the application is platform independent. In fact, the SPA identification is a formal regular expression matching problem and the results are 100% exact. As the program is using Java embedded modules written over string manipulation of well established algorithms, the exactitude of the solution is perfectly established. DNAGear is able to identify the types of the S. aureus sequences and detect both new types and repeats. Comparing to manual processing, which is time consuming and error prone, this application saves a lot of time and effort and gives very reliable results. Additionally, the users do not need to prepare the forward-reverse sequences manually, or even by using additional tools. They can simply create them in DNAGear and perform the typing task. In short, researchers who do not have commercial software will benefit a lot from this

  2. [Sanatorium-and-spa treatment of children with mucoviscidosis and pancreatic lesions].

    Science.gov (United States)

    Mesropian, S K; Kaĭsinova, A S; Stanilevich, T B; Ter-Akopov, N G

    2010-01-01

    Over 5 years ago, the Yunost' sanatorium, Essentuki, and the Russian Centre of Mucoviscidosis, Moscow, began to jointly implement a rehabilitation program for children with mucoviscidosis. The data obtained made it possible for the first time to propose incorporation of drinking carbonate mineral water in the combined sanatorium-and-spa treatment of such patients. The new method allowed effectiveness of this therapy to be improved by 16-18%.

  3. Analysis of Customer Loyalty through Total Quality Service, Customer Relationship Management and Customer Satisfaction

    Science.gov (United States)

    Binsar Kristian P., Feliks Anggia; Panjaitan, Hotman

    2014-01-01

    This research talks about total quality service and customer relationship management effects toward customer satisfaction and its impact on customer loyalty. Fast food restaurant KFC, always strives to continue to make improvements in total quality service, so that customer satisfaction can be maintained, which in turn will have an impact on…

  4. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    van Triest, S.; van Raaij, E.M.; Bun, M.; Vernooij, M.

    2007-01-01

    We study the effects of customer-specific marketing expenses on customer retention and cus-tomer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a type of expenses targeted at individual customer relationships: the

  5. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    van Triest, S.; Bun, M.J.G.; van Raaij, E.M.; Vernooij, M.J.A.

    2009-01-01

    We study the effects of customer-specific marketing expenses on customer retention and customer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a hitherto unstudied type of expense targeted at individual customer

  6. Creating Customer Delight.

    Science.gov (United States)

    Black, Jim

    1995-01-01

    This article proposes that college admissions officers interested in improving service should focus on creating customer delight rather than simply satisfaction, studying the system when things go wrong rather than placing blame, establishing employee well-being as the highest priority of the organization, providing necessary tools and training…

  7. Students as Customers?

    Science.gov (United States)

    Cuthbert, Rob

    2010-01-01

    The idea that students might be treated as customers triggers academics' antipathy, which in turn can lead to managerial irritation and political frustration. There are different discourses which barely overlap as their protagonists speak past one another. This article argues that these differences can be reconciled by re-conceiving the…

  8. Making Product Customization Profitable

    DEFF Research Database (Denmark)

    Mortensen, Niels Henrik; Hvam, Lars; Haug, Anders

    2010-01-01

    The main result presented in this paper is the Framework for Product Family Master Plan. This framework supports the identification of a product architecture for companies that customize products and services. The framework has five coherent aspects, the market, product assortment, supply...

  9. Pulling Marbles from a Bag: Deducing the Regional Impact History of the SPA Basin from Impact Melt Rocks

    Science.gov (United States)

    Cohen, Barbara A.; Coker, R. F.

    2009-01-01

    The South Pole-Aitken (SPA) basin is an important target for absolute age-dating. Vertical and lateral impact mixing ensures that regolith within SPA will contain rock fragments from SPA itself, local impact craters, and faraway giant basins. About 20% of the regolith at any given site is foreign [1, 2], but much of this material will be cold ejecta, not impact melt. We calculated the fraction of contributed impact melt using scaling laws to estimate the amount and provenance of impact melt, demonstrating that SPA melt is the dominant impact melt rock (>70%) likely to be present. We also constructed a statistical model to illustrate how many randomly-selected impact-melt fragments would need to be dated, and with what accuracy, to confidently reproduce the impact history of a site. A detailed impact history becomes recognizable after a few hundred to a thousand randomly-selected marbles, however, it will be useful to have more information (e.g. compositional, mineralogical, remote sensing) to group fragments. These exercises show that SPA melt has a high probability of being present in a scoop sample and that dating of a few hundred to a thousand impact-melt fragments will yield the impact history of the SPA basin.

  10. Determination of protective properties of Bardejovske Kuple spa curative waters by rotational viscometry and ABTS assay

    Directory of Open Access Journals (Sweden)

    TOPOLSKA Dominika

    2014-02-01

    Full Text Available Mineral waters from Bardejovske Kupele spa are natural, strongly mineralized, with healing effects. They are classified as hydrocarbonic - containing chloride and sodium - carbonic, cold, hypotonic, with a relatively high boric acid content. Potential anti-oxidative effects of curative waters from Bardejovske Kupele were investigated against the hyaluronan (HA degradation. High-molar-mass HA was exposed to the action of ascorbate and cupric ions, which initiate free-radical chain degradation. Time-dependent changes of dynamic viscosity (h of the HA solutions were monitored by rotational viscometry. The radical scavenging capacity of curative waters was determined by the ABTS assay. Despite a significantly high content of transition metal ions, especially iron, remarkable protective effects of the two curative spa waters were found, namely Alzbeta and Klara. Even though “Alzbeta´s“ iron content was 3.5-fold higher than “Klara´s“, “Alzbeta“ was shown to have better protective properties against the HA degradation compared to “Klara“. Bolus addition of ferric ions to the reaction system instead of the natural iron-containing curative water caused a significant HA degradation. The ABTS decolorization assay revealed that the curative spa waters were proven as poorly effective scavengers of the ABTS·+ cation radical.

  11. Transmission of Staphylococcus aureus from maternity unit staff members to newborns disclosed through spa typing.

    Science.gov (United States)

    Matussek, Andreas; Taipalensuu, Jan; Einemo, Ing-Marie; Tiefenthal, Malena; Löfgren, Sture

    2007-03-01

    We observed previously that newborn infants are colonized with Staphylococcus aureus, even if their mothers do not carry S aureus. This observation indicated a cross colonization, and, thus, a risk for nosocomial infection, although the infants are roomed in with their mothers. The S aureus colonization of infants, their parents, and staff members was measured at 3 maternity units. Possible transmission routes were determined using spa typing of S aureus isolates. Infants had the highest S aureus carriage (45%) compared with fathers (39%), mothers (27%), and staff members (27%). In 13 out of 44 colonized infants, transmission from staff members was indicated. This transmission was more frequent than was transmission from their own parents (11 cases), and occurred even in cases when parents were colonized with S aureus of other spa types. We confirm a high level of transmission of S aureus from staff members to infants, indicating a risk for patient safety, which necessitates continuing work with implementing scientific evidence for infection control. The spa typing is a rapid and valuable epidemiological tool, and it can be used in improving hospital hygiene control programs.

  12. Removal of linear alkylbenzene sulfonate (LAS) and its intermediate, sulfophenylalkanoates (spa) using a bioreactor

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Ku [Seoul National Univ., Seoul (Korea, Republic of); Kim, Ji Hyeon; Yoo, Young Je [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of); Kim, Hwa Yong [Seoul National Univ., Seoul (Korea, Republic of)

    1995-12-01

    A fluidized-bed bioreactor was used to treat the industrial wastewater containing linear alkylbenzene sulfonate(LAS). Microorganism obtained by acclimation showed low growth rate and substrate inhibition at relatively high substrate concentration. It was found from the experiment using fluidized-bed bioreactor that 64 {mu}m-thick biofilm was made after 15 days. The 93.4% LAS removal efficiency in the reactor was obtained at 120 mg/L of initial LAS concentration, while the removal efficiency of sulfophenylalkannoates(SPA) which is a representative intermediate of biodegradation of LAS was 60-88% depending on the initial concentration of LAS. When sodium benzoate was added to the second reactor, the remaining SPA became lowered by 40% compared to the control experiment. And when activated carbon was added to the reactor, the removal efficiency of SPA was 96.2% and that of LAS was 100% when initial inflowing concentration of LAS was 350 mg/L. 13 refs., 4 tabs., 8 figs.

  13. CUSTOMS POLICY, CUSTOMS BUSINESS, CUSTOMS REGULATION: TO PROBLEM OF CONCEPTION CORRELATIONS

    OpenAIRE

    A. D. Molokovich; K. N. Shabeka

    2010-01-01

    Theoretical and methodological comprehension of customs regulation place and role in provision of trade and transport activity under conditions of world integration processes is considered in the paper.The essence of such economic categories as «customs policy», «customs regulation», «customs and tariff regulation», «customs business» is ascertained with the help of justified argumentation, clear conception approaches.

  14. Has the Web really empowered health care consumers? The truth is customers may not have changed as much as we think.

    Science.gov (United States)

    Wilkins, S T; Navarro, F H

    2001-01-01

    The experts tell us that fueled by unprecedented access to health information online, today's new health care consumer will revolutionize the way health care services are organized and delivered. An examination of consumers from a health value-graphic perspective, however, casts some doubt on these predictions. Patterns emerging online are simply making us more aware of existing consumer segments that have always been actively involved in their own health.

  15. CUSTOMER-ORIENTED MANAGEMENT PRINCIPLES IN SPORTS PLACES AND SPACES AS AN EFFECTIVE STEP TO PROVIDE PHYSICAL AND MENTAL HEALTH OF CITIZENS

    Directory of Open Access Journals (Sweden)

    Habib Honari

    2011-01-01

    Full Text Available The aim of this research was to study the factors affecting productivity of sport places and spacesin the city of Tehran in the field of customer-orientation. The methodology of the study wasdescriptive-survey that was conducted as a field-study. The research population included expertsand managers of sports places and spaces in Tehran; and the sample consisted of 40 managersand experts. The sampling method was non-random. The measure was a researcher-madequestionnaire with 45 items and 7-point Likert scale that its validity was approved by 13 experts.Cronbach's Alpha was used to determine its reliability which was α = 0.87. The descriptivestatistics was used to describe the examinees status in terms of education; age; and sex. FriedmanTest was applied to prioritize the factors affecting productivity of the sports areas in the field ofcustomer-orientation. The results showed that in customer orientation field; cross-relation andinteraction of managers with the community places highest priority (5/80 and type ofapplication (athletic; educational and entertaining has the lowest priority (4/80. The findingscould play an important role in satisfying users of sporting spaces (as a most-user field in thecity.

  16. Customer value & business success in the 21st century.

    Science.gov (United States)

    Szablowski, P A

    2000-01-01

    Many health care organizations are realizing the importance of understanding the needs and expectations of customers and prospective customers, coupled with developing services that best meet and exceed those expectations. These concepts represent an innovative yet fundamental approach to building success beyond the clinical aspects. To create, build on, and measure the "customer value factor" in its bottom line, health care organizations must (1) understand how meeting and exceeding the needs and expectations of customers will become the most significant differentiator of true business value, (2) learn how to develop realistic, measurable, and successful customer value processes within complex organizations, (3) understand how customer value can link with the power of strategic communications to become the new currency for the next millennium.

  17. Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns.

    Science.gov (United States)

    Gucht, Dinska Van; Adriaens, Karolien; Baeyens, Frank

    2017-07-17

    (1) Background: Characteristics and usage patterns of vapers (e-cigarette users) have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2) Methods: Customers were questioned on their smoking history, current smoking and vaping status, reasons for vaping, perceived harmfulness, and potential health changes due to vaping; (3) Results: Almost everyone (99%, 95% CI 0.96, 1.00) smoked before they started vaping. A great majority agreed that unlike with other smoking-cessation aids, they could quit smoking (81%, 95% CI 0.79, 0.90) due to vaping. Almost all customers were regular vapers (93.6%, 95% CI 0.89, 0.96) who used state-of-the-art open system devices without modifications and e-liquid with 10 mg/mL nicotine on average. Vapers reported using e-cigs to quit smoking, because e-cigs are healthier, and for financial reasons. The majority (52.6%, 95% CI 0.46, 0.60) perceived vaping as not that harmful to not harmful at all , but one fifth (21.8%, 95% CI 0.16, 0.28) believed vaping to be harmful. More than half (57.8%, 95% CI 0.50, 0.65) reported gaining more pleasure from vaping than from smoking. A substantial majority (84.2%, 95% CI 0.78, 0.89) agreed that their health had improved since they started vaping; (4) Conclusions: Findings are similar to those obtained in other vape shop studies, but also to the results of convenience samples of less-well-defined populations.

  18. Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns

    Directory of Open Access Journals (Sweden)

    Dinska Van Gucht

    2017-07-01

    Full Text Available (1 Background: Characteristics and usage patterns of vapers (e-cigarette users have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2 Methods: Customers were questioned on their smoking history, current smoking and vaping status, reasons for vaping, perceived harmfulness, and potential health changes due to vaping; (3 Results: Almost everyone (99%, 95% CI 0.96, 1.00 smoked before they started vaping. A great majority agreed that unlike with other smoking-cessation aids, they could quit smoking (81%, 95% CI 0.79, 0.90 due to vaping. Almost all customers were regular vapers (93.6%, 95% CI 0.89, 0.96 who used state-of-the-art open system devices without modifications and e-liquid with 10 mg/mL nicotine on average. Vapers reported using e-cigs to quit smoking, because e-cigs are healthier, and for financial reasons. The majority (52.6%, 95% CI 0.46, 0.60 perceived vaping as not that harmful to not harmful at all, but one fifth (21.8%, 95% CI 0.16, 0.28 believed vaping to be harmful. More than half (57.8%, 95% CI 0.50, 0.65 reported gaining more pleasure from vaping than from smoking. A substantial majority (84.2%, 95% CI 0.78, 0.89 agreed that their health had improved since they started vaping; (4 Conclusions: Findings are similar to those obtained in other vape shop studies, but also to the results of convenience samples of less-well-defined populations.

  19. Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns

    Science.gov (United States)

    Van Gucht, Dinska; Adriaens, Karolien; Baeyens, Frank

    2017-01-01

    (1) Background: Characteristics and usage patterns of vapers (e-cigarette users) have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2) Methods: Customers were questioned on their smoking history, current smoking and vaping status, reasons for vaping, perceived harmfulness, and potential health changes due to vaping; (3) Results: Almost everyone (99%, 95% CI 0.96, 1.00) smoked before they started vaping. A great majority agreed that unlike with other smoking-cessation aids, they could quit smoking (81%, 95% CI 0.79, 0.90) due to vaping. Almost all customers were regular vapers (93.6%, 95% CI 0.89, 0.96) who used state-of-the-art open system devices without modifications and e-liquid with 10 mg/mL nicotine on average. Vapers reported using e-cigs to quit smoking, because e-cigs are healthier, and for financial reasons. The majority (52.6%, 95% CI 0.46, 0.60) perceived vaping as not that harmful to not harmful at all, but one fifth (21.8%, 95% CI 0.16, 0.28) believed vaping to be harmful. More than half (57.8%, 95% CI 0.50, 0.65) reported gaining more pleasure from vaping than from smoking. A substantial majority (84.2%, 95% CI 0.78, 0.89) agreed that their health had improved since they started vaping; (4) Conclusions: Findings are similar to those obtained in other vape shop studies, but also to the results of convenience samples of less-well-defined populations. PMID:28714914

  20. Mucosal adhesion properties of the probiotic Lactobacillus rhamnosus GG SpaCBA and SpaFED pilin subunits

    NARCIS (Netherlands)

    Ossowski, von I.; Reunanen, J.; Satokari, R.M.; Vesterlund, S.; Kankainen, M.; Huhtinen, H.; Tynkkynen, S.; Salminen, S.; Vos, de W.M.; Palva, A.

    2010-01-01

    Lactobacillus rhamnosus GG is a well-established Gram-positive probiotic strain, whose health-benefiting properties are in part dependent upon a prolonged residency in the gastrointestinal tract and likely dictated by an adherence to the intestinal mucosa. Previously, we identified two pilus gene

  1. Standards and Customer Service: Employees Behavior towards Customers

    Directory of Open Access Journals (Sweden)

    Venelin Terziev

    2017-09-01

    Full Text Available Ensuring effective customer service requires targeted efforts in a number of areas, one of which is to develop service standards for each market segment. The development and implementation of standards requires the organization to accurately determine customer service types, the cost of providing alternative services, and measures for measuring and controlling the services provided. At the core of the developed and implemented standards is the development and establishment of the customer service policy, which should start with a consumer demand analysis. The definition of customer service level should allow for quantitative measurement because the vague and quantifiable policy does not provide opportunities for evaluation and control of the activities and expenses of customer service. When developing service standards, it is appropriate to apply an algorithm that focuses primarily on standards related to employee behavior towards customers. This paper explores the need and capability to develop customer service standards and provides an algorithm for developing standards for employee behavior toward customers.

  2. How to strengthen customer loyalty, using customer segmentation?

    Directory of Open Access Journals (Sweden)

    MELNIC Elena Lidia

    2017-01-01

    Full Text Available Do you provide exceptional customer service?”, “Is the customer service in your company extraordinary?” “How to convert satis fied customers into loyal customers?” - are the most frequent questions of today’s managers and have driven the research on this article to getting the answer to a highly important marketing topic “How to strengthen customer loyalty using customer segmentation?”. Anyone who has bought a product or a service has probably suffered at least once from a company’s apparent indifference to what should be its first concern: the customer experiences. If this is the case, the company is in a wrong direction, since loyalty is the most powerful tool in today competitive market. To strengthen the bonds with these high-profit customers, innovative companies are deploying enterprise-wide strategies built on consumer segmentation.

  3. Service quality and perceived customer value in community pharmacies.

    Science.gov (United States)

    Guhl, Dennis; Blankart, Katharina E; Stargardt, Tom

    2018-01-01

    A patient's perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies-defined as perceived customer value-in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents' prescription fill in the last six months in Germany. The service elements personal interaction (path coefficient: 0.31), physical aspect (0.12), store policy (0.24), and availability (0.1) have a positive significant effect on perceived customer value. Consultation and reliability have no significant influence. We further find a strong positive interdependency between perceived customer value, customer satisfaction (0.75), and customer loyalty (0.71). Thus, pharmacies may enhance customer satisfaction and loyalty if they consider the customer perspective and focus on the relevant service elements. To enhance benefit, personal interaction appears to be most important to address appropriately.

  4. The Effect of Customer Empowerment on Adherence to Expert Advice

    OpenAIRE

    Camacho, Nuno; Jong, Martijn; Stremersch, Stefan

    2014-01-01

    textabstractCustomers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional empowerment and study whether empowerment leads customers to adhere more or less to expert advice. We empirically test our model using a unique dataset involving 11,735 respondents in 17 countries on four...

  5. Customer Segmentation by Factors Influencing Brand Loyalty and Customer Involvement

    OpenAIRE

    Tereza Vebrová; Kateřina Venclová; Stanislav Rojík

    2016-01-01

    Brand loyalty and customer involvement are two important concepts that help explain and understand a significant part of consumer shopping behavior. The aim of the present work is to identify factors influencing brand loyalty and customer involvement. A further aim is to consider subsequent segmentation of customers with respect to different degrees of brand loyalty and customer involvement. The research was focused on the field of Czech telecommunication services – mobile operators. Primary ...

  6. Customization of biomedical terminologies.

    Science.gov (United States)

    Homo, Julien; Dupuch, Laëtitia; Benbrahim, Allel; Grabar, Natalia; Dupuch, Marie

    2012-01-01

    Within the biomedical area over one hundred terminologies exist and are merged in the Unified Medical Language System Metathesaurus, which gives over 1 million concepts. When such huge terminological resources are available, the users must deal with them and specifically they must deal with irrelevant parts of these terminologies. We propose to exploit seed terms and semantic distance algorithms in order to customize the terminologies and to limit within them a semantically homogeneous space. An evaluation performed by a medical expert indicates that the proposed approach is relevant for the customization of terminologies and that the extracted terms are mostly relevant to the seeds. It also indicates that different algorithms provide with similar or identical results within a given terminology. The difference is due to the terminologies exploited. A special attention must be paid to the definition of optimal association between the semantic similarity algorithms and the thresholds specific to a given terminology.

  7. Assesment of customer relationship development

    Directory of Open Access Journals (Sweden)

    Dagmar Lesáková

    2011-01-01

    Full Text Available The focus of this paper is customer relationship marketing and its new trends. The particular goal of the presented research study was to identify and analyse the indicators of customer relationship development in human resources recruitment / leasing companies. Nine indicators have been explored: mission statement concerning customer commitment, customer attraction, customer commitment, development of customer value, understanding customer needs, goals for customer satisfaction, after sales services, measurement of customer satisfaction, complaint management. The indicators were made sequentially operational in order to translate customer relationship development into specific activities designed to increase business performance. Based on a set of customer indicators four scientific hypotheses were tested. We proved that strong customer orientation has a positive impact on business performance. Out of nine indicators, seven of them have a strong impact on business outcomes. The research confirms that business performance increases with firm size and market density, and that introduction of quality management systems improves company performance. Finally, the appropriateness of the customer relationship indicators applied in human resources recruitment companies is discussed.

  8. Outsourcing customer support : The role of provider customer focus

    NARCIS (Netherlands)

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  9. Customer retention through supplier-organization-customer relationship management

    OpenAIRE

    Žvirelienė, Renata; Bučiūnienė, Ilona; Škudienė, Vida; Sakalas, Algimantas

    2009-01-01

    The research objective was to assess the relationship marketing outputs' (internal relationship, relationship with customer, relationship with supplier) interrelationship and their relationship with customers' retention. The internal and external relationship dimensions of commitment, satisfaction, trust, communication, cooperation and empathy were used to measure supplier-organization-customer relationship strength. The survey was conducted in cargo vehicles trading industry companies in Lit...

  10. Customer Engagement as a New Perspective in Customer Management

    NARCIS (Netherlands)

    Verhoef, Peter C.; Reinartz, Werner J.; Krafft, Manfred

    Since 2000, customer management (CM) research has evolved and has had a significant impact on the marketing discipline. In an increasingly networked society where customers can interact easily with other customers and firms through social networks and other new media, the authors propose that

  11. Impact of Customer Relationship Management on Customer Loyalty, Customer Retention and Customer Profitability for Hotelier Sector

    OpenAIRE

    Sandra-Dinora Orantes-Jiménez; Graciela Vázquez-Álvarez; Ricardo Tejeida-Padilla

    2017-01-01

    Since the entrance of strategies oriented to marketing relational in Hotelier Sector, the traditional way of travel agents and other representatives arranging hospitality services for hotel and travel reservations has changed. The strategies oriented to customer relationship management are a relatively new area of specialty loyalty marketing in the hotel and hotelier sector, with advancements being made constantly. The use of this type of strategy can allow hoteliers or companies to tailo...

  12. Partnership with the customer

    Science.gov (United States)

    Trachta, Gregory S.

    This discussion will recount some historical observations about establishing partnerships with the customer. It suggests that such partnerships are established as the natural evolutionary product of a continuous improvement culture. Those are warm, ethereal terms about a topic that some people think already suffers from an excess of hot air. We will focus on some real-world activities and workplace artifacts to show there are substantive concepts behind the TQM buzzwords.

  13. CERTS customer adoption model

    Energy Technology Data Exchange (ETDEWEB)

    Rubio, F. Javier; Siddiqui, Afzal S.; Marnay, Chris; Hamachi,Kristina S.

    2000-03-01

    This effort represents a contribution to the wider distributed energy resources (DER) research of the Consortium for Electric Reliability Technology Solutions (CERTS, http://certs.lbl.gov) that is intended to attack and, hopefully, resolve the technical barriers to DER adoption, particularly those that are unlikely to be of high priority to individual equipment vendors. The longer term goal of the Berkeley Lab effort is to guide the wider technical research towards the key technical problems by forecasting some likely patterns of DER adoption. In sharp contrast to traditional electricity utility planning, this work takes a customer-centric approach and focuses on DER adoption decision making at, what we currently think of as, the customer level. This study reports on Berkeley Lab's second year effort (completed in Federal fiscal year 2000, FY00) of a project aimed to anticipate patterns of customer adoption of distributed energy resources (DER). Marnay, et al., 2000 describes the earlier FY99 Berkeley Lab work. The results presented herein are not intended to represent definitive economic analyses of possible DER projects by any means. The paucity of data available and the importance of excluded factors, such as environmental implications, are simply too important to make such an analysis possible at this time. Rather, the work presented represents a demonstration of the current model and an indicator of the potential to conduct more relevant studies in the future.

  14. Toward Customized Care

    Science.gov (United States)

    Minvielle, Etienne

    2018-01-01

    Patients want their personal needs to be taken into account. Accordingly, the management of care has long involved some degree of personalization. In recent times, patients’ wishes have become more pressing in a moving context. As the population ages, the number of patients requiring sophisticated combinations of longterm care is rising. Moreover, we are witnessing previously unvoiced demands, preferences and expectations (eg, demand for information about treatment, for care complying with religious practices, or for choice of appointment dates). In view of the escalating costs and the concerns about quality of care, the time has now come to rethink healthcare delivery. Part of this reorganization can be related to customization: what is needed is a customized business model that is effective and sustainable. Such business model exists in different service sectors, the customization being defined as the development of tailored services to meet consumers’ diverse and changing needs at near mass production prices. Therefore, its application to the healthcare sector needs to be seriously considered. PMID:29524957

  15. Comparison of the DiversiLab Repetitive Element PCR System with spa Typing and Pulsed-Field Gel Electrophoresis for Clonal Characterization of Methicillin-Resistant Staphylococcus aureus▿

    Science.gov (United States)

    Babouee, B.; Frei, R.; Schultheiss, E.; Widmer, A. F.; Goldenberger, D.

    2011-01-01

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has become an increasing problem worldwide in recent decades. Molecular typing methods have been developed to identify clonality of strains and monitor spread of MRSA. We compared a new commercially available DiversiLab (DL) repetitive element PCR system with spa typing, spa clonal cluster analysis, and pulsed-field gel electrophoresis (PFGE) in terms of discriminatory power and concordance. A collection of 106 well-defined MRSA strains from our hospital was analyzed, isolated between 1994 and 2006. In addition, we analyzed 6 USA300 strains collected in our institution. DL typing separated the 106 MRSA isolates in 10 distinct clusters and 8 singleton patterns. Clustering analysis into spa clonal complexes resulted in 3 clusters: spa-CC 067/548, spa-CC 008, and spa-CC 012. The discriminatory powers (Simpson's index of diversity) were 0.982, 0.950, 0.846, and 0.757 for PFGE, spa typing, DL typing, and spa clonal clustering, respectively. DL typing and spa clonal clustering showed the highest concordance, calculated by adjusted Rand's coefficients. The 6 USA300 isolates grouped homogeneously into distinct PFGE and DL clusters, and all belonged to spa type t008 and spa-CC 008. Among the three methods, DL proved to be rapid and easy to perform. DL typing qualifies for initial screening during outbreak investigation. However, compared to PFGE and spa typing, DL typing has limited discriminatory power and therefore should be complemented by more discriminative methods in isolates that share identical DL patterns. PMID:21307215

  16. Customer Integration during Innovation Development

    DEFF Research Database (Denmark)

    Pedrosa, Alex

    2012-01-01

    of companies’ growing interest in effectively collaborating with customers, research has investigated the importance of firm–customer interaction during innovation development. However, despite valuable insights into the performance-enhancing effects of customer integration, research has thus far overlooked......To stay viable, companies need to increase their innovation development investments over time. However, successful innovation development also cannot happen without customers, and thus companies seek opportunities to enhance their knowledge of current and future customer needs. As a result...... the activities companies should engage in when integrating customers during innovation development. Thus, this study investigates how and when customer-oriented companies engage in customer interaction during innovation development. Using a multiple case study design, this study examines four substantive cases...

  17. [Impact of SPA therapy with sulphureous mineral water on quality of life and psychological distress in chronic plaque psoriasis].

    Science.gov (United States)

    Costantino, M; Filippelli, A

    2014-01-01

    The plaque psoriasis, one of the most common form of psoriasis, is a chronic inflammatory disease. This pathology can cause devastating effects on quality of life and social relations with significant physical and psychological distress. Currently among the therapeutic agents available for the treatment of psoriasis is including SPA therapy, whose mechanism of action is only partially known, as well as very few studies examined the impact of this therapy on the quality of life. On the basis of these considerations, the research analyzed the effectiveness of SPA bath therapy (BLT) and its impact on quality of life and psychological distress in patients suffering from chronic plaque psoriasis. The study was conducted on 35 patients with chronic plaque psoriasis: 23% male and 77% female; mean age:56 ± 19 years; age range:17-85 years. The subjects were treated, for 2 weeks, with sulphureous SPA bath therapy from Terme of Telese SpA (Benevento-Italy). At the beginning and at the end of the SPA treatment considered was evaluated: the itching symptom (using NRS scale); the PASI Index; the impact on quality of life (using SF-36 and DLQI questionnaires) and on psychological distress (using ZUNG -tests). At the end of the SPA treatment, the mean values ± SD, compared to baseline, have showed a significant (p 1.0 ± 1.0) and PASI score (4 ± 4-->1.7 ± 2) with an improvement in quality of life and psichological distress as demonstrated by SF-36, DLQI and ZUNG tests. The data of this research show that the sulphureous SPA bath therapy can be considered very useful in patients with mild-to-moderate psoriasis for the improving of the quality of life and social relationship.

  18. Risk management in customs control

    OpenAIRE

    Drobot, Elena; Klevleeva, Aziza

    2016-01-01

    The particularities of risk-management system implementation within customs control are discussed in the article. The authors single out the elements of risk-management system, evaluate effectiveness of risk-management in customs control. The main reasons for non-implementation of risk-management system in customs control are described, as well. Particular attention is paid to the benefits of customs risk management.

  19. Energizing Companies through Customer Compliments

    OpenAIRE

    Kipfelsberger, Petra; Bruch, Heike; Herhausen, Dennis

    2015-01-01

    While complaint management has received much attention, customer compliments and their systematic handling have been largely ignored. Based on two empirical studies, this article suggests that customer compliments bear great potential for benefiting firms, and gives recommendations on how managers can enable, stimulate, and amplify positive customer feedback.

  20. Repeat Customer Success in Extension

    Science.gov (United States)

    Bess, Melissa M.; Traub, Sarah M.

    2013-01-01

    Four multi-session research-based programs were offered by two Extension specialist in one rural Missouri county. Eleven participants who came to multiple Extension programs could be called "repeat customers." Based on the total number of participants for all four programs, 25% could be deemed as repeat customers. Repeat customers had…

  1. The art of customer service.

    Science.gov (United States)

    Williams, Jeni

    2007-10-01

    Strategies for improving the consumer service skills of finance staff include: Hire employees who have a customer service background. Work with your human resources department to provide customer service training. Monitor new hires extensively. Offer front-end employees scripted language for situations they may face on the job. Measure the quality of customer service provided. Provide incentives for performance.

  2. 19 CFR 146.3 - Customs supervision.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Customs supervision. 146.3 Section 146.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) FOREIGN TRADE ZONES General Provisions § 146.3 Customs supervision. (a) Assignment of Customs officers. Customs officers will be...

  3. The Effect of Customer Empowerment on Adherence to Expert Advice

    NARCIS (Netherlands)

    N.M.A. Camacho (Nuno); M.G. de Jong (Martijn); S. Stremersch (Stefan)

    2014-01-01

    textabstractCustomers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional

  4. The Role of Aspiration Level in Risky Choice: A Comparison of Cumulative Prospect Theory and SP/A Theory.

    Science.gov (United States)

    Lopes; Oden

    1999-06-01

    In recent years, descriptive models of risky choice have incorporated features that reflect the importance of particular outcome values in choice. Cumulative prospect theory (CPT) does this by inserting a reference point in the utility function. SP/A (security-potential/aspiration) theory uses aspiration level as a second criterion in the choice process. Experiment 1 compares the ability of the CPT and SP/A models to account for the same within-subjects data set and finds in favor of SP/A. Experiment 2 replicates the main finding of Experiment 1 in a between-subjects design. The final discussion brackets the SP/A result by showing the impact on fit of both decreasing and increasing the number of free parameters. We also suggest how the SP/A approach might be useful in modeling investment decision making in a descriptively more valid way and conclude with comments on the relation between descriptive and normative theories of risky choice. Copyright 1999 Academic Press.

  5. MASS CUSTOMIZATION and PRODUCT MODELS

    DEFF Research Database (Denmark)

    Svensson, Carsten; Malis, Martin

    2003-01-01

    to the product. Through the application of a mass customization strategy, companies have a unique opportunity to create increased customer satisfaction. In a customized production, knowledge and information have to be easily accessible since every product is a unique combination of information. If the dream...... of a customized alternative instead of a uniform mass-produced product shall become a reality, then the cross-organizational efficiency must be kept at a competitive level. This is the real challenge for mass customization. A radical restructuring of both the internal and the external knowledge management systems...

  6. Customs control of radioactive materials

    International Nuclear Information System (INIS)

    Causse, B.

    1998-01-01

    Customs officers take part in the combat against illicit traffic od radioactive materials by means of different regulations dealing with nuclear materials, artificial radiation sources or radioactive wastes. The capability of customs officers is frequently incomplete and difficult to apply due to incompatibility of the intervention basis. In case of contaminated materials, it seems that the customs is not authorised directly and can only perform incidental control. In order to fulfil better its mission of fighting against illicit traffic of radioactive materials customs established partnership with CEA which actually includes practical and theoretical training meant to augment the capabilities of customs officers

  7. UNDERSTANDING CUSTOMERS - PROFILING AND SEGMENTATION

    Directory of Open Access Journals (Sweden)

    Mircea Andrei SCRIDON

    2008-01-01

    Full Text Available In any industry, the first step to finding and creating profitable customers isdetermining what drives profitability. This leads to better prospecting andmore successful customer relationship management. Any company cansegment and profile their customer base to uncover those profit drivers usingthe knowledge of their customers, products, and markets. Or they can usedata-driven techniques to find natural clusters in their customer or prospectbase. Whatever the method, the process will lead to knowledge andunderstanding that is critical to maintaining a competitive edge

  8. Sustainability Evaluation of Mass Customization

    DEFF Research Database (Denmark)

    Brunø, Thomas Ditlev; Nielsen, Kjeld; Taps, Stig B.

    2013-01-01

    This paper addresses the issue whether the concepts mass customization and sustainability are fundamentally compatible by asking the question: can a mass customized product be sustainable? Some factors indicate that mass customized products are less sustainable than standardized products; however...... other factors suggest the opposite. This paper explores these factors during three life cycle phases for a product: Production, Use and End of Life. It is concluded that there is not an unambiguous causal relationship between mass customization and sustainability; however several factors unique to mass...... customized products are essential to consider during product development....

  9. Customer interruption cost and results

    Energy Technology Data Exchange (ETDEWEB)

    Eua-Arporn, B.; Bisarnbutra, S. [Chulalongkorn Univ., Bangkok (Thailand)

    1997-12-31

    Results of a comprehensive study on short-term direct impacts and consumer interruption costs, incurred as a result of power supply interruption, were discussed. The emphasis was on questionnaire development, general responses and the average customer damage function of some selected sectors. The customer damage function was established for each category of customers (agriculture, industry, mining, wholesale, retail merchandising, residential, etc) as well as for different locations. Results showed that the average customer damage function depended mostly on customer category. Size and location were not significant factors. 5 refs., 7 tabs.

  10. Combining qualitative design-based methods and quantitative consumer research methods to improve customer experience in small service businesses : an example from the health club industry

    NARCIS (Netherlands)

    Christine Lille, de; Remko van der Lugt; Dr. Gerrita van der Veen

    2015-01-01

    Author supplied: Abstract How can you provide health clubs with the possibility of offering innovative and differentiating services in an increasingly competitive and rapidly changing environment? This was the issue raised by the Dutch health club industry, which has grown rapidly in recent

  11. Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study

    Directory of Open Access Journals (Sweden)

    Koike Y

    2013-05-01

    Full Text Available Yoshihisa Koike,1 Hideki Kondo,2 Satoshi Kondo,1 Masayuki Takagi,1 Yoshio Kano31Department of Occupational Therapy, Prefectural University of Hiroshima, Mihara, Japan; 2Yoshiigawa Hospital, Okayama, Japan; 3Department of Occupational Therapy, Kibi International University, Takahashi, JapanPurpose: To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients.Methods: Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week. Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale.Results: Significant decreases in systolic (P < 0.01 and diastolic blood pressure (P < 0.05 along with a significant increase in tympanic temperature (P < 0.01 were observed after the steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P < 0.01 and the overall dementia severity items in Dementia Mood Assessment Scale (P < 0.05.Limitations: Japanese people are very fond of foot baths. However, it is difficult to understand why inpatients cannot receive steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded.Conclusion: The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients.Keywords: steam foot spa, geriatric inpatients, cognitive impairment, tympanic temperature

  12. Performance of scintillation proximity assay (SPA) to measure the level of VEGFR 1 protein

    International Nuclear Information System (INIS)

    LEE, So-Young; LIM, Jae-Cheong; KIM, Jin-Joo

    2014-01-01

    Scintillation proximity assay is a one of radioimmunoassay and can be assayed without the washing or filtration procedures normally used to separate bound from free fractions. Due to its simplicity and high-throughput protocol, it is broadly applicable to immunology, receptor binding, monitoring receptor-ligand interactions and enzyme reactions. Briefly, an antibody or receptor is coated on SPA beads. When a radiolabeled antigen or ligand binds to the beads, the SPA beads stimulate to emit short range electrons. The 3 H and 125 I are commonly used for radiolabeling and the produced photons are detectable with a liquid scintillation counter (LSC). A binding affinity of unlabeled ligands can be determined by competitive reaction of the radiolabeled ligands. Bevacizumab is a recombinant humanized monoclonal antibody, and can stop or delay growth of tumors by inhibiting vascular endothelial growth factor (VEGF). Bevacizumab was approved by FDA for metastatic cancer such as colorectal cancers, ovarian cancers, breast cancers and glioblastoma multiform of the brain. Recently, Dan G. duda et al. was reported that the concentration of vascular endothelial growth factor receptor-1 (VEGFR-1) in plasma may potentially be used as a negative selection biomarker. In this study, we describe a method using scintillation proximity assay to detect the amounts of VEGFR-1 protein. This method is successfully used to measure the concentration of VEGFR-1 protein in human cell extracts. In summary, a simple and sensitive assay is developed for measuring the amount of VEGFR 1 protein in cancer cell lysate using SPA beads. The antibody coating on the beads and antigen binding are achieved in one mixing step

  13. Performance of scintillation proximity assay (SPA) to measure the level of VEGFR 1 protein

    Energy Technology Data Exchange (ETDEWEB)

    LEE, So-Young; LIM, Jae-Cheong; KIM, Jin-Joo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    Scintillation proximity assay is a one of radioimmunoassay and can be assayed without the washing or filtration procedures normally used to separate bound from free fractions. Due to its simplicity and high-throughput protocol, it is broadly applicable to immunology, receptor binding, monitoring receptor-ligand interactions and enzyme reactions. Briefly, an antibody or receptor is coated on SPA beads. When a radiolabeled antigen or ligand binds to the beads, the SPA beads stimulate to emit short range electrons. The {sup 3}H and {sup 125}I are commonly used for radiolabeling and the produced photons are detectable with a liquid scintillation counter (LSC). A binding affinity of unlabeled ligands can be determined by competitive reaction of the radiolabeled ligands. Bevacizumab is a recombinant humanized monoclonal antibody, and can stop or delay growth of tumors by inhibiting vascular endothelial growth factor (VEGF). Bevacizumab was approved by FDA for metastatic cancer such as colorectal cancers, ovarian cancers, breast cancers and glioblastoma multiform of the brain. Recently, Dan G. duda et al. was reported that the concentration of vascular endothelial growth factor receptor-1 (VEGFR-1) in plasma may potentially be used as a negative selection biomarker. In this study, we describe a method using scintillation proximity assay to detect the amounts of VEGFR-1 protein. This method is successfully used to measure the concentration of VEGFR-1 protein in human cell extracts. In summary, a simple and sensitive assay is developed for measuring the amount of VEGFR 1 protein in cancer cell lysate using SPA beads. The antibody coating on the beads and antigen binding are achieved in one mixing step.

  14. Rehabilitation of patients with rheumatoid arthritis treated in stationary spa treatment

    Directory of Open Access Journals (Sweden)

    Amila Jaganjac

    2015-04-01

    Full Text Available Introduction: Rheumatic diseases are nonsurgical diseases of the locomotor system and connective tissue. Rheumatoid arthritis (RA is a systemic inflammatory disease of connective tissue of unknown cause, with progressive chronic or subacute course. The aim of the research is to determine whether stationary spa treatment leads to improvement of the functional status in patients with rheumatoid arthritis. Methods: We included 35 patients with diagnosis of rheumatoid arthritis, referred for treatment at the spa " Ilidža " Gradačac from February to April 2014. Patients not adhering to treatment protocols were excluded. We used Visual analogue pain scale (VAS, HAQ questionnaire and assessment of the clinical condition before and after the treatment based on the scores 1-5.Results: There were 32 female and 3 male patients. The average age was 62.28±8.31 years. Based on the HAQ, 12 patients had no difficulties, 9 of them perform activities with little difficulties, 10 with many difficulties, and 4 patients cannot perform certain activities. Before treatment VAS was 6.63±2.36, and after treatment the 2.51±2.27. Ratings of clinical condition before treatment was 2.38±0.74, and after the treatment 3.64±0.98. The most frequently used therapies were kinesitherapy, magnetotherapy and interferential electricity. Conclusions: Stationary treatment at the spa „Ilidža“ Gradačac leads to an improvement of the functional status in patients with rheumatoid arthritis.

  15. Managing Customer Value

    OpenAIRE

    William B. Dodds

    1999-01-01

    This paper builds the framework for linking the established work of competitive advantage with the emerging discipline of value marketing. The outcome of this linkage is the concept of strategic value management. Strategic value management focuses on the right combinations of product quality, customer service and fair prices as the key to selling to todayÕs value conscious consumers. The core of the strategy stresses the firmÕs ability to combine and manage these dimensions of value in a way ...

  16. Profiling the Mobile Customer

    DEFF Research Database (Denmark)

    Jessen, Pernille Wegener; King, Nancy J.

    2010-01-01

    of significant concerns about privacy and data protection. This second article in a two part series on "Profiling the Mobile Customer" explores how to best protect consumers' privacy and personal data through available mechanisms that include industry self-regulation, privacy-enhancing technologies...... discusses the current limitations of using technology to protect consumers from privacy abuses related to profiling. Concluding that industry self-regulation and available privacy-enhancing technologies will not be adequate to close important privacy gaps related to consumer profiling without legislative...

  17. Services Supporting the Customer

    DEFF Research Database (Denmark)

    Gremyr, Ida; Halldorsson, Arni; Hsuan, Juliana

    2017-01-01

    This paper focuses on customer and user experience of advanced service offerings, focusing mechanisms such as e.g. feedback processes as a means to utilise and learn from users’ experiences. The purpose is to understand how servitization changes the constellation of actors in aftermarket value...... creation, and what mechanisms are needed for firms to exploit the interactions in these new constellation as a basis for service improvement and development. By studying two manufacturing firms offering advanced services, this paper points to changed actor configurations (both intra- and inter......-organisational) and interaction mechanisms (existing and new) when transitioning to offering more advanced services such as “services supporting customers”....

  18. Ready: how to keep your customers coming back.

    Science.gov (United States)

    Eliscu, A T

    2000-01-01

    Customer service is a major, but often overlooked, issue in health care today. While other industries and organizations recognize how good customer relations can affect long-term success, many health care providers have yet to learn this valuable lesson. The Ritz-Carlton, which won the prestigious Baldridge Award for service, has a well-earned reputation for excellent customer service. Like health care providers, this hotel industry icon hires hourly workers, puts them in uniform and has them work in teams. Unlike health care, however, The Ritz-Carlton seems to be able to generate a much higher level of customer satisfaction. How? This chapter illustrates the techniques the hotel chain uses to accomplish its goal and how these important tools can apply to the health care industry.

  19. To Customize or Not to Customize? Exploring Science Teacher Customization in an Online Lesson Portal

    Science.gov (United States)

    Littenberg-Tobias, Joshua; Beheshti, Elham; Staudt, Carolyn

    2016-01-01

    New technologies are increasingly giving science teachers the ability to access and customize science lessons. However, there is substantial debate in the literature about whether and under what conditions teacher customization benefit student learning. In this study, we examined teacher customization of inquiry-based science lessons from an…

  20. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    S. van Triest (Sander); M.J.G. Bun (Maurice); E.M. van Raaij (Erik); M.J.A. Vernooij (Maarten)

    2009-01-01

    textabstractWe study the effects of customer-specific marketing expenses on customer retention and customer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a hitherto unstudied type of expense targeted at individual

  1. Binding of human collectins (SP-A and MBP) to influenza virus.

    OpenAIRE

    Malhotra, R; Haurum, J S; Thiel, S; Sim, R B

    1994-01-01

    Collectins are a group of soluble proteins each of which has collagenous domains and non-collagenous globular domains, the latter containing the consensus residues found in C-type lectins. Members of the collectin family are the serum proteins mannan-binding protein (MBP), conglutinin, CL-43, and the lung-associated proteins surfactant protein A (SP-A) and surfactant protein D (SP-D). MBP and conglutinin have been shown previously to bind to influenza viruses and to inhibit the infectivity an...

  2. Theories and contemporary challenges of a global pasta leader: the case of Barilla SpA

    OpenAIRE

    Wolf, Ronald Scott

    2015-01-01

    Barilla Holding SpA (Barilla), a successful multinational foods manufacturing company with headquarters in Parma, Italy began with humble beginnings in 1877 (Barilla, 2014a) as a small bread and pasta shop -- Barilla is now a leading global sales player second only to private label brands, jumping from 9-12% of total market from the period 2009-2014 and is the dominant sales leader in both Italy and the US with 2014 sales of 900 and 800 US$ million respectively (Euromonitor, 2015) -- This pap...

  3. [Spa-based water procedures and complications in the course of their performance].

    Science.gov (United States)

    Persiianova-Dubrova, A L; Badalov, N G; L'vova, N V; Krikorova, S A; Tupitsyna, Iu Iu; Uianaeva, A I; Barashkov, G N; Povazhnaia, E L

    2010-01-01

    The scope of applications of spa-based water procedures have become considerably extended during the recent years; accordingly, the frequency of complications and accidents has increased. The present review considers the possible mechanisms underlying such complications and various factors promoting their development, such as the patients' age and chronic diseases, the use of pharmaceutical products affecting thermoregulation and cardiovascular function. Special attention is given to the influence of alcohol consumption on the frequency of complications, accidents, and sudden death associated with hyperthermal procedures, the possibility of infectious diseases and measures necessary for their prevention.

  4. The mismanagement of customer loyalty.

    Science.gov (United States)

    Reinartz, Werner; Kumar, V

    2002-07-01

    Who wouldn't want loyal customers? Surely they should cost less to serve, they'd be willing to pay more than other customers, and they'd actively market your company by word of mouth, right? Maybe not. Careful study of the relationship between customer loyalty and profits plumbed from 16,000 customers in four companies' databases tells a different story. The authors found no evidence to support any of these claims. What they did find was that the link between customers and profitability was more complicated because customers fall into four groups, not two. Simply put: Not all loyal customers are profitable, and not all profitable customers are loyal. Traditional tools for segmenting customers do a poor job of identifying that latter group, causing companies to chase expensively after initially profitable customers who hold little promise of future profits. The authors suggest an alternative approach, based on well-established "event-history modeling" techniques, that more accurately predicts future buying probabilities. Armed with such a tool, marketers can correctly identify which customers belong in which category and market accordingly. The challenge in managing customers who are profitable but disloyal--the "butterflies"--is to milk them for as much as you can while they're buying from you. A softly-softly approach is more appropriate for the profitable customers who are likely to stay loyal--your "true friends." As for highly loyal but not very profitable customers--the "barnacles"--you need to find out if they have the potential to spend more than they currently do. And, of course, for the "strangers"--those who generate no loyalty and no profits--the answer is simple: Identify early and don't invest anything.

  5. Customer-driven competition

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, R. [Ontario Hydro, Toronto, ON (Canada)

    1996-12-31

    Ontario Hydro`s customer-driven strategy, recently approved by Hydro`s Executive Board, was described. The strategy is founded on the following components: (1) the dissolution of the Ontario power pool, i.e., the loss of Hydro`s franchise monopoly on generation, leaving only power transmission in the hands of the Corporation, (2) divestment of Ontario Hydro`s system operations and market operations functions to a new, independent Crown corporation called the Central Market Operator, (3) functional and organizational unbundling of Ontario Hydro into three signature businesses, Genco, Transco, and Retailco, and in the latter two, the functional unbundling of wires from sales and services, (4) a fully commercial Ontario Hydro with normal corporate powers, and (5) a corporate strategy for Ontario Hydro to grow in businesses in an open, symmetrical North American energy market. According to Ontario Hydro management this will allow competition and choice to all customers, have a disciplining effect on prices, and give rise to a retail market of new products and services, while at the same time preserve and enhance the value of public investment in the Corporation.

  6. Customer-driven competition

    International Nuclear Information System (INIS)

    Taylor, R.

    1996-01-01

    Ontario Hydro's customer-driven strategy, recently approved by Hydro's Executive Board, was described. The strategy is founded on the following components: (1) the dissolution of the Ontario power pool, i.e., the loss of Hydro's franchise monopoly on generation, leaving only power transmission in the hands of the Corporation, (2) divestment of Ontario Hydro's system operations and market operations functions to a new, independent Crown corporation called the Central Market Operator, (3) functional and organizational unbundling of Ontario Hydro into three signature businesses, Genco, Transco, and Retailco, and in the latter two, the functional unbundling of wires from sales and services, (4) a fully commercial Ontario Hydro with normal corporate powers, and (5) a corporate strategy for Ontario Hydro to grow in businesses in an open, symmetrical North American energy market. According to Ontario Hydro management this will allow competition and choice to all customers, have a disciplining effect on prices, and give rise to a retail market of new products and services, while at the same time preserve and enhance the value of public investment in the Corporation

  7. Pulling Marbles from a Bag: Deducing the Regional Impact History of the SPA Basin from Impact-Melt Rocks

    Science.gov (United States)

    Cohen, Barbara A.; Coker, Robert F.

    2010-01-01

    The South Pole Aitken (SPA) basin is the stratigraphically oldest identifiable lunar basin and is therefore one of the most important targets for absolute age-dating to help understand whether ancient lunar bombardment history smoothly declined or was punctuated by a cataclysm. A feasible near-term approach to this problem is to robotically collect a sample from near the center of the basin, where vertical and lateral mixing provided by post-basin impacts ensures that such a sample will be composed of small rock fragments from SPA itself, from local impact craters, and from faraway giant basins. The range of ages, intermediate spikes in the age distribution, and the oldest ages are all part of the definition of the absolute age and impact history recorded within the SPA basin.

  8. Using Customer Relationship Trajectories to Segment Customers and Predict Profitability

    OpenAIRE

    Mark Tanya; Niraj Rakesh; Dawar Niraj

    2007-01-01

    A central premise of relationship marketing theory is that economic benefits flow fromretaining customers. However, the early research focus on the duration of the relationship may obscure other important aspects of the interactions with the customer that drive profitability. Borrowing from the branding literature, where different types of customer relationships have been described (but not empirically examined), we study the patterns of business customers’ buying behavior, or trajectories th...

  9. customer satisfaction, customer relationship management, Fuzzy Delphi, system dynamics.

    OpenAIRE

    Habib A. Mirghafoori; Ali Morovati Sharifabadi; Ensiyeh Taki

    2016-01-01

    This paper investigates the factors which are affecting customers satisfaction of Mobarake steel complex . Since there is a wide rang of factors affecting customer satisfaction,this paper pays attention to those factors which have CRM approach. The investigation society of the research is the marketing experts of Moabarake steel complex who have direct relationship with customers.At first, the factors were identified by experts using Fuzzy Delphi method and then the relationship between facto...

  10. Customer Retention & Customer Relationship Marketing: Strategi Pemasaran Yang Potensial

    OpenAIRE

    Aprilia, Ariesya

    2004-01-01

    The traditional marketing approach advocates the marketing mix principles and the quest for market share dominance through mass marketing techniques and a focus on new customer acquisition. This approach has guided managers for decades in planning in implementing their marketing strategies. But nowadays, traditional approach has been changed by customer retention. Customer retention, in the traditional marketing approach, is however seen as the 'end' rather than the means to delivering long-t...

  11. Challenges and opportunities in multichannel customer management

    NARCIS (Netherlands)

    Neslin, Scott A.; Grewal, Dhruv; Leghorn, Robert; Shankar, Venkatesh; Teerling, Marije L.; Thomas, Jacquelyn S.; Verhoef, Peter C.

    2006-01-01

    Multichannel customer management is the design, deployment, coordination, and evaluation of channels through which firms and customers interact, with the goal of enhancing customer value through effective customer acquisition, retention, and development. The authors identify five major challenges

  12. Challenges and opportunities in multichannel customer management

    NARCIS (Netherlands)

    Neslin, Scott A.; Grewal, Dhruv; Leghorn, Robert; Shankar, Venkatesh; Teerling, Marije L.; Thomas, Jacquelyn S.; Verhoef, Peter C.

    Multichannel customer management is the design, deployment, coordination, and evaluation of channels through which firms and customers interact, with the goal of enhancing customer value through effective customer acquisition, retention, and development. The authors identify five major challenges

  13. Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review

    Science.gov (United States)

    Antonelli, Michele; Donelli, Davide

    2018-02-01

    Balneotherapy and spa therapy are well-known practices, even though limited evidence has been produced about their biological effects. This systematic review primarily aims at assessing if balneotherapy, mud/peloid therapy, and spa therapy may influence cortisol levels. Secondarily, it aims at understanding if these interventions may improve stress resilience. PubMed/Medline, Embase, and Cochrane Library were searched for relevant articles in English or Italian about studies involving healthy and sub-healthy subjects or patients with a diagnosed disease about effects of balneotherapy, mud/peloid therapy, and spa therapy on serum and salivary cortisol levels. Fifteen studies involving 684 subjects were included. Five studies investigated biological effects of balneotherapy alone. Two of them reported significant changes of cortisol levels in healthy participants. The other three studies reported no significant variations in patients with rheumatic conditions. No studies investigated biological effects of mud/peloid therapy alone. Ten studies investigated biological effects of spa therapy with or without included mud/peloid therapy, and in all but two studies, significant variations of cortisol levels were reported. Our main findings suggest that balneotherapy may have the potential to influence cortisol levels in healthy subjects, in such a way as to improve stress resilience. Spa therapy with or without included mud/peloid therapy demonstrated the same potential to influence cortisol levels also in sub-healthy subjects and in patients with a diagnosed disease. Therefore, balneotherapy and spa therapy may be considered as useful interventions for the management of stress conditions. Further investigation is needed because of limited available data.

  14. Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence.

    Science.gov (United States)

    Karagülle, Mine; Karagülle, Müfit Zeki

    2015-02-01

    In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.

  15. Customer satisfaction and customer loyalty as predictors of future business potential

    DEFF Research Database (Denmark)

    Eskildsen, Jacob Kjær; Kristensen, Kai

    2008-01-01

    This paper analyses the relationship between customer satisfaction, customer loyalty and the future business potential of existing customers. The data for the analysis come from the Danish Customer Satisfaction Index 2006. Here a total of approximately 2000 private customers evaluated...

  16. Principles of bioclimatic architecture applied at the project of spa center at Stara Planina mountain

    Directory of Open Access Journals (Sweden)

    Marić Igor

    2011-01-01

    Full Text Available Application of bioclimatic parameters in the design of tourist objects is an important factor for reducing energy consumption and preserving the environment. It represents the response to constant changing of climate conditions. Given the fact that development of tourism has negative consequences on the environment, it is necessary to examine the way design process can affect the reduction of energy and environmental pollution. This paper analyzes the principles of bioclimatic planning and design of the Spa Center at the Balkan Mountain that is one of the most valuable ecosystems in Serbia. Adaptation to the existing climate change was analyzed on two levels. The first level was urban factors that include analysis of local climate and environment that affect the positioning of the object and preliminary form. The second level was architecture factors with technical and technological solutions that can be achieved through the application of climate and energy responsible designing. Final analyses indicate that the bioclimatic approach is necessary in the initial stage of setting preliminary design for the building, because later it would take more effort to install technology that requires time and the whole process makes much more expensive. The work indicates that the energy needs of optimized Spa center like represented, from the very beginning of planning and designing, can be drastically reduced.

  17. Balneotherapy for atopic dermatitis in children at Comano spa in Trentino, Italy.

    Science.gov (United States)

    Farina, Stefania; Gisondi, Paolo; Zanoni, Mauro; Pace, Manuela; Rizzoli, Laura; Baldo, Ermanno; Girolomoni, Giampiero

    2011-12-01

    No controlled studies have investigated whether balneotherapy is effective in atopic dermatitis (AD). To investigate the efficacy and safety of balneotherapy performed at Comano spa (Trentino, Italy) compared to topical corticosteroids (TCS) in the treatment of AD. This was an open, randomized, clinical trial including 104 children (aged 1-14 years) with mild to moderate AD who were assigned either to balneotherapy (n = 54) or TCS (n = 50) once daily for 2 weeks. AD severity and quality of life were measured using the SCORAD, investigator global assessment (IGA), patients' self global assessment (PSGA), children's dermatology life quality index (CDLQI) and family dermatitis impact questionnaire (FDIQ). Subjective measures were re-evaluated 4 months after the end of therapy. Balneotherapy and TCS resulted in a significant reduction of all parameters at week 2. TCS were more effective than balneotherapy regarding SCORAD (46% ± 7.71 vs 26% ± 9.4, mean ± SD; p balneotherapy compared to those treated with TCS (p Balneotherapy at Comano spa appears to be beneficial in children with mild to moderate AD.

  18. THE INFLUENCE OF CROSS-TRAINING DUE TO SPA TREATMENT IN CURRING FUNCTIONAL NEUROTIC DISORDERS

    Directory of Open Access Journals (Sweden)

    Rade Stefanović

    2006-06-01

    Full Text Available Modern civilization moves to endless automation and mechanization. This fact, in one hand, has positive effect on increase of life standard, but also carries its own risks and threats of mankind. Axelberg, famous academician, makes an interesting remark that only a hundred years ago man did 96 % of his work by himself, while today most manufacturing processes are 100% automated. Stress, lack of physical activity and bad food regime are canses of organic damages of cardiopulmonary system. Latest research, conducted in many countries, shows that for proper functioning of every organism the minimum of moving is necessary.Term neurosis was introduced in medical literature by Scottish doctor W. Cullen in 1777. By that term were considered different clinical appearances which are believed neurotic todey, but also the phenomena today considered as psychosomatic disorders of character and behavior. Pavlov’s reflexive theory is basic in treatment of some types of neurossis’ during spa treatments in Nerečinska Banja. It usually starts at the beginning of May and ends in October, but sometimes if weather is nice, it can last until the middle of November. The treatment cure last tventy-one day, doesn’t include medicaments, but only spa water, baths and massage.

  19. Diverse modulation of spa transcription by cell wall active antibiotics in Staphylococcus aureus

    DEFF Research Database (Denmark)

    Nielsen, Lene Nørby; Roggenbuck, Michael; Haaber, Jakob Krause

    2012-01-01

    ABSTRACT: BACKGROUND: The aim of this study was to investigate the effect of various classes of clinically relevant antibiotics at sub-lethal concentrations on virulence gene expression and biofilm formation in Staphylococcus aureus. FINDINGS: LacZ promoter fusions of genes related to staphylococ......ABSTRACT: BACKGROUND: The aim of this study was to investigate the effect of various classes of clinically relevant antibiotics at sub-lethal concentrations on virulence gene expression and biofilm formation in Staphylococcus aureus. FINDINGS: LacZ promoter fusions of genes related...... to staphylococcal virulence were used to monitor the effects of antibiotics on gene expression in a disc diffusion assay. The selected genes were hla and spa encoding alpha-hemolysin and Protein A, respectively and RNAIII, the effector molecule of the agr quorum sensing system. The results were confirmed...... by quantitative real-time PCR. Additionally, we monitored the effect of subinhibitory concentrations of antibiotics on the ability of S. aureus to form biofilm in a microtiter plate assay. The results show that sub-lethal antibiotic concentrations diversely modulate expression of RNAIII, hla and spa. Consistently...

  20. Waste heat utilization in the thermal spa of Lavey-les-Bains

    International Nuclear Information System (INIS)

    2004-01-01

    This final report for the Swiss Federal Office of Energy looks at the possibilities for improved waste water utilization in the Lavey-les-Bains thermal spa, Switzerland. According to the regulations in force, the temperature of the waste water rejected into the Rhone river shall not exceed 30 o C, what is currently not the case. Also the operational cost shall be reduced and the waste water quality improved. The installations are presented. From the two geothermal wells, mineral water comes out at an average flow rate of 940 l/min and a temperature of 63 o C. Actual waste water data are reported. The measured thermal water consumption data, including seasonal variations, are analysed by computerized simulation and measures to reduce the consumed volume by the optimization of internal procedures are evaluated. Measures to reduce the quantity of the rejected free chlorine are discussed. Several possible adaptations of the existing space heating, domestic water heating and pools' heating are evaluated, including cost. In addition, extensions of the thermal spa center to recreational activities are discussed, as the construction of a tropical greenhouse is

  1. Characterization of Si(112) and In/Si(112) studied by SPA-LEED

    Energy Technology Data Exchange (ETDEWEB)

    Hoecker, Jan; Speckmann, Moritz; Schmidt, Thomas; Falta, Jens [Institute of Solid State Physics, University of Bremen, 28359 Bremen (Germany)

    2010-07-01

    High index surfaces are of strong interest in todays research because of the possibility to grow low dimensional structures. It has for instance already been shown that the adsorption of Ga can induce the formation of 1D metal chains on Si(112) (cf. Snijders et al., PRB 72, 2005). In this work we investigated the clean Si(112) surface and the adsorption of In on Si(112) to establish an analogy to Ga/Si(112) using spot profile analyzing low energy electron diffraction (SPA-LEED). By means of reciprocal space mapping we determined the bare Si(112) surface to be decomposed into alternating (5512) and (111) facets in [1 anti 10] direction with (2 x 1) and (7 x 7) reconstruction, respectively (cf. Baski et al., Surf. Sci. 392, 1997). With SPA-LEED we were able to observe the decreasing intensity of the facet spots in-situ while depositing In on Si(112) and thus reveal the smoothening of the surface due to the deposition of In. At saturation coverage we found a (3.x1) reconstruction, where x is dependent on the deposition temperature and changes from x=7 at 400 C to x=5 at 500 C. This leads us to the assumption that the reconstruction is not incommensurate but a mixture of (3 x 1) and (4 x 1) building blocks, which is very similar to the super structure of Ga on Si(112).

  2. Strategic planning of the master programme in health informatics at Aalborg University: targeting and updating the programme, to meet explicit customer needs.

    Science.gov (United States)

    Nøhr, C; Bygholm, A; Hejlesen, O

    1998-06-01

    Education is essentially giving people new skills and qualifications to fulfil certain tasks. In planning and managing educational programmes it is crucial to know what skills and what qualifications are needed to carry out the tasks in question, not to mention the importance of knowing what tasks are relevant to carry out. The programme in health informatics at Aalborg University produces health informatics professionals. The students are developing skills in solving informatics problems in health care organisations. The programme has been running for 3 years now and to maintain the perception of the aim for the programme a number of activities have been launched. In the following, the programme will be presented, the activities to obtain information on how to keep the programme targeted and updated will be described and the changes that are going to be introduced will be outlined.

  3. Radiological impact of a spent fuel disposal in a deep geological granite formation - results of the european spa project

    International Nuclear Information System (INIS)

    Baudoin, P.; Gay, D.; Certes, C.; Serres, C.

    2000-01-01

    The SPA project (Spent fuel disposal Performance Assessment) is the latest of four integrated performance assessment exercises on nuclear waste disposal in geological formations, carried out in the framework of the European Community 'Nuclear Fission' Research Programmes. The SPA project, which was undertaken by ENRESA, GRS, IPSN, NRG, SCK.CEN and VTT between May 1996 and April 1999, was devoted to the study of disposal of spent fuel in various host rock formations (clay, crystalline rocks and salt formation). This project is a direct continuation of the efforts made by the European Community since 1982 to build a common understanding of the methods applicable to deep disposal performance assessment. (authors)

  4. Process Improvement: Customer Service.

    Science.gov (United States)

    Cull, Donald

    2015-01-01

    Utilizing the comment section of patient satisfaction surveys, Clark Memorial Hospital in Jeffersonville, IN went through a thoughtful process to arrive at an experience that patients said they wanted. Two Lean Six Sigma tools were used--the Voice of the Customer (VoC) and the Affinity Diagram. Even when using these tools, a facility will not be able to accomplish everything the patient may want. Guidelines were set and rules were established for the Process Improvement Team in order to lessen frustration, increase focus, and ultimately be successful. The project's success is driven by the team members carrying its message back to their areas. It's about ensuring that everyone is striving to improve the patients' experience by listening to what they say is being done right and what they say can be done better. And then acting on it.

  5. Customer Touch Point Histories

    DEFF Research Database (Denmark)

    Beckmann, Suzanne C.; Haurum, Helle

    Customers’ engagement behaviours are considered an important source of value to the firm. So far, the discussion has mainly been conceptual and focused on the company’s perspective. By adopting the customer’s perspective we investigated what drive and explain customers’ engagement behaviours...... as reactions to their service encounters over time with a firm, using in-depth interviews. We found the following key factors driving and explaining customers’ engagement behaviours: (1) mundane product and service environment indeed drives customers’ engagement behaviours and mediating capabilities...... are identified, (2) customers produce (positive) value for the firm through engagement behaviours when perceived alignment between firm-initiated experience and product/service is present, and (3) transactions matter and drive (other) engagement behaviours....

  6. Energy providers: customer expectations

    International Nuclear Information System (INIS)

    Pridham, N.F.

    1997-01-01

    The deregulation of the gas and electric power industries, and how it will impact on customer service and pricing rates was discussed. This paper described the present situation, reviewed core competencies, and outlined future expectations. The bottom line is that major energy consumers are very conscious of energy costs and go to great lengths to keep them under control. At the same time, solutions proposed to reduce energy costs must benefit all classes of consumers, be they industrial, commercial, institutional or residential. Deregulation and competition at an accelerated pace is the most likely answer. This may be forced by external forces such as foreign energy providers who are eager to enter the Canadian energy market. It is also likely that the competition and convergence between gas and electricity is just the beginning, and may well be overshadowed by other deregulated industries as they determine their core competencies

  7. Customer experiences and expectations

    International Nuclear Information System (INIS)

    Morton, C. R.

    1997-01-01

    Customer experiences and expectations from competition and cogeneration in the power industry were reviewed by Charles Morton, Director of Energy at CPC International, by describing Casco's decision to get into cogeneration in the early 1990s in three small corn milling plants in Cardinal, London and Port Colborne, Ontario, mainly as result of the threat of a 40 per cent increase in power prices. He stressed that cost competitiveness of cogeneration is entirely site-specific, but it is generally more attractive in larger facilities that operate 24 hours a day, where grid power is expensive or unreliable. Because it is reliable, cogeneration holds out the prospect of increased production-up time, as well as offering a hedge against higher energy costs, reducing the company's variable costs when incoming revenues fall short of costs, and providing an additional tool in head-to-head competition

  8. Custom anatomic healing abutments

    Directory of Open Access Journals (Sweden)

    Vinayak S Gowda

    2016-01-01

    Full Text Available Dental implants with their increasing success rates and predictability of final outcome are fast becoming the treatment of choice for replacing missing teeth. Considering the success of immediate implant placement in reducing tissue loss and achieving good esthetic results, is making it a more popular treatment modality in implant dentistry. Understanding the management of gingival tissues in relation to implants to obtain maximum esthetics is of utmost importance. The use of provisional abutments and immediate temporization has a proven track record of their ability to produce optimal esthetics and to guide the tissue response during the healing phase. With careful patient selection and execution, customized healing abutments can provide an effective method to enhance the esthetic and emergence profile for anterior implant restorations.

  9. Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

    Science.gov (United States)

    Chary-Valckenaere, Isabelle; Loeuille, Damien; Jay, Nicolas; Kohler, François; Tamisier, Jean-Noë; Roques, Christian-François; Boulange, Michel; Gay, Gérard

    2018-02-01

    To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: `immediate versus delayed treatment' paradigm). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the French-Quick DASH (F-QD) score at 6 months. The effect size of spa therapy was calculated, and the proportion of patients reaching minimal clinically important improvement (MCII) was compared. Secondary endpoints were the mean change in SF-36, treatment use and tolerance. One hundred eighty-six patients were included (94 patients as controls, 92 in the spa group) and analysed by intention to treat. At 6 months, the mean change in the F-QD score was statistically significantly greater among spa therapy patients than controls (- 32.6 versus - 8.15%; p impact on SF-36 components but not on drug intake. Spa therapy provided a statistically significant benefit on pain, function and quality of life in patients with chronic shoulder pain after 6 months compared with usual care.

  10. Detecting drugs at customs

    International Nuclear Information System (INIS)

    Hibbert, D.B.

    1999-01-01

    The principle of measuring ions by their drift times at atmospheric pressure is not new, but it has been only recently that ion mobility spectrometry (IMS) has been realised as a powerful method of identifying certain molecules of importance at low concentrations. The impetus has arisen initially from the desire of the military to detect chemical warfare agents in the field but more recently has been taken up by police and customs services to monitor drugs of abuse and explosives. The Australian Customs Service (Border Technology) has purchased a number of IM spectrometers and has installed them in all international ports and airports. The first cases of persons apprehended for importation of controlled substances with evidence from IMS have appeared in the courts and the legal system is coming to terms with this new forensic tool. Ion mobility spectrometry may be thought of as time of flight mass spectrometry at atmospheric pressure. The presence of gas gives the possibility of a number of ion-molecule reactions, and the time taken to traverse drift tubes of a few centimetres at a field of typically 25 kV m -1 is around 10-20 ms. Ions are generated by a 63 Ni source, which ionises the carrier gas (dry air), which in turn ionises the injected analyte. Detection limits in the low ppb range are found for many substances. Details of sample collection, sensitivity and limitations of the ion mobility spectrometry are given. Extensions to IMS include the use of Fourier Transform method, electro spray and neural networks

  11. Take Five for Customer Service

    Directory of Open Access Journals (Sweden)

    Laura J. Ax-Fultz

    2016-05-01

    Full Text Available Businesses leverage excellent customer service to improve profitability. Although not profit-driven, libraries should leverage excellent customer service to achieve their unique missions. Evaluating and improving customer service practices will help a library determine if it is successfully serving its customers. The library should review three areas to improve customer service: the physical space of the library, how library employees work with library policies, and the communication skills of the library staff. By using the Take Five model, the library can make immediate, no-cost changes or plan for future improvements by taking just five minutes, every day, to assess specific areas. Over a few weeks or months, these small changes will result in better customer service.

  12. Predictive Systems for Customer Interactions

    Science.gov (United States)

    Vijayaraghavan, Ravi; Albert, Sam; Singh, Vinod Kumar; Kannan, Pallipuram V.

    With the coming of age of web as a mainstream customer service channel, B2C companies have invested substantial resources in enhancing their web presence. Today customers can interact with a company, not only through the traditional phone channel but also through chat, email, SMS or web self-service. Each of these channels is best suited for some services and ill-matched for others. Customer service organizations today struggle with the challenge of delivering seamlessly integrated services through these different channels. This paper will evaluate some of the key challenges in multi-channel customer service. It will address the challenge of creating the right channel mix i.e. providing the right choice of channels for a given customer/behavior/issue profile. It will also provide strategies for optimizing the performance of a given channel in creating the right customer experience.

  13. 19 CFR 19.34 - Customs supervision.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Customs supervision. 19.34 Section 19.34 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS WAREHOUSES, CONTAINER STATIONS AND CONTROL OF MERCHANDISE THEREIN Space Bonded for the Storage of Wheat § 19.34 Customs supervision. Port...

  14. Analisa Pengaruh Customer Experience Terhadap Customer Loyalty Dengan Customer Engagement Dan Customer Trust Sebagai Variabel Intervening Di the Body Shop

    OpenAIRE

    Felita, Christina Irene

    2015-01-01

    Perkembangan bisnis ritel saat ini berkembang sangat pesat. Sebagai Perusahaan ritel yang bergerak di bidang beauty & personal care, The Body Shop harus memiliki keunggulan bersaing agar dapat menang dalam persaingan yang ketat. Salah satu strategi untuk menciptakan keunggulan bersaing adalah dengan memberikan customer experience yang tepat dan memuaskan sehingga dapat memanjakan mereka sebagai customer dan membuat mereka menjadi customer yang loyal. Penelitian ini dilakukan untuk mengan...

  15. Customizing Prices in Online Markets

    OpenAIRE

    Werner Reinartz

    2002-01-01

    Dynamic pricing is the dynamic adjustment of prices to consumers depending on the value these customers attribute to a good. Underlying the concept of dynamic pricing is what marketers call price customization. Price customization is the charging of different prices to end consumers based on a discriminatory variable. Internet technology will serve as a great enabling tool for making dynamic pricing accessible to many industries.

  16. Customer Segmentation by Factors Influencing Brand Loyalty and Customer Involvement

    Directory of Open Access Journals (Sweden)

    Tereza Vebrová

    2016-01-01

    Full Text Available Brand loyalty and customer involvement are two important concepts that help explain and understand a significant part of consumer shopping behavior. The aim of the present work is to identify factors influencing brand loyalty and customer involvement. A further aim is to consider subsequent segmentation of customers with respect to different degrees of brand loyalty and customer involvement. The research was focused on the field of Czech telecommunication services – mobile operators. Primary data were acquired through the method of questionnaire survey. In total, the questionnaire was completed by 340 respondents, of which 319 respondents owned their mobile phones for private purposes only. For more accurate interpretation of the identified factors the Exploratory Factor Analysis method was used. Four factors of brand loyalty were extracted, which account for 75 % of the variability of the original parameters: (1 Cognitive affective loyalty, (2 Trustworthiness, (3 Attitudinal loyalty and (4 Commitment and three factors of customer involvement were found to account for 71 % variability of the original parameters: (1 Social involvement, (2 Centrality, (3 Importance. High loyalty customers mostly have only one SIM card and 73 % of them use a tariff. In a further group of highly involved customers own from 80 % only one SIM card. This study forms part of a research programme investigating the influence of customer involvement on brand loyalty.

  17. Influence of Customer Focused Mission Statement on Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Chijioke Nwachukwu

    2017-01-01

    Full Text Available The purpose of this study is to examine the influence of customer‑focused mission statements on customer satisfaction in selected cell phone manufacturing companies in the United States. The study employed content analysis for the mission statement and data from America customer satisfaction index (ACSI. In analysing our data, Pearson correlation, and multiple regression techniques were used. The result showed that product and service, technology, philosophy, self‑concept, and public image mission statement components are strongly positively correlated with customer satisfaction. Customer, survival, growth and profitability and market mission statement components are insignificantly negatively correlated with customer satisfaction. The study, therefore, recommends that companies that want to remain competitive by enhancing customer satisfaction should formulate mission statements from a customer perspective so that they include product and service, technology, philosophy, self‑concept, and public image components. The main limitation of the study represents the sample size and structure. This study empirically investigated the correlation and association of nine mission statement components with customer satisfaction.

  18. Customer requirements based ERP customization using AHP technique

    NARCIS (Netherlands)

    Parthasarathy, S.; Daneva, Maia

    2014-01-01

    Purpose– Customization is a difficult task for many organizations implementing enterprise resource planning (ERP) systems. The purpose of this paper is to develop a new framework based on customers’ requirements to examine the ERP customization choices for the enterprise. The analytical hierarchy

  19. Undervalued or Overvalued Customers : Capturing Total Customer Engagement Value

    NARCIS (Netherlands)

    Kumar, V.; Aksoy, Lerzan; Donkers, Bas; Venkatesan, Rajkumar; Wiesel, Thorsten; Tillmanns, Sebastian

    Customers can interact with and create value for firms in a variety of ways. This article proposes that assessing the value of customers based solely upon their transactions with a firm may not be sufficient, and valuing this engagement correctly is crucial in avoiding undervaluation and

  20. Smart Automation, Customer Experience and Customer Engagement in Electric Vehicles

    Directory of Open Access Journals (Sweden)

    Asad Ullah

    2018-04-01

    Full Text Available A major challenge to cleaner and more sustainable transportation is the lack of adoptability of electric vehicles (EVs by customers. Therefore, most of the vehicles we see on the road use fossil fuel instead of sustainable green energy sources. One way to improve customer acceptance is to market EVs as a socially desirable product, rather than only environmentally friendly. The silver lining to promote is the potential of information and communications technology (ICT features in EVs, which can lead to a deeper connection between the EVs and their users. These engaging technologies can bring customers closer to the company, resulting in generating big data, which can lead to even deeper insights into customer preferences. Because the technology of vehicle connectivity and automation is just taking off, it is important to understand how these technologies in EVs can enhance customer experiences and result in sustainable customer engagement. Unfortunately, this important research area remains neglected. This research, therefore, is focused on building a conceptual framework for understanding the influence of electric vehicle (EV automation and connectivity on customer experience, and ultimately, customer engagement.

  1. Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

    Science.gov (United States)

    Chary-Valckenaere, Isabelle; Loeuille, Damien; Jay, Nicolas; Kohler, François; Tamisier, Jean-Noë; Roques, Christian-François; Boulange, Michel; Gay, Gérard

    2018-06-01

    To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: `immediate versus delayed treatment' paradigm). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the French-Quick DASH (F-QD) score at 6 months. The effect size of spa therapy was calculated, and the proportion of patients reaching minimal clinically important improvement (MCII) was compared. Secondary endpoints were the mean change in SF-36, treatment use and tolerance. One hundred eighty-six patients were included (94 patients as controls, 92 in the spa group) and analysed by intention to treat. At 6 months, the mean change in the F-QD score was statistically significantly greater among spa therapy patients than controls (- 32.6 versus - 8.15%; p < 0.001) with an effect size of 1.32 (95%CI: 0.97-1.68). A significantly greater proportion of spa therapy patients reached MCII (59.3 versus 17.9%). Spa therapy was well tolerated with a significant impact on SF-36 components but not on drug intake. Spa therapy provided a statistically significant benefit on pain, function and quality of life in patients with chronic shoulder pain after 6 months compared with usual care.

  2. Running Head: Improving Pharmacy Customer Satisfaction

    Science.gov (United States)

    2006-06-29

    move to a prospective payment system. As part of measuring appropriate resource utilization, customer or * - patient satisfaction has been introduced...the consumer . If a patient does not like the manner in how the care was delivered [regardless of the caliber of care, they may choose to take their...features of a health care plan to patients . The rising cost of healthcare and pharmaceuticals causes many to closely Fevaluate the plans they choose

  3. A Study to Investigate the Effect of Customer Value on Customer Satisfaction, Brand Loyalty and Customer Relationship Management Performance

    OpenAIRE

    Berrin Onaran,; Zeki Atil Bulut,; Alparslan Ozmen

    2013-01-01

    Beyond satisfying needs, customer value is the key to establish and maintain long run relationships. Hence, providing excellent customer value as a driving force of customer relationships management performance plays a key role in gaining sustainable competitive advantage. The aim of this research is to investigate the relationships among dimensions of customer value, customer satisfaction, brand loyalty and customer relationship management performance. Data obtained from customers of thermal...

  4. Captivate the customer or vanish

    International Nuclear Information System (INIS)

    Regis, J.

    1994-01-01

    Throughout its expansion program in the 1960s and its energy efficiency programs in the 1970s and 1980s, Hydro-Quebec had a satisfactory proportion of satisfied customers. However, at the end of the 1980s, the utility's customer satisfaction rating slipped below 50% for the first time. Hydro-Quebec's first response was to re-establish transmission system reliability. Service interruptions per customer were reduced from 10 h/y in 1989 to just over 4 h in 1993. Starting in 1990, the utility devised a strategy aimed at fully integrated quality management, with customer service as the top priority. A series of performance commitments was adopted which pinpointed 27 specific targets, each linked to a specific activity; of those targets, 16 are directly related to customer service. A training plan was developed which makes the customer the focus of every action taken by a Hydro-Quebec employee, and office hours have been reorganized in response to constantly evolving customer needs. A courtesy call strategy has been adopted to anticipate customer expectations before they are expressed. Highly personalized and accurately targeted informational tools have been developed for each customer category and a toll-free energy efficiency hotline has been established. Energy efficiency publications are distributed to business and residential customers. Satisfaction with Hydro-Quebec activities rose from 77% in 1992 to 93% in 1993, and credibility in energy efficiency rose from 73% to 85%. A new project being investigated is an electronic superhighway with a variety of customer applications including home automation, load and meter telecontrol, telebilling, and direct payment

  5. 30 CFR 47.73 - Providing labels and MSDSs to customers.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Providing labels and MSDSs to customers. 47.73 Section 47.73 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND... MSDSs to customers. For a hazardous chemical produced at the mine, the operator must provide customers...

  6. Diversifying customer review rankings.

    Science.gov (United States)

    Krestel, Ralf; Dokoohaki, Nima

    2015-06-01

    E-commerce Web sites owe much of their popularity to consumer reviews accompanying product descriptions. On-line customers spend hours and hours going through heaps of textual reviews to decide which products to buy. At the same time, each popular product has thousands of user-generated reviews, making it impossible for a buyer to read everything. Current approaches to display reviews to users or recommend an individual review for a product are based on the recency or helpfulness of each review. In this paper, we present a framework to rank product reviews by optimizing the coverage of the ranking with respect to sentiment or aspects, or by summarizing all reviews with the top-K reviews in the ranking. To accomplish this, we make use of the assigned star rating for a product as an indicator for a review's sentiment polarity and compare bag-of-words (language model) with topic models (latent Dirichlet allocation) as a mean to represent aspects. Our evaluation on manually annotated review data from a commercial review Web site demonstrates the effectiveness of our approach, outperforming plain recency ranking by 30% and obtaining best results by combining language and topic model representations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Quality Customer Service Action Plan

    International Nuclear Information System (INIS)

    2008-12-01

    Since its establishment in 1992 the RPII has been committed to the provision of high quality services to its customers. This report outlines how the RPII will work towards providing a high quality service to our customers and the standards we aim for in the provision of our services

  8. Customer Service in Ontario's Colleges

    Science.gov (United States)

    Keith, John

    2005-01-01

    No doubt there are detractors who cringe at the prospect of connecting the term customer service with an institution of higher education. Some may consider the term demeaning. However, given the college funding crisis and current economic climate, a quality customer service strategy is a prudent adjunct to any marketing activity undertaken. It is…

  9. Essays on multichannel customer management

    NARCIS (Netherlands)

    Konus, U.

    2010-01-01

    The main goal of this dissertation is to gain a greater understanding of multichannel customer behavior and how firms can manage their multichannel marketing activities. The first study reveals that three customer segments can be identified based on their orientation towards using multiple channels

  10. On measurement of customer satisfaction

    DEFF Research Database (Denmark)

    Kristensen, Kai; Kanji, Gopal; Dahlgaard, Jens Jørn

    1992-01-01

    Based on a theoretical argument where company profit as a function of total customer satisfaction is maximized, a new system for measuring and balancing customer satisfaction with respect to individual quality characteritics is developed. A proced implementation is suggested and the results...

  11. Rational customs clearance technology choice

    OpenAIRE

    Shramenko, N.; Andriets, V.

    2008-01-01

    Issues concerning cargo delivery efficiencyincrease by choice of rational customs clearance technology have been considered. Three possible variants of customs clearance andmethods which allow to define the most rational version of cargo delivery in international road communication based on main efficiency criteria for definite distance have been presented.

  12. Customer Satisfaction with Public Libraries.

    Science.gov (United States)

    D'Elia, George; Rodger, Eleanor Jo

    1996-01-01

    Surveys conducted in 142 urban public libraries examined customer satisfaction, comparisons with other libraries, and factors affecting satisfaction. Overall, customers were satisfied with their libraries but experienced different levels of satisfaction based on convenience, availability of materials and information, and services facilitating…

  13. Customizing Curriculum with Digital Resources

    Science.gov (United States)

    Miller, Jeffrey

    2011-01-01

    To effectively use digital resources in the classroom, teachers must customize the information, merge it with pre-existing curriculum, differentiate it for diverse student populations, and still meet standards-based learning goals. This article describes a solution to these challenges: the Curriculum Customization Service, which provides access to…

  14. Team Foundation Server 2013 customization

    CERN Document Server

    Beeming, Gordon

    2014-01-01

    This book utilizes a tutorial based approach, focused on the practical customization of key features of the Team Foundation Server for collaborative enterprise software projects.This practical guide is intended for those who want to extend TFS. This book is for intermediate users who have an understanding of TFS, and basic coding skills will be required for the more complex customizations.

  15. 78 FR 41299 - Customs Brokers

    Science.gov (United States)

    2013-07-10

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection DEPARTMENT OF THE TREASURY 19 CFR Part 111 Customs Brokers CFR Correction In Title 19 of the Code of Federal Regulations, Parts 0 to 140, revised as of April 1, 2013, on page 684, in Sec. 111.13, in paragraph (b), reinstate the second...

  16. Effects of age and spa treatment on match running performance over two consecutive games in highly trained young soccer players.

    Science.gov (United States)

    Buchheit, Martin; Horobeanu, Cosmin; Mendez-Villanueva, Alberto; Simpson, Ben M; Bourdon, Pitre C

    2011-03-01

    The aim of this study was to examine the effect of age and spa treatment (i.e. combined sauna, cold water immersion, and jacuzzi) on match running performance over two consecutive matches in highly trained young soccer players. Fifteen pre- (age 12.8 ± 0.6 years) and 13 post- (15.9 ± 1 y) peak height velocity (PHV) players played two matches (Matches 1 and 2) within 48 h against the same opposition, with no specific between-match recovery intervention (control). Five post-PHV players also completed another set of two consecutive matches, with spa treatment implemented after the first match. Match running performance was assessed using a global positioning system with very-high-intensity running (> 16.1-19.0 km · h(-1)), sprinting distance (>19 km · h(-1)), and peak match speed determined. Match 2 very-high-intensity running was "possibly" impaired in post-PHV players (-9 ± 33%; ± 90% confidence limits), whereas it was "very likely" improved for the pre-PHV players (+27 ± 22%). The spa treatment had a beneficial impact on Match 2 running performance, with a "likely" rating for sprinting distance (+30 ± 67%) and "almost certain" for peak match speed (+6.4 ± 3%). The results suggest that spa treatment is an effective recovery intervention for post-PHV players, while its value in pre-PHV players is questionable.

  17. 75 FR 65263 - Virginia Graeme Baker Pool and Spa Safety Act; Public Accommodation; Withdrawal of Proposed Rule

    Science.gov (United States)

    2010-10-22

    ...'' or ``Act'') as ``an inn, hotel, motel, or other place of lodging, except for an establishment located... interpretive rule to interpret ``public accommodations facility'' in the VGB Act as ``an inn, hotel, motel, or... CONSUMER PRODUCT SAFETY COMMISSION 16 CFR Part 1450 Virginia Graeme Baker Pool and Spa Safety Act...

  18. LHC suppliers win Golden Hadron awards : Gianfranco Malvestiti and Ernesto Malvestiti de Ernesto Malvestiti SpA (Italie)

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    Ernesto Malvestiti SpA (Italy) is the main manufacturer of the metal collars needed to ensure the rigidity of the superconducting dipoles. The firm was awarded its prize in recognition of the central role it played during the transition from aluminium to stainless-steel collars.

  19. 75 FR 22512 - Airworthiness Directives; Piaggio Aero Industries S.p.A. Model PIAGGIO P-180 Airplanes

    Science.gov (United States)

    2010-04-29

    ... Airworthiness Directives; Piaggio Aero Industries S.p.A. Model PIAGGIO P-180 Airplanes AGENCY: Federal Aviation... presence of potential ignition sources such as electrical equipment and connectors. As a consequence, this..., agree with their substance. But we might have found it necessary to use different words from those in...

  20. 75 FR 67639 - Airworthiness Directives; Piaggio Aero Industries S.p.A Model PIAGGIO P-180 Airplanes

    Science.gov (United States)

    2010-11-03

    ... Friday, except Federal holidays. For service information identified in this proposed AD, contact Piaggio... Piaggio Aero Industries have issued service information (referred to after this as ``the MCAI''), to... Information Piaggio Aero Industries S.p.A. has issued Service Bulletin (Mandatory) N.: SB 80-0275, Rev. N. 0...