WorldWideScience

Sample records for marketed lens care

  1. Contact Lens Care

    Science.gov (United States)

    ... Consumers Consumer Information by Audience For Women Contact Lens Care Share Tweet Linkedin Pin it More sharing ... www.fda.gov/medwatch Learn More about Contact Lens Care Other Tips on Contact Lenses Decorative Contact ...

  2. [Current quality management situation and administration countermeasure study of enterprises marketing corneal contact lens].

    Science.gov (United States)

    Liu, Yungui; Yao, Ying; Shangguan, Shihao; Gu, Qun; Gao, Wuming; Chen, Yaoshui

    2014-05-01

    Study the current quality management situation of enterprises marketing corneal contact lens via systemic investigations and explore effective administration countermeasures in the future. The quality management indicators of sixty-two corneal contact lens marketing enterprises in Xuhui district of Shanghai were systematically investigated and enterprises of different operation models was compared and analyzed. Wholesale enterprises and retail chain enterprises are apparently better than independent enterprises almost in all facets. Facilitate market accession of corneal contact lens marketing enterprises, encourage the business model of retail chain, enhance supervision of corneal contact lens marketing enterprises, especially independent franchisors.

  3. Proper Lens Care (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.

  4. Proper Lens Care (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. This podcast discusses the importance of proper lens hygiene and maintenance.

  5. A theoretical lens for revealing the complexity of chronic care

    NARCIS (Netherlands)

    Borgermans, L.; de Maeseneer, J.; Wollersheim, H.; Vrijhoef, H.J.M.; Devroey, D.

    2013-01-01

    The increasing prevalence of co-occurring multiple chronic conditions in an aging population has influenced the debate on complexity in chronic care and nowadays provides an impetus to the reform of numerous health systems. This article presents a theoretical lens for understanding the complexity of

  6. Marketing occupational health care.

    Science.gov (United States)

    Norris, M J; Harris, J C

    1981-01-01

    A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

  7. Bacterial transmission from lens storage cases to contact lenses - Effects of lens care solutions and silver impregnation of cases

    NARCIS (Netherlands)

    Vermeltfoort, Pit B. J.; Hooymans, Johanna M. M.; Busscher, Henk J.; van der Mei, Henny C.

    2008-01-01

    The killing efficacies of multipurpose lens care solutions on planktonic and biofilm bacteria grown in polypropylene contact lens storage cases with and without silver impregnation and effects on bacterial transmission from storage cases to silicone hydrogel contact lenses were investigated. For

  8. Healthy Contact Lens Wear and Care

    Centers for Disease Control (CDC) Podcasts

    2014-02-04

    In this podcast, CDC’s Dr. Jennifer Cope explains some basic steps for proper wear and care of soft contact lenses.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/4/2014.

  9. Bacterial transmission from lens storage cases to contact lenses-Effects of lens care solutions and silver impregnation of cases.

    Science.gov (United States)

    Vermeltfoort, Pit B J; Hooymans, Johanna M M; Busscher, Henk J; van der Mei, Henny C

    2008-10-01

    The killing efficacies of multipurpose lens care solutions on planktonic and biofilm bacteria grown in polypropylene contact lens storage cases with and without silver impregnation and effects on bacterial transmission from storage cases to silicone hydrogel contact lenses were investigated. For transmission studies, biofilms of Staphylococcus aureus 835 or Pseudomonas aeruginosa no. 3 were grown on lens storage cases and incubated with a contact lens in different multipurpose lens care solutions (Opti-Free(R)Express(R), ReNu(R) MultiPlus(R), and SoloCare Aquatrade mark) or 0.9% NaCl. In addition, planktonic bacteria were directly suspended in multipurpose solutions and their killing efficacies were determined. The numbers of transmitted live and dead bacteria on the lenses were measured using a combination of plate counting and fluorescence microscopy. The highest killing efficacies were shown by Opti-Free(R) Express(R) for planktonic as well as for biofilm bacteria. Silver impregnation of lens cases in combination with the prescribed solution increased the killing efficacy for P. aeruginosa in biofilms, whereas effects for S. aureus were minor. Lowest numbers of live and dead bacteria were transmitted to a lens in Opti-Free(R) Express(R) multipurpose solution, with no significant differences between lens types and no effects of silver impregnation. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 2008. (c) 2008 Wiley Periodicals, Inc.

  10. Relationship marketing in health care.

    Science.gov (United States)

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  11. Proper Lens Care (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-17

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.  Created: 8/17/2017 by MMWR.   Date Released: 8/17/2017.

  12. Proper Lens Care (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-17

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.  Created: 8/17/2017 by MMWR.   Date Released: 8/17/2017.

  13. Health care marketing: Basic features

    OpenAIRE

    Gajić-Stevanović Milena

    2006-01-01

    Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation.

  14. Land and markets in African cities: Time for a new lens?

    CSIR Research Space (South Africa)

    Napier, Mark

    2013-10-01

    Full Text Available -1 Trading Places: Accessing land in African cities Chapter 1 Land and markets in African cities: Time for a new lens? Mark Napier CSIR, Built Enviroment, Pretoria, South Africa, 0001 MNapier@csir.co.za Abstract Most people living in cities...

  15. Home care technology through an ability expectation lens.

    Science.gov (United States)

    Wolbring, Gregor; Lashewicz, Bonnie

    2014-06-20

    Home care is on the rise, and its delivery is increasingly reliant on an expanding variety of health technologies ranging from computers to telephone "health apps" to social robots. These technologies are most often predicated on expectations that people in their homes (1) can actively interact with these technologies and (2) are willing to submit to the action of the technology in their home. Our purpose is to use an "ability expectations" lens to bring together, and provide some synthesis of, the types of utility and disadvantages that can arise for people with disabilities in relation to home care technology development and use. We searched the academic databases Scopus, Web of Science, EBSCO ALL, IEEE Xplore, and Compendex to collect articles that had the term "home care technology" in the abstract or as a topic (in the case of Web of Science). We also used our background knowledge and related academic literature pertaining to self-diagnosis, health monitoring, companionship, health information gathering, and care. We examined background articles and articles collected through our home care technology search in terms of ability expectations assumed in the presentation of home care technologies, or discussed in relation to home care technologies. While advances in health care support are made possible through emerging technologies, we urge critical examination of such technologies in terms of implications for the rights and dignity of people with diverse abilities. Specifically, we see potential for technologies to result in new forms of exclusion and powerlessness. Ableism influences choices made by funders, policy makers, and the public in the development and use of home health technologies and impacts how people with disabilities are served and how useful health support technologies will be for them. We urge continued critical examination of technology development and use according to ability expectations, and we recommend increasing incorporation of

  16. Pastoral care: marketing "high touch".

    Science.gov (United States)

    Finn, M

    1986-01-01

    Marketing pastoral care skills is important both within and without the health care organization. To increase administrators' awareness of the value of the pastoral care department, for example, chaplains must be able to demonstrate that their activities can affect the bottom line. They must therefore develop a system of accountability that defines and measures their services in objective terms. Such a system would include the reporting of monthly visit statistics as well as the collection of data from patients and personnel on the adequacy of pastoral care services. Other awareness-building activities could include participation in nursing practice rounds, in-service presentations, involvement in hospital social events, and placement of articles about pastoral care in hospital publications. Activities that would help to foster good community relations and thereby improve census include participation in the area clergy association, work with local church groups that visit the sick and the homebound, providing speakers to community organizations, and sponsoring a memorial Mass for families of patients who have died at the hospital. Pastoral care staff should not feel threatened by the changing health care environment. Instead they must recognize the opportunity it provides to create ways to minister to a new mix of patients and to reach new groups.

  17. Increased resistance of contact lens related bacterial biofilms to antimicrobial activity of soft contact lens care solutions

    Science.gov (United States)

    Szczotka-Flynn, Loretta B.; Imamura, Yoshifumi; Chandra, Jyotsna; Yu, Changping; Mukherjee, Pranab K.; Pearlman, Eric; Ghannoum, Mahmoud A.

    2014-01-01

    PURPOSE To determine if clinical and reference strains of Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus form biofilms on silicone hydrogel contact lenses, and ascertain antimicrobial activities of contact lens care solutions. METHODS Clinical and American Type Culture Collection (ATCC) reference strains of Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus were incubated with lotrafilcon A lenses under conditions that facilitate biofilm formation. Biofilms were quantified by quantitative culturing (colony forming units, CFUs), and gross morphology and architecture were evaluated using scanning electron microscopy (SEM) and confocal microscopy. Susceptibilities of the planktonic and biofilm growth phases of the bacteria to five common multipurpose contact lens care solutions and one hydrogen peroxide care solution were assessed. RESULTS P. aeruginosa, S. marcescens, and S. aureus reference and clinical strains formed biofilms on lotrafilcon A silicone hydrogel contact lenses, as dense networks of cells arranged in multiple layers with visible extracellular matrix. The biofilms were resistant to commonly used biguanide preserved multipurpose care solutions. P. aeruginosa and S. aureus biofilms were susceptible to a hydrogen peroxide and a polyquaternium preserved care solution, whereas S. marcescens biofilm was resistant to a polyquaternium preserved care solution but susceptible to hydrogen peroxide disinfection. In contrast, the planktonic forms were always susceptible. CONCLUSIONS P. aeruginosa, S. marcescens, and S. aureus form biofilms on lotrafilcon A contact lenses, which in contrast to planktonic cells, are resistant to the antimicrobial activity of several soft contact lens care products. PMID:19654521

  18. Disinfection efficacy of contact lens care solutions against ocular pathogens.

    Science.gov (United States)

    Miller, M J; Callahan, D E; McGrath, D; Manchester, R; Norton, S E

    2001-01-01

    Three commercially available products labeled as multi-purpose contact lens solutions, one multi-purpose disinfecting solution, and a hydrogen peroxide system were evaluated for antimicrobial activity according to the current International Organization for Standardization (ISO) and the U.S. Food and Drug Administration (FDA) stand-alone procedure for disinfecting products. One multi-purpose solution was selected to assess its antimicrobial activity against two human corneal isolates of Pseudomonas aeruginosa. Products were challenged with bacteria and fungi, and following a specified period, aliquots of inoculated test solution were neutralized and plated on validated recovery media. After incubation the number of viable microorganisms was enumerated and mean log reductions determined. ReNu MultiPlus (Bausch & Lomb, Rochester, NY), AOSEPT (CIBA Vision Corporation, Duluth, GA), and Opti-Free Express with Aldox (Alcon Laboratories, Ft. Worth, TX) were the only lens care products that met the stand-alone criteria for all required microorganisms within their minimum recommended disinfection time. Of these, ReNu MultiPlus provided the greatest overall antimicrobial activity. ReNu MultiPlus demonstrated a significantly higher mean log reduction of Staphylococcus aureus and Serratia marcescens than Opti-Free Express. ReNu MultiPlus also gave a higher mean log reduction of S. aureus and S. marcescens than AOSEPT, and a higher mean log reduction of Candida albicans and Fusarium solani than AOSEPT, Complete Comfort Plus (Allergan, Irivine, CA), and Solo-Care (CIBA Vision Corp.) (at 4 hours). Both Complete Comfort Plus and Solo-Care (at 4 hours) met the primary acceptance criteria for bacteria; however, neither product possessed enough antimicrobial activity to meet the minimum criteria for yeast or mold. ReNu Multiplus was effective against corneal isolates of P. aeruginosa. ReNu MultiPlus, AOSEPT, and Opti-Free Express met the requirements of the stand-alone primary

  19. Effective managed care marketing strategies for evolving markets.

    Science.gov (United States)

    Conlon, M K

    1997-11-01

    In a world of increased competition and changing consumer expectations, one of the keys to a fiscally sound health plan is having a dynamic marketing strategy that takes into account the shifting attitudes of consumers as managed care markets mature. The primary goal of any health plan marketing strategy should be the acquisition and retention of members. Providing cost-efficient and convenient service for enrollees, offering low or no deductibles, having convenient office locations, and minimizing paper-work are important elements of such a marketing strategy. Factors such as brand awareness and the perceived image of a health plan also are important considerations in acquiring and retaining market share. The relative importance of these consumer satisfaction criteria change as a managed care market evolves and matures. Financial and marketing managers, thus, should ascertain their market's stage of development and respond with appropriate marketing strategies.

  20. A marketing matrix for health care organizations.

    Science.gov (United States)

    Weaver, F J; Gombeski, W R; Fay, G W; Eversman, J J; Cowan-Gascoigne, C

    1986-06-01

    Irrespective of the formal marketing structure successful marketing for health care organizations requires the input on many people. Detailed here is the Marketing Matrix used at the Cleveland Clinic Foundation in Cleveland, Ohio. This Matrix is both a philosophy and a tool for clarifying and focusing the organization's marketing activities.

  1. Bacterial and fungal biofilm formation on contact lenses and their susceptibility to lens care solutions

    Directory of Open Access Journals (Sweden)

    Siddharth Kackar

    2017-01-01

    Full Text Available Background: Microbial biofilm formation on contact lenses and lens storage cases may be a risk factor for contact lens-associated corneal infections. Various types of contact lens care solutions are used to reduce microbial growths on lenses. Objectives: The present study aimed at comparing the growths of biofilms on the different contact lenses and lens cases. The study also aimed at determining the effect of lens care solutions and bacteriophage on these biofilms. Materials and Methods: One type of hard lens and two types of soft lenses were used for the study. The organisms used were Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, Candida albicans ATCC 60193 and Escherichia coli ATCC 25922. Biofilm production was performed by modified O'Toole and Kolter method and effect of lens cleaning solutions and a crude coliphage on biofilms was also studied. Results were visualised using scanning electron microscopy and quantitated by colony counting method and spectrophotometric measurement of optical density (OD. Statistical analysis was done by SPSS 11.5, Kruskal–Wallis test and Chi-square test. Results: Soft lens cleaning solutions had a significant inhibitory effect (P = 0.020 on biofilm formation on soft lenses and also lens cases (P < 0.001. Soft lens cleaning solution 2 was more efficient than solution 1. However, no such inhibitory effect was observed with regard to hard lens cleaning solution, but for a significant reduction in the OD values (P < 0.001. There was no significant inhibitory effect by bacteriophages. Conclusion: This study showed the importance of selecting the appropriate lens cleaning solution to prevent biofilm production on contact lenses.

  2. Marketing quality and value to the managed care market.

    Science.gov (United States)

    Kazmirski, G

    1998-11-01

    Quantifying quality and marketing care delivery have been long-term challenges in the health care market. Insurers, employers, other purchasers of care, and providers face a constant challenge in positioning their organizations in a proactive, competitive niche. Tools that measure patient's self-reported perception of health care needs and expectations have increased the ability to quantify quality of care delivery. When integrated with case management and disease management strategies, outcomes reporting and variance analysis tracking can be packaged to position a provider in a competitive niche.

  3. Treatment, material, care, and patient-related factors in contact lens-related dry eye.

    Science.gov (United States)

    Ramamoorthy, Padmapriya; Sinnott, Loraine T; Nichols, Jason J

    2008-08-01

    To examine the effect of general contact lens and material characteristics, care solutions, treatment, and patient-related factors on contact lens-related dry eye. The data were derived from the Contact Lens and Dry Eye Study, designed as a cross-sectional and nested case-control study including 360 subjects. In separate statistical models, logistic regression was used to examine general contact lens characteristics, specific hydrogel lens materials, care solutions, and patient-related factors associated with dry eye status (controlled for age, gender, and current treatments). Several factors were significantly associated with dry eye, including treatment factors such as a recent contact lens refitting (odds ratios [OR] = 5.75, 95% confidence intervals [CI] = 2.14 to 15.46) and use of artificial tears/rewetting drops (OR = 1.09, 95% CI = 1.02 to 1.16), in addition, currently worn materials including Food and Drug Administration (FDA) group II (OR = 2.98, 95% CI = 1.14 to 6.19) and IV (OR = 1.87, 95% CI = 1.08 to 3.24). Significant patient-related factors included decreased overall satisfaction (OR = 3.57, 95% CI = 2.08 to 5.88,), dry eye in the absence of contact lens wear (OR = 6.54, 95% CI = 2.57 to 16.62), reduced daily lens wear duration (OR = 1.16, 95% CI = 1.06 to 1.26), and reduced ability to wear lenses as long as desired (OR = 2.44, 95% CI = 1.30 to 4.54). Care solutions were not associated with contact lens-related dry eye. The strong association of common treatment factors with dry eye status in contact lens wearers suggests that these treatments are not entirely effective. The use of high water content materials was strongly related to dry eye in lens wearers, whereas care solutions were not. Contact lens-related dry eye was also associated with several patient-related factors such as greater ocular discomfort (without lenses), dissatisfaction, and inability to wear lenses for desired durations.

  4. What can health care marketing learn from bank marketing?

    Science.gov (United States)

    Mindak, W A

    1988-01-01

    A useful technique in assessing opportunities for international marketers is called "lead lag" analysis. It suggests that one can predict developments, such as demand patterns, in one country by looking at an analogous country. Applying such a technique to the domestic scene, what could we predict about the development and application of marketing to the health care sector if we looked at an analogous service such as banking? Many experts believe that health care is following in the footsteps of banking and point to environmental similarities such as changes in government regulation, new forms of nontraditional competition, increased concern about retail sectors, and pressures on scarce resources. Are there lessons that health care marketers can learn from bankers that might help them avoid some false starts or expensive mistakes?

  5. In-vitro analysis of the microbicidal activity of 6 contact lens care solutions

    Directory of Open Access Journals (Sweden)

    Hildebrandt Claudia

    2012-10-01

    Full Text Available Abstract Background Contact lens-related infections are often associated with inadequate contact lens hygiene, and therefore, contact lens care products should be able to sufficiently minimise the amount of pathogens that are responsible for these infections. In 2001, the EN ISO 14729 was introduced to ensure adequate disinfection efficacy of contact lens care solutions, but this norm has recently been criticised. Methods In this study, six frequently used contact lens care solutions were retested according to the Stand Alone Test of the EN ISO 14729 (2001. The Stand Alone Test is a quantitative suspension test. In addition, the products were tested in a modified setting adding an organic load. The load was a mixture of human blood serum, lysozyme, and mucine, which resembles tear fluid. Results The criteria of the Stand Alone Test recommended in EN ISO 14729 were only met by Aosept Plus. This 3% hydrogen-peroxide-based contact lens care solution attained a reduction factor of > 5 log units for bacteria and > 4 for fungi in all cases. Two further contact lens care solutions, Blue Vision and Optifree Replenish, met the criteria of a reduction factor of > 3 log units for bacteria and > 1 log unit for fungi, but only in the presence of artificial tear fluid. The three remaining products did not exhibit adequate disinfecting efficacy, at least against one of the tested microorganisms. Conclusions Through the observation that the artificial tear fluid used in this study influences the disinfecting efficacy of contact lens care solutions, especially that of multi-purpose solutions, in a different way than does albumin, mucine, or even the organic load suggested in EN ISO 14729, it becomes obvious that the test conditions in the EN ISO 14729 should be revised in order to create more realistic conditions, e.g., by using a more realistic artificial tear fluid. Furthermore, we suggest adapting the EN ISO 14729 to the European test hierarchy for chemical

  6. The health care market: can hospitals survive?

    Science.gov (United States)

    Goldsmith, J C

    1980-01-01

    Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations.

  7. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  8. Social marketing: planning before conceiving preconception care.

    Science.gov (United States)

    Prue, Christine E; Daniel, Katherine Lyon

    2006-09-01

    Social marketing approaches can help to shape the formation of and to create demand for preconception care services. This article describes four components of social marketing, often referred to as the 4 P's, that should be carefully researched and set in place before a national effort to launch and sustain preconception care services is pursued. First, the product or package of services must be defined and adapted using the latest in scientific and health care standards and must be based on consumer needs and desires. Second, the pricing of the services in financial or opportunity costs must be acceptable to the consumer, insurers, and health care service providers. Third, the promotion of benefits must be carefully crafted to reach and appeal to both consumers and providers. Fourth, the placement and availability of services in the marketplace must be researched and planned. With the application of market research practices that incorporate health behavior theories in their exploration of each component, consumer demand for preconception care can be generated, and providers can take preconception care to the market with confidence.

  9. Adhesion of Pseudomonas aeruginosa to contact lenses after exposure to multi-purpose lens care solutions

    NARCIS (Netherlands)

    Bruinsma, GM; Van der Mei, HC; Busscher, HJ; de Vries, Jacob

    2001-01-01

    Elemental surface compositions of contact lenses were measured after exposure to different lens care solutions (LCS) using X-ray photoelectron spectroscopy and were related to adhesion and detachment of Pseudomonas aeruginosa. Etafilcon A and polymacon contact lenses, prior to and after exposure to

  10. Inefficacy of marketed contact lens disinfection solutions against keratitis-causing Acanthamoeba castellanii belonging to the T4 genotype.

    Science.gov (United States)

    Lakhundi, Sahreena; Khan, Naveed Ahmed; Siddiqui, Ruqaiyyah

    2014-06-01

    The aim of this study was to assess the anti-amoebic effects of marketed contact lens disinfecting solutions. Using amoebistatic, amoebicidal, and cysticidal assays, nine different contact lens solutions were tested including: ReNu MultiPlus, DuraPlus, Ultimate Plus, OptiFree Replenish, OptiFree Express, Kontex Clean, Kontex Normal, Kontex Multisol extra+, Kontex Soak. In vitro growth inhibition (amoebistatic) assays were performed by incubating Acanthamoeba castellanii with aforementioned contact lens disinfection solutions as per manufacturer's instructions in the growth medium for up to 48h at 30°C. To determine amoebicidal and cysticidal effects, amoebae were incubated with contact lens solutions in phosphate buffered saline for 24h and viability was determined by haemocytometer counting as well as re-inoculating them in the growth medium. For controls, solutions were tested against bacterial corneal pathogen, Pseudomonas aeruginosa, as well as amoebae were incubated with the solvent alone. Of the nine contact lens solutions tested, none of them showed potent amoebicidal effects. Only DuraPlus and OptiFree Replenish exhibited trophozoite lysis of 85.3% and 73.7% respectively. In contrast, all contact lens disinfection solutions except Kontex Clean, Kontex Normal, Kontex Multisol extra+, tested showed amoebistatic effects. Importantly, none of the contact lens disinfection solutions exhibited cysticidal effects using qualitative assays, i.e., cysts treated with aforementioned solutions re-emerged as viable amoebae upon inoculation in the growth medium. However, more than 3-log reduction was observed when ReNu MultiPlus, DuraPlus and OptiFree Express were tested against P. aeruginosa which is in accordance with the ISO Stand-Alone Primary acceptance criteria. These findings are of great concern for contact lens users. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Changing the lens: widening the approach to primary care research.

    Science.gov (United States)

    Checkland, Kath

    2003-10-01

    After years of being shielded from most of the managerial and organisational changes in health care, primary care is going through a period of change in many countries. Much of the research that has been done in primary care, in common with that in secondary care, puts at the centre of its methodology the concept of professionalism. However, there are other ways of theorising medical work, and using a wider range of theoretical 'lenses' when planning research into the impact of change will enhance and enrich that research. Viewing primary care physicians as 'workers', concerned, like other workers, with constructing understanding of what they do that helps them cope with pressures and uncertainties, shifts the focus of research questions away from issues of professional status towards the practical ways in which they deal with change in their local contexts. Research using this theoretical approach may be able to explain phenomena that other, more broad-brush approaches cannot.

  12. Contact lens use and its compliance for care among healthcare workers in Pakistan

    Directory of Open Access Journals (Sweden)

    Muhammed Hamza Khan

    2013-01-01

    Full Text Available Background: Poor care and hygiene of contact lens (CL results in eye problems and infections. Healthcare workers have an important role in advocating correct lens care. Objectives: To determine the practices of CL care and the adverse consequences of poor CL care among healthcare workers. Setting and Design: A cross-sectional study in one public and three private sector hospitals in Karachi, Pakistan, in 2009-2010. Materials and Methods: We questioned 500 healthcare workers of all ages and both sexes, who wore CL, about compliance with advice on care and any complications due to improper hygiene practices. Ethical approval was obtained. Chi-square tests were used to determine significance and p-value less than 0.05 was considered statistically significant. Results: Of the total CL users, 385 (77% were females. Most (75% respondents wore CL to correct myopia, whereas 54% wore CL only occasionally. Surprisingly, only 24% knew the CL cleaning protocol. Lens solution was changed daily by 33% of users and after more than 2 weeks by 42%. Although 412 (82% participants practised reasonable hand hygiene before inserting CL, 88 (18% did not. Infection and eye dryness were statistically significantly (P < 0.01 associated with sex, hand-washing, and frequency of CL use. Conclusion: Noncompliance with the CL protocol was common among healthcare workers in our society. This behavior calls for targeted health education and awareness programs for healthcare workers.

  13. The equity lens in the health care performance evaluation system.

    Science.gov (United States)

    Barsanti, Sara; Nuti, Sabina

    2014-01-01

    The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the 'equity process' by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups. Copyright © 2013 John Wiley & Sons, Ltd.

  14. Microbial contamination of contact lenses, lens care solutions, and their accessories: a literature review.

    Science.gov (United States)

    Szczotka-Flynn, Loretta B; Pearlman, Eric; Ghannoum, Mahmoud

    2010-03-01

    A contact lens (CL) can act as a vector for microorganisms to adhere to and transfer to the ocular surface. Commensal microorganisms that uneventfully cohabitate on lid margins and conjunctivae and potential pathogens that are found transiently on the ocular surface can inoculate CLs in vivo. In the presence of reduced tissue resistance, these resident microorganisms or transient pathogens can invade and colonize the cornea or conjunctiva to produce inflammation or infection. The literature was reviewed and used to summarize the findings over the last 30 years on the identification, enumeration, and classification of microorganisms adherent to CLs and their accessories during the course of normal wear and to hypothesize the role that these microorganisms play in CL infection and inflammation. Lens handling greatly increases the incidence of lens contamination, and the ocular surface has a tremendous ability to destroy organisms. However, even when removed aseptically from the eye, more than half of lenses are found to harbor microorganisms, almost exclusively bacteria. Coagulase-negative Staphylococci are most commonly cultured from worn lenses; however, approximately 10% of lenses harbor Gram-negative and highly pathogenic species, even in asymptomatic subjects. In storage cases, the incidence of positive microbial bioburden is also typically greater than 50%. All types of care solutions can become contaminated, including up to 30% of preserved products. The process of CL-related microbial keratitis and inflammation is thought to be preceded by the presence or transfer or both of microorganisms from the lens to the ocular surface. Thus, this detailed understanding of lens-related bioburden is important in the understanding of factors associated with infectious and inflammatory complications. Promising mechanisms to prevent bacterial colonization on lenses and lens cases are forthcoming, which may decrease the incidence of microbially driven CL complications.

  15. Organizational economics and health care markets.

    Science.gov (United States)

    Robinson, J C

    2001-04-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership.

  16. Interpersonal complaints regarding cancer care through a gender lens.

    Science.gov (United States)

    Olsson, Erik Masao

    2016-07-11

    Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides

  17. Accountable Care Organizations: Integrated Care Meets Market Power.

    Science.gov (United States)

    Scheffler, Richard M

    2015-08-01

    Will accountable care organizations (ACOs) deliver high-quality care at lower costs? Or will their potential market power lead to higher prices and lower quality? ACOs appear in various forms and structures with financial and clinical integration at their core; however, the tools to assess their quality and the incentive structures that will determine their success are still evolving. Both market forces and regulatory structures will determine how these outcomes emerge. This introduction reviews the evidence presented in this special issue to tackle this thorny trade-off. In general the evidence is promising, but the full potential of ACOs to improve the health care delivery system is still uncertain. This introductory review concludes that the current consensus is to let ACOs grow, anticipating that they will make a contribution to improve our poor-quality and high-cost delivery system. Copyright © 2015 by Duke University Press.

  18. Acanthamoeba encystment: multifactorial effects of buffers, biocides, and demulcents present in contact lens care solutions

    Directory of Open Access Journals (Sweden)

    Kovacs CJ

    2015-10-01

    Full Text Available Christopher J Kovacs, Shawn C Lynch, Marjorie J Rah, Kimberly A Millard, Timothy W Morris Bausch & Lomb Incorporated, Rochester, NY, USA Purpose: To determine whether agents which are purportedly capable of inducing encystment of Acanthamoeba can recapitulate the signal when tested in differing formulations. Methods: In accordance with the International Standard ISO 19045, Acanthamoeba castellanii ATCC 50370 trophozoites were cultured in antibiotic-free axenic medium, treated with test solutions, and encystment rates plus viability were measured via bright field and fluorescent microscopy. Test solutions included phosphate-buffered saline (PBS, borate-buffered saline, biguanide- and hydrogen peroxide (H2O2-based biocides, propylene glycol (PG and povidone (POV ophthalmic demulcents, and one-step H2O2-based contact lens disinfection systems. Results: Only PBS solutions with 0.25 ppm polyaminopropyl biguanide (PAPB and increasing concentrations of PG and POV stimulated A. castellanii encystment in a dose-dependent manner, whereas PBS solutions containing 3% H2O2 and increasing concentrations of PG and POV did not stimulate encystment. Borate-buffered saline and PBS/citrate solutions containing PG also did not stimulate encystment. In addition, no encystment was observed after 24 hours, 7 days, or 14 days of exposures of trophozoites to one-step H2O2 contact lens disinfection products or related solutions. Conclusion: The lack of any encystment observed when trophozoites were treated with existing or new one-step H2O2 contact lens care products, as well as when trophozoites were exposed to various related test solutions, confirms that Acanthamoeba encystment is a complex process which depends upon simultaneous contributions of multiple factors including buffers, biocides, and demulcents. Keywords: propylene glycol, contact lens care system, hydrogen peroxide disinfecting solution

  19. Marketing a managed care plan: achieving product differentiation.

    Science.gov (United States)

    Romeo, N C

    1996-01-01

    The health care marketplace is changing dramatically, even without federal reform measures. This is a volatile, yet promising, time to market a managed care plan. Before marketing the product, it is critical that the competition is thoroughly evaluated and consumer and employer needs are researched. The final product should be distinguishable from the competition and address market needs. Promotion can then begin, utilizing a proactive public relations and advertising campaign in addition to traditional methods of marketing.

  20. Internal marketing: creating quality employee experiences in health care organizations.

    Science.gov (United States)

    Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

    2011-01-01

    To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

  1. Hierarchization and segmentation of informal care markets in Slovenia.

    Science.gov (United States)

    Hrženjak, Majda

    2012-01-01

    The article is the result of qualitative research of informal care markets in Slovenia in the field of childcare, elder care, and cleaning. The author assesses Slovenia's position in the “global care chain” and finds that “local care chains” prevail in the field of childcare and elder care, while a co-occurrence of female gender, “other” ethnicity, and poverty is typical in the field of household cleaning. The main emphasis of the article is on the analysis of hierarchization of the informal market of care work according to following two criteria: social reputation of individual type of care work and citizenship status of care workers.

  2. Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible

    NARCIS (Netherlands)

    K.J. Grit (Kor); T. Zuiderent-Jerak (Teun)

    2017-01-01

    textabstractMany Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care

  3. Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible.

    Science.gov (United States)

    Grit, Kor; Zuiderent-Jerak, Teun

    2017-09-01

    Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of "care-intensity packages" in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the 'making' rather than the 'liberalising' of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such.

  4. The Financial Crisis through the Lens of Foreign Exchange Swap Markets

    OpenAIRE

    Crystal Ossolinski; Andrew Zurawski

    2010-01-01

    During the financial crisis, non-US banks relied increasingly on foreign exchange swap markets to fund their US dollar asset holdings. This caused the cost of borrowing US dollars via the swap market to rise above the measured cost of borrowing US dollars directly in money markets – an apparent deviation from the covered interest parity condition. Pricing in the Australian dollar foreign exchange swap market, and to a lesser degree the cross-currency swap market, also reflected the global s...

  5. Push and pull strategies: applications for health care marketing.

    Science.gov (United States)

    Kingsley, B R

    1987-08-01

    As health care markets mature and expand, strategies available in other industries become useful. This article examines how traditional push-pull strategies apply to health care. Marketers using a push strategy recognize that the sale of their services or goods is dependent upon the endorsement of a middleman and promote their product through the middleman. Those using a pull strategy market directly to the consumer. In this article, the author outlines the advantages and disadvantages of using each strategy.

  6. Managed Care, Distance Traveled, and Hospital Market Definition

    OpenAIRE

    Frech, Ted E

    1998-01-01

    Most scholars and antitrust cases have defined hospital service markets as primarily local. But, two recent decisions have greatly expanded geographic markets, incorporating hospitals as far as 100 miles apart. Managed care plans, now important in most markets, were believed to shift patients to distant hospitals to capture lower prices. We examine distance traveled and its connection to managed care penetration. In contrast to earlier literature, we examine both direct and indirect effects. ...

  7. Marketing in the long-term care continuum.

    Science.gov (United States)

    Laurence, J Nathan; Kash, Bita A

    2010-04-01

    Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

  8. Hospital marketing orientation and managed care processes: are they coordinated?

    Science.gov (United States)

    White, K R; Thompson, J M; Patel, U B

    2001-01-01

    The hospital marketing function has been widely adopted as a way to learn about markets, attract sufficient resources, develop appropriate services, and communicate the availability of such goods to those who may be able to purchase such services. The structure, tasks, and effectiveness of the marketing function have been the subject of increased inquiry by researchers and practitioners alike. A specific understanding of hospital marketing in a growing managed care environment and the relationship between marketing and managed care processes in hospitals is a growing concern. Using Kotler and Clarke's framework for assessing marketing orientation, we examined the marketing orientation of hospitals in a single state at two points in time--1993 and 1999. Study findings show that the overall marketing orientation score decreased from 1993 to 1999 for the respondent hospitals. The five elements of the Kotler and Clarke definition of marketing orientation remained relatively stable, with slightly lower scores related to customer philosophy. In addition, we evaluated the degree to which selected managed care activities are carried out as part of its marketing function. A significant (p marketing function was evident from 1993 to 1999. With increasing numbers of managed care plan enrollees, hospitals are likely focusing on organizational buyers as important customers. In order to appeal to organizational buyers, hospital executives may be focusing more on clinical quality and cost efficiency in the production of services, which will improve a hospital's position with organizational buyers.

  9. Marketing ambulatory care to women: a segmentation approach.

    Science.gov (United States)

    Harrell, G D; Fors, M F

    1985-01-01

    Although significant changes are occurring in health care delivery, in many instances the new offerings are not based on a clear understanding of market segments being served. This exploratory study suggests that important differences may exist among women with regard to health care selection. Five major women's segments are identified for consideration by health care executives in developing marketing strategies. Additional research is suggested to confirm this segmentation hypothesis, validate segmental differences and quantify the findings.

  10. Combining service marketing and strategic alliances in health care.

    Science.gov (United States)

    Lazarus, I R

    1993-11-01

    With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.

  11. Health care: development of data for a marketing approach.

    Science.gov (United States)

    Stitt, V J

    1985-06-01

    Marketing in health care is a relatively new process. It is a business tool that can serve a very useful purpose. Health care management has become aware of the usefulness of marketing in long-range planning. Through a well-thought-out marketing plan, the provider will not be leaving the future to chance. A well-conceived, patient-oriented, competitor-aware marketing plan should place the medical practice at a strategic advantage as the health care industry joins other industries in the competitive marketplace for the consumer's dollar.The ever-increasing political and regulatory environment that the health care field is undergoing emphasizes the need for the inclusion of marketing skills, such as cost containment, in the medical curriculum. It should be the obligation of the training facilities as well as medical societies to respond to this need by providing the education that will enable black providers to survive in this competitive environment.

  12. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-01-01

    ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

  13. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-08-11

    Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

  14. Health care capital market and product market constraints and the role of the chief financial officer.

    Science.gov (United States)

    Wheeler, J R; Smith, D G

    2001-01-01

    To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. The constraints imposed on health care systems by both capital and product markets has made the role of the CFO a challenge.

  15. [Physiotherapeutic care marketing research: current state-of-the art].

    Science.gov (United States)

    Babaskin, D V

    2011-01-01

    Successful introduction of modern technologies into the national health care systems strongly depends on the current pharmaceutical market situation. The present article is focused on the peculiarities of marketing research with special reference to physiotherapeutic services and commodities. Analysis of the structure and sequence of marketing research processes is described along with the methods applied for the purpose including their support by the use of Internet resources and technologies.

  16. What Drives Publishing Productivity for Pretenure Marketing Faculty: Insights Using the Lens of Resource Advantage Theory

    Science.gov (United States)

    Runyan, Rodney C.; Finnegan, Carol; Gonzalez-Padron, Tracy; Line, Nathan D.

    2013-01-01

    The promotion, tenure, and salary of marketing faculty have been topics of intense interest recently. What has received less interest are the drivers of publishing productivity, especially for new, pretenure faculty. We use resource advantage (RA) theory to examine the drivers of pretenure faculty productivity, specifically in the top marketing…

  17. Why Ecologists Should Care about Financial Markets.

    Science.gov (United States)

    Galaz, Victor; Gars, Johan; Moberg, Fredrik; Nykvist, Björn; Repinski, Cecilia

    2015-10-01

    Financial actors such as international banks and investors play an important role in the global economy. This role is shifting due to financial innovations, increased sustainability ambitions from large financial actors, and changes in international commodity markets. These changes are creating new global connections that potentially make financial markets, actors, and instruments important aspects of global environmental change. Despite this, the way financial markets and actors affect ecosystem change in different parts of the world has seldom been elaborated in the literature. We summarize these financial trends, explore how they connect to ecosystems and ecological change in both direct and indirect ways, and elaborate on crucial research gaps. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Winning market positioning strategies for long term care facilities.

    Science.gov (United States)

    Higgins, L F; Weinstein, K; Arndt, K

    1997-01-01

    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

  19. The wellness movement: imperatives for health care marketers.

    Science.gov (United States)

    Bloch, P H

    1984-01-01

    This paper examines the impact of the growing national health consciousness on the delivery of health care services. The health-involved consumer is first profiled and implications for health care marketing strategy are then identified. Suggestions are also made regarding the tailoring of health services to the health-involved segment.

  20. Competition and quality in home health care markets.

    Science.gov (United States)

    Jung, Kyoungrae; Polsky, Daniel

    2014-03-01

    Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Modeling Market Shares of Competing (e)Care Providers

    Science.gov (United States)

    van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

    In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

  2. An exploratory investigation of hospice marketing: How are palliative care providers marketing their services?

    Science.gov (United States)

    Matthews, Michael; Peters, Cara; Lawson, Stephanie

    2017-01-01

    Hospice and palliative care is a recent, but fast growing, industry in healthcare. Demographics suggest that hospice care will only increase. The purpose of this article is to examine strategic marketing initiatives hospice organizations currently employ. Data were collected at a hospice regional conference, capturing opinions from hospice organizations located in North and South Carolina. The results show that many hospice organizations do not have a dedicated marketing staff person, have a limited marketing budget, do not fully utilize all strategic planning tools, and have yet to differentiate themselves via branding. Implications of these findings for hospice providers are discussed.

  3. Variations in mature market consumer behavior within a health care product: implications for marketing strategy.

    Science.gov (United States)

    Hopper, J A; Busbin, J W

    1995-01-01

    America is undergoing a profound age shift in its demographic make-up with people 55 and over comprising an increasing proportion of the population. Marketers may need to increase their response rate to this shift, especially in refining the application of marketing theory and practice to older age consumers. To this end, a survey of older couple buying behavior for health insurance coverage is reported here. Results clarify evaluative criteria and the viability of multiple market segmentation for health care coverage among older consumers as couples. Commentary on the efficacy of present health coverage marketing programs is provided.

  4. Public perceptions of health care professionals' participation in pharmaceutical marketing.

    Science.gov (United States)

    Crigger, Nancy J; Courter, Laura; Hayes, Kristen; Shepherd, K

    2009-09-01

    Trust in the nurse-patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing.

  5. Night market contact lens-related corneal ulcer: Should we increase public awareness?

    Directory of Open Access Journals (Sweden)

    Umi Kalthum Md Noh

    2015-07-01

    Full Text Available A 21-year-old Malay woman presented with a 4-day history of left eye progressive painful blurring of vision due to cosmetic CL wear. She had always bought her CLs from a night market and disposed it after every 3–4 months. She had a very poor CL hygiene regime and continuously wore the lenses for more than 8 hours daily. Prior to the presentation, she had been using a combination of steroid and antibiotic eye drop as prescribed by a general practitioner whom she had consulted earlier for similar complaints of eye redness and pain associated with reduced vision. Her condition and vision deteriorated after 2 days of medication instillation.

  6. Segmentation analysis of financial savings markets through the lens of psycho-demographics

    Directory of Open Access Journals (Sweden)

    Tendy Matenge

    2016-08-01

    Full Text Available Purpose: This study seeks to contribute to the discourse of financial savings market segmentation. The study explores different segments of savers on the basis of demographic and psychographic characteristics that are unique to each segment relying on the perspectives of a sample of consumers of financial saving programmes. Design/methodology/approach: Principles of perceptual mapping were used to analyse 33 semi-structured interviews that gathered data on the participants’ psychographic make-up such as personal values, motives for saving, attitudes towards savings and perceived conditions of savings. Findings: Eight distinct segments emerged on each psychographic characteristic based on the participants’ demographics of income, gender and age. However, only five were sizeable enough to be interpreted, being three segments from the males’ category and two from the females’ category. The three segments that emerged within the male category are young low-income earners (YoLI, young high-income earners (YoHI and old high-income earners (OHI while the two female segments include YoLI and OHI. The most sizeable segment of savers in both gender-based categories is one of old adults who have a high income. These segments vary in terms of values, motives and perceptions. Originality/value: The study suggests that a multi-dimensional approach of segmenting financial savings markets is more effective, as neither the demographic nor the psychographic segmentation can fully describe the saving behaviour of consumers. Research implications: The findings of the present study provide strategic communication implications for financial institutions for the respective segments.

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... had not been properly fitted by an eye care professional, the lenses stuck to my eye like ... lenses do not require the same level of care or consideration as a standard contact lens because ...

  8. Marketers don't wear plaid: marketing and health care administration in the Canadian context.

    Science.gov (United States)

    Rigby, J M; Backman, A M

    1997-01-01

    Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

  9. Developing a promotion plan for health care marketing.

    Science.gov (United States)

    Hallums, A

    1994-07-01

    Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.

  10. Marketing service guarantees for health care.

    Science.gov (United States)

    Levy, J S

    1999-01-01

    The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.

  11. Four proposals for market-based health care system reform.

    Science.gov (United States)

    Sumner, W

    1994-08-01

    A perfectly free, competitive medical market would not meet many social goals, such as universal access to health care. Micromanagement of interactions between patients and providers does not guarantee quality care and frequently undermines that relationship, to the frustration of all involved. Furthermore, while some North American health care plans are less expensive than others, none have reduced the medical inflation rate to equal the general inflation rate. Markets have always fixed uneven inflation rates in other domains. The suggested reforms could make elective interactions between patients and providers work more like a free market than did any preceding system. The health and life insurance plan creates cost-sensitive consumers, informed by a corporation with significant research incentives and abilities. The FFEB proposal encourages context-sensitive pricing, established by negotiation processes that weigh labor and benefit. Publication of providers' expected outcomes further enriches the information available to consumers and may reduce defensive medicine incentives. A medical career ladder would ease entry and exit from medical professions. These and complementary reforms do not specifically cap spending yet could have a deflationary impact on elective health care prices, while providing incentives to maintain quality. They accomplish these ends by giving more responsibility, information, incentives, and choice to citizens. We could provide most health care in a marketlike environment. We can incorporate these reforms in any convenient order and allow them to compete with alternative schemes. Our next challenge is to design, implement, and evaluate marketlike health care systems.

  12. Identifying consumer segments in health services markets: an application of conjoint and cluster analyses to the ambulatory care pharmacy market.

    Science.gov (United States)

    Carrol, N V; Gagon, J P

    1983-01-01

    Because of increasing competition, it is becoming more important that health care providers pursue consumer-based market segmentation strategies. This paper presents a methodology for identifying and describing consumer segments in health service markets, and demonstrates the use of the methodology by presenting a study of consumer segments in the ambulatory care pharmacy market.

  13. The manager's role in marketing. The Health Care Group.

    Science.gov (United States)

    1991-06-01

    With the impending reductions in physician reimbursements, the key to a practice's ongoing vitality will be its ability to increase volume and gain greater market share. Traditionally, most doctors have relied on word-of-mouth referrals from current patients and physicians to bring in new patients. In today's health care environment, however, this approach to practice building is not enough to assure growth.

  14. Competition in Health Care Markets : Treatment Volume and Quality

    NARCIS (Netherlands)

    Boone, Jan

    2018-01-01

    This paper introduces a workhorse model to analyze the effects of provider and insurer competition in health care markets. The two contracting imperfections we focus on are the following: (i) whether or not a patient should be treated and (ii) treatment quality are both not contractible. We derive

  15. Planning the Marketing Activity in the Health Care Services

    Directory of Open Access Journals (Sweden)

    Violeta Radulescu

    2008-06-01

    Full Text Available The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access of population to basic services, etc.The formulation of the marketing strategies, in the marketing planning process, starts from the generic strategy chosen by the organization according to its mission and objectives. As it has to adapt to the environment where it acts, to cope with the changes that appear, the organization must benefit from a perspective vision, all its actions must be subordinated to this vision in a whole marketing policy.

  16. Bringing eCare platforms to the market.

    Science.gov (United States)

    Vannieuwenborg, Frederic; Van der Auwermeulen, Thomas; Van Ooteghem, Jan; Jacobs, An; Verbugge, Sofie; Colle, Didier

    2017-09-01

    Due to changes in the demographic situation of most Western European countries, interest in Information and Communication Technologies (ICT)-supported care services is growing fast. eCare services that foster better care information exchange, social involvement, lifestyle monitoring services, etc., offered via ICT platforms, integrated in the homes of the elderly are believed to be cost-effective. Additionally, they could lead to an increased quality of life of both care receiver and (in)formal caregiver. Currently, adoption and integration of these eCare platforms (eCPs) is slowed down by several barriers such as unclear added value, a lack of regulations, or lack of sustainable financial models. In this work, the added value of eCPs is identified for the several involved key actors such as the care receiver, the (in)formal care providers, and the home care organizations. In a second step, several go-to-market strategies are formulated. Because the gap between the current way of providing home care and providing home care supported by a fully integrated eCP seems too big to bridge in one effort, a migration path is provided for stepwise integration and adoption of eCPs in the current way of home care provisioning.

  17. Effectively marketing prepaid medical care with decision support systems.

    Science.gov (United States)

    Forgionne, G A

    1991-01-01

    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

  18. Point-of-care diagnostics: market trends and growth drivers.

    Science.gov (United States)

    Rajan, Aruna; Glorikian, Harry

    2009-01-01

    There is a significant demand for in vitro diagnostic (IVD) testing to move closer to the patient point-of-care diagnostics [POC]), whether in the hospital, physician's office, rapid clinic or the home, effectively cutting time to results and helping patients make better informed decisions about their health. To analyze the point-of-care market and its trends and growth drivers. In 2007, POC made up 30% of the IVD market and is expected to grow at 9% a year. Although the overall POC market is expected to grow steadily, infectious POC is now the most attractive segment. Availability of rapid random access molecular diagnostic system for critical care infectious diseases such as MRSA and sepsis in the near future is likely to be a significant driver of infectious POC post 2012. Owing to the extraordinary increase in the cost of care, healthcare delivery is moving to increasingly decentralized settings such as rapid clinics and the home, driven by point-of-care diagnostics that provide accurate and directional results. We are evolving from the analog testing world to the digital testing world, where diagnosis is exact and therapy can be administered and be predictably effective.

  19. Cross-border reproductive care : market forces in action or market failure? An economic perspective

    NARCIS (Netherlands)

    Connolly, Mark

    2011-01-01

    From an economist's perspective, cross-border reproductive care (CBRC) reflects a global market economy bringing together the needs of patients and skills of doctors at an agreed price. From this perspective CBRC is neither wrong nor right, rather it reflects rational economic behaviour of couples

  20. Marketing.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    There is not enough marketing of dentistry; but there certainly is too much selling of poor quality service that is being passed off as dentistry. The marketing concept makes the patient and the patients' needs the ultimate criteria of marketing efforts. Myths and good practices for effective marketing that will promote oral health are described under the traditional four "Ps" categories of "product" (best dental care), "place" (availability), "promotion" (advertising and other forms of making patients aware of available services and how to use them), and "price" (the total cost to patients of receiving care).

  1. [Beyond the horizon of health-care delivery - medical marketing].

    Science.gov (United States)

    Hoffmann, M; Großterlinden, L G; Rueger, J M; Ruecker, A H

    2014-12-01

    The progress in medical health care and demographic changes cause increasing financial expenses. The rising competitive environment on health-care delivery level calls for economisation and implementation of a professional marketing set-up in order to ensure long-term commercial success. The survey is based on a questionnaire-analysis of 100 patients admitted to a trauma department at a university hospital in Germany. Patients were admitted either for emergency treatment or planned surgical procedures. Competence and localisation represent basic criteria determing hospital choice with a varying focus in each collective. Both collectives realise a trend toward economisation, possibly influencing medical care decision-making. Patients admitted for planned surgical treatment are well informed about their disease, treatment options and specialised centres. The main source of information is the internet. Both collectives claim amenities during their in-hospital stay. Increasing economisation trends call for a sound and distinct marketing strategy. The marketing has to be focused on the stakeholders needs. Concomitant factors are patient satisfaction, the establishment of cooperation networks and maintenance/improvement of medical health-care quality. Georg Thieme Verlag KG Stuttgart · New York.

  2. Market-oriented health care reforms: trends and future options.

    Science.gov (United States)

    van de Ven, W P

    1996-09-01

    In many (predominantly) publicly financed health care systems market-oriented health care reforms are being implemented or have been proposed. The purpose of these reforms is to make resource allocation in health care more efficient, more innovative and more responsive to consumers preferences while maintaining equity. At the same time, the advances in technology result in a divergence of consumers' preferences with respect to health care and urge society to (re)think about the meaning of the solidarity principle in health care. In this paper we indicate some international trends in health care reforms and explore some potential future options. From an international perspective we can observe a trend towards universal mandatory health insurance, contracts between third-party purchasers and the providers of care, competition among providers of care and a strengthening of primary care. These trends can be expected to continue. A more controversial issue is whether there should also be competition among the third-party purchasers and whether in the long run there will occur a convergence towards some "ideal" model. Although regulated competition in health care can be expected to yield more value for money, it might yield both more efficiency and higher total costs. It has been argued that equity can be maintained in a competitive health care system if we interpret equity as "equal access to cost-effective care within a reasonable period of time". Because the effectiveness of care has to be considered in relation to the medical indication and the condition of the patient, the responsibility for cost-effective care rests primarily with the providers of care. Guidelines and protocols should be developed by the profession and sustained by financial incentives embedded in contracts. It has been argued that the third-party purchasers could start to concentrate on the contracts with the primary care physicians. Contracts with other providers could then be a natural

  3. Assessing the viability of situationally driven segmentation opportunities in the health care market.

    Science.gov (United States)

    Gehrt, K C; Pinto, M B

    1993-01-01

    The impact of situational factors has typically been investigated in the context of goods marketing. Very few studies have investigated the influence of situational factors on services marketing. This study demonstrates the importance of situational influence on services marketing by delineating a consumer-based, situationally characterized competitive market structure for health care services. The competitive structure of the health care market is delineated in terms of the similarity/substitutability of the three-factor, situational characterizations of ten health care alternatives. The general marketing implications of the market-structure delineation procedure and the health care-specific implications of the findings are discussed.

  4. Market competition in health care markets in the Netherlands: some lessons for England?

    Science.gov (United States)

    den Exter, André P; Guy, Mary J

    2014-01-01

    This article seeks to establish what lessons might be available to the English health care sector following enactment of the Health and Social Care Act 2012 from the Dutch experience of introducing market competition into health care via a mandatory health insurance scheme implemented by for-profit insurance companies. The existence of the Beveridge NHS model in England, and a Bismarckian insurance system in The Netherlands perhaps suggest that a comparison of the two countries is at best limited, and reinforced by the different Enthoven-inspired competitive models each has adopted. However, we contend that there are positive and negative issues arising from introducing competition into health care-, e.g. concerns about equity and benefits of efficiencies-which go beyond national boundaries and different systems and reflect the global paradigm shift towards the use of market forces in previously non-market areas such as health. The article examines the situation in England following the HSCA 2012 and The Netherlands following the 2006 reforms before analysing two areas of common ground: the focus in both countries on competition on quality (as opposed to price) and integrated care, which is assuming ever greater significance. We suggest that our combined insights (as a health lawyer and competition lawyer respectively) coupled with a comparative approach create a novel contribution to current calls for a wider public debate about the real role of markets in health care over and above simple characterisation as a force for good or bad. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy.

    Science.gov (United States)

    Hager, David R; Persaud, Rosemary A; Naseman, Ryan W; Choudhary, Kavish; Carter, Kristen E; Hansen, Amanda

    2017-05-01

    Background: While hospital beds continue to decline as patients previously treated as inpatients are stabilized in ambulatory settings, the number of critical care beds available in the United States continues to rise. Growth in pharmacy student graduation, postgraduate year 2 critical care (PGY2 CC) residency programs, and positions has also increased. There is a perception that the critical care trained pharmacist market is saturated, yet this has not been evaluated since the rise in pharmacy graduates and residency programs. Purpose: To describe the current perception of critical care residency program directors (CC RPDs) and directors of pharmacy (DOPs) on the critical care pharmacist job market and to evaluate critical care postresidency placement and anticipated changes in PGY2 CC programs. Methods: Two electronic surveys were distributed from October 2015 to November 2015 through Vizient/University HealthSystem Consortium, American Society of Health-System Pharmacists (ASHP), Society of Critical Care Medicine, and American College of Clinical Pharmacy listservs to target 2 groups of respondents: CC RPDs and DOPs. Questions were based on the ASHP Pharmacy Forecast and the Pharmacy Workforce Center's Aggregate Demand Index and were intended to identify perceptions of the critical care market of the 2 groups. Results: Of 116 CC RPDs, there were 66 respondents (56.9% response rate). Respondents have observed an increase in applicants; however, they do not anticipate increasing the number of positions in the next 5 years. The overall perception is that there is a balance in supply and demand in the critical care trained pharmacist market. A total of 82 DOPs responded to the survey. Turnover of critical care pharmacists within respondent organizations is expected to be low. Although a majority of DOPs plan to expand residency training positions, only 9% expect to increase positions in critical care PGY2 training. Overall, DOP respondents indicated a balance of

  6. Assessing the market for long-term care services.

    Science.gov (United States)

    Rice, J A; Taylor, S

    1984-02-01

    Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

  7. New directions for hospital strategic management: the market for efficient care.

    Science.gov (United States)

    Chilingerian, J A

    1992-01-01

    An analysis of current trends in the health care industry points to buyers seeking high quality, yet efficient, care as an emerging market segment. To target this market segment, hospitals must be prepared to market the efficient physicians. In the coming years, hospitals that can identify and market their best practicing providers will achieve a competitive advantage.

  8. Is performance related to marketing research in the health care industry?

    Science.gov (United States)

    Naidu, G M; Kleimenhagen, A; Pillari, G D

    1994-01-01

    Marketing research has grown to become indispensable for superior performance in packaged goods industries. While health care institutions are spending large amounts on marketing research, few studies focus upon the relationship of marketing research to health care organizational performance. Utilizing a national sample of U.S. hospitals, this article points out that marketing research and superior performance are positively associated.

  9. Morality, consumerism and the internal market in health care.

    Science.gov (United States)

    Sorell, T

    1997-01-01

    Unlike the managerially oriented reforms that have brought auditing and accounting into such prominence in the UK National Health Service (NHS), and which seem alien to the culture of the caring professions, consumerist reforms may seem to complement moves towards the acceptance of wide definitions of health, and towards increasing patient autonomy. The empowerment favoured by those who support patient autonomy sounds like the sort of empowerment that is sometimes associated with the patient's charter. For this reason moral criticism of recent NHS reforms may stop short of calling consumerism into question. This, however, would be a mistake: consumerism can be objectionable both within and beyond the health care market. PMID:9134485

  10. Segmentation of hospital markets: where do HMO enrollees get care?

    Science.gov (United States)

    Escarce, J J; Shea, J A; Chen, W

    1997-01-01

    Commercially insured and Medicare patients who are not in health maintenance organizations (HMOs) tend to use different hospitals than HMO patients use. This phenomenon, called market segmentation, raises important questions about how hospitals that treat many HMO patients differ from those that treat few HMO patients, especially with regard to quality of care. This study of patients undergoing coronary artery bypass graft surgery found no evidence that HMOs in southeast Florida systematically channel their patients to high-volume or low-mortality hospitals. These findings are consistent with other evidence that in many areas of the country, incentives for managed care plans to reduce costs may outweigh incentives to improve quality.

  11. [The Second Health Care Market: Market Mapping Based upon Consumer Perception].

    Science.gov (United States)

    Teichert, T; Mühlbach, C

    2018-03-01

    The aim of the study was to present a picture of consumers' views on the specific market of health and health products, the second German health market. Market analysis of the product categories was carried out. A large-scale representative survey (N=1 033) determined with an innovative adaptation of the repertory grid method the consumer's perspective on the specific market. Basic questions concerning attitudes to health as well as healthy behaviors completed the telephone survey. In the saturated markets, market for health is growing, especially in the context of aging societies, and this is not limited to primary medical products. In this study, product categories such as "dental care", "fruit and vegetables" or "nuts" were classified as healthy products. The relevance of health also in the macroeconomic context has been long underestimated. Health has still a high priority for consumers. A disclosure of individual perceptions in the health context provides a significantly more relevant product design. The identification of healthy product dimensions from the consumer's perspective sheds light on the actually desired product properties and the available potential to meet these desires. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... contacto de color Sep. 26, 2013 It started as an impulsive buy from a souvenir shop, but ... require the same level of care or consideration as a standard contact lens because they can be ...

  13. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... With Proper Contact Lens Care Apr 23, 2018 Solar Eclipse Inflicts Damage in the Shape of the ... edging closer, thanks to a wave of new technologies aiming to fix failing eye parts with human- ...

  14. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not require the same level of care or consideration as a standard contact lens because they can ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ...

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not require the same level of care or consideration as a standard contact lens because they can ... Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. Follow the contact lens care directions for cleaning, disinfecting, and wearing the lenses. Never share contact ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  17. Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.

    Science.gov (United States)

    Desmond, Sharon

    2017-03-02

    The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

  18. Nonprice competition and quality of care in managed care: the New York SCHIP market.

    Science.gov (United States)

    Liu, Hangsheng; Phelps, Charles E

    2008-06-01

    To examine the effect of nonprice competition among managed care plans on the quality of care in the New York SCHIP market. U.S. Census 2000; 2002 New York State Managed Care Plan Performance Report; and 2001 New York State Managed Care Annual Enrollment Report. Each market is defined as a county, and competition is measured as the number of plans in a market. Quality of care is measured in percentages using three Consumer Assessment of Health Plans Survey and three Health Plan Employer Data and Information Set scores. Two-stage least squares is applied to address the endogeneity between competition and the quality of care, using population as an instrument. We find a negative association between competition and quality of care. An additional managed care plan is significantly associated with a decrease of 0.40-2.31 percentage points in four out of six quality measures. After adjusting for production cost, a positive correlation is observed between price and quality measures across different pricing regions. It seems likely that pricing policy is a constraint on quality production, although it may not be interpreted as a causal relationship and further study is needed.

  19. The adaptation of health care marketing to the digital era.

    Science.gov (United States)

    Radu, G; Solomon, M; Gheorghe, C M; Hostiuc, M; Bulescu, I A; Purcarea, V L

    2017-01-01

    The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future.

  20. The adaptation of health care marketing to the digital era

    Science.gov (United States)

    Radu, G; Solomon, M; Gheorghe, CM; Hostiuc, M; Bulescu, IA; Purcarea, VL

    2017-01-01

    The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future. PMID:28255375

  1. Health Care Marketing at Keller Army Community Hospital West Point, New York

    Science.gov (United States)

    1982-08-01

    p. 58 3 Robin S.E. MacStravic, "Market Research In Ambulatory Care," Journal of Ambulatory Care Management 4 (May, 1981), 37. 41bid. 5 "Should We... Kotler , Philip. Marketing for Nonprofit Organizations. Englewood Cliffs: Prentice-Hall, Inc., 1975. MacStravic, Robin E. Marketing Health Care. Germantown...they react to complaints, outside stimuli, or higher headquarters rather than take a proactive marketing approach to management . This study seeks to

  2. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.

    Science.gov (United States)

    Horvat, Ana; Filipovic, Jovan

    2018-02-01

    This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations. As the results indicate a dependency between functions of leadership and levels of the maturity of health organizations, we propose a model that connects the two. The study broadens our understanding of the implications of complexity thinking and its reflection on leadership functions and overall organizational performance. The correlations between leadership functions and maturity could have practical applications in policy processing, thus improving the quality of outcomes and the overall level of service quality. © 2017 John Wiley & Sons, Ltd.

  3. Compliance among soft contact lens wearers.

    Science.gov (United States)

    Kuzman, Tomislav; Kutija, Marija Barisić; Masnec, Sanja; Jandroković, Sonja; Mrazovac, Danijela; Jurisić, Darija; Skegro, Ivan; Kalauz, Miro; Kordić, Rajko

    2014-12-01

    Contact lens compliance is proven to be crucial for preventing lens wear-related complications because of the interdependence of the steps in lens care regime and their influence on lens system microbial contamination. Awareness of the patients' lens handling compliance as well as correct recognition of non-compliant behaviours is the basis for creating more targeted strategies for patient education. The aim of this study was to investigate compliance among soft contact lens (SCL) wearers in different aspects of lens care handling and wearing habits. In our research 50 asymptomatic lens wearers filled out a questionnaire containing demographic data, lens type, hygiene and wearing habits, lenses and lens care system replacement schedule and self-evaluation of contact lens handling hygiene. We established criteria of compliance according to available manufacturer's recommendations, prior literature and our clinical experience. Only 2 (4%) of patients were fully compliant SCL wearers. The most common non-compliant behaviours were insufficient lens solution soaking time (62%), followed by failure to daily exchange lens case solution and showering while wearing lenses. 44% of patients reported storing lenses in saline solution. Mean lens storage case replacement was 3.6 months, with up to 78% patients replacing lens case at least once in 3 months. Average grade in self evaluating level of compliance was very good (4 +/- 0.78) (from 1-poor level of hygiene to 5-great level of hygiene). Lens wearers who reported excessive daily lens wear and more than 10 years of lens wearing experience were also found to be less compliant with other lens system care procedures. (t = -2.99, df=47, p rate, self grading was relatively high. Therefore, these results indicate the need for patient education and encouragement of better lens wearing habits and all of the lens maintenance steps at each patient visit.

  4. Primary health care organizations - through a conceptual and a political lens.

    Science.gov (United States)

    Sturmberg, Joachim P

    2011-06-01

    Governments around the world are looking at means to improve health care services and health outcomes for their communities within a sustainable expenditure framework. There is a general agreement that strengthening primary health care is the way for the future. Primary health care organizations (PHCOs) are seen as a means to achieving more effective and efficient health care. This paper proposes a complex adaptive framework for PHCOs, taking account of health and illness being subjective experiences, health care being 'whole person'-focused, and PHCOs focusing on all of a community's health determinants and community-based health care needs. Such approach would foster building healthy local communities as much as seamless integration of health services for all. However, despite the expressed intensions towards patient-centred health care reform the bureaucratic mindset of Australian health policy makers risks true reform by imposing highly structured - rather than 'simple'- policy and operational rules. © 2011 Blackwell Publishing Ltd.

  5. Community benefits in a changing health care market.

    Science.gov (United States)

    1997-07-01

    Market changes in the health industry--mergers, acquisitions, and other transactions--are eliminating many of the traditional sources of care for people who have no insurance or poor coverage. There are fewer public or private nonprofit hospitals with a charitable mission. Moreover, through Medicaid contracting, a portion of the funds that once supported broad public health goals now go to private HMOs that serve only their own members. Advocates are responding with the demand that health providers--nonprofit and for-profit, hospitals and health plans--collaborate with the residents of communities where they do business to improve people's health.

  6. MediCaring: development and test marketing of a supportive care benefit for older people.

    Science.gov (United States)

    Lynn, J; O'Connor, M A; Dulac, J D; Roach, M J; Ross, C S; Wasson, J H

    1999-09-01

    To develop an alternative healthcare benefit (called MediCaring) and to assess the preferences of older Medicare beneficiaries concerning this benefit, which emphasizes more home-based and supportive health care and discourages use of hospitalization and aggressive treatment. To evaluate the beneficiaries' ability to understand and make a choice regarding health insurance benefits; to measure their likelihood to change from traditional Medicare to the new MediCaring benefit; and to determine the short-term stability of that choice. Focus groups of persons aged 65+ and family members shaped the potential MediCaring benefit. A panel of 50 national experts critiqued three iterations of the benefit. The final version was test marketed by discussing it with 382 older people (men > or = 75 years and women > or = 80 years) in their homes. Telephone surveys a few days later, and again 1 month after the home interview, assessed the potential beneficiaries' understanding and preferences concerning MediCaring and the stability of their responses. Focus groups were held in community settings in New Hampshire, Washington, DC, Cleveland, OH, and Columbia, SC. Test marketing occurred in New Hampshire, Cleveland, OH; Columbia, SC, and Los Angeles, CA. Focus group participants were persons more than 65 years old (11 focus groups), healthcare providers (9 focus groups), and family decision-makers (3 focus groups). Participants in the in-home informing (test marketing group) were persons older than 75 years who were identified through contact with a variety of services. Demographics, health characteristics, understanding, and preferences. Focus group beneficiaries between the ages of 65 and 74 generally wanted access to all possible medical treatment and saw MediCaring as a need of persons older than themselves. Those older than age 80 were mostly in favor of it. Test marketing participants understood the key points of the new benefit: 74% generally liked it, and 34% said they would

  7. UV Induced Degradation of Polycarbonate-Based Lens Materials and Implications for the Heath Care Field

    Science.gov (United States)

    Harkay, J. R.; Henry, Jerry

    2006-10-01

    Experimental research is being carried out at Keene State at the undergraduate level that utilizes facilities in both physics and chemistry to study the effects of mono- and polychromatic UV radiation from various sources, including a Deuterium lamp, a solarization unit (at Polyonics, a local industry), and the Sun, to study the photodegradation of polycarbonate-based lens materials used to produce eyewear. Literature in the field of optometry and ophthalmology indicates a correlation between exposure to the UVB band of natural sunlight and the onset of cataract formation, as well as other eye disorders. The public is usually advised that plastic eyeglass lenses will provide protection from this damaging radiation. It is well known that polycarbonate plastic ``yellows'' when exposed to intense sunlight and, particularly, UV light^1,2, either via photo-Fries rearrangement or by a photooxidative process, forming polyconjugated systems and is an industrial concern primarily for cosmetic reasons. We have preliminary data, however, that indicates that the yellowing'' is an indication of a more sinister problem in the case of eyeglasses in that it is accompanied by an increase in transmissivity in the UVB band where the wearer expects and needs protection. Our group includes a local optometrist who will share results with peers in his field. [1] A. Andrady, J. Polymer Sci., 42, 1991 [2] E. P. Gorelov, Inst. Khim. Fiz., Russian Federation

  8. An exploratory study of services marketing in global markets: major areas of inquiry for the health care services industry.

    Science.gov (United States)

    Young, S; Erdem, S A

    1996-01-01

    It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.

  9. Seniors managing multiple medications: using mixed methods to view the home care safety lens.

    Science.gov (United States)

    Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

    2015-12-12

    Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home

  10. 77 FR 70583 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Science.gov (United States)

    2012-11-26

    ... Parts 144, 147, 150, et al. Patient Protection and Affordable Care Act; Health Insurance Market Rules... and 156 [CMS-9972-P] RIN 0938-AR40 Patient Protection and Affordable Care Act; Health Insurance Market... Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal...

  11. Nonprofit health care services marketing: persuasive messages based on multidimensional concept mapping and direct magnitude estimation.

    Science.gov (United States)

    Hall, Michael L

    2009-01-01

    Persuasive messages for marketing healthcare services in general and coordinated care in particular are more important now for providers, hospitals, and third-party payers than ever before. The combination of measurement-based information and creativity may be among the most critical factors in reaching markets or expanding markets. The research presented here provides an approach to marketing coordinated care services which allows healthcare managers to plan persuasive messages given the market conditions they face. Using market respondents' thinking about product attributes combined with distance measurement between pairs of product attributes, a conceptual marketing map is presented and applied to advertising, message copy, and delivery. The data reported here are representative of the potential caregivers for which the messages are intended. Results are described with implications for application to coordinated care services. Theory building and marketing practice are discussed in the light of findings and methodology.

  12. Engineers’ Responsibilities for Global Electronic Waste: Exploring Engineering Student Writing Through a Care Ethics Lens

    Science.gov (United States)

    Campbell, Ryan C.; Wilson, Denise

    2016-01-01

    This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student’s writing on the human health and environmental impacts of “backyard” electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers of tomorrow associated engineers with responsibility for the electronic waste (e-waste) problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering. PMID:27368195

  13. Engineers' Responsibilities for Global Electronic Waste: Exploring Engineering Student Writing Through a Care Ethics Lens.

    Science.gov (United States)

    Campbell, Ryan C; Wilson, Denise

    2017-04-01

    This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student's writing on the human health and environmental impacts of "backyard" electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers of tomorrow associated engineers with responsibility for the electronic waste (e-waste) problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering.

  14. Communication technologies through an etymological lens: looking for a classification, reflections about health, medicine and care.

    Science.gov (United States)

    Colucci, Massimiliano

    2015-11-01

    Information and communication technologies are widely used in healthcare. However, there is not still a unified taxonomy for them. The lack of understanding of this phenomenon implies theoretical and ethical issues. This paper attempts to find out the basis for a classification, starting from a new perspective: the structural elements are obtained from the etymologies of the lexicon commonly used, that is words like telemedicine, telehealth, telecare and telecure. This will promote a better understanding of communication technologies; at the same time, it will allow to draw some reflection about health, medicine and care, and their semantic and relational nature.

  15. Objective lens

    Science.gov (United States)

    Olczak, Eugene G. (Inventor)

    2011-01-01

    An objective lens and a method for using same. The objective lens has a first end, a second end, and a plurality of optical elements. The optical elements are positioned between the first end and the second end and are at least substantially symmetric about a plane centered between the first end and the second end.

  16. Expanding the Caring Lens: Nursing and Medical Students Reflecting on Images of Older People.

    Science.gov (United States)

    Brand, Gabrielle; Miller, Karen; Saunders, Rosemary; Dugmore, Helen; Etherton-Beer, Christopher

    2016-01-01

    In changing higher education environments, health profession's educators have been increasingly challenged to prepare future health professionals to care for aging populations. This article reports on an exploratory, mixed-method research study that used an innovative photo-elicitation technique and interprofessional small-group work in the classroom to enhance the reflective learning experience of medical and nursing students. Data were collected from pre- and postquestionnaires and focus groups to explore shifts in perceptions toward older persons following the reflective learning session. The qualitative data revealed how using visual images of older persons provides a valuable learning space for reflection. Students found meaning in their own learning by creating shared storylines that challenged their perceptions of older people and themselves as future health professionals. These data support the use of visual methodologies to enhance engagement, reflection, and challenge students to explore and deepen their understanding in gerontology.

  17. Operating environment and USA nursing homes' participation in the subacute care market: a longitudinal analysis.

    Science.gov (United States)

    Weech-Maldonado, Robert; Qaseem, Amir; Mkanta, William

    2009-02-01

    We examined the impact of environmental factors on USA nursing homes' participation in the subacute care market. Findings suggest that the Balanced Budget Act of 1997 did not have a significant impact in the participation of nursing homes in the subacute care market from 1998 to 2000. However, there was a declining trend in the participation of nursing homes in the subacute care market after the implementation of Medicare prospective payment system (PPS). Furthermore, nursing homes with a higher proportion of Medicare residents were more likely to exit the subacute care market after PPS. Results also suggest that nursing homes have responded strategically to the environmental demand for subacute care services. Nursing homes located in markets with higher Medicare managed care penetration were more likely to offer subacute care services. Environmental munificence was also an important predictor of nursing home innovation into subacute care. Nursing homes in states with higher Medicaid reimbursement and those in less competitive markets were more likely to participate in the subacute care market.

  18. Using a patient survey for marketing a professional health care practice.

    Science.gov (United States)

    Solomon, R J

    1990-06-01

    Small, private, professional health care practices are at a disadvantage when conducting market survey research because they cannot afford to employ or purchase the expensive specialized marketing skills of their larger competitors. The author describes a method that small private practices can use to conduct patient marketing surveys. Survey findings are reported and examples are provided of how the results influenced subsequent marketing decisions. Suggestions are offered to help ensure the success of similar studies in other practices.

  19. Marketing and social work--synergy in long-term care.

    Science.gov (United States)

    Loomis, L M; Bufano, J T

    1985-08-01

    The concept of marketing is new to the long-term care industry. Limited financial resources dictate that administrators investigate ways to supplement marketing staff. St. John's Home in Rochester, New York, has focused attention on the way in which social work can enhance the effectiveness of the marketing program. Presented here is the role of social work in the marketing mix: product, place, price, promotion, and public relations.

  20. Internal marketing within a health care organization: developing an implementation plan.

    Science.gov (United States)

    Hallums, A

    1994-05-01

    This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

  1. Strategy Dynamics through a Demand-Based Lens: The Evolution of Market Boundaries, Resource Rents and Competitive Positions

    OpenAIRE

    Adner, Ron; Zemsky, Peter

    2003-01-01

    We develop a novel approach to the dynamics of business strategy that is grounded in an explicit treatment of consumer choice when technologies improve over time. We address the evolution of market boundaries, resource rents and competitive positions by adapting models of competition with differentiated products. Our model is consistent with the central strategy assertion that competitive interactions are governed by superior value creation and competitive advantage. More importantly, it show...

  2. Market segmentation and industry overcapacity considering input resources and environmental costs through the lens of governmental intervention.

    Science.gov (United States)

    Jiang, Zhou; Jin, Peizhen; Mishra, Nishikant; Song, Malin

    2017-09-01

    The problems with China's regional industrial overcapacity are often influenced by local governments. This study constructs a framework that includes the resource and environmental costs to analyze overcapacity using the non-radial direction distance function and the price method to measure industrial capacity utilization and market segmentation in 29 provinces in China from 2002 to 2014. The empirical analysis of the spatial panel econometric model shows that (1) the industrial capacity utilization in China's provinces has a ladder-type distribution with a gradual decrease from east to west and there is a severe overcapacity in the traditional heavy industry areas; (2) local government intervention has serious negative effects on regional industry utilization and factor market segmentation more significantly inhibits the utilization rate of regional industry than commodity market segmentation; (3) economic openness improves the utilization rate of industrial capacity while the internet penetration rate and regional environmental management investment have no significant impact; and(4) a higher degree of openness and active private economic development have a positive spatial spillover effect, while there is a significant negative spatial spillover effect from local government intervention and industrial structure sophistication. This paper includes the impact of resources and the environment in overcapacity evaluations, which should guide sustainable development in emerging economies.

  3. Channel leadership in health care marketing: a natural role for hospitals.

    Science.gov (United States)

    Fugate, D L; Decker, P J

    1990-01-01

    Health care has entered an era of rapid change. Most observers agree that important long-term changes will fundamentally reshape health care as we know it. To that end, health care providers should consider the benefits of operating vertically integrated marketing system with hospitals as the channel leader. Whether an administered VMS (hospitals have the power to gain compliance) or a corporate VMS (hospitals own successive levels of care providers), integrated channel management holds the promise of cost containment and quality patient care for the future. However, a great deal of integrating work must be done before VMSs will become a practical solution. Research studies are needed on each of the issues just discussed. As marketers, it is time we make a transition from treating health care marketing as a disjointed entity and instead treat it as an industry where all marketing principles are considered including channel management.

  4. Contact Lens Risks

    Science.gov (United States)

    ... There is a risk of eye infection from bacteria in swimming pool water, hot tubs, lakes and the ocean Replace your contact lens storage case every 3 months or as directed by your eye care professional. Other Risks of Contact Lenses Other risks of contact lenses include pink eye ( ...

  5. Marketing and the medical specialist in the managed care environment.

    Science.gov (United States)

    Treister, N W

    1997-01-01

    Marketing means more than just communicating or advertising to potential patients; marketing means identifying your customers and working to meet or exceed their expectations. There are five key areas of a marketing plan: (1) Establish the foundation, beginning with your mission statement; (2) Assess your marketing environment by internal and external research; (3) Target your efforts, looking at image and perception; (4) Develop your particular mix of product, price, place of distribution, and promotion; and (5) implement and evaluate your marketing process. This article discusses the importance of a marketing plan for the medical specialist and highlights the features unique to a practice working in a system of capitated reimbursement. Applying these principles will help to demonstrate added value, protect the fundamental role of the patient-physician relationship, ensure that our efforts are aligned with professional missions and goals, and ultimately increase profitability and professional success.

  6. Marketing in home health care. A practical approach.

    Science.gov (United States)

    Freitag, E M

    1988-06-01

    Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.

  7. Adapting Child Care Market Price Surveys to Support State Quality Initiatives. White Paper

    Science.gov (United States)

    Branscome, Kenley

    2016-01-01

    Recent changes to the Child Care and Development Fund (CCDF) require a state's child care market price survey to: (1) be statistically valid and reliable and (2) reflect variations in the cost of child care services by geographic area, type of provider, and age of child. States may use an alternative methodology for setting payment rates--such as…

  8. The patient as partner: a competitive strategy in health care marketing.

    Science.gov (United States)

    MacStravic, S

    1988-01-01

    The idea of the patient as partner incorporates a perspective that involves the patient in the care experience for explicit and important purposes. This article includes discussions of patient contributions; quality of care; cost implications; patient and provider satisfaction; and marketing, facilitation, and evaluation of a program that is designed to involve the patient in the care experience.

  9. Applying social marketing in health care: communicating evidence to change consumer behavior.

    Science.gov (United States)

    Evans, W Douglas; McCormack, Lauren

    2008-01-01

    Social marketing uses commercial marketing strategies to change individual and organizational behavior and policies. It has been effective on a population level across a wide range of public health and health care domains. There is limited evidence of the effectiveness of social marketing in changing health care consumer behavior through its impact on patient-provider interaction or provider behavior. Social marketers need to identify translatable strategies (e.g., competition analysis, branding, and tailored messages) that can be applied to health care provider and consumer behavior. Three case studies from social marketing illustrate potential strategies to change provider and consumer behavior. Countermarketing is a rapidly growing social marketing strategy that has been effective in tobacco control and may be effective in countering pharmaceutical marketing using specific message strategies. Informed decision making is a useful strategy when there is medical uncertainty, such as in prostate cancer screening and treatment. Pharmaceutical industry marketing practices offer valuable lessons for developing competing messages to reach providers and consumers. Social marketing is an effective population-based behavior change strategy that can be applied in individual clinical settings and as a complement to reinforce messages communicated on a population level. There is a need for more research on message strategies that work in health care and population-level effectiveness studies.

  10. Brand name changes help health care providers win market recognition.

    Science.gov (United States)

    Keesling, G

    1993-01-01

    As the healthcare industry continues to recognize the strategic implications of branding, more providers will undertake an identity change to better position themselves in competitive markets. The paper examines specific healthcare branding decisions, the reasons prompting brand name decisions and the marketing implications for a change in brand name.

  11. 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."

  12. The strategic marketing reaction of conventional nonprofit hospitals to the market entry of alternative care provider organizations.

    Science.gov (United States)

    Schul, P L; Remington, S J; Planchon, J M

    1994-01-01

    A study was conducted examining the competitive reaction of incumbent firms to the market entry of new form competition in the health care services industry. Specifically, the study addressed the relative impact of both objective and perceptual characteristics of the threat potential posed by the entrance of alternative care facilities (ACF's) into markets previously dominated by nonprofit hospital organizations. The results showed that incumbent hospitals tend to rely most extensively on limited, low-risk market differentiation when responding to the threat posed by ACF entrants. Objective characteristics reflective of the structural complexity of the threat were found to be less important in influencing incumbent reaction than were administrators' perceptions of new entrant threat.

  13. Wide-field synovial fluid imaging using polarized lens-free on-chip microscopy for point-of-care diagnostics of gout (Conference Presentation)

    Science.gov (United States)

    Zhang, Yibo; Lee, Seung Yoon; Zhang, Yun; Furst, Daniel; Fitzgerald, John; Ozcan, Aydogan

    2016-03-01

    Gout and pseudogout are forms of crystal arthropathy caused by monosodium urate (MSU) and calcium pyrophosphate dehydrate (CPPD) crystals in the joint, respectively, that can result in painful joints. Detecting the unique-shaped, birefringent MSU/CPPD crystals in a synovial fluid sample using a compensated polarizing microscope has been the gold-standard for diagnosis since the 1960's. However, this can be time-consuming and inaccurate, especially if there are only few crystals in the fluid. The high-cost and bulkiness of conventional microscopes can also be limiting for point-of-care diagnosis. Lens-free on-chip microscopy based on digital holography routinely achieves high-throughput and high-resolution imaging in a cost-effective and field-portable design. Here we demonstrate, for the first time, polarized lens-free on-chip imaging of MSU and CPPD crystals over a wide field-of-view (FOV ~ 20.5 mm2, i.e., gout and pseudogout. Circularly polarizer partially-coherent light is used to illuminate the synovial fluid sample on a glass slide, after which a quarter-wave-plate and an angle-mismatched linear polarizer are used to analyze the transmitted light. Two lens-free holograms of the MSU/CPPD sample are taken, with the sample rotated by 90°, to rule out any non-birefringent objects within the specimen. A phase-recovery algorithm is also used to improve the reconstruction quality, and digital pseudo-coloring is utilized to match the color and contrast of the lens-free image to that of a gold-standard microscope image to ease the examination by a rheumatologist or a laboratory technician, and to facilitate computerized analysis.

  14. Marketing: a flawed concept when applied to health care?

    Science.gov (United States)

    Young, A P

    Since the introduction of a marketing orientation to the NHS in 1990, arguments continue to abound as to the extent and success of the internal market. This article identifies where and how the market is operating and explores the inherent difficulties of using this model, both ethically and economically. The dangers of increasing inequality, social manipulation, continuing cost pressures, loss of professional autonomy and restricted professional collaboration have to be balanced against the potential value of marketing on performance measures and a more responsive service. The article concludes that marketing needs to be tailored to the particular culture of the NHS rather than copied from the private sector and should emphasize client needs, integrated planning, good communication and the development of agreed quality indicators.

  15. The political construction of elder care markets: comparing Denmark, Finland and Italy

    DEFF Research Database (Denmark)

    Burau, Viola; Zechner, Minna; Dahl, Hanne Marlene

    2017-01-01

    underpinning the policies of marketization, using the ‘What's the problem?’ approach by Carol Bacchi. The central question is how the market was discursively framed as the solution to the perceived problems of three different systems of elder care, and how such processes are similar or different across......In Europe over the last two decades, marketization has become an important policy option in elder care. Comparative studies predominantly adopt an institutional perspective and analyze the politics and policies of marketization. This analysis takes a step back and examines the fundamental ideas...... the three countries. The analysis includes two extreme types of elder care systems, the Nordic public systems in Denmark and Finland, and the Southern European family-based model in Italy. Empirically, the analysis offers interesting insights into processes of constructing and legitimating markets...

  16. ServicePro. A comprehensive customer care tool for highly penetrated markets

    International Nuclear Information System (INIS)

    Weiner, B.

    1997-01-01

    Contemporary marketing measures focus on recruiting new customers as a means of boosting sales. As the share of the market occupied by natural gas increases, the more probable it is that there will be dissatisfied customers who are prepared to switch to other energy sources. Systematic customer care measures are therefore a necessity ServicePro is a customer care concept that has been developed in response to this need. Its three modules are technical, contractual and general customer care. Practical local implementation is assisted by database software and a manual containing tools and examples. Customer care activities also strengthen customer relations and improve the gas utility's image. (au)

  17. How to Be Bullish on Marketing Child Care in a Challenging Economy.

    Science.gov (United States)

    Wassom, Julie

    1992-01-01

    Discusses factors to consider when developing marketing strategies for building enrollment in child care programs. Factors are (1) focus on a market; (2) the impression of the service that is created in customers' minds; (3) the urgency of the advertising message; (4) perceived value of the service; and (5) cost effectiveness. (SM)

  18. E-mail marketing grows up: a primer for the managed care industry.

    Science.gov (United States)

    Dysart, J

    2000-02-01

    Managed care plans are jumping onto the electronic marketing bandwagon in a big way, taking advantage of not only the basic E-mail system but also expanding on that medium and developing creative vehicles to send the health plan's message. In this article, the author describes how E-mail technology is being used to hone the marketing edge in MCOs.

  19. Web site review. Carolinas HealthCare recognized Internet marketing potential early.

    Science.gov (United States)

    Botvin, Judith D

    2005-01-01

    Since the early days of the Internet, administrators Carolinas HealthCare System in Charlotte, NC, have appreciated its potential as a marketing tool. This places a lot of expectations on the Web site, www.carolinashealthcare.org, which is managed by the marketing-public relations department. Find out how the well-established site fulfills its mission and more.

  20. Problem analysis: application in the development of market strategies for health care organizations.

    Science.gov (United States)

    Martin, J

    1988-03-01

    The problem analysis technique is an approach to understanding salient customer needs that is especially appropriate under complex market conditions. The author demonstrates the use of the approach in segmenting markets and conducting competitive analysis for positioning strategy decisions in health care.

  1. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Science.gov (United States)

    2013-02-27

    ... Parts 144, 147, 150, et al. Patient Protection and Affordable Care Act; Health Insurance Market Rules... Insurance Market Rules; Rate Review AGENCY: Department of Health and Human Services. ACTION: Final rule. SUMMARY: This final rule implements provisions related to fair health insurance premiums, guaranteed...

  2. Strategic planning and marketing research for older, inner-city health care facilities: a case study.

    Science.gov (United States)

    Wood, V R; Robertson, K R

    1992-01-01

    Numerous health care facilities, located in downtown metropolitan areas, now find themselves surrounded by a decaying inner-city environment. Consumers may perceive these facilities as "old," and catering to an "urban poor" consumer. These same consumers may, therefore, prefer to patronize more modern facilities located in suburban areas. This paper presents a case study of such a health care facility and how strategic planning and marketing research were conducted in order to identify market opportunities and new strategic directions.

  3. Study of Marketing Components Affecting Health Care Services in Hospitals

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Akbarian Bafghi

    2016-10-01

    Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.

  4. 20 strategies for marketing your managed care plan.

    Science.gov (United States)

    Firshein, J

    1996-01-01

    In today's fiercely competitive managed care marketplace, healthcare executives must find a way to set their plans apart from the competition and build a sufficient customer base. At the same time, they must confront a growing anti-managed care backlash among a wary and confused public. Healthcare executive magazine talked with managed care experts to gather their views on key strategies to help executives meet both of these challenges. Here's what they suggest.

  5. Lens Model

    DEFF Research Database (Denmark)

    Nash, Ulrik William

    2014-01-01

    Firms consist of people who make decisions to achieve goals. How do these people develop the expectations which underpin the choices they make? The lens model provides one answer to this question. It was developed by cognitive psychologist Egon Brunswik (1952) to illustrate his theory of probabil...

  6. Dementia care and labour market: the role of job satisfaction.

    NARCIS (Netherlands)

    Vernooy-Dassen, M.J.F.J.; Faber, M.J.; Olde Rikkert, M.G.M.; Koopmans, R.T.C.M.; Achterberg, T. van; Braat, D.D.M.; Raas, G.P.; Wollersheim, H.C.H.

    2009-01-01

    OBJECTIVES: A labour shortage in the dementia care sector is to be expected in the near future in the Netherlands and in many other European states. The objective of this study is to analyse why people quit or avoid jobs in dementia care. METHOD: An integrative analysis was used to study reports,

  7. Primary care referral management: a marketing strategy for hospitals.

    Science.gov (United States)

    Bender, A D; Geoghegan, S S; Lundquist, S H; Cantone, J M; Krasnick, C J

    1990-06-01

    With increasing competition among hospitals, primary care referral development and management programs offer an opportunity for hospitals to increase their admissions. Such programs require careful development, the commitment of the hospital staff to the strategy, an integration of hospital activities, and an understanding of medical practice management.

  8. Policy conflicts : Market-oriented reform in health care

    NARCIS (Netherlands)

    Dolfsma, W.A.; Mcmaster, R.

    From an institutionalist perspective, we identify five sources of policy conflict. Each may explain why policies intended to obtain particular goals for an institutionalized practice may have unintended consequences. We illustrate by analyzing attempts at introducing market-oriented reform in health

  9. An exploration of the applicability of situational segmentation in the health care market: development of a situational taxonomy.

    Science.gov (United States)

    Gehrt, K C; Pinto, M B

    1990-01-01

    Competition in the health care market has intensified in recent years. Health care providers are increasingly adopting innovative marketing techniques to secure their positions in the marketplace. This paper examines an innovative marketing technique, situational segmentation, and assesses its applicability to the health care market. Situational segmentation has proven useful in many consumer goods markets but has received little attention in the context of health care marketing. A two-stage research process is used to develop a taxonomy of situational factors pertinent to health care choice. In stage one, focus group interviews are used to gather information which is instrumental to questionnaire development. In stage two, the responses of 151 subjects to a 51 item questionnaire are factor analyzed. The results demonstrate that situational segmentation is a viable strategy in the health care market.

  10. A new measure of the impact of managed care on healthcare markets.

    Science.gov (United States)

    Pawlson, L G; Moy, E M; Kim, J I; Griner, P F

    2001-11-01

    Most studies of managed care impact have used health maintenance organization (HMO) penetration or index of competition as the marker of managed care impact. However, little empirical evidence has been found to support the validity of these or other measures in current use. In addition, as managed care evolves to forms other than HMOs and managed care penetration in large metropolitan areas approaches 100% of commercially insured patients, the utility of the most commonly used measure, HMO penetration, will decrease still further. To provide a preliminary analysis of the use of premiums as a measure of market impact of managed care. Retrospective analysis (quartile, correlation, multiple-variable linear regression) of publicly available datasets. Labor market-adjusted HMO premiums from 3 publicly available sources, for the 56 largest metropolitan areas in the United States, were compared with penetration and index of competition as predictors of the dependent market variable, hospital bed-days per 1000 population. Health maintenance organization premiums in the Federal Employees Health Benefits Program emerged as the best predictor of HMO market impact. Average HMO premiums reported in the Interstudy database and for the Medicare+Choice program also outperformed penetration or index of competition in relating to several commonly available markers of competition such as bed-days per 1000. Premiums charged by HMOs are a useful measure of the impact of managed care on healthcare markets in large metropolitan areas.

  11. Marketing for health-care organizations: an introduction to network management.

    Science.gov (United States)

    Boonekamp, L C

    1994-01-01

    The introduction of regulated competition in health care in several Western countries confronts health care providing organizations with changing relationships, with their environment and a need for knowledge and skills to analyse and improve their market position. Marketing receives more and more attention, as recent developments in this field of study provide a specific perspective on the relationships between an organization and external and internal parties. In doing so, a basis is offered for network management. A problem is that the existing marketing literature is not entirely appropriate for the specific characteristics of health care. After a description of the developments in marketing and its most recent key concepts, the applicability of these concepts in health-care organizations is discussed. States that for the health-care sector, dominated by complex networks of interorganizational relationships, the strategic marketing vision on relationships can be very useful. At the same time however, the operationalization of these concepts requires special attention and a distinct role of the management of health-care organizations, because of the characteristics of such organizations and the specific type of their service delivery.

  12. Contracts and supply assurance in the UK health care market.

    Science.gov (United States)

    Fenn, P; Rickman, N; McGuire, A

    1994-07-01

    We present a formal model of the relationship between a health care purchaser and a provider drawing on the recent experience of explicit contracting in the UK health sector. Specifically we model the contractual relationships emerging between District Health Authorities, who are presently the dominant health care purchasers, and the providers of hospital care. The comparative static analysis implies that the transaction cost of using non-local hospitals, the expected patient demand, the extent of excess capacity in local hospitals, and the proportion of that excess capacity expected to be lost to competitive purchasers, are all important determinants of the choice of contract.

  13. Employee motivation and employee performance in child care : the effects of the introduction of market forces on employees in the Dutch child-care sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    Employee Motivation and Employee Performance in Child Care: The Effects of the Introduction of Market Focus on Employees in the Dutch Child-Care Sector Mirjam Plantinga (RUG) This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on

  14. Employee Motivation and Employee Performance in Child Care : The effects of the Introduction of Market Forces on Employees in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on employee governance, motivation and performance. The Dutch child-care sector is transitioning from a welfare sector into a market sector. The transition process in child care is

  15. Relationship marketing and disadvantaged health care segments: using internal marketing to improve the vocational rehabilitation process.

    Science.gov (United States)

    Peltier, James W; Scovotti, Carol

    2004-01-01

    The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.

  16. Health Care Market Concentration Trends In The United States: Evidence And Policy Responses.

    Science.gov (United States)

    Fulton, Brent D

    2017-09-01

    Policy makers and analysts have been voicing concerns about the increasing concentration of health care providers and health insurers in markets nationwide, including the potential adverse effect on the cost and quality of health care. The Council of Economic Advisers recently expressed its concern about the lack of estimates of market concentration in many sectors of the US economy. To address this gap in health care, this study analyzed market concentration trends in the United States from 2010 to 2016 for hospitals, physician organizations, and health insurers. Hospital and physician organization markets became increasingly concentrated over this time period. Concentration among primary care physicians increased the most, partially because hospitals and health care systems acquired primary care physician organizations. In 2016, 90 percent of Metropolitan Statistical Areas (MSAs) were highly concentrated for hospitals, 65 percent for specialist physicians, 39 percent for primary care physicians, and 57 percent for insurers. Ninety-one percent of the 346 MSAs analyzed may have warranted concern and scrutiny because of their concentration levels in 2016 and changes in their concentrations since 2010. Public policies that enhance competition are needed, such as stricter enforcement of antitrust laws, reducing barriers to entry, and restricting anticompetitive behaviors. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Does certificate of need law enhance competition in inpatient care market? An empirical analysis.

    Science.gov (United States)

    Paul, Jomon A; Ni, Huan; Bagchi, Aniruddha

    2017-06-29

    This article investigates the impact of Certificate of Need (CON) laws on competition in the inpatient care market. One of the major criticisms of these laws is that it may hinder competition in the health care market, which can lead to higher prices. However, from a theoretical standpoint, CON laws could also promote competition by limiting excessive expansion from incumbents. Our main conclusion is that CON laws by and large enhanced competition in the inpatient market during the period of our study. This indicates that the effects of CON laws to hinder predatory behavior could dominate its effects of preventing new entrants into the inpatient care market. We do not find statistically significant evidence to reject the exogeneity assumption of either CON laws or their stringency in our study. We also find factors such as proportion of population aged 18-44, proportion of Asian American population, obesity rate, political environment, etc., in a state significantly impact competition. Our findings could shed some light to public policy makers when deciding the appropriate health programs or legislative framework to promote health care market competition and thereby facilitate quality health care.

  18. Marketing strategy adjustments in the ambulatory care center industry: implications for community pharmacy.

    Science.gov (United States)

    Phillips, J H

    1989-01-01

    Each stage of a product's life cycle requires marketing strategy modifications in response to changing demand levels. The purpose of this study was to investigate changes in ambulatory care center (ACC) operational characteristics indicative of product, market, and distribution channel adjustments that could have a competitive impact upon community pharmacy practice. A questionnaire was mailed to a national sample of 325 ACC managers. Evidence of new product feature additions includes increased emphasis on continued care and increased prevalence of prescription drug dispensing. Expansion into new market segments and distribution channels was demonstrated by increased participation in HMO and employer relationships. The observed adjustments in ACC marketing strategies present obvious challenges as well as less obvious opportunities for community pharmacy practice.

  19. How to attract customers and develop online shop’s marketing? : Case: Baby Care

    OpenAIRE

    Zhu, Xiaomeng; Wang, Xu

    2015-01-01

    The main purpose of this study was to find out suitable marketing strategy for our online shop which is named Baby Care selling baby products mainly. As ‘E-Commerce’ calls growing rapidly in China, online shops pattern is slowly recognized and accepted by consumers. Baby products’ marketing also becomes more and more popular and competitive. Today our online shop with traditional retailers is not only to partake in network counterparts, but also, it occupies a place to implement. Thus we need...

  20. A critical review of recent US market level health care strategy literature.

    Science.gov (United States)

    Wells, R; Banaszak-Holl, J

    2000-09-01

    In this review, we argue that it would be profitable if the neoclassical economic theories that have dominated recent US market level health care strategy research could be complemented by greater use of sociological frameworks. Sociological theory can address three central questions that neoclassical economic theories have tended to slight: (1) how decision-makers' preferences are determined; (2) who the decision-makers are; and (3) how decision-makers' plans are translated into organizational action. We suggest five sociological frameworks that would enable researchers to address these issues better relative to market level strategy in health care. The frameworks are (1) institutional theory, (2) organizational ecology, (3) social movements, (4) social networks, and (5) internal organizational change. A recent global trend toward privatization of health care provision makes US market level strategy research increasingly applicable to non-US readers.

  1. Impacts of market and organizational characteristics on hospital efficiency and uncompensated care.

    Science.gov (United States)

    Hsieh, Hui-Min; Clement, Dolores G; Bazzoli, Gloria J

    2010-01-01

    Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.

  2. Resistance of Pseudomonas aeruginosa isolates to hydrogel contact lens disinfection correlates with cytotoxic activity.

    Science.gov (United States)

    Lakkis, C; Fleiszig, S M

    2001-04-01

    One of the most common pathogens in infection of hydrogel contact lens wearers is Pseudomonas aeruginosa, which can gain access to the eye via contamination of the lens, lens case, and lens care solutions. Only one strain per species is used in current regulatory testing for the marketing of chemical contact lens disinfectants. The aim of this study was to determine whether P. aeruginosa strains vary in their susceptibility to hydrogel contact lens disinfectants. A method for rapidly screening bacterial susceptibility to contact lens disinfectants was developed, based on measurement of the MIC. The susceptibility of 35 P. aeruginosa isolates to two chemical disinfectants was found to vary among strains. MICs ranged from 6.25 to 100% for both disinfectants at 37 degrees C, and a number of strains were not inhibited by a 100% disinfectant concentration in the lens case environment at room temperature (22 degrees C). Resistance to disinfection appeared to be an inherent rather than acquired trait, since some resistant strains had been isolated prior to the introduction of the disinfectants and some susceptible P. aeruginosa strains could not be made more resistant by repeated disinfectant exposure. A number of P. aeruginosa strains which were comparatively more resistant to short-term disinfectant exposure also demonstrated the ability to grow to levels above the initial inoculum in one chemical disinfectant after long-term (24 to 48 h) disinfectant exposure. Resistance was correlated with acute cytotoxic activity toward corneal epithelial cells and with exsA, which encodes a protein that regulates cytotoxicity via a complex type III secretion system. These results suggest that chemical disinfection solutions may select for contamination with cytotoxic strains. Further investigation of the mechanisms and factors responsible for resistance may also lead to strategies for reducing adverse responses to contact lens wear.

  3. Information vs advertising in the market for hospital care.

    Science.gov (United States)

    Montefiori, Marcello

    2008-09-01

    Recent health care reforms have introduced prospective payments and have allowed patients to choose their preferred providers. The expected outcome is efficiency in production and an increase in the quality level. The former objective should be obtained by the prospective payment scheme; the latter by the demand mechanism, through the competition between providers. Unfortunately, because of asymmetry of information, patients are unable to observe the true quality and the demand for health care services depends on a perceived quality as influenced by the hospital advertising. Inefficiency in the resource allocation and social welfare loss are the two likely effects. In this paper we show how the purchaser can implement effective policies to overcome these undesired effects.

  4. Robotic surgery in urological oncology: patient care or market share?

    Science.gov (United States)

    Kaye, Deborah R; Mullins, Jeffrey K; Carter, H Ballentine; Bivalacqua, Trinity J

    2015-01-01

    Surgical robotic use has grown exponentially in spite of limited or uncertain benefits and large costs. In certain situations, adoption of robotic technology provides value to patients and society. In other cases, however, the robot provides little or no increase in surgical quality, with increased expense, and, therefore, does not add value to health care. The surgical robot is expensive to purchase, maintain and operate, and can contribute to increased consumerism in relation to surgical procedures, and increased reliance on the technology, thus driving future increases in health-care expenditure. Given the current need for budget constraints, the cost-effectiveness of specific procedures must be evaluated. The surgical robot should be used when cost-effective, but traditional open and laparoscopic techniques also need to be continually fostered.

  5. Pricing in health care organizations. A key component of the marketing mix.

    Science.gov (United States)

    Marlowe, D

    1989-01-01

    Pricing is one of the key components of a successful marketing mix. Pricing objectives, strategies, and tactics cannot stand alone, however. To be effective, price must work in harmony with other marketing and management activities. Despite its importance, use of pricing as a management tool is limited in health care compared to other industries. Many factors contribute to this situation, including the structure of the health-care exchange process, limited consumer knowledge, and a limited ability to measure costs. I will provide an overview of pricing information, both within and outside health care. Specifically, we will explore the definition of pricing, nonmonetary pricing, price elasticity, classical pricing theory, and the role of pricing in a health-care setting.

  6. HealthStyles: a new psychographic segmentation system for health care marketers.

    Science.gov (United States)

    Endresen, K W; Wintz, J C

    1988-01-01

    HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior.

  7. Word-of-mouth communications in health care marketing.

    Science.gov (United States)

    MacStravic, R S

    1985-10-01

    Word-of-mouth (WOM) advertising can be an important communications tool, since it addresses the right target--the decision maker, contains the needed information, and occurs at the right time. An effective WOM communications program will use a marketing survey to identify decision makers and measure their degree of preference for the provider to determine which decision makers can be influenced. A survey also should be used to discover the most significant information sources. To involve those sources in a WOM communications effort requires that they be satisfied with their provider and that they be convinced the provider is the best choice for the person who has requested the recommendation. To increase the likelihood that sources will be informed about a specific provider, pamphlets or other materials can be distributed to assist them. Other forms of encouragement include patient surveys and employee bonuses. An institution's WOM program should also be consistent with its other communications efforts. Messages must be compatible with the themes of advertising and publicity campaigns.

  8. Managed care market share and cesarean section rates in the United States: is there a link?

    Science.gov (United States)

    Hueston, W J; Sutton, A

    2000-11-01

    After peaking during the early 1980s, cesarean section rates in the United States have been falling for the last decade. At the same time, managed care enrollment has increased dramatically. This study examines whether managed care penetration in local markets is associated with lower cesarean section rates in those geographic area. A cross-sectional comparison of cesarean section rates and health maintenance organization (HMO) market penetration in 61 selected metropolitan areas in the United States was conducted. National birth certificate data for 1996 were used to calculate crude and race-adjusted cesarean section rates for residents in each area. No relationship between overall cesarean section rates in the metropolitan areas and managed care penetration was observed. Subanalyses of racial groups demonstrated the existence of a weak association between managed care penetration and cesarean section rates for white women (21.2% for the highest quartile of HMO penetration, compared with 19.1% for the lowest quartile; P = .03), but not for African-Americans or other minorities. Managed care penetration in a market may have an association with cesarean section rates for white women, but the strength of this relationship is small. Even if managed care delivery systems reduce cesarean section rates in their own populations, this change is likely to have only a small impact on overall cesarean rates. HMO penetration is unlikely to influence national cesarean section rates, nor does it appear to explain state variations in these rates.

  9. Strategies to enhance price and quality competition in health care: lessons learned from tracking local markets.

    Science.gov (United States)

    Lesser, Cara S; Ginsburg, Paul B

    2006-06-01

    Drawing on observations from tracking changes in local health care markets over the past ten years, this article critiques two Federal Trade Commission and Department of Justice recommendations to enhance price and quality competition. First, we take issue with the notion that consumers, acting independently, will drive greater competition in health care markets. Rather we suggest an important role remains for trusted agents who can analyze inherently complex price and quality information and negotiate on consumers' behalf. With aggregated information identifying providers who deliver cost-effective care, consumers would be better positioned to respond to financial incentives about where to seek care and thereby drive more meaningful competition among providers to reduce costs and improve quality. Second, we take issue with the FTC/DOJ recommendation to provide more direct subsidies to prevent distortions in competition. In the current political environment, it is not practical to provide direct subsidies for all of the unfunded care that exists in health care markets today; instead, some interference with competition may be necessary to protect cross subsidies. Barriers can be reduced, though, by revising pricing policies that have resulted in marked disparities in the relative profitability of different services.

  10. Marketing aspects of development of medical waste management in health care institutions in Ukraine

    Directory of Open Access Journals (Sweden)

    Inesa Gurinа

    2015-02-01

    Full Text Available The concept of marketing approach to medical waste management in health care is suggested.The goal of research was to study the state of marketing activities of health care institutions on medical waste management and development trends of   resolution of outstanding issues.Methods. The methods, which were used in the research, are the methods of mathematical statistics, social studies and scientific knowledge.Results. Environmental marketing institutions of healthcare means perfectly safe for the environment provision of health services. The main directions of environmental marketing concept in health care institutions is the acceptance generally binding legal standards of Use Resources, strict control the formation and licensing of medical waste; economic incentives for workers, aimed at minimizing their interest in the volumes of medical waste; financing of R & D relative to the development of new waste and sound technologies; develop a system of taxes and penalties for polluting the environment and so on.Conclusions. As a result of the implementation of marketing strategies for managing medical waste of healthcare institutions are obtained strategic, social, environmental and economic benefits.

  11. Beyond Antitrust: Health Care And Health Insurance Market Trends And The Future Of Competition.

    Science.gov (United States)

    Glied, Sherry A; Altman, Stuart H

    2017-09-01

    The United States relies on competition to balance costs and quality in the health care system. But concentration is increasing throughout the hospital, physician, and insurer markets. Midsize community hospitals face declining demand and growing competition from both larger hospitals and smaller freestanding diagnostic and surgical centers, leaving the midsize hospitals vulnerable to closure or merger with other facilities. Competition among insurers has been limited by the development of hospital systems that extend the bargaining power of "must-have" hospitals (those perceived to provide the best care for complex and less common conditions) across local health care markets. Government antitrust enforcement could play an important role in maintaining competition in both the hospital and insurer markets, but in many markets, the impact of that enforcement has been limited to date. Policy makers should consider supplementing antitrust activities with strategies that combine competition and regulation-for example, by regulating selected prices and structuring competition to cover entire insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Going for the gold: the redistributive agenda behind market-based health care reform.

    Science.gov (United States)

    Evans, R G

    1997-04-01

    Political conflict over the respective roles of the state and the market in health care has a long history. Current interest in market approaches represents the resurgence of ideas and arguments that have been promoted with varying intensity throughout this century. (In practice, advocates have never wanted a truly competitive market, but rather one managed by and for particular private interests). Yet international experience over the last forty years has demonstrated that greater reliance on the market is associated with inferior system performance--inequity, inefficiency, high cost, and public dissatisfaction. The United States is the leading example. So why is this issue back again? Because market mechanisms yield distributional advantages for particular influential groups. (1) A more costly health care system yields higher prices and incomes for suppliers--physicians, drug companies, and private insurers. (2) Private payment distributes overall system costs according to use (or expected use) of services, costing wealthier and healthier people less than finance from (income-related) taxation. (3) Wealthy and unhealthy people can purchase (real or perceived) better access or quality for themselves, without having to support a similar standard for others. Thus there is, and always has been, a natural alliance of economic interest between service providers and upper-income citizens to support shifting health financing from public to private sources. Analytic arguments for the potential superiority of hypothetical competitive markets are simply one of the rhetorical forms through which this permanent conflict of economic interest is expressed in political debate.

  13. Market trends in baby skin care products and implications for clinical practice.

    Science.gov (United States)

    Gao, Xiang; Simpson, Eric L

    2014-01-01

    Although the U.S. pediatric skin care market is a $1.7 billion industry, little is known regarding the usage pattern of skin care products in very young children. We have begun to recognize that common over-the-counter skin care products may have positive or negative effects on skin barrier function. Thus, knowing what and how skin care products are used early in life is important. The goal of the current study was to better understand skin care product use in the United States using market research data. We found that the prevalence of use was greater than 50% for all skin care product categories and age groups. Premoistened cleansing wipes and cloths were the most frequently used product, followed by baby oil and lotion and body and baby powder. Baby bath and shampoo products were used at least five times per week per household, and caregivers generally preferred products that were fragrance-free and made for sensitive skin. Lower-income households reported a higher frequency of product use and were less likely to purchase fragrance-free products or ones that were made for sensitive skin. Our findings suggest that the prevalence of pediatric skin care product use is high and conflicts with current recommended skin care guidelines. Product use and preferences may also vary according to race and ethnicity and household income level. © 2014 Wiley Periodicals, Inc.

  14. Does Medicaid managed care market penetration impact provider participation, costs, utilization, and access?

    Science.gov (United States)

    Minott, Jenny

    2010-09-01

    Key findings. (1) An increase in commercial plan penetration increased the liklihood [sic] that a physician would accept new Medicaid patients, but this did not significantly impact enrollee costs. (2) An increase in Medicaid-dominant HMO market penetration increased the probability that individuals reported using the ED as their primary source of care.

  15. Markets and medicine: the politics of health care reform in Britain, Germany, and the United States

    National Research Council Canada - National Science Library

    Giaimo, Susan

    2002-01-01

    ...: The Limits of Markets in Health Care 193 Appendix: Information on Interviews and Methodology 225 Notes 233 Bibliography 263 Index 293 List of TablesTables I. Physicians' Earnings Relative to Other Occupations in the United Kingdom, Germany, and the United States, 1965-92 13 2. Physicians' Mean Gross Income in the United Kingdom, Germany, and...

  16. Algorithm design of liquid lens inspection system

    Science.gov (United States)

    Hsieh, Lu-Lin; Wang, Chun-Chieh

    2008-08-01

    In mobile lens domain, the glass lens is often to be applied in high-resolution requirement situation; but the glass zoom lens needs to be collocated with movable machinery and voice-coil motor, which usually arises some space limits in minimum design. In high level molding component technology development, the appearance of liquid lens has become the focus of mobile phone and digital camera companies. The liquid lens sets with solid optical lens and driving circuit has replaced the original components. As a result, the volume requirement is decreased to merely 50% of the original design. Besides, with the high focus adjusting speed, low energy requirement, high durability, and low-cost manufacturing process, the liquid lens shows advantages in the competitive market. In the past, authors only need to inspect the scrape defect made by external force for the glass lens. As to the liquid lens, authors need to inspect the state of four different structural layers due to the different design and structure. In this paper, authors apply machine vision and digital image processing technology to administer inspections in the particular layer according to the needs of users. According to our experiment results, the algorithm proposed can automatically delete non-focus background, extract the region of interest, find out and analyze the defects efficiently in the particular layer. In the future, authors will combine the algorithm of the system with automatic-focus technology to implement the inside inspection based on the product inspective demands.

  17. Marketing depression care management to employers: design of a randomized controlled trial.

    Science.gov (United States)

    Rost, Kathryn M; Marshall, Donna

    2010-03-16

    Randomized trials demonstrate that depression care management can improve clinical and work outcomes sufficiently for selected employers to realize a return on investment. Employers can now purchase depression products that provide depression care management, defined as employee screening, education, monitoring, and clinician feedback for all depressed employees. We developed an intervention to encourage employers to purchase a depression product that offers the type, intensity, and duration of care management shown to improve clinical and work outcomes. In a randomized controlled trial conducted with 360 employers of 30 regional business coalitions, the research team proposes to compare the impact of a value-based marketing intervention to usual-care marketing on employer purchase of depression products. The study will also identify mediators and organizational-level moderators of intervention impact. Employers randomized to the value-based condition receive a presentation encouraging them to purchase depression products scientifically shown to benefit the employee and the employer. Employers randomized to the usual-care condition receive a presentation encouraging them to monitor and improve quality indicators for outpatient depression treatment. Because previous research demonstrates that the usual-care intervention will have little to no impact on employer purchasing, depression product purchasing rates in the usual-care condition capture vendor efforts to market depression products to employers in both conditions while the value-based intervention is being conducted. Employers in both conditions are also provided free technical assistance to undertake the actions each presentation encourages. The research team will use intent-to-treat models of all available data to evaluate intervention impact on the purchase of depression products using a cumulative incidence analysis of 12- and 24-month data. By addressing the 'value to whom?' question, the study advances

  18. Marketing depression care management to employers: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Marshall Donna

    2010-03-01

    Full Text Available Abstract Background Randomized trials demonstrate that depression care management can improve clinical and work outcomes sufficiently for selected employers to realize a return on investment. Employers can now purchase depression products that provide depression care management, defined as employee screening, education, monitoring, and clinician feedback for all depressed employees. We developed an intervention to encourage employers to purchase a depression product that offers the type, intensity, and duration of care management shown to improve clinical and work outcomes. Methods In a randomized controlled trial conducted with 360 employers of 30 regional business coalitions, the research team proposes to compare the impact of a value-based marketing intervention to usual-care marketing on employer purchase of depression products. The study will also identify mediators and organizational-level moderators of intervention impact. Employers randomized to the value-based condition receive a presentation encouraging them to purchase depression products scientifically shown to benefit the employee and the employer. Employers randomized to the usual-care condition receive a presentation encouraging them to monitor and improve quality indicators for outpatient depression treatment. Because previous research demonstrates that the usual-care intervention will have little to no impact on employer purchasing, depression product purchasing rates in the usual-care condition capture vendor efforts to market depression products to employers in both conditions while the value-based intervention is being conducted. Employers in both conditions are also provided free technical assistance to undertake the actions each presentation encourages. The research team will use intent-to-treat models of all available data to evaluate intervention impact on the purchase of depression products using a cumulative incidence analysis of 12- and 24-month data. Discussion By

  19. THE RELATIONSHIP BETWEEN MARKETING MIX AND PATIENT LOYALTY IN INTENSIVE CARE UNIT, ANUTAPURA PUBLIC HOSPITAL PALU

    Directory of Open Access Journals (Sweden)

    Muh. Ryman Napirah

    2016-09-01

    Full Text Available Background: The problem generally faced by hospital is unable to provide something really needed by the customers. One of the main factors is the poor marketing mix of hospital that impacts to low quality and influences the patients loyality. Objective: The research aims to investigate the relationship between marketing mix and patient loyalty in intensive care unit at Anutapura Public Hospital Palu. Methods: This was a cross sectional study involving 97 persons who were randomly selected without considering the level of population. The data were analyzed thought univariat and bivariat on the significance level 95% (p<0,05. The marketing mix concept of 7P (product, price, place, promotion, people, process, dan physical evidence. Was used to guide this study. Results: The result of chi-square test indicated that there was a relationship of marketing mix product (p= 0,01, price (p= 0,00, promotion (p= 0,04, people (p= 0,00; and no relationship of marketing mix place (p= 0,21, process (p= 1,00, dan physical evidence (p= 1,00 with patient loyalty. Conclusion: It is expected tht the hospital of Anutapura Palu could increase the strategy of marketing mix for the sake of keeping the patients loyalty as the profit value of the hospital, especially for marketing place, process, and physical evidence.

  20. Internal marketing strategy: Focusing on staff orientation in health care in South Africa

    Directory of Open Access Journals (Sweden)

    J. W. De Jager

    2008-12-01

    Full Text Available Purpose: The purpose of the paper is to determine the levels of satisfaction in respect of pre identified internal marketing-related variables in a large provincial hospital in South Africa. Problem investigated: Low job satisfaction is often cited as a major cause of high turnover among health care providers worldwide. Likewise the Public Health Care Industry in South Africa is facing complex employee retention issues. In determining the reasons for high turnover an interest in evaluating employee satisfaction among health care providers has increased. Measuring components of job satisfaction will assist not only the health care organisations' management to understand hospital culture, but also to compile an effective internal marketing plan and strategy. Design/Methodology/Approach: A staff satisfaction survey was conducted amongst staff members at a provincial hospital in the Tshwane region, South Africa. Attitudes of staff on pre-identified staff satisfaction variables were assessed. These variables were employed to implement an internal marketing strategy. A list of variables was formulated after an extensive literature study had been conducted. A total of 416 staff members voluntarily completed a self-administered questionnaire. A five-point Likert type scale was used to measure the levels of satisfaction on staff-related issues, with a view to addressing issues in the internal marketing strategy. Findings : It was evident that the management principles currently employed by the management team were a cause for concern among staff members. Based on the analysis that identified the satisfaction variables best it was clear that management should take immediate steps to address the following issues : • Clarification of hospital goals \\ objectives; • Understanding the goals of the respective departments; • The functioning of the Human resource department; • Functioning of the overall hospital management; and Implications: This paper

  1. Confidentiality Concerns Raised by DNA-Based Tests in the Market-Driven Managed Care Setting

    Energy Technology Data Exchange (ETDEWEB)

    Kotval, Jeroo S.

    2006-07-28

    In a policy climate where incentives to cherry pick are minimized, Managed Care Organizations can implement practices that safeguard medical privacy to the extent that data is protected from falling into the hands of third parties who could misuse it to discriminate. To the extent that these practices have been codified into the regulatory Network of the Health Insurance Portability and Accountability Act (HIPAA) Consumers may be able to rest easy about their genetic data being revealed to third parties who may discriminate. However, there are limitations to the use of policy instruments to prevent the discrimination of an entire genre of clients by market driven managed care organizations. Policy measures, to assure that knowledge of genetic conditions and their future costs would not be used by market driven managed care organizations to implement institutional policies and products that would implicitly discriminate against a genre of clients with genetic conditions, present difficulties.

  2. Changes in the Medicare home health care market: the impact of reimbursement policy.

    Science.gov (United States)

    Choi, Sunha; Davitt, Joan K

    2009-03-01

    The Balanced Budget Act of 1997 introduced 2 new reimbursement structures, the Interim Payment System (IPS, 1997-2000) and the Prospective Payment System (PPS, begun October 2000) for Medicare home health agencies (HHAs) under the fee-for-service program. This article describes and compares the impact of these changes on the Medicare home health market from a period before the BBA through the IPS and PPS in relation to agency characteristics. A secondary analysis of 1996, 1999, and 2002 Provider of Services data was conducted on all Medicare-certified HHAs. Frequencies and rates of change were calculated by agency characteristics to describe changes in the number of active agencies through those years. Logistic regression models were used to compare factors associated with market exits under different payment systems. The results indicate dramatic but disproportional changes in response to the IPS and the PPS among Medicare home health care agencies. Agency closures were greater and market entries fewer during the IPS, but more branch offices/subunits were closed during the PPS. Proprietary and freestanding agencies experienced greater volatility throughout, with the greatest number of closures seen in Region VI (Dallas). These results demonstrate the direct impact of policy changes on the home health care market and highlight the need to evaluate policy changes to understand both intended and unintended impacts on health markets. Future research should analyze the effect of these policy changes on other healthcare providers and systems and their impact on health outcomes for Medicare beneficiaries.

  3. Converging or Diverging Lens?

    Science.gov (United States)

    Branca, Mario

    2013-01-01

    Why does a lens magnify? Why does it shrink objects? Why does this happen? The activities that we propose here are useful in helping us to understand how lenses work, and they show that the same lens can have different magnification capabilities. A converging lens can also act as a diverging lens. (Contains 4 figures.)

  4. A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model

    Science.gov (United States)

    2009-01-01

    Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. PMID:19785754

  5. Marketing health care to employees: the structure of employee health care plan satisfaction.

    Science.gov (United States)

    Mascarenhas, O A

    1993-01-01

    Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

  6. Market principles in health care and social security policy in Japan.

    Science.gov (United States)

    Akiyama, Hiroshi

    2004-01-01

    Although health care in Japan is under the management of an obligatory insurance system, it is within the framework of a capitalist economy, and has helped achieve longevity during the post-war period. However, average lifetime has been improving in western European and Asian countries that have developed later. It has also been said that higher longevity is not necessarily due only to health care but also to the enhancement of environmental health achieved by economic improvements. On the other hand, the so-called 'development' led by capitalism and the market economy, and the luxuries that sometimes can be construed as uncultured, have caused unnecessary environmental destruction and disparities in wealth. Is it too cynical to think that the extended lifespan of the advanced countries has been achieved at the expense of the epidemics, refugee problems and wars which have resulted in a reduced lifespan in developing countries? It is said that capitalism is an economic ideology that includes many contradictions and is following a path of destruction. In addition, under the name of globalization, capitalism has continuously and rapidly caused vicious cycles of corruption, which are features commonly seen in today's world. It is still common that financial failures and threats are indirectly solved by initiating wars--a method completely inimical to health care. Along with environmental factors and the logic of this market doctrine, we have been trying to reform our financially-collapsed health care system. However, we cannot count on the 'durability' of any reform conducted without some awareness of our economic mistakes. It is often said that it is only because of the existence of the economy that we have health care. However, it is more realistic to say that stable health care and social security lead to a stable economy. Health care did not collapse. It was the market economy upon which health care depended that collapsed. Therefore, one must not consider that

  7. Public health care providers and market competition: the case of Finnish occupational health services.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2011-02-01

    As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.

  8. Precision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care.

    Science.gov (United States)

    Belard, Arnaud; Buchman, Timothy; Forsberg, Jonathan; Potter, Benjamin K; Dente, Christopher J; Kirk, Allan; Elster, Eric

    2017-04-01

    Improving diagnosis and treatment depends on clinical monitoring and computing. Clinical decision support systems (CDSS) have been in existence for over 50 years. While the literature points to positive impacts on quality and patient safety, outcomes, and the avoidance of medical errors, technical and regulatory challenges continue to retard their rate of integration into clinical care processes and thus delay the refinement of diagnoses towards personalized care. We conducted a systematic review of pertinent articles in the MEDLINE, US Department of Health and Human Services, Agency for Health Research and Quality, and US Food and Drug Administration databases, using a Boolean approach to combine terms germane to the discussion (clinical decision support, tools, systems, critical care, trauma, outcome, cost savings, NSQIP, APACHE, SOFA, ICU, and diagnostics). References were selected on the basis of both temporal and thematic relevance, and subsequently aggregated around four distinct themes: the uses of CDSS in the critical and surgical care settings, clinical insertion challenges, utilization leading to cost-savings, and regulatory concerns. Precision diagnosis is the accurate and timely explanation of each patient's health problem and further requires communication of that explanation to patients and surrogate decision-makers. Both accuracy and timeliness are essential to critical care, yet computed decision support systems (CDSS) are scarce. The limitation arises from the technical complexity associated with integrating and filtering large data sets from diverse sources. Provider mistrust and resistance coupled with the absence of clear guidance from regulatory bodies further retard acceptance of CDSS. While challenges to develop and deploy CDSS are substantial, the clinical, quality, and economic impacts warrant the effort, especially in disciplines requiring complex decision-making, such as critical and surgical care. Improving diagnosis in health care

  9. Issues of quality and consumer rights in the health care market.

    Science.gov (United States)

    Copeland, C

    1998-04-01

    This Issue Brief describes how the structure of the health care market has changed in the recent years. It outlines the growth in managed care and the changes in the types of managed care plans available. In addition, it discusses the issue of quality in the health care market. It also includes an overview of the legislative topics and issues relating to quality and consumer rights that policymakers are currently considering. Growth in national health expenditures, the medical care price index, and employer health care costs has slowed significantly since 1990. This decreased growth has coincided with substantial increases in managed care plan enrollment. The percentage of employees enrolled in managed care plans increased from 48 percent to 85 percent from 1992 to 1997. Quality is a multidimensional concept. Although individuals may agree on its components, they may disagree on the relative importance of these components. Therefore, disagreement exists not only on how to measure quality but also on how it is defined. Consequently, policy decisions need to be based on an evaluation of a particular law's effect as opposed to its stated goal or intent. This distinction is important because a law that addresses access or consumer rights does not necessarily address the quality of care a consumer receives. Ultimately, whether an individual believes that a law truly addresses quality will depend in a large part on his or her subjective opinion of what quality entails. To date, comparison of the quality of managed care plans with that of fee-for-service plans has not produced results that uniformly differentiate between these two plan types in either a positive or a negative way. In addition, it is important to note that the current debate on the quality of care provided in the health care market is not new to the present managed care era. The regulations and mandates discussed in this report would not guarantee increased quality in the health care market, unless quality

  10. Selection Behavior in the Market for Private Complementary Long-term Care Insurance in Germany

    DEFF Research Database (Denmark)

    Bauer, Jan; Schiller, Jörg; Schreckenberger, Christopher

    is dominating in this market, with respect to both the decision to buy a CompLTCI policy and the decision about the extent of CompLTCI coverage. We identify occupational status, residential location and the holding of further supplementary health insurance policies as unused observables contributing...... to selection effects in this market. Our results suggest that non-linearitiesin the relationship of potential sources of selection to insurance coverage and risk should be considered. A panel data analysis shows that an increase in health insurance payouts is positively correlated with the uptake of Comp......In this paper, we analyze selection effects in the German market for private complementary longterm care insurance contracts (CompLTCI) within a static and dynamic framework. Using data on more than 98,000 individuals from a German insurance company, we provide evidence that advantageous selection...

  11. A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model.

    Science.gov (United States)

    Luck, Jeff; Hagigi, Fred; Parker, Louise E; Yano, Elizabeth M; Rubenstein, Lisa V; Kirchner, JoAnn E

    2009-09-28

    Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.

  12. Marketing environment dynamics and implications for pricing strategies: the case of home health care.

    Science.gov (United States)

    Ponsford, B J; Barlow, D

    1999-01-01

    This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

  13. Adherence of preventive oral care products in the Syrian market to evidence-based international recommendations.

    Science.gov (United States)

    Habes, D; Mahzia, R; Nakhleh, K; Joury, E

    2016-09-25

    No study has investigated the availability and adherence of preventive oral care products on the Syrian market to evidence-based international recommendations. Data were collected in 2012, and updated in 2016, in terms of availability, characteristics and adherence to evidence-based international recommendations. Few preventive products adhered to the recommendations. Despite the large decrease in the number of oral care products on the Syrian market, due to the Syrian crisis, nonadherence of some of the available products is still present. A multisectorial approach at a policy level is needed to address such important limitations. The Syrian Ministry of Health should reform regulations for fluoride products to become subject to drug monitoring systems; the Syrian Arab Committee for Measurements and Standards needs to update its standards; and the Syrian General Dental Association should distribute a preventive booklet to dental practitioners.

  14. Integrating housing and long-term care services for the elderly: a social marketing approach.

    Science.gov (United States)

    Moore, S T

    1991-01-01

    Subsidized senior high-rise apartments have tended to neglect the needs of an increasingly aged and frail resident population. Research demonstrates that this population has greater unmet needs than elderly who reside in traditional community housing. This paper makes the case for a vertically integrated marketing approach to serving the elderly. Such an approach would combine housing and community based long-term care services into a single system of care. Enriched senior high-rise apartments are a viable alternative for elders who need assistance in order to maintain an independent lifestyle.

  15. Quality choice in a health care market: a mixed duopoly approach.

    Science.gov (United States)

    Sanjo, Yasuo

    2009-05-01

    We investigate a health care market with uncertainty in a mixed duopoly, where a partially privatized public hospital competes against a private hospital in terms of quality choice. We use a simple Hotelling-type spatial competition model by incorporating mean-variance analysis and the framework of partial privatization. We show how the variance in the quality perceived by patients affects the true quality of medical care provided by hospitals. In addition, we show that a case exists in which the quality of the partially privatized hospital becomes higher than that of the private hospital when the patient's preference for quality is relatively high.

  16. Marketing of personalized cancer care on the web: an analysis of Internet websites.

    Science.gov (United States)

    Gray, Stacy W; Cronin, Angel; Bair, Elizabeth; Lindeman, Neal; Viswanath, Vish; Janeway, Katherine A

    2015-05-01

    Internet marketing may accelerate the use of care based on genomic or tumor-derived data. However, online marketing may be detrimental if it endorses products of unproven benefit. We conducted an analysis of Internet websites to identify personalized cancer medicine (PCM) products and claims. A Delphi Panel categorized PCM as standard or nonstandard based on evidence of clinical utility. Fifty-five websites, sponsored by commercial entities, academic institutions, physicians, research institutes, and organizations, that marketed PCM included somatic (58%) and germline (20%) analysis, interpretive services (15%), and physicians/institutions offering personalized care (44%). Of 32 sites offering somatic analysis, 56% included specific test information (range 1-152 tests). All statistical tests were two-sided, and comparisons of website content were conducted using McNemar's test. More websites contained information about the benefits than limitations of PCM (85% vs 27%, P market one or more nonstandard tests as compared with standard tests (88% vs 44%, P = .04). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. The economics of choice: lessons from the U.S. health‐care market

    Science.gov (United States)

    Hanoch, Yaniv; Rice, Thomas

    2011-01-01

    Abstract The English health‐care system is moving towards increasing consumers’ choice. Following economic thinking, it is assumed that such a policy will improve quality, enhance patient satisfaction and reduce health disparities. Indeed, the English health‐care system has already built the necessary infrastructure to increase patients’ choice. Before expanding the range of choices further, however, it is important that policy makers be aware of the limitations and hurdles that such a policy contains. Here, we highlight these limitations by drawing on the influential work of Kenneth Arrow, who has argued that we cannot treat the health‐care market as if it was just another market, and the ideas of Herbert Simon, who questioned whether people had sufficient cognitive abilities to make effective choices in an information‐rich environment. In the light of these two strands of thought, we review evidence suggesting that many older adults have low (health) literacy levels, raising concerns over their ability to obtain, process and understand medical‐related information, with its increasing complexity, associated risks and emotional involvement. We also discuss recent findings from the United States highlighting the difficulties older users of health‐care face with a wide range of prescription drug insurance plans from which to choose. Thus, learning from the experience of health‐care systems where choice is abundant could help any health system interested in extending patients’ choice to better target the domains where more choice could be beneficial and possibly avoid those where it could be detrimental. PMID:21122041

  18. MARKET RESEARCH OF CARE GOODS FOR NEWBORNS AND FIRST YEAR CHILDREN

    Directory of Open Access Journals (Sweden)

    A. I. Ovod

    2015-01-01

    Full Text Available Comparative results of marketing research of care goods for newborns and first year children conducted in 2009 and 2014 showed that there were changes in the range of products and consumer preferences. The analysis revealed that the economic situation affected the determinants of choice in this category of goods and the location of purchasing. The findings should be considered by pharmaceutical companies in their procurement in order to improve their competitive position. 

  19. Social marketing meets health literacy: Innovative improvement of health care providers’ comfort with patient interaction

    Science.gov (United States)

    Primack, Brian A.; Bui, Thuy; Fertman, Carl I.

    2010-01-01

    Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522

  20. [Service quality in health care: the application of the results of marketing research].

    Science.gov (United States)

    Verheggen, F W; Harteloh, P P

    1993-01-01

    This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.

  1. Single lens to lens duplication: The missing link

    OpenAIRE

    Bhatt, Rupal; Jethani, Jitendra; Saluja, Praveen; Bharti, Vinay

    2008-01-01

    Congenital anomalies of the lens include a wide range from lens coloboma to primary aphakia and doubling of lens. There have been few case reports of double lens; the etiology suggested is metaplastic changes in the surface ectoderm that leads to formation of two lens vesicles and hence resulting in double lens. We report a case with bilobed lens, which raises the possibility of explaining the etiology of double lens.

  2. Exposure of medical students to pharmaceutical marketing in primary care settings: frequent and influential.

    Science.gov (United States)

    Sarikaya, Ozlem; Civaner, Murat; Vatansever, Kevser

    2009-12-01

    It is known that interaction between pharmaceutical companies and medical professionals may lead to corruption of professional values, irrational use of medicine, and negative effects on the patient-physician relationship. Medical students frequently interact with pharmaceutical company representatives and increasingly accept their gifts. Considering the move toward early clinical encounters and community-based education, which expose students early to pharmaceutical representatives, the influence of those gifts is becoming a matter of concern. This study examines the frequency and influence of student exposure to drug marketing in primary care settings, as well as student perceptions of physician-pharmaceutical company relationships. This was a two-phase study consisting of qualitative research followed by a cross-sectional survey. Clinical experience logbooks of 280 second-year students in one school were analysed, and the themes that emerged were used to develop a survey that was administered to 308 third-year students from two medical schools. Survey results showed a 91.2% exposure to any type of marketing, and 56.8% of students were exposed to all classes of marketing methods studied. Deliberate targeting of students by pharmaceutical representatives, in particular, was correlated with being less sensitive to the negative effects of and having positive opinions about interactions with pharmaceutical companies. The vast majority of students are exposed to drug marketing in primary care settings, and may become more vulnerable to that strategy. Considering that medical students are vulnerable and are targeted deliberately by pharmaceutical companies, interventions aimed at developing skills in the rational use of medicines and in strategies for coping with drug marketing should be devised.

  3. Retaining customers in a managed care market. Hospitals must understand the connection between patient satisfaction, loyalty, retention, and revenue.

    Science.gov (United States)

    Gemme, E M

    1997-01-01

    Traditionally, health care patients have been treated by health care professionals as people with needs rather than as customers with options. Although managed care has restricted patient choice, choice has not been eliminated. The premise of this article is that patients are primary health care consumers. Adopting such a premise and developing an active customer retention program can help health care organizations change their culture for the better, which may lead to higher customer retention levels and increased revenues. Customer retention programs based on service excellence that empower employees to provide excellent care can eventually lead to a larger market share for health care organizations trying to survive this era of intense competition.

  4. Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage.

    Science.gov (United States)

    Eibner, Christine; Saltzman, Evan

    2015-03-20

    The goals of the Affordable Care Act (ACA) are to enable all legal U.S. residents to have access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market. The ACA also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages. The law's tax credits and cost-sharing subsidies offer a "carrot" that may encourage enrollment among some young and healthy individuals who would otherwise remain uninsured, while the individual mandate acts as a "stick" by imposing penalties on individuals who choose not to enroll. In this article, the authors use the COMPARE microsimulation model, an analytic tool that uses economic theory and data to predict the effects of health policy reforms, to estimate how eliminating the ACA's individual mandate, eliminating the law's tax credits, and combined scenarios that change these and other provisions of the act might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is a COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage. The authors find that eliminating the ACA's tax credits and eliminating the individual mandate both increase premiums and reduce enrollment on the individual market. They also find that these key features of the ACA help to protect against adverse selection and stabilize the market by encouraging healthy people to enroll and, in the case of the tax credit, shielding subsidized enrollees from premium increases. Further, they find that individual market premiums are only modestly sensitive to young adults' propensity to enroll in insurance coverage, and ensuring market stability does not require that young adults make up a particular share of enrollees.

  5. An Academic-Marketing Collaborative to Promote Depression Care: A Tale of Two Cultures

    Science.gov (United States)

    Kravitz, Richard L.; Epstein, Ronald M.; Bell, Robert A.; Rochlen, Aaron B.; Duberstein, Paul; Riby, Caroline H.; Caccamo, Anthony F.; Slee, Christina K.; Cipri, Camille S.; Paterniti, Debora A.

    2011-01-01

    Objectives Commercial advertising and patient education have separate theoretical underpinnings, approaches, and practitioners. This paper aims to describe a collaboration between academic researchers and a marketing firm working to produce demographically targeted public service anouncements (PSAs) designed to enhance depression care-seeking in primary care. Methods An interdisciplinary group of academic researcherss contracted with a marketing firm in Rochester, NY to produce PSAs that would help patients with depressive symptoms engage more effectively with their primary care physicians (PCPs). The researchers brought perspectives derived from clinical experience and the social sciences and conducted empirical research using focus groups, conjoint analysis, and a population-based survey. Results were shared with the marketing firm, which produced four PSA variants targeted to gender and socioeconomic position. Results There was no simple, one-to-one relationship between research results and the form, content, or style of the PSAs. Instead, empirical findings served as a springboard for discussion and kept the creative process tethered to the experiences, attitudes, and opinions of actual patients. Reflecting research findings highlighting patients’ struggles to recognize, label, and disclose depressive symptoms, the marketing firm generated communication objectives that emphasized: a) educating the patient to consider and investigate the possibility of depression; b) creating the belief that the PCP is interested in discussing depression and capable of offering helpful treatment; and c) modelling different ways of communicating with physicians about depression. Before production, PSA prototypes were vetted with additional focus groups. The winning prototype, “Faces,” involved a multi-ethnic montage of formerly depressed persons talking about how depression affected them and how they improved with treatment, punctuated by a physician who provided clinical

  6. An academic-marketing collaborative to promote depression care: a tale of two cultures.

    Science.gov (United States)

    Kravitz, Richard L; Epstein, Ronald M; Bell, Robert A; Rochlen, Aaron B; Duberstein, Paul; Riby, Caroline H; Caccamo, Anthony F; Slee, Christina K; Cipri, Camille S; Paterniti, Debora A

    2013-03-01

    Commercial advertising and patient education have separate theoretical underpinnings, approaches, and practitioners. This paper aims to describe a collaboration between academic researchers and a marketing firm working to produce demographically targeted public service anouncements (PSAs) designed to enhance depression care-seeking in primary care. An interdisciplinary group of academic researchers contracted with a marketing firm in Rochester, NY to produce PSAs that would help patients with depressive symptoms engage more effectively with their primary care physicians (PCPs). The researchers brought perspectives derived from clinical experience and the social sciences and conducted empirical research using focus groups, conjoint analysis, and a population-based survey. Results were shared with the marketing firm, which produced four PSA variants targeted to gender and socioeconomic position. There was no simple, one-to-one relationship between research results and the form, content, or style of the PSAs. Instead, empirical findings served as a springboard for discussion and kept the creative process tethered to the experiences, attitudes, and opinions of actual patients. Reflecting research findings highlighting patients' struggles to recognize, label, and disclose depressive symptoms, the marketing firm generated communication objectives that emphasized: (a) educating the patient to consider and investigate the possibility of depression; (b) creating the belief that the PCP is interested in discussing depression and capable of offering helpful treatment; and (c) modelling different ways of communicating with physicians about depression. Before production, PSA prototypes were vetted with additional focus groups. The winning prototype, "Faces," involved a multi-ethnic montage of formerly depressed persons talking about how depression affected them and how they improved with treatment, punctuated by a physician who provided clinical information. A member of the

  7. Using aspen for artist stretcher frames: adding value through quality service, direct marketing, and careful material selection

    Science.gov (United States)

    Chris Polson

    2001-01-01

    Aspen wood, when carefully selected and kiln dried, makes excellent stock for artist stretcher frames. Direct marketing techniques including the Internet and word of mouth give access to national markets, providing a more diverse and stable customer base for operations from a rural area. High-quality service, as shown by product performance and rapid order fulfillment...

  8. Health-care reform or labor market reform? A quantitative analysis of the affordable care act

    OpenAIRE

    Nakajima, Makoto; Tuzemen, Didem

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) requires all individuals to have health insurance, and introduces penalties to large firms that do not offer affordable coverage to their employees. While the possible effects of the ACA on the insurance decision of individuals have been studied, what is less studied is how the ACA can affect labor demand. In particular, since the ACA does not require small firms to offer health insurance, and does not require firms to offer health insuranc...

  9. Pengaruh Penerapan Green Marketing terhadap Kepuasan dan Loyalitas Pelanggan (Survei pada Pelanggan Treatment Naavagreen Natural Skin Care Cabang Malang)

    OpenAIRE

    Irkhamni, Deby Anggraini; Suharyono, Suharyono

    2017-01-01

    This research conducted aims to know that influence of Green Marketing on Customer Satisfaction and Customer Loyalty treatment Naavagreen Natural Skin Care Malang Branch. This type of research is explanatory research with quantitative approach. Variables in this research are Green Marketing, Customer Satisfaction, and Customer Loyalty. Population in this research are customer of treatment Naavagreen Natural Skin Care Malang Branch who had done treatment in as many as two times or more and hav...

  10. A marketing plan for health care in the financial district of San Francisco.

    Science.gov (United States)

    Evans, S

    1987-01-01

    The development of a corporate health marketing program for the Medical Pavilion was based on three assumptions. 1. Medical Pavilion will contribute positively to health care cost containment for employers by providing convenient, quality medical care which will help to reduce employee time lost from work due to physician visits, and through health screening, early diagnosis, and out-patient procedures, decrease unnecessary hospitalization. 2. The level of awareness among chief executive officers, benefits directors, corporate medical directors, and employees will be positively related to utilization of health services at the Medical Pavilion. 3. The Medical Pavilion will be organized on a private practice model; although special programs related to employer coverage and specific benefits may be considered separately. The recommended goals of the corporate health program of the Medical Pavilion were as follows: 1. To develop demographic profiles based on current utilization of medical services in a random sample to corporations in the Financial District. 2. To design a survey of corporate leadership to determine a needs assessment strategy for the development of preventive health services programs to be offered at the Medical Pavilion. 3. To select an advertising and public relations agency; and determine the marketing bridges, for the first year and the following five year period. 4. To evaluate effectiveness of the corporate health marketing plan referral data collected through the Management Information System to be established at the Medical Pavilion.

  11. Gram negative bacteria and contact lens induced acute red eye

    Directory of Open Access Journals (Sweden)

    Sankaridurg Padmaja

    1996-01-01

    Full Text Available Two patients using hydrogel contact lenses on a daily wear schedule slept overnight with the lenses and woke up with a Contact Lens Induced Acute Red Eye (CLARE. The contact lenses recovered aseptically at the time of the event grew significant colonies of Pseudomonas aeruginosa and Aeromonas hydrophila in patient A and Pseudomonas aeruginosa and Serratia liquefaciens from patient B. Similar organisams from the contact lenses were recovered from the lens case and lens care solutions of patient B. In both the patients the condition resolved on discontinuation of lens wear. Patient compliance as a requirement for successful contact lens wear is highlighted with the illustration of these cases.

  12. The impact of market-based 'reform' on cultural values in health care.

    Science.gov (United States)

    Curtin, L L

    1999-12-01

    The many issues managed care poses for providers and health networks are crystallized in the moral problems occasioned by its shifting of the financial risks of care from insurer to provider. The issues occasioned by market-based reform include: the problems presented by clashes between public expectations and payer restrictions; the corporatization of health service delivery and the cultural shift from humanitarian endeavor to business enterprise the depersonalization of treatment as time and money constraints stretch resources, and the culture rewards efficient "business-like" behavior the underfunding of care for the poor and uninsured, even as these populations grow the restructuring of care and reengineering of healthcare roles as the emphasis shifts from quality of care to conservation of resources rapid mergers of both health plans and institutional providers with all the inherent turmoil as rules change, services are eliminated, and support services are minimized to save money the unhealthy competition inherent in market-based reform that posits profit taking and market share as the measures of successful performance the undermining of the professional ethic of advocacy the use of incentives that pander to greed and self-interest. The costs of sophisticated technologies and the ongoing care of increasingly fragile patients have pulled many other elements into what previously were considered "privileged" professional interactions. The fact that very few citizens indeed could pay out-of-pocket for the treatment and ongoing care they might need led to social involvement (few people remember that both widespread health insurance and public programs are relatively recent phenomena--only about 30 years old). However, whether in tax dollars or insurance premiums, other people's money is being spent on the patient's care. Clearly, those "other people" never intended to give either the patient or the professional open-ended access to their collective pocketbooks

  13. A case study in the politics of free-market health care.

    Science.gov (United States)

    Begun, J W; Lippincott, R C

    1982-01-01

    Historically, most health occupations have developed legal and ethical restrictions on price advertising and other characteristics of "commercial" practice. Many of these regulations recently have come under critical scrutiny, on the grounds that they inhibit free-market health care delivery, thus keeping prices high, and productivity and innovation low. To help inform current health policy deliberations, we analyze the political history of anticompetitive regulations in one health occupation, optometry. Restrictions on commercial practice arose as a result of professional optometry's purge of commercial elements in the 1930s. Optometry's success in achieving commercial-practice restrictions at the state level was determined by the economic structure of the ophthalmic goods and services industry in each state in the 1930s, and by the political resources and organization of the competing interest groups. Efforts to deregulate health occupations will precipate political conflict to the extent that economic interests are threatened. Opposition to deregulation will be based overtly on the grounds that quality of care will deteriorate, and a significant political investment by proponents of free-market health care will be required to overcome such opposition.

  14. The economics of choice: lessons from the U.S. health-care market.

    Science.gov (United States)

    Hanoch, Yaniv; Rice, Thomas

    2011-03-01

    The English health-care system is moving towards increasing consumers' choice. Following economic thinking, it is assumed that such a policy will improve quality, enhance patient satisfaction and reduce health disparities. Indeed, the English health-care system has already built the necessary infrastructure to increase patients' choice. Before expanding the range of choices further, however, it is important that policy makers be aware of the limitations and hurdles that such a policy contains. Here, we highlight these limitations by drawing on the influential work of Kenneth Arrow, who has argued that we cannot treat the health-care market as if it was just another market, and the ideas of Herbert Simon, who questioned whether people had sufficient cognitive abilities to make effective choices in an information-rich environment. In the light of these two strands of thought, we review evidence suggesting that many older adults have low (health) literacy levels, raising concerns over their ability to obtain, process and understand medical-related information, with its increasing complexity, associated risks and emotional involvement. We also discuss recent findings from the United States highlighting the difficulties older users of health-care face with a wide range of prescription drug insurance plans from which to choose. Thus, learning from the experience of health-care systems where choice is abundant could help any health system interested in extending patients' choice to better target the domains where more choice could be beneficial and possibly avoid those where it could be detrimental. © 2010 Blackwell Publishing Ltd.

  15. Developing social marketed individual preconception care consultations: Which consumer preferences should it meet?

    Science.gov (United States)

    van Voorst, Sabine F; Ten Kate, Chantal A; de Jong-Potjer, Lieke C; Steegers, Eric A P; Denktaş, Semiha

    2017-10-01

    Preconception care (PCC) is care that aims to improve the health of offspring by addressing risk factors in the pre-pregnancy period. Consultations are recognized as a method to promote perinatal health. However, prospective parents underutilize PCC services. Uptake can improve if delivery approaches satisfy consumer preferences. Aim of this study was to identify preferences of women (consumers) as a first step to social marketed individual PCC consultations. In depth, semi-structured interviews were performed to identify women's views regarding the four components of the social marketing model: product (individual PCC consultation), place (setting), promotion (how women are made aware of the product) and price (costs). Participants were recruited from general practices and a midwife's practice. Content analysis was performed by systematic coding with NVIVO software. The 39 participants reflected a multiethnic intermediately educated population. Product: Many participants had little knowledge of the need and the benefits of the product. Regarding the content of PCC, they wish to address fertility concerns and social aspects of parenthood. PCC was seen as an informing and coaching service with a predominant role for health-care professionals. the general practitioner and midwife setting was the most mentioned setting. Promotion: A professional led promotion approach was preferred. Price: Introduction of a fee for PCC consultations will make people reconsider their need for a consultation and could exclude vulnerable patients from utilization. This study provides consumer orientated data to design a social marketed delivery approach for individual PCC consultations. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  16. Aberration design of zoom lens systems using thick lens modules.

    Science.gov (United States)

    Zhang, Jinkai; Chen, Xiaobo; Xi, Juntong; Wu, Zhuoqi

    2014-12-20

    A systematic approach for the aberration design of a zoom lens system using a thick lens module is presented. Each component is treated as a thick lens module at the beginning of the design. A thick lens module refers to a thick lens component with a real lens structure, like lens materials, lens curvatures, lens thicknesses, and lens interval distances. All nine third-order aberrations of a thick lens component are considered during the design. The relationship of component aberrations in different zoom positions can be approximated from the aberration shift. After minimizing the aberrations of the zoom lens system, the nine third-order aberrations of every lens component can be determined. Then the thick lens structure of every lens component can be determined after optimization according to their first-order properties and third-order aberration targets. After a third optimization for minimum practical third-order aberrations of a zoom lens system, the aberration design using the thick lens module is complete, which provides a practical zoom lens system with thick lens structures. A double-sided telecentric zoom lens system is designed using the thick lens module in this paper, which shows that this method is practical for zoom lens design.

  17. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  18. Relationship between National Institutes of Health research awards to US medical schools and managed care market penetration.

    Science.gov (United States)

    Moy, E; Mazzaschi, A J; Levin, R J; Blake, D A; Griner, P F

    1997-07-16

    Medical research conducted in academic medical centers is often dependent on support from clinical revenues generated in these institutions. Anecdotal evidence suggests that managed care has the potential to affect research conducted in academic medical centers by challenging these clinical revenues. To examine whether empirical evidence supports a relationship between managed care and the ability of US medical schools to sustain biomedical research. Data on annual extramural research grants awarded to US medical schools by the National Institutes of Health (NIH) from fiscal years 1986 to 1995 were obtained, and each medical school was matched to a market for which information about health maintenance organization (HMO) penetration in 1995 was available. Growth in total NIH awards, traditional research project (R01) awards, R01 awards to clinical and basic science departments, and changes in institutional ranking by NIH awards were compared among schools located in markets with low, medium, and high managed care penetration. Medical schools in all markets had comparable rates of growth in NIH awards from 1986 to 1990. Thereafter, medical schools in markets with high managed care penetration had slower growth in the dollar amounts and numbers of NIH awards compared with schools in markets with low or medium managed care penetration. This slower growth for schools in high managed care markets was associated with loss of share of NIH awards, equal to $98 million in 1995, and lower institutional ranking by NIH awards. Much of this revenue loss can be explained by the slower growth of R01 awards to clinical departments in medical schools in high managed care markets. These findings provide evidence of an inverse relationship between growth in NIH awards during the past decade and managed care penetration among US medical schools. Whether this association is causal remains to be determined.

  19. Using focus groups and social marketing to strengthen promotion of group prenatal care.

    Science.gov (United States)

    Vonderheid, Susan C; Carrie, S Klima; Norr, Kathleen F; Grady, Mary Alice; Westdahl, Claire M

    2013-01-01

    Centering Pregnancy, an innovative group model of prenatal care, shows promise to reduce persistent adverse maternal-infant outcomes and contain costs. Because this innovation requires systemwide change, clinics reported needing support enrolling women into groups and obtaining organizational buy-in. This study used the 3-step social marketing communication strategy to help clinic staff identify key customers and customer-specific barriers to adopting or supporting Centering Pregnancy. They developed targeted information to reduce barriers and built skills in communicating with different customers through role-playing. Findings provide practical information for others to use this communication strategy to improve implementation of Centering Pregnancy.

  20. It takes three to tango: Soft budget constraint and cream skimming in the hospital care market

    OpenAIRE

    Levaggi, Rosella; Montefiori, Marcello

    2005-01-01

    Cream skimming is an illegal behaviour that consists in choosing to treat patients according to their ability to recover. It arises from the use of prospective payment schemes in an asymmetry of information framework. In this context in fact the provider can observe some relevant information (freely or at a cost) before making its effort which will then be used to its own advantage. The paper studies the scope for these types of behaviour in a mixed market for hospital care where the hospital...

  1. Personalized commissioning, public spaces: the limits of the market in English social care services.

    Science.gov (United States)

    Needham, Catherine

    2013-01-01

    The article explores the implications of personal budgets within English social care services, which position the individual as market actor. Rooting the research in the broader personalization agenda, the study looks at the limitations of the market in relation to individual purchase of private goods (e.g. home care), in the pooling of funds to purchase group services and in the provision of public goods such as building-based services. The article takes a multi-method approach, combining an interpretive focus on the framing of the personal budget-holder by advocates of personalization with national evaluation data, and data from a small survey of day centre workers. The article identifies three framings of the individual budget-holder articulated by advocates of personalization. The first is that personal budget-holders will be empowered market actors, commissioning the services they need. The second is that budget-holders will pool resources with others to purchase group services in order to broaden the range of options available to them. The third is that services which cannot be disaggregated into individual or group budgets - such as day centres - are not valued by service users. The article looks at the evaluation data on these three claims in turn. It identifies four limitations to the capacity of people to purchase care goods on an individual basis: lack of transparency in allocating budgets, complexity in managing a budget, excessive auditing of spending and lack of responsiveness from the provider market. Pooling of budgets to purchase collective services is found to be underdeveloped, and hampered by the complexity which is a broader limitation on personal budgets. Day centres are found to be closing not in response to commissioning decisions by individual budget-holders but because of decommissioning by local authorities, minimising the scope for individuals to express a preference for this type of care. The survey highlights patterns of day centre

  2. Informal Care and Labor Market Outcomes: Evidence From Chinese Married Women.

    Science.gov (United States)

    Chen, Lu; Zhao, Na; Fan, Hongli; Coyte, Peter C

    2015-10-16

    Data were used from the 1991-2009 China Health and Nutrition Survey to examine the influence of informal care on labor market outcomes for married women of working aged, with emphasis on caregiving intensity. After accounting for potential endogeneity between caregiving and labor force participation (LFP) through simultaneous equations modeling, caregivers who provided more than 15 or 20 hr of caregiving per week were 4.5-7.7% less likely to be LFPs. Intensive caregivers who remained working had significantly lower (4.97-7.20) weekly hours of work. The significant positive effect of informal care on LFP only existed in the rural sample, and these women also had much lower hours of work than their urban counterparts. Opportunities exist for policy interventions that target intensive caregivers in order to allow them to balance both work and caregiving. © The Author(s) 2015.

  3. The impact of competition on quality and prices in the English care homes market.

    Science.gov (United States)

    Forder, Julien; Allan, Stephen

    2014-03-01

    This study assesses the impact of competition on quality and price in the English care/nursing homes market. Considering the key institutional features, we use a theoretical model to assess the conditions under which further competition could increase or reduce quality. A dataset comprising the population of 10,000 care homes was used. We constructed distance/travel-time weighted competition measures. Instrumental variable estimations, used to account for the endogeneity of competition, showed quality and price were reduced by greater competition. Further analyses suggested that the negative quality effect worked through the effect on price - higher competition reduces revenue which pushes down quality. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Competition and quality in health care markets: a differential-game approach.

    Science.gov (United States)

    Brekke, Kurt R; Cellini, Roberto; Siciliani, Luigi; Straume, Odd Rune

    2010-07-01

    We investigate the effect of competition on quality in health care markets with regulated prices taking a differential game approach, in which quality is a stock variable. Using a Hotelling framework, we derive the open-loop solution (health care providers set the optimal investment plan at the initial period) and the feedback closed-loop solution (providers move investments in response to the dynamics of the states). Under the closed-loop solution competition is more intense in the sense that providers observe quality in each period and base their investment on this information. If the marginal provision cost is constant, the open-loop and closed-loop solutions coincide, and the results are similar to the ones obtained by static models. If the marginal provision cost is increasing, investment and quality are lower in the closed-loop solution (when competition is more intense). In this case, static models tend to exaggerate the positive effect of competition on quality.

  5. Market and organizational factors associated with hospital vertical integration into sub-acute care.

    Science.gov (United States)

    Hogan, Tory H; Lemak, Christy Harris; Hearld, Larry R; Sen, Bisakha P; Wheeler, Jack R C; Menachemi, Nir

    2018-04-11

    Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted. The purpose of this study is to examine the correlates of hospital vertical integration into SAC. Using panel data of U.S. acute care hospitals (2008-2012), we conducted logit regression models to examine environmental and organizational factors associated with hospital vertical integration. Results are reported as average marginal effects. Among 3,775 unique hospitals (16,269 hospital-year observations), 25.7% vertically integrated into skilled nursing facilities during at least 1 year of the study period. One measure of complexity, the availability of skilled nursing facilities in a county (ME = -1.780, p integration into SAC. Measures of munificence, percentage of the county population eligible for Medicare (ME = 0.018, p integration into SAC. Dynamism, when measured as the change county population between 2008 and 2011 (ME = 1.19e-06, p integration into SAC. Organizational resources, when measured as swing beds (ME = 0.069, p integration into SAC. Organizational resources, when measured as investor owned (ME = -0.052, p integration into SAC. Hospital adaption to the changing health care landscape through vertical integration varies across market and organizational conditions. Current Centers for Medicare and Medicaid reimbursement programs do not take these factors into consideration. Vertical integration strategy into SAC may be more appropriate under certain market conditions. Hospital leaders may consider how to best align their organization's SAC strategy with their operating environment.

  6. The history and global market of oral home-care products

    Directory of Open Access Journals (Sweden)

    Juliana Jobim Jardim

    2009-06-01

    Full Text Available This literature review reports the history and the current market of oral home-care products. It provides information extending from the products used by our ancestors to those currently available, as well as on the changes in the supply and consumption of these products. Although the scientific knowledge about oral diseases has improved greatly in recent years, our ancestors had already been concerned with cleaning their teeth. A variety of rudimentary products and devices were used since before recorded history, like chewing sticks, tree twigs, bird feathers, animal bones, tooth powder and home-made mouth rinses. Today, due to technological improvements of the cosmetic industry and market competition, home-use oral care products available in the marketplace offer a great variety of options. An increase in the consumption of oral care products has been observed in the last decades. Estimates show that Latin America observed a 12% increase in hygiene and beauty products sales between 2002 and 2003, whereas the observed global rate was approximately 2%. A significant increase in the per capita consumption of toothpaste, toothbrush, mouthrinse and dental floss has been estimated from 1992 to 2002, respectively at rates of 38.3%, 138.3%, 618.8% and 177.2%. Pertaining to this increased supply and consumption of oral care products, some related questions remain unanswered, like the occurrence of changes in disease behavior due to the use of new compounds, their actual efficacy and correct indications, and the extent of the benefits to oral health derived from consuming more products.

  7. "Social marketing" for early neonatal care: saving newborn lives in Pakistan.

    Science.gov (United States)

    Ejaz, Iram; Shaikh, Babar Tasneem

    2010-01-01

    According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care.

  8. Differing Impacts Of Market Concentration On Affordable Care Act Marketplace Premiums.

    Science.gov (United States)

    Scheffler, Richard M; Arnold, Daniel R; Fulton, Brent D; Glied, Sherry A

    2016-05-01

    Recent increases in market concentration among health plans, hospitals, and medical groups raise questions about what impact such mergers are having on costs to consumers. We examined the impact of market concentration on the growth of health insurance premiums between 2014 and 2015 in two Affordable Care Act state-based Marketplaces: Covered California and NY State of Health. We measured health plan, hospital, and medical group market concentration using the well-known Herfindahl-Hirschman Index (HHI) and used a multivariate regression model to relate these measures to premium growth. Both states exhibited a positive association between hospital concentration and premium growth and a positive (but not statistically significant) association between medical group concentration and premium growth. Our results for health plan concentration differed between the two states: It was positively associated with premium growth in New York but negatively associated with premium growth in California. The health plan concentration finding in Covered California may be the result of its selectively contracting with health plans. Project HOPE—The People-to-People Health Foundation, Inc.

  9. 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.

  10. Building relationships with physicians. Internal marketing efforts help strengthen organizational bonds at a rural health care clinic.

    Science.gov (United States)

    Peltier, J W; Boyt, T; Westfall, J E

    1997-01-01

    Physician turnover is costly for health care organizations, especially for rural organizations. One approach management can take to reduce turnover is to promote physician loyalty by treating them as an important customer segment. The authors develop an information--oriented framework for generating physician loyalty and illustrate how this framework has helped to eliminate physician turnover at a rural health care clinic. Rural health care organizations must develop a more internal marketing orientation in their approach to establishing strong relationship bonds with physicians.

  11. [The influence of the economic recession on health care labor market in Croatia].

    Science.gov (United States)

    Bagat, Mario; Drakulić, Velibor

    2010-01-01

    Trends in the labor market, as a result of global economic recession, are characterized by reduction of manpower activity, decreased number of employed and increased number of unemployed persons. As the result of economic recession more then million workplaces are expected to be lost in the European Union. The aim of this study was to analyze the influence of economic recession on labor market in general and healthcare labor market in Croatia. In Q1/2009, the number of employed persons in the European Union declined by -1.2% compared to the same quarter of 2008, while in Croatia the number of employed persons declined by -0.4%. The comparison of quarterly employment rate in Croatia and the European Union in the period from Q2/2008 to Q1/2009 was not significantly different (p = 0.169, df = 6, t = 1.564, Student t test). Average unemployment rate in Q1/2009 in the European Union was 8.1% +/- 0.3 and it was increased by 9.4% compared to Q4/2008, while in Croatia the average unemployment rate in Q1/2009 was 8.4% +/- 0.1 and it was increased by 3.3% compared to Q4/2008. Monthly changes of unemployment rates compared between the European Union and Croatia in the six month period (Q4/2008 and Q1/2009) was significantly different (p = 0.001, df = 10, t = 4.425, Student t test). In Croatian health care system in Q1/2009 the number of employed person increased by 0.7% compared to Q1/2008, while the number of unemployed persons in the same period was reduced by -1.0%. Trends in the labor market in Croatia follow the global trends in the labor market in times of economic recession, although the increase in unemployment in Croatia was slower than in the countries of the European Union. As a result of Croatian healthcare system organization, system of financing, supply and demand on healthcare labor market, healthcare workforce in Croatia was less affected by recession than workforce in Croatia in general.

  12. The impact of market and organizational characteristics on nursing care facility service innovation: a resource dependency perspective.

    Science.gov (United States)

    Banaszak-Holl, J; Zinn, J S; Mor, V

    1996-04-01

    Using resource dependency theory as a conceptual framework, this study investigates both the organizational and environmental factors associated with an emerging health care service delivery innovation, the provision of specialty care in designated units in nursing care facilities. We consider two types of specialty units, Alzheimer's Disease and subacute care. The Medicare/Medicaid Automated Certification Survey (MMACS) data file was merged with local market area data obtained from the 1992 Area Resource File and with state level regulatory data. The likelihood of providing Alzheimer's Disease or subacute care in dedicated units was estimated by separate logistic regressions. Results indicate that facilities with fewer Medicare patients are more likely to operate a dedicated Alzheimer's care unit, while facilities located in markets with a large HMO population and greater hospital supply are more likely to operate a subacute care unit. While competition among nursing homes, for the most part, is an incentive to innovate, greater regulatory stringency appears to constrain the development of specialty care units of both types. Finally, organizational characteristics (e.g., size and proprietary status) appear to be important enabling factors influencing the propensity to provide specialty care in dedicated units. Nursing care facilities are moving toward providing specialty care units partly as a response to a growing demand by resource providers and to maintain a competitive edge in tighter markets. Loosening regulation directed at cost containment would further encourage the development of specialty care but should be preceded by some evaluation of population needs for specialty care and the effectiveness of specialty care units.

  13. Managing costs, managing benefits: employer decisions in local health care markets.

    Science.gov (United States)

    Christianson, Jon B; Trude, Sally

    2003-02-01

    To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. This is an observational study with data collection over a six-year period. The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions.

  14. Using relationship marketing to develop and sustain nurse loyalty: a case of a rural health care institution.

    Science.gov (United States)

    Peltier, J W; Boyt, T; Westfall, J

    1999-01-01

    The prosperity of a health care organization is contingent on its ability to compete for and retain a high quality staff of "loyal" nurses. Although the benefits of maintaining a loyal nursing staff are obvious, turnover in the health care industry is dangerously high. One solution for reducing turnover is to develop and sustain a loyal nursing staff. The purpose of this article is to apply customer-oriented marketing theories and practices to better understand how strong nurse-provider relationships can be developed and maintained over time. The authors first examine relationship marketing literature as it applies to nurse relationship and management issues. Second, a framework for conceptualizing internal marketing efforts devoted to enhancing nursing staff satisfaction and retention in tested. Finally, strategies for practicing relationship marketing will be provided.

  15. Refractive neutron lens

    International Nuclear Information System (INIS)

    Petrov, P.V.; Kolchevsky, N.N.

    2013-01-01

    Model of the refractive neutron lens is proposed. System of N lenses acts as one thin lens with a complex refraction index n*. The maximum number N max of individual lenses for 'thick' neutron lens is calculated. Refractive neutron lens properties (resolution, focal depth) as function of resolution factor F 0 =ρbc/μ and depth of field factor dF 0 =λF 0 =λρbc/μ are calculated. It is shown that micro resolution of the refractive neutron optics is far from the wavelength in size and its open possibilities for progress in refractive neutron optics. (authors)

  16. The crisis of capitalism and the marketization of health care: the implications for public health professionals

    Directory of Open Access Journals (Sweden)

    Martin McKee

    2012-12-01

    Full Text Available The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for corporations and the small elite who lead them and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

  17. Social care going market : Institutional and cultural change regarding services for the elderly

    Directory of Open Access Journals (Sweden)

    Ingo Bode

    2015-03-01

    Full Text Available Over the last two decades or so, major Western societies have remoulded the institutional set-up by which they are deailing with social risks related to frailty during old age. While the 20th century had brought a transnational tendency towards the establishment of elderly care ‘going public’, the proliferation of more market-based services brings confusion into the societal norm-set underlying the aforementioned tendency. Marketisation has placed the emphasis on economic values engrained in liberal worldviews, leading into a new welfare culture that devaluates universalism and reemphasises the sovereignty of the individual. However, the new cult of the individual produces contradictory signals. Drawing on an encompassing study on the ‘culture of welfare markets’ in elderly care provision, covering two (post-liberal and two (post-corporatist welfare regimes (Canada, Britain; France, Germany, the paper looks at these fuzzy developments in order to assess the cultural embeddedness of what can be referred to as the mixed economy of elderly care. The analysis, charting major patterns of both institutional change and public communication around it, elucidates that we currently are facing a permanent struggle between liberal values and (renewed elements of the ‘going-public-agenda’ proliferating over the 1970s and 1980s, that is, a hybrid and ‘nervous’ cultural configuration in which senior social citizenship remains an issue, albeit on precarious foundations.

  18. Hospital and Health Insurance Markets Concentration and Inpatient Hospital Transaction Prices in the U.S. Health Care Market.

    Science.gov (United States)

    Dauda, Seidu

    2018-04-01

    To examine the effects of hospital and insurer markets concentration on transaction prices for inpatient hospital services. Measures of hospital and insurer markets concentration derived from American Hospital Association and HealthLeaders-InterStudy data are linked to 2005-2008 inpatient administrative data from Truven Health MarketScan Databases. Uses a reduced-form price equation, controlling for cost and demand shifters and accounting for possible endogeneity of market concentration using instrumental variables (IV) technique. The findings suggest that greater hospital concentration raises prices, whereas greater insurer concentration depresses prices. A hypothetical merger between two of five equally sized hospitals is estimated to increase hospital prices by about 9 percent (p costs. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  19. The Implementation Word Of Mouth As Part Of Integrated Marketing Communication At Beauty Clinic Giva Skin Care Medan

    Directory of Open Access Journals (Sweden)

    Murlizar

    2017-07-01

    Full Text Available Even though it is a new comer in facial beauty parlors Klinik Kecantikan Giva Skin Care located on Jalan Sei Batanghari Medan is able to compete with the other beauty parlors. The tight competitiveness in beauty parlors has caused it to think hard to creatively attract and increase consumers from time to time. In carrying out its marketing strategy it applies Integrated Marketing Communication IMC and Transmedia Branding through varied new media which contribute ideally to develop the brand of Klinik Kecantikan Giva Skin Care to its consumers and its prospective consumers. The objective of the research was to find out and identify Word Of Mouth WOM as part of IMC and Transmedia Branding which have been consistently done by this beauty parlos in the last two years. The research used descriptive qualitativemethod and constructive paradigm the data were analyzed by conducting case study. Constructivism considered that the subject in this case Nanda as the marketing manager of Klinik Kecantikan Giva Skin Care was the central factor in the communicativeactivity and in the social relations and was functioned as the social control. The data were gathered by conducting observation in-depth interviews with the marketing manager and library study. The result of the research showed that Klinik Kecantikan Giva Skin Care applied Transmedia Brand and IMC in the form of Advertising Direct Marketing Interactive Media and Internet Selling Promotion Publicity and Personal Selling in order to maintain its survival in the midst tight competitiveness in beauty parlor business in Medan.

  20. Person-Centered Care Practices in Long-Term Care in the Deep South: Consideration of Structural, Market, and Administrator Characteristics.

    Science.gov (United States)

    Jacobs, M Lindsey; Snow, A Lynn; Parmelee, Patricia A; Davis, Jullet A

    2018-03-01

    The purpose of this study was to identify structural, market, and administrator factors of nursing homes that are related to the implementation of person-centered care. Administrators of Medicare/Medicaid-certified nursing homes in the Deep South were invited to complete a standardized survey about their facility and their perceptions and attitudes regarding person-centered care practices (PCCPs). Nursing home structural and market factors were obtained from public websites, and these data were matched with administrator data. Consistent with the resource-based theory of competitive advantage, nursing homes with greater resources and more competition were more likely to implement PCCPs. Implementation of person-centered care was also higher in nursing homes with administrators who perceived culture change implementation to be feasible in their facilities. Given that there is a link between resource availability and adoption of person-centered care, future research should investigate the cost of such innovations.

  1. Government intervention in health care markets is practical, necessary, and morally sound.

    Science.gov (United States)

    Nichols, Len M

    2012-01-01

    This essay makes the affirmative case for health reform by expounding on three fundamental points: (1) one moral case for expanding access to coverage and care to all is grounded in scriptural concepts of community and mutual obligation which continue to inform the American pursuit of justice; (2) the structure of PPACA springs from an appreciation of and approach to channeling market forces that was developed and proposed by a coalition of moderate and conservative Republican U.S. senators almost 20 years ago; (3) the most humane path to a better and more sustainable health system lies in implementing (and amending where appropriate) PPACA as fast and fully as we can. The purpose of this essay is to articulate why it is not possible to make our health system better, sustainable and serve us all without government playing specific and limited but absolutely crucial catalytic roles. © 2012 American Society of Law, Medicine & Ethics, Inc.

  2. Market mechanisms and the management of health care. The UK model and experience.

    Science.gov (United States)

    Lapsley, I

    1997-01-01

    Examines recent reforms of the UK's National Health Service (NHS), and explores the pressures for change in the pursuit of an efficient NHS and the conflicts which this causes in an organization which was based on the aim of equity. In particular, addresses the "false revolutions" of managerial change introduced after the Griffiths Report (1983) and the accounting changes introduced in the wake of the Griffiths proposals. Evidence shows that these intended revolutions were limited in impact. The result of these failures has been the introduction of the "real revolution"--the internal market in health care. This is a radical change in both the NHS management arrangements and in service delivery, with the division of the NHS into purchasers (health authorities and GP fund holders) and providers (hospital and community services, whether provided by private, voluntary or state-owned facilities.

  3. Degree of patient satisfaction with health care performance assesed by marketing surveys.

    Science.gov (United States)

    Druguş, Daniela; Azoicăi, Doina

    2015-01-01

    Marketing surveys of the health system collect useful information to develop effective management strategies. The research aim consisted in measuring patient satisfaction with health care quality. The qualitative research was based on an online SurveyMonkey open-ended questionnaire. The analysis of patient satisfaction/dissatisfaction with healthcare professionals was performed in 1838 patients. Correlation analysis allowed the identification of some determinants associated with patient satisfaction. The variable most commonly associated with satisfaction was "I got adequate information about procedures/treatment" according to 32.2% of respondents. The patients who were dissatisfied most commonly complained that they were "Not adequately informed about maneuvers and treatment", reported by 40.0% of respondents. This study provides a basis for building an original model for determining the variables of an efficient healthcare system which to ensure a high degree of patient satisfaction.

  4. Market liberalism in health care: a dysfunctional view of respecting "consumer" autonomy.

    Science.gov (United States)

    Kekewich, Michael A

    2014-03-01

    The unfortunately vast history of paternalism in both medicine and clinical research has resulted in perpetually increasing respect for patient autonomy and free choice in Western health care systems. Beginning with the negative right to informed consent, the principle of respect for autonomy has for many patients evolved into a positive right to request treatments and expect accommodation. This evolution of patient autonomy has mirrored a more general social attitude of market liberalism where increasing numbers of patients have come to embody the role of the "consumer." This paper explores this transformation and critiques the current way in which respect for patient autonomy is put into practice. Ultimately, this paper concludes that the consumer view of patient autonomy is dysfunctional. Moreover, this paper argues that, based on the inherent goals of medicine, some form of paternalism is required in any meaningfully therapeutic relationship.

  5. Solutions on a high-speed wide-angle zoom lens with aspheric surfaces

    Science.gov (United States)

    Yamanashi, Takanori

    2012-10-01

    Recent development in CMOS and digital camera technology has accelerated the business and market share of digital cinematography. In terms of optical design, this technology has increased the need to carefully consider pixel pitch and characteristics of the imager. When the field angle at the wide end, zoom ratio, and F-number are specified, choosing an appropriate zoom lens type is crucial. In addition, appropriate power distributions and lens configurations are required. At points near the wide end of a zoom lens, it is known that an aspheric surface is an effective means to correct off-axis aberrations. On the other hand, optical designers have to focus on manufacturability of aspheric surfaces and perform required analysis with respect to the surface shape. Centration errors aside, it is also important to know the sensitivity to aspheric shape errors and their effect on image quality. In this paper, wide angle cine zoom lens design examples are introduced and their main characteristics are described. Moreover, technical challenges are pointed out and solutions are proposed.

  6. Risk transfer formula for individual and small group markets under the Affordable Care Act.

    Science.gov (United States)

    Pope, Gregory C; Bachofer, Henry; Pearlman, Andrew; Kautter, John; Hunter, Elizabeth; Miller, Daniel; Keenan, Patricia

    2014-01-01

    The Affordable Care Act provides for a program of risk adjustment in the individual and small group health insurance markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the third of three in this issue of the Medicare & Medicaid Research Review that describe the ACA risk adjustment methodology and focuses on the risk transfer formula. In our first companion article, we discussed the key issues and choices in developing the methodology. In our second companion paper, we described the risk adjustment model that is used to calculate risk scores. In this article we present the risk transfer formula. We first describe how the plan risk score is combined with factors for the plan allowable premium rating, actuarial value, induced demand, geographic cost, and the statewide average premium in a formula that calculates transfers among plans. We then show how each plan factor is determined, as well as how the factors relate to each other in the risk transfer formula. The goal of risk transfers is to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences. Illustrative numerical simulations show the risk transfer formula operating as anticipated in hypothetical scenarios.

  7. Assessing the relationship between healthcare market competition and medical care quality under Taiwan's National Health Insurance programme.

    Science.gov (United States)

    Liao, Chih-Hsien; Lu, Ning; Tang, Chao-Hsiun; Chang, Hui-Chih; Huang, Kuo-Cherh

    2018-06-04

    There is still significant uncertainty as to whether market competition raises or lowers clinical quality in publicly funded healthcare systems. We attempted to assess the effects of market competition on inpatient care quality of stroke patients in a retrospective study of the universal single-payer health insurance system in Taiwan. In this 11-year population-based study, we conducted a pooled time-series cross-sectional analysis with a fixed-effects model and the Hausman test approach by utilizing two nationwide datasets: the National Health Insurance Research Database and the National Hospital and Services Survey in Taiwan. Patients who were admitted to a hospital for ischemic or hemorrhagic stroke were enrolled. After excluding patients with a previous history of stroke and those with different types of stroke, 247 379 ischemic and 79 741 hemorrhagic stroke patients were included in our analysis. Four outcome indicators were applied: the in-hospital mortality rate, 30-day post-operative complication rate, 14-day re-admission rate and 30-day re-admission rate. Market competition exerted a negative or negligible effect on the medical care quality of stroke patients. Compared to hospitals located in a highly competitive market, in-hospital mortality rates for hemorrhagic stroke patients were significantly lower in moderately (β = -0.05, P markets (β = -0.05, P market competition on the quality of care of ischemic stroke patients was insignificant. Simply fostering market competition might not achieve the objective of improving the quality of health care. Other health policy actions need to be contemplated.

  8. Assessing local market and organizational readiness for the integration of complementary and alternative medicine into ambulatory care centers.

    Science.gov (United States)

    Makowski, Suzana K E

    2004-01-01

    Complementary and alternative medicine (CAM) is one of the fastest growing segments of the health care industry today, with studies suggesting that between 30% and 50% of the adult population in the United States uses some form of CAM. Many ambulatory care centers are considering integrating CAM into their clinical services. This article will review some of the national trends and present a framework for assessing local market demand for CAM in order to help prioritize an organization's CAM integration strategy.

  9. Orbiting objective lens telescope system and method

    International Nuclear Information System (INIS)

    Crooks, J.W. Jr.

    1984-01-01

    A large objective lens is placed in a highly eccentric orbit about the earth. The orbit and orientation of the lens are carefully chosen so that it focuses light or other radiation from a preselected astronomical object into an image which slowly moves across the surface of the earth. A row of optical sensing units is located on the surface of the earth so that the image focused by the orbiting objective lens will travel substantially perpendicularly across the row during an observation. Output data generated from the sensing units may be multiplexed and fed to a real time processor which produces display signals. Each of the sensing units provides one scan line of the image being observed. The display signals are fed to a suitable display device which produces a picture of the preselected astronomical object. The objective lens may comprise a large flexible Fresnel zone plate or a flexible convex lens carried by a bicycle wheel-type supporting structure. The lens and supporting structure may be unfolded from compact cargo configurations and rotated after being placed into orbit

  10. Bacterial adhesion forces to Ag-impregnated contact lens cases and transmission to contact lenses.

    Science.gov (United States)

    Qu, Wenwen; Busscher, Henk J; van der Mei, Henny C; Hooymans, Johanna M M

    2013-03-01

    To measure adhesion forces of Pseudomonas aeruginosa, Staphylococcus aureus, and Serratia marcescens to a rigid contact lens (CL), standard polypropylene, and Ag-impregnated lens cases using atomic force microscopy and determine bacterial transmission from lens case to CL. Adhesion forces of bacterial strains to Ag-impregnated and polypropylene lens cases and a rigid CL were measured using atomic force microscopy. Adhesion forces were used to calculate Weibull distributions, from which transmission probabilities from lens case to CL were derived. Transmission probabilities were compared with actual transmission of viable bacteria from a lens case to the CL in 0.9% NaCl and in an antimicrobial lens care solution. Bacterial transmission probabilities from polypropylene lens cases based on force analysis coincided well for all strains with actual transmission in 0.9% NaCl. Bacterial adhesion forces on Ag-impregnated lens cases were much smaller than that on polypropylene and CLs, yielding a high probability of transmission. Comparison with actual bacterial transmission indicated bacterial killing due to Ag ions during colony-forming unit transmission from an Ag-impregnated lens case, especially for P. aeruginosa. Transmission of viable bacteria from Ag-impregnated lens cases could be further decreased by use of an antimicrobial lens care solution instead of 0.9% NaCl. Bacterial transmission probabilities are higher from Ag-impregnated lens cases than from polypropylene lens cases because of small adhesion forces, but this is compensated for by enhanced bacterial killing due to Ag impregnation, especially when in combination with an antimicrobial lens care solution. This calls for a balanced combination of antimicrobial lens care solutions and surface properties of a lens case and CL.

  11. Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

    Science.gov (United States)

    Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

    2016-08-01

    A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Capsular 'pits' in the human lens.

    OpenAIRE

    Harris, M. L.; Brown, N. A.; Shun-Shin, G. A.; Smith, G. T.

    1992-01-01

    The lens capsule is an atypical basement membrane surrounding the lens epithelial cells and lens fibres which make up the remainder of the human lens. A seemingly unreported morphological change visible in the lens capsule with the biomicroscope is described.

  13. Intraocular lens fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Salazar, Mike A. (Albuquerque, NM); Foreman, Larry R. (Los Alamos, NM)

    1997-01-01

    This invention describes a method for fabricating an intraocular lens made rom clear Teflon.TM., Mylar.TM., or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube.

  14. Intraocular lens fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Salazar, M.A.; Foreman, L.R.

    1997-07-08

    This invention describes a method for fabricating an intraocular lens made from clear Teflon{trademark}, Mylar{trademark}, or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube. 13 figs.

  15. Public and private in italian health care: trends and market quotas

    Directory of Open Access Journals (Sweden)

    Maria Michela Gianino

    2006-12-01

    Full Text Available

    Background: The Italian healthcare system has two components: public and private healthcare providers. Both deliver services on behalf of and payable by the national health care service. This study explores therelationships between public and private healthcare providers.

    Methods: The number of hospital admissions and length of stay or number of times the service was accessed stratified by year 2000, 2001, 2002; DRG; type of hospital admission (ordinary or day hospital/surgery; health provider category: public institutions without a specific reference territory, public institutions with a specific reference territory and accredited private institutions and medical or surgery DRGs. A distinction is made between those DRGs defined as belonging to the private sector and those falling within the public sector, assuming there is a majority market portion for services primarily supplied by the private sector. Case-mix index was utelised as the indicator for the complexity of the cases treated and the comparative performance index was used as the indicator for efficiency. Lastly in order to evaluate the services delivered with an inappropriate organizational profile reference is made the rulings defining Essential Level of assistance.

    Results: The results showed a shift in the reallocation of service volumes for ordinary admissions towards the private sector; the reallocation relates to the volumes but not to the types of cases treated, since the DRG mix remained substantially unchanged over the 3-year period and those DRG that absorb 51% of services were essentially constant. The private sector never achieved a market majority quota but rather controlled market niches with minority quotas. The private institutions treated less complex cases and worked with lower efficiency levels than the public sector. There was also a shift in the distribution of admissions from ordinary admissions to

  16. Daily disposable contact lens prescribing around the world.

    Science.gov (United States)

    Efron, Nathan; Morgan, Philip B; Helland, Magne; Itoi, Motozumi; Jones, Deborah; Nichols, Jason J; van der Worp, Eef; Woods, Craig A

    2010-10-01

    Daily disposable contact lenses were introduced into the market 16 years ago. Data that we have gathered from annual contact lens fitting surveys conducted in Australia, Canada, Japan, The Netherlands, Norway, the UK and the USA between 2000 and 2008 indicates an overall increase in daily disposable lens fitting during this period. Daily disposable lenses are especially popular in Japan, Norway and the UK. There is a trend for these lenses to be fitted on a part-time basis. Males are over-represented in daily disposable lens fitting-a trend that is especially evident in Canada. Daily disposable lens wearers are about two years younger than wearers of reusable lenses in Japan and The Netherlands. The convenience and health benefits of daily disposable lenses are expected to fuel continued growth in this sector. Copyright (c) 2010 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  17. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... Costume Contact Lenses Can Ruin Vision Eye Makeup Safety In fact, it is illegal to sell colored ...

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... new application of artificial intelligence shows whether a patient’s eyes point to high blood pressure or risk ...

  19. The lens and cataracts.

    Science.gov (United States)

    Matthews, Andrew G

    2004-08-01

    It is conservatively estimated that some form of lens opacity is present in 5% to 7% of horses with otherwise clinically normal eyes.These opacities can range from small epicapsular remnants of the fetal vasculature to dense and extensive cataract. A cataract is defined technically as any opacity or alteration in the optical homogeneity of the lens involving one or more of the following: anterior epithelium, capsule, cortex, or nucleus. In the horse, cataracts rarely involve the entire lens structure (ie, complete cataracts) and are more usually localized to one anatomic landmark or sector of the lens. Complete cataracts are invariably associated with overt and significant visual disability. Focal or incomplete cataracts alone seldom cause any apparent visual dysfunction in affected horses,however.

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her ...

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... glow-in-the-dark lizard lenses, costume contacts can certainly add a spooky, eye-popping touch. But ... consideration as a standard contact lens because they can be purchased over-the-counter or on the ...

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... valid prescription that includes the brand name, lens measurements, and expiration date. Purchase the colored contact lenses ... with human-made versions. U.S. News Highlights the Value of Ophthalmologists APR 20, 2018 By Dan T. ...

  4. Vortex gas lens

    Science.gov (United States)

    Bogdanoff, David W.; Berschauer, Andrew; Parker, Timothy W.; Vickers, Jesse E.

    1989-01-01

    A vortex gas lens concept is presented. Such a lens has a potential power density capability of 10 to the 9th - 10 to the 10th w/sq cm. An experimental prototype was constructed, and the divergence half angle of the exiting beam was measured as a function of the lens operating parameters. Reasonably good agreement is found between the experimental results and theoretical calculations. The expanded beam was observed to be steady, and no strong, potentially beam-degrading jets were found to issue from the ends of the lens. Estimates of random beam deflection angles to be expected due to boundary layer noise are presented; these angles are very small.

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... ask for a prescription. There is no such thing as a "one size fits all" contact lens. ...

  6. Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

    Science.gov (United States)

    Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

    2017-12-01

    Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

  7. The role of the sickness funds in the Belgian health care market.

    Science.gov (United States)

    Nonneman, W; van Doorslaer, E

    1994-11-01

    This article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance program. It is shown how, despite extensive government regulation, the markets for GP, specialist and hospital services exhibit fierce competition of the non-price variety. Next, the paper considers the three problems perceived to be the most pressing ones at present: (i) the problem of raising sufficient revenues to cover the public share of health expenditures; (ii) the (related) cost containment problem; and (iii) the problem of ensuring efficiency through appropriate incentive mechanisms. Finally, two recently proposed options for reform are discussed and complemented with a third proposal based on the ideas of regulated competition. It is concluded that strengthening the role of the third-party payers remains crucial in any attempt to reshape the system to make it efficient and affordable while keeping it equitable.

  8. Walking the Line: Navigating Market and Gift Economies of Care in a Consumer-Directed Home-Based Care Program for Older Adults.

    Science.gov (United States)

    Torres, Jacqueline M; Kietzman, Kathryn G; Wallace, Steven P

    2015-12-01

    Paid caregivers of low-income older adults navigate their role at what Hochschild calls the "market frontier": the fuzzy line between the "world of the market," in which services are exchanged for monetary compensation, and the "world of the gift," in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long-term services and supports, shape the practice of "walking the line" among caregivers of older adults. We used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California's In-Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach. Related and nonrelated caregivers are often expected to "gift" hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further "walk the line" between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to "walk the line" in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers' burden. Given economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low-income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long-term services and supports thus leave the needs of both caregivers and consumers unmet

  9. eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data.

    Science.gov (United States)

    Schneider, Janina Anne; Holland, Christopher Patrick

    2017-04-13

    Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets. The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website. The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per

  10. Optimising value and quality in general practice within the primary health care sector through relationship marketing: a conceptual framework.

    Science.gov (United States)

    Bansal, Manjit K

    2004-01-01

    Discusses the rationale of applying relationship marketing and service quality concepts within the primary health care sector. The use of relational strategies in general practice, by modelling the relationships between practitioners and patients from a marketing perspective, could potentially lead to sustained high quality service being provided, and to more efficient use of resources. This essentially conceptually focused paper addresses an area that has not yet been researched in detail, and furthers understanding of the relationships that facilitate exchange within general practice and service delivery in non-profit, resource-constrained conditions. Deeper understanding of the needs and expectations of patients and the way these can be delivered by general practice can only lead to improvements for all parties involved. The relationship marketing paradigm presents itself as a potentially exciting way of addressing issues associated with ensuring that the highest level of quality is delivered in this area of the UK National Health Service.

  11. [Effects of pharmacy market deregulation regarding patient-centred drug care in Germany from a health economics perspecitve].

    Science.gov (United States)

    Rumm, R; Böcking, W

    2013-03-01

    This article analyses the impact of a potential deregulation Germany's pharmacy market by allowing foreign ownership of pharmacies and removing the limit of the number pharmacies that can be owned by a pharmacist. Based on a mathematical model and empirical values of foreign countries, scenarios for the German market are calculated and the impact on all participants of the health care system analysed. The key outcomes are:- A deregulation would enables the creation of pharmacy chains- In all simulated scenarios the total number of pharmacies would drastically grow- The increased pharmacy density improves patient centred drug care- The competition among pharmacies increases and leads to the closure of many independently owned and operated pharmacies. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Marketing marketing

    NARCIS (Netherlands)

    dr. Karel Jan van Alsem

    2013-01-01

    In deze installatierede betoogt Karel Jan Alsem dat marketing een grotere strategische rol in organisaties zou moeten krijgen. Want marketing is bij uitstek de verbinding tussen klantwensen en het DNA van een organisatie. Doordat merken gemiddeld voor mensen niet heel belangrijk zijn, is goede

  13. Assessing competition in hospital care markets: the importance of accounting for quality differentiation.

    Science.gov (United States)

    Tay, Abigail

    2003-01-01

    Quality differentiation is especially important in the hospital industry, where the choices of Medicare patients are unaffected by prices. Unlike previous studies that use geographic market concentration to estimate hospital competitiveness, this article emphasizes the importance of quality differentiation in this spatially differentiated market. I estimate a random-coefficients discrete-choice model that predicts patient flow to different hospitals and find that demand responses to both distance and quality are substantial. The estimates suggest that patients do not substitute toward alternative hospitals in proportion to current market shares, implying that geographic market concentration is an inappropriate measure of hospital competitiveness.

  14. Inadequately marketing our brand: Medical student awareness of acute care surgery.

    Science.gov (United States)

    Montgomery, Stephanie C; Privette, Alicia R; Ferguson, Pamela L; Mirdamadi, Meena; Fakhry, Samir M

    2015-11-01

    Despite focused national efforts to promote acute care surgery (ACS), little is known about medical student awareness of ACS as a career choice. The impending shortage of general surgeons emphasizes the need to increase interest in this comprehensive surgical specialty. The goal of this study was to determine whether students would be more likely to consider choosing ACS if they were aware of the specialty and its benefits. A survey was distributed electronically to medical students at our institution, a Level I trauma center with an active ACS service. The survey asked questions regarding specialty choice and factors that were used in making that decision. Also included were questions regarding their familiarity and affinity for ACS. The survey was returned by 518 students. Each medical school year was proportionately represented. Twenty-one percent of the students reported surgery as their career choice; however, women were half as likely to choose surgery as men. When asked to define ACS, 23% of all students gave the correct response. Only 8.9% of the students in the preclinical years correctly defined ACS. Even in the clinical years, 54% were unaware of ACS as a specialty. Students reported that the top factors that influenced their choice were controllable lifestyle, predictable schedule, and a positive medical school role model. When asked to identify what would make ACS appealing, a 50-hour work week was deemed most influential. When given the definition of ACS with approximate pay and on-call hours, 41.5% of the students and 75% of those interested in surgery would be likely to choose ACS as a career. This study highlights that awareness of ACS as a specialty is lacking. This may reflect inadequate marketing of our "brand" both locally and nationally. Focused efforts at familiarizing students with ACS and increased role modeling may increase interest in ACS.

  15. The Nonprofit Advantage: Producing Quality in Thick and Thin Child Care Markets

    Science.gov (United States)

    Cleveland, Gordon; Krashinsky, Michael

    2009-01-01

    Nonprofit child care centers are frequently observed to produce child care which is, on average, of higher quality than care provided in commercial child care centers. In part, this nonprofit advantage is due to different input choices made by nonprofit centers--lower child--staff ratios, better-educated staff and directors, higher rates of…

  16. Social marketing potential of qualitative cost- free-to-patient eye care ...

    African Journals Online (AJOL)

    2010-02-08

    Feb 8, 2010 ... sought to identify factors that are of marketing importance in qualitative ... Identifie les facteurs de marketing valeur incluse: publicité Grâce à: Personnes (46.5%), ville crier (21.2%), radio ..... occurrence of interviewer's error.

  17. Microbial contamination of soft contact lenses & accessories in asymptomatic contact lens users

    Directory of Open Access Journals (Sweden)

    Deeksha V Thakur

    2014-01-01

    Full Text Available Background & objectives: With increasing use of soft contact lenses the incidence of contact lens induced infections is also increasing. This study was aimed to assess the knowledge of new and existing contact lens users about the risk of microbial contamination associated with improper use and maintenance of contact lenses, type of microbial flora involved and their potential to cause ophthalmic infections. Methods: Four samples each from 50 participants (n=200 were collected from the lenses, lens care solutions, lens care solution bottles and lens cases along with a questionnaire regarding their lens use. The samples were inoculated onto sheep blood agar, Mac Conkey′s agar and Sabouraud′s dextrose agar. Organisms were identified using standard laboratory protocols. Results: Overall rate of microbial contamination among the total samples was 52 per cent. The most and the least contaminated samples were found to be lens cases (62% and lens care solution (42%, respectively. The most frequently isolated contaminant was Staphylococcus aureus (21% followed by Pseudomonas species (19.5%. Majority (64% of the participants showed medium grade of compliance to lens cleaning practices. Rate of contamination was 100 and 93.75 per cent respectively in those participants who showed low and medium compliance to lens care practices as compared to those who had high level of compliance (43.75% ( p0 <0.05. Interpretation & conclusions: Lens care practices amongst the participants were not optimum which resulted into high level contamination. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required.

  18. Symmetric lens with extended depth of focus

    OpenAIRE

    Cho, Sung Nae

    2008-01-01

    The lens surface profile is derived based on the instantaneous focal length versus the lens radius data. The lens design based on instantaneous focal length versus the lens radius data has many useful applications in software assisted image focusing technology.

  19. The limits of market-based reforms in the NHS: the case of alternative providers in primary care.

    Science.gov (United States)

    Coleman, Anna; Checkland, Kath; McDermott, Imelda; Harrison, Stephen

    2013-01-01

    Historically, primary medical care in the UK has been delivered by general practitioners who are independent contractors, operating under a contract, which until 2004 was subject to little performance management. In keeping with the wider political impetus to introduce markets and competition into the NHS, reforms were introduced to allow new providers to bid for contracts to provide primary care services in England. These contracts known as 'Alternative Provider Medical Services', were encouraged by two centrally-driven rounds of procurement (2007/8 and 2008/9). This research investigated the commissioning and operation of such Alternative Providers of Primary Care (APPCs). Two qualitative case studies were undertaken in purposively sampled English Primary Care Trusts (PCTs) and their associated APPCs over 14 months (2009-10). We observed 65 hours of meetings, conducted 23 interviews with PCT and practice staff, and gathered relevant associated documentation. We found that the procurement and contracting process was costly and time-consuming. Extensive local consultation was undertaken, and there was considerable opposition in some areas. Many APPCs struggled to build up their patient list sizes, whilst over-performing on walk-in contracts. Contracting for APPCs was 'transactional', in marked contrast to the 'relational' contracting usually found in the NHS, with APPCs subject to tight performance management. These complicated and costly processes contrast to those experienced by traditionally owned GP partnerships. However, managers reported that the perception of competition had led existing practices to improve their services. The Coalition Government elected in 2010 is committed to 'Any Qualified Provider' of secondary care, and some commentators argue that this should also be applied to primary care. Our research suggests that, if this is to happen, a debate is needed about the operation of a market in primary care provision, including the trade-offs between

  20. The limits of market-based reforms in the NHS: the case of alternative providers in primary care

    Science.gov (United States)

    2013-01-01

    Background Historically, primary medical care in the UK has been delivered by general practitioners who are independent contractors, operating under a contract, which until 2004 was subject to little performance management. In keeping with the wider political impetus to introduce markets and competition into the NHS, reforms were introduced to allow new providers to bid for contracts to provide primary care services in England. These contracts known as ‘Alternative Provider Medical Services’, were encouraged by two centrally-driven rounds of procurement (2007/8 and 2008/9). This research investigated the commissioning and operation of such Alternative Providers of Primary Care (APPCs). Methods Two qualitative case studies were undertaken in purposively sampled English Primary Care Trusts (PCTs) and their associated APPCs over 14 months (2009-10). We observed 65 hours of meetings, conducted 23 interviews with PCT and practice staff, and gathered relevant associated documentation. Results and conclusions We found that the procurement and contracting process was costly and time-consuming. Extensive local consultation was undertaken, and there was considerable opposition in some areas. Many APPCs struggled to build up their patient list sizes, whilst over-performing on walk-in contracts. Contracting for APPCs was ‘transactional’, in marked contrast to the ‘relational’ contracting usually found in the NHS, with APPCs subject to tight performance management. These complicated and costly processes contrast to those experienced by traditionally owned GP partnerships. However, managers reported that the perception of competition had led existing practices to improve their services. The Coalition Government elected in 2010 is committed to ‘Any Qualified Provider’ of secondary care, and some commentators argue that this should also be applied to primary care. Our research suggests that, if this is to happen, a debate is needed about the operation of a market

  1. A catoptric lens

    International Nuclear Information System (INIS)

    Rambauske, W.R.

    1973-01-01

    The invention relates to a catoptric lens for combining energies transmitted by several sources such as lasers; said lens comprising mirrors, the reflective surfaces of which have their focuses spaced from a common axis of symmetry. By means of these reflecting surfaces, which are generated by the nutation of portions of quadratic conics about the axis of symmetry, it is possible to focus the energy emmited by several lasers at the focus of the exit-mirror reflecting surface. This can be applied to thermonuclear fusion [fr

  2. A five-year assessment of the affordable care act: market forces still trump the common good in U.S. Health care.

    Science.gov (United States)

    Geyman, John P

    2015-01-01

    The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  3. The effect of compliance on contact lens case contamination.

    Science.gov (United States)

    Tilia, Daniel; Lazon de la Jara, Percy; Zhu, Hua; Naduvilath, Thomas J; Holden, Brien A

    2014-03-01

    To determine the efficacy of written instructions on contact lens case hygiene and to quantify the effect of noncompliance on contact lens case contamination. Data were retrospectively analyzed from 16 prospective, 3-month daily-wear studies during which six commercially available silicone hydrogel contact lenses and seven lens care solutions (LCS) were tested following a similar protocol. Verbal instructions regarding case hygiene (rinse case with LCS, not tap water) were given in nine studies, while the same instructions were given verbally and in written format in seven studies. A survey on contact lens, LCS, and lens case hygiene was completed at 1- and 3-month visits and compliance with case hygiene instructions was determined. Regular contact lens cases were used for 1 month and collected for microbial analysis at the 1- and 3-month visits. The rate of case contamination and the types of microbes contaminating cases were evaluated. Participants given verbal and written instructions were more likely to be compliant with case hygiene instructions than those just given verbal instructions (odds ratio [OR]: 2.19, p hygiene can be improved by effective communication of instructions. Contact lens wearers should be actively discouraged from rinsing contact lens cases with tap water because of the increased risk of GNB contamination.

  4. New information technology and communication in health care: using e-mail for marketing services

    Directory of Open Access Journals (Sweden)

    Jorge Iván Martínez Espitia

    2015-01-01

    Full Text Available Research that was conducted was aimed to determine their use of e-mail independent health professionals. Email is one of the tools of information and communication that has shown great versatility and efciency as a means to improve the relationship between those who provide services or sell products users. Good communication is essential to keep current customers and attract new business prospects. To achieve the objective of the research a survey that measured the perception and use of email marketing by independent health professionals was conducted in Colombia. Four variables, including tenure email account, receiving these email accounts marketing of products or services, read marketing emails and use by marketing professionals were measured with email. The result of this study showed that independent health professionals in Colombia are familiar with this type of marketing. Generally interested incorporate it as one of your marketing tools, but do not know how to do this activity, which is described in a simple way how to do a marketing campaign with the use of emails to the users of health services.

  5. New information technology and communication in health care: using e-mail for marketing services

    Directory of Open Access Journals (Sweden)

    Jorge Iván Martínez Espitia

    2014-07-01

    Full Text Available Research that was conducted was aimed to determine their use of e-mail independent health professionals. Email is one of the tools of information and communication that has shown great versatility and efciency as a means to improve the relationship between those who provide services or sell products users. Good communication is essential to keep current customers and attract new business prospects. To achieve the objective of the research a survey that measured the perception and use of email marketing by independent health professionals was conducted in Colombia. Four variables, including tenure email account, receiving these email accounts marketing of products or services, read marketing emails and use by marketing professionals were measured with email. The result of this study showed that independent health professionals in Colombia are familiar with this type of marketing. Generally interested incorporate it as one of your marketing tools, but do not know how to do this activity, which is described in a simple way how to do a marketing campaign with the use of emails to the users of health services.

  6. Can You Hear Me Now? Marketing Essentials for Audiologists in a Noisy Health Care World

    Science.gov (United States)

    Rudden, DAnne

    2016-01-01

    Audiologists, even those with a strong acumen for business, are not traditionally taught the basics of creating a robust practice identity and dynamic marketing plan. This activity will teach learners how to create a distinct brand that separates them from others in a competitive and distracted marketplace. Additionally, learners will gain an understanding for how to blend traditional marketing tools with more modern online options and social media. Upon completion, learners will be familiar with the skills necessary to actively create, implement, and track the effectiveness of their marketing strategy using proven methodologies. PMID:28028325

  7. Can You Hear Me Now? Marketing Essentials for Audiologists in a Noisy Health Care World.

    Science.gov (United States)

    Rudden, DAnne

    2016-11-01

    Audiologists, even those with a strong acumen for business, are not traditionally taught the basics of creating a robust practice identity and dynamic marketing plan. This activity will teach learners how to create a distinct brand that separates them from others in a competitive and distracted marketplace. Additionally, learners will gain an understanding for how to blend traditional marketing tools with more modern online options and social media. Upon completion, learners will be familiar with the skills necessary to actively create, implement, and track the effectiveness of their marketing strategy using proven methodologies.

  8. [Health care units image development on the market of medical services].

    Science.gov (United States)

    Kemicer-Chmielewska, Ewa; Karakiewicz, Beata

    2010-01-01

    The cause for this document is to present a deliberation on public health facility image development on the medical services market. Marketization of the health service, growing awareness of Polish citizens and their expectation of high service quality as well as increased competition in the healthcare system market is the reason why health unit managers need to put a lot of strength and effort in sustaining or improving the image of the facility they run. Such action gives a chance for obtaining a competitive advantage.

  9. A Tribute to Len Barton

    Science.gov (United States)

    Tomlinson, Sally

    2010-01-01

    This article constitutes a short personal tribute to Len Barton in honour of his work and our collegial relationship going back over 30 years. It covers how Len saw his intellectual project of providing critical sociological and political perspectives on special education, disability and inclusion, and his own radical political perspectives. Len's…

  10. Luneburg lens in silicon photonics.

    Science.gov (United States)

    Di Falco, Andrea; Kehr, Susanne C; Leonhardt, Ulf

    2011-03-14

    The Luneburg lens is an aberration-free lens that focuses light from all directions equally well. We fabricated and tested a Luneburg lens in silicon photonics. Such fully-integrated lenses may become the building blocks of compact Fourier optics on chips. Furthermore, our fabrication technique is sufficiently versatile for making perfect imaging devices on silicon platforms.

  11. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. There is no such thing as a "one size fits all" contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into the cornea. Even if you have perfect vision, you need to get an eye exam and a prescription ...

  12. MISSING: BUBBLE CHAMBER LENS

    CERN Multimedia

    2001-01-01

    Would the person who borrowed the large bubble chamber lens from the Microcosm workshops on the ISR please return it. This is a much used piece from our object archives. If anybody has any information about the whereabouts of this object, please contact Emma.Sanders@cern.ch Thank you

  13. The Lens of Chemistry

    Science.gov (United States)

    Thalos, Mariam

    2013-01-01

    Chemistry possesses a distinctive theoretical lens--a distinctive set of theoretical concerns regarding the dynamics and transformations of a perplexing variety of organic and nonorganic substances--to which it must be faithful. Even if it is true that chemical facts bear a special (reductive) relationship to physical facts, nonetheless it will…

  14. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her with a corneal ... A recent article from U.S. News and World Report explains what ophthalmologists are and how they can ...

  15. Quadrupole magnetic lens

    International Nuclear Information System (INIS)

    Piskunov, V.A.

    1981-01-01

    The following connection of windings of electromagnet is suggested for simplification of the design of qUadrupole magnetic lens intended for use in radiotechnical and electron-optical devices. The mentioned windings are connected with each other by a bridge scheme and the variable resistors are switched in its diagonals in the lens containing four electromagnet with windings connected with two variable resistors the mobile contacts of which are connected with a direct current source. Current redistribution between left windings and right windings takes place at shift of mobile contact of variable resistor, and current redistribution between upper and low coils of electromagnets takes place at shifting mobile contact of the other variable resistor. In this case smooth and independent electron-optical misalignment of lens by two mutually perpendicular directions proceeds. Use of the given design of the lens in the oscillograph permits to use printing assembly for alignment plate and to reduce the number of connections at the expense of decreasing the number of resistors

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... can be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... ask for a prescription. There is no such thing as a "one size fits all" contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into ...

  17. Can You Hear Me Now? Marketing Essentials for Audiologists in a Noisy Health Care World

    OpenAIRE

    Rudden, DAnne

    2016-01-01

    Audiologists, even those with a strong acumen for business, are not traditionally taught the basics of creating a robust practice identity and dynamic marketing plan. This activity will teach learners how to create a distinct brand that separates them from others in a competitive and distracted marketplace. Additionally, learners will gain an understanding for how to blend traditional marketing tools with more modern online options and social media. Upon completion, learners will be familiar ...

  18. The Fortune 500 on health care. Most top executives want to set the market free.

    Science.gov (United States)

    West, V L; Minifie, J R; Aiyer, J P

    1997-01-01

    The nature of the American health care marketplace is in a state of flux and refinement. The recent attempt by the federal government to change the health care system has brought these issues to the forefront of public and private discourse. This research endeavor examines if these discussions influenced health care decisions by some of the nation's most influential decision makers.

  19. A Tribute to Dr. Willy Lens

    Directory of Open Access Journals (Sweden)

    Maarten Vansteenkiste

    2016-07-01

    Full Text Available Dr. Willy Lens, born on December 10th, 1943, passed away on August 29th, 2014. With his passing, the motivation community has lost a seminal member, a mentor, and a friend. Dr. Lens – a Fellow of the Association for Psychological Science and Founding Fellow of the American Educational Research Association – made fundamental contributions to the study of motivation both through his own work and through his caring and thoughtful mentorship of a large community of scholars. With this tribute, we want to honor Dr. Willy Lens’ significance to psychology and education as well as his positive influence, both personally and professionally, on the lives of dozens of scholars. With his contagious enthusiasm and caring mentorship, Willy was an example for our academic community and with this tribute we express our gratitude for the privilege to have collaborated with him.

  20. The emerging market for supplemental long term care insurance in Germany in the context of the 2013 Pflege-Bahr reform.

    Science.gov (United States)

    Nadash, Pamela; Cuellar, Alison Evans

    2017-06-01

    The growing cost of long term care is burdening many countries' health and social care systems, causing them to encourage individuals and families to protect themselves against the financial risk posed by long term care needs. Germany's public long-term care insurance program, which mandates coverage for most Germans, is well-known, but fewer are aware of Germany's growing voluntary, supplemental private long-term care insurance market. This paper discusses German policymakers' 2013 effort to expand it by subsidizing the purchase of qualified policies. We provide data on market expansions and the extent to which policy goals are being achieved, finding that public subsidies for purchasing supplemental policies boosted the market, although the effect of this stimulus diminished over time. Meanwhile, sales growth in the unsubsidized market appears to have slowed, despite design features that create incentives for lower-risk individuals to seek better deals there. Thus, although subsidies for cheap, low-benefit policies seem to have achieved the goal of market expansion, the overall impact and long-term sustainability of these products is unclear; conclusions about its impact are further muddied by significant expansions to Germany's core program. The German example reinforces the examples of the US and France private long term care insurance markets, to show how such products flourish best when supplementing a public program. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. The Correlation between Daily Lens Wear Duration and Dry Eye Syndrome.

    Science.gov (United States)

    Lubis, Rodiah Rahmawaty; Gultom, Monica Tumiar Hanna

    2018-05-20

    To analyze the correlation between the daily lens wear duration and dry eye syndrome. This study was an analytic cross sectional study using consecutive sampling conducted among the students in Economy and Bussiness Faculty and Faculty of Humanities in University of Sumatera Utara aged between 17 to 23 that wore contact lens continously for at least a year and 5 days a week. The symptoms were assessed using Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and interview about their contact lens comfort; eye drops usage, contact lens washing habit, daily circumstances, places to buy contact lens and personal experince in wearing contact lens. The questionnaire was completed by 53 students. All of them were female and wore softlens wearers. The mean duration of daily wear was 8.19 ± 2.20 hours. The most common symptom experienced was dry eye and the least symptom experienced was removing lens. The most frequent symptom experienced was closing eyes and the least frequent symptom experienced was removing lenses. This study used Exact Test as analysis statistic method. The result was p > 0.05 which means there is no correlation between daily lens wear duration and dry eye syndrome. This study showed that dry eye syndrome was not correlated with daily lens wear duration, but affected by many factors such as contact lens, lens care solution, eye drops usage and environment.

  2. Demand management: another marketing tool or a way to quality care?

    Science.gov (United States)

    Mohler, M J; Harris, J M

    1998-05-01

    Demand management tools are population-based strategies used to control costs and improve utilization of services by assisting health consumers in maintaining their health and seeking appropriate health care. These tools are increasingly used by health care delivery systems and, in the US, by fiscal intermediaries, such as insurance companies. If these tools are not properly applied, there is a clear possibility that their use may lead a reduction of health care services with no improvement in clinical, humanistic, or economic outcomes. Demand management effectiveness has not been rigorously examined by the medical industry or academia. Before adopting or purchasing demand management technologies, health care systems should examine them carefully to determine how the tools were developed and who they were intended to serve. Once implemented, careful tracking of population outcomes is as necessary with these technologies as with any other technologies that can affect health care.

  3. Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.

    Science.gov (United States)

    Gruber, Jonathan

    2014-06-01

    Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.

  4. Nursing home performance under case-mix reimbursement: responding to heavy-care incentives and market changes.

    Science.gov (United States)

    Davis, M A; Freeman, J W; Kirby, E C

    1998-10-01

    To examine the effect of case mix-adjusted reimbursement policy and market factors on nursing home performance. Data from Medicaid certification inspection surveys, Medicaid cost reports, and the Kentucky State Center for Health Statistics for the years 1989 and 1991, to examine changes in nursing home performance stemming from the adoption of case mix-adjusted reimbursement in 1990. In addition to cross-sectional regressions, a first-difference approach to fixed-effects regression analyses was employed to control for facility differences that were essentially fixed during the survey years and to estimate the effects of time-varying predictors on changes in facility expenditures, efficiency, and profitability. Facilities that increased the proportion of Medicaid residents and eliminated excess capacity experienced higher profitability gains during the beginning phase of case-mix reimbursement. Having a heavy-care resident population was positively related to expenditures prior to reimbursement reform, and it was negatively related to expenditures after the case-mix reimbursement policy was introduced. While facility-level changes in case mix had no reliable influence on costs or profits, nursing homes showing an increased prevalence of poor-quality nursing practices exhibited increases in efficiency and profitability. At the market level, reductions in excess or empty nursing home beds were accompanied by a significant growth in home health services. Moreover, nursing homes located in markets with expanding home health services exhibited higher increases in costs per case-mix unit. Characteristics of the reimbursement system appear to reward a cost minimization orientation with potentially detrimental effects on quality of care. These effects, exacerbated by a supply-constrained market, may be mitigated by policies that encourage the expansion of home health service availability.

  5. "Do I stay or do I go?"--job change and labor market exit intentions of employees providing informal care to older adults.

    Science.gov (United States)

    Schneider, Ulrike; Trukeschitz, Birgit; Mühlmann, Richard; Ponocny, Ivo

    2013-10-01

    This article examines whether providing informal eldercare to an older dependent person predicts employees' intentions to change jobs or exit the labor market and, if so, which particular aspects of both caregiving (e.g. time demands, physical/cognitive care burden) and their current work environment shape these intentions. We used data from a sample of 471 caring and 431 noncaring employees in Austria and split the analyses by gender. We found different aspects of informal caregiving to be associated with the intention to change jobs and with the anticipated labor market withdrawal of male and female workers. A time-based conflict between informal eldercare and paid work was significantly and positively related to the intended job change of female workers but not of their male counterparts. Flexible work arrangements were found to facilitate the attachment of female workers to their jobs and the labor market. Intentions to exit the labor market of male workers appeared to be triggered by a physical care burden rather than time demands. We studied the effects of providing informal eldercare on the turnover intention of men and women in a group of workers who were also the main carers providing support to a dependent older person with substantial care needs. The intention of male and female workers to change jobs and exit the labor market is shaped by the different characteristics of informal caregiving. Time-based conflicts between informal care and paid work are associated with a higher relative risk of anticipating job changes for female workers. Flextime facilitates the job and labor market attachment of female workers with eldercare responsibilities. The intensity of personal care provided to an older relative is significantly positively related to male workers' relative risk of anticipated labor market exit. Care to an older person in need of supervision makes the labor market exit of female workers less likely, lending thus support to the idea of the respite

  6. Corneal ring infiltration in contact lens wearers

    Directory of Open Access Journals (Sweden)

    Seyed Ali Tabatabaei

    2017-01-01

    Full Text Available To report a case of atypical sterile ring infiltrates during wearing soft silicone hydrogel contact lens due to poor lens care. A 29-year-old woman presented with complaints of pain, redness, and morning discharge. She was wearing soft silicone hydrogel contact lens previously; her current symptoms began 1 week before presentation. On examination, best-corrected visual acuity was 20/40 in that eye. Slit-lamp examination revealed dense, ring-shaped infiltrate involving both the superficial and deep stromal layers with lucid interval to the limbus, edema of the epithelium, epithelial defect, and vascularization of the superior limbus. Cornea-specific in vivo laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM, Heidelberg Engineering GmbH, Dossenheim, Germany revealed Langerhans cells and no sign of Acanthamoeba or fungal features, using lid scraping and anti-inflammatory drops; her vision completely recovered. We reported an atypical case of a sterile corneal ring infiltrate associated with soft contact lens wearing; smear, culture, and confocal microscopy confirmed a sterile inflammatory reaction.

  7. Growth of the Asian health-care market: global implications for the pharmaceutical industry.

    Science.gov (United States)

    Epstein, Richard J

    2007-10-01

    The global economy is being transformed by an explosion of information unleashed by the internet, the digital revolution, communications and increased international mobility. This transformation is manifesting in many ways, including rapid development of countries such as China, commoditization of public services, mobilization of workforces, shifting of market control from suppliers to consumers, interlinked rises in product demand and customer expectations, and problems regulating international business competition. As Asia is home to half of the world's population, and offers both a large relatively low-cost workforce in some countries and a potentially huge retail market, this region could be central to the future of the global economy. Like other industries, the pharmaceutical industry faces a new array of Asia-specific opportunities and challenges. Success in meeting these challenges will go to those pharmaceutical companies that best understand the unique strengths and constraints of Asia's diverse cultures, talents and markets.

  8. Child-Care and Participation in the Labor Market for Married Women in Mediterranean Countries

    OpenAIRE

    Nicodemo, Catia; Waldmann, Robert

    2009-01-01

    Parents in the labor force have balance their work and home life, including the choice of the type of care to provide for their children while they work. In this paper we study the connection between the married women's labor force participation, child care arrangements and the time that husbands and wives spent to take care of children in Mediterranean countries. As more women now are in the labor force the interest in the use child care and housework of husband have grown. We use the new da...

  9. Using cognitive concept mapping to understand what health care means to the elderly: an illustrative approach for planning and marketing.

    Science.gov (United States)

    Shewchuk, Richard; O'Connor, Stephen J

    2002-01-01

    This article describes a process that can be used for eliciting and systematically organizing perceptions held by key stakeholders. An example using a limited sample of older Medicare recipients is developed to illustrate how this approach can be used. Internally, a nominal group technique (NGT) meeting was conducted to identify an array of health care issues that were perceived as important by this group. These perceptions were then used as stimuli to develop an unforced card sort task. Data from the card sorts were analyzed using multidimensional scaling and hierarchical cluster analysis to demonstrate how qualitative input of participants can be organized. The results of these analyses are described to illustrate an example of an interpretive framework that might be used when seeking input from relevant constituents. Suggestions for how this process might be extended to health care planning/marketing efforts are provided.

  10. Developing social marketed individual preconception care consultations: Which consumer preferences should it meet?

    NARCIS (Netherlands)

    S.F. van Voorst (Sabine); C.A. Ten Kate (Chantal A.); L.C. de Jong-Potjer (L.); E.A.P. Steegers (Eric); S. Denktaş (Semiha)

    2017-01-01

    textabstractAims: Preconception care (PCC) is care that aims to improve the health of offspring by addressing risk factors in the pre-pregnancy period. Consultations are recognized as a method to promote perinatal health. However, prospective parents underutilize PCC services. Uptake can improve if

  11. Bringing the Market Back In? Institutional complementarity and hierarchy in Dutch housing and health care

    NARCIS (Netherlands)

    J-K. Helderman

    2007-01-01

    textabstractFrom the 1980s onwards, governments began to rediscover the benefits of the market as an alternative governance mechanism for allocation in systems of social provisions. Yet, if social policy regimes are delegated the task of providing goods and services that are not easily produced by

  12. A Correlation of Thin Lens Approximation to Thick Lens Design by Using Coddington Factors in Lens Design and Manufacturing

    OpenAIRE

    FARSAKOĞLU, Ö. Faruk

    2014-01-01

    The effect of Coddington factors on aberration functions has been analysed using thin lens approximation. Minimizing spherical aberrations of singlet lenses using Coddington factors in lens design depending on lens manufacturing is discussed. Notation of lens test plate pairs used in lens manufacturing is also presented in terms of Coddington shape factors.

  13. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Muzigaba, Moise; van Wyk, Brian; Puoane, Thandi

    2018-01-01

    Background Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. Objective To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. Methods An explora...

  14. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

    OpenAIRE

    Moise Muzigaba; Brian van Wyk; Thandi Puoane

    2018-01-01

    Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.Objective: To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.Methods: An explor...

  15. Corrupt practices in chinese medical care: the root in public policies and a call for Confucian-market approach.

    Science.gov (United States)

    Fan, Ruiping

    2007-06-01

    This paper argues that three salient corrupt practices that mark contemporary Chinese health care, namely the over-prescription of indicated drugs, the prescription of more expensive forms of medication and more expensive diagnostic work-ups than needed, and illegal cash payments to physicians-i.e., red packages-result not from the introduction of the market to China, but from two clusters of circumstances. First, there has been a loss of the Confucian appreciation of the proper role of financial reward for good health care. Second, misguided governmental policies have distorted the behavior of physicians and hospitals. The distorting policies include (1) setting very low salaries for physicians, (2) providing bonuses to physicians and profits to hospitals from the excessive prescription of drugs and the use of more expensive drugs and unnecessary expensive diagnostic procedures, and (3) prohibiting payments by patients to physicians for higher quality care. The latter problem is complicated by policies that do not allow the use of governmental insurance and funds from medical savings accounts in private hospitals as well as other policies that fail to create a level playing field for both private and government hospitals. The corrupt practices currently characterizing Chinese health care will require not only abolishing the distorting governmental policies but also drawing on Confucian moral resources to establish a rightly directed appreciation of the proper place of financial reward in the practice of medicine.

  16. Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform.

    Science.gov (United States)

    Felland, Laurie E; Grossman, Joy M; Tu, Ha T

    2011-05-01

    Lingering fallout--loss of jobs and employer coverage--from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Hospitals with significant market clout continued to command high payment rate increases from private insurers, and tighter hospital-physician alignment heightened concerns about growing provider market power. High and rising premiums led to increasing employer adoption of consumer-driven health plans and continued increases in patient cost sharing, but the broader movement to educate and engage consumers in care decisions did not keep pace. State and local budget deficits led to some funding cuts for safety net providers, but an influx of federal stimulus funds increased support to community health centers and shored up Medicaid programs, allowing many people who lost private insurance because of job losses to remain covered. Hospitals, physicians and insurers generally viewed health reform coverage expansions favorably, but all worried about protecting revenues as reform requirements phase in.

  17. Market competition, ownership, payment systems and the performance of health care providers - a panel study among Finnish occupational health services providers.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2013-10-01

    Many health care reforms rely on competition although health care differs in many respects from the assumptions of perfect competition. Finnish occupational health services provide an opportunity to study empirically competition, ownership and payment systems and the performance of providers. In these markets employers (purchasers) choose the provider and prices are market determined. The price regulation of public providers was abolished in 1995. We had data on providers from 1992, 1995, 1997, 2000 and 2004. The unbalanced panel consisted of 1145 providers and 4059 observations. Our results show that in more competitive markets providers in general offered a higher share of medical care compared to preventive services. The association between unit prices and revenues and market environment varied according to the provider type. For-profit providers had lower prices and revenues in markets with numerous providers. The public providers in more competitive regions were more sensitive to react to the abolishment of their price regulation by raising their prices. Employer governed providers had weaker association between unit prices or revenues and competition. The market share of for-profit providers was negatively associated with productivity, which was the only sign of market spillovers we found in our study.

  18. Grounding the Marketing Strategy of the Organizations in the Field of Health Care

    Directory of Open Access Journals (Sweden)

    Iuliana Cetina

    2009-03-01

    Full Text Available The application of marketing in the health services presents certain particularities determined by market characteristics, of the organizations, products, staff and consumers. The consumers of health services are different of those of other goods and services, due to the lack of information concerning the means of rendering a service and its price, the means of taking a decision, the purchase and consume conduit, the capacity limited by the assessment of the services’ and result quality. In addition, within the last years there have been registered major changes in the conduit of the consumer of health services pursuant to the significant modifications occurred at the demographic and social level.Under these conditions, the grounding of the strategies of the organizations which function in the health field, both at macroeconomic, and microeconomic level, cannot be performed without a deep knowledge of the consumer of health services, with its needs, preferences, and its conduit of purchase and consume.

  19. Factors affecting the entry of for-profit providers into a price regulated market for formal long-term care services: a case study from Japan.

    Science.gov (United States)

    Tokunaga, Mutsumi; Hashimoto, Hideki

    2013-01-01

    While the distinct behaviors of for-profit and non-profit providers in the healthcare market have been compared in the economic literature, their choices regarding market entry and exit have only recently been debated. Since 2000, when public Long-Term Care Insurance was introduced in Japan, for-profit providers have been able to provide formal long-term homecare services. The aim of this study is to determine which factors have affected market entry of for-profit providers under price regulation and in competition with existing non-profit providers. We used nation-wide panel data from 2002 to 2010, aggregated at the level of local public insurers (n = 1557), a basic area unit of service provision. The number of for-profit providers per elderly population in the area unit was regressed against factors related to local demand and service costs using first-difference linear regression, a fixed effects model, and Tobit regression for robustness checking. Results showed that demand (the number of eligible care recipients) and cost factors (population density and minimum wage) significantly influenced for-profit providers' choice of market entry. These findings indicate that for-profit providers will strategically choose a local market for maximizing profit. We believe that price regulation should be redesigned to incorporate quality of care and market conditions, regardless of the profit status of the providers, to ensure equal access to efficient delivery of long-term care across all regions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. CUSTOMER CARE - A TOTALLY IGNORED MANAGEMENT TOOL ON THE ROMANIAN SERVICES MARKET

    Directory of Open Access Journals (Sweden)

    Roxana SÂRBU

    2009-06-01

    Full Text Available Quality and customer satisfaction are important subjects receiving increasing attention worldwide. An organization's ability to remain in business depends entirely on its ability to win and retain customers. The nature and number of competitors and their ability to offer similar products/services at similar prices has led to increasing emphasis being placed on customer care. Customer care is about people pleasing people and it involves specific actions that keep customers satisfied and coming back for more.

  1. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  2. Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.

    Science.gov (United States)

    Muzigaba, Moise; Van Wyk, Brian; Puoane, Thandi

    2018-01-30

    Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff) using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis. Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians. Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a

  3. Proceedings of the CERI 2006 natural gas conference : North American markets : fragile, handle with care

    International Nuclear Information System (INIS)

    2006-01-01

    This conference was attended by decision makers throughout the supply chain in the natural gas industry who face the continuing challenges of changes in market mechanisms, pricing options, and transmission alternatives. It provided an opportunity to review issues affecting producers, shippers, marketers, and end-users in an environment of tight energy markets and high, inelastic demand. The constraints on adequate energy supplies are influenced by economic factors, current and future resources, materials, equipment, skilled labour, technology and financial capital. The 8 sessions of the conference dealt with the tight North American gas supply; the slow development of new supplies; resource access issues, including politics and supply security; the geopolitics of natural gas; impacts of high prices on the North American economy; energy industry impacts of high natural gas prices; domestic politics and high natural gas prices; and, radical planning scenarios for the future of natural gas. The conference featured 23 presentations, of which 6 have been catalogued separately for inclusion in this database. refs., tabs., figs

  4. Ethical aspects of future health care: globalisation of markets and differentiation of societies - ethical challenges.

    Science.gov (United States)

    Kluge, Eike-Henner W

    2008-01-01

    The shift in health care to an aggregate corporate and distributed model dominated by electronic methods of diagnosis, record-keeping and communication spanning jurisdictional boundaries raises technical, social and paradigmatic issues. The technical issues concern the material natures of the tools, devices, procedures and protocols; the social issues gravitate around abstract matters like individual rights and models of responsibility within a corporate setting and accountability in inter-jurisdictional contexts; the paradigmatic issues centre in the question of how the rights and duties of traditional and direct health care translate into the mediated context of the globally expanded corporate model of eHealth and telemedicine. The present discussion presents a brief overview of the issues and sketches some of their implications for the evolution of contemporary health care.

  5. Dealing with labor shortages in long-term care: a marketing problem.

    Science.gov (United States)

    Moore, S T

    1990-01-01

    A recent analysis of data from the Bureau of Labor statistics raise serious implications for the long-term care industry. The human resource problems faced by managers in long-term care will escalate into a fullblown crisis by the end of this century. This will result from a decrease in the number of young workers available to work in unskilled and semiskilled occupations. The effect of this shortage will be exaggerated by an expansion of other sectors of the service industry. Long-term care facilities will be forced to compete with the fast food and retail industry as well as other sectors of the health industry for scarce workers. This article briefly examines the causes, consequences of this problem and suggests several strategies to mitigate the effect of the coming labor shortage.

  6. Characteristics of the thick, compound refractive lens

    International Nuclear Information System (INIS)

    Pantell, Richard H.; Feinstein, Joseph; Beguiristain, H. Raul; Piestrup, Melvin A.; Gary, Charles K.; Cremer, Jay T.

    2003-01-01

    A compound refractive lens (CRL), consisting of a series of N closely spaced lens elements each of which contributes a small fraction of the total focusing, can be used to focus x rays or neutrons. The thickness of a CRL can be comparable to its focal length, whereupon a thick-lens analysis must be performed. In contrast with the conventional optical lens, where the ray inside the lens follows a straight line, the ray inside the CRL is continually changing direction because of the multiple refracting surfaces. Thus the matrix representation for the thick CRL is quite different from that for the thick optical lens. Principal planes can be defined such that the thick-lens matrix can be converted to that of a thin lens. For a thick lens the focal length is greater than for a thin lens with the same lens curvature, but this lengthening effect is less for the CRL than for the conventional optical lens

  7. Hospital cost and quality performance in relation to market forces: an examination of U.S. community hospitals in the "post-managed care era".

    Science.gov (United States)

    Jiang, H Joanna; Friedman, Bernard; Jiang, Shenyi

    2013-03-01

    Managed care substantially transformed the U.S. healthcare sector in the last two decades of the twentieth century, injecting price competition among hospitals for the first time in history. However, total HMO enrollment has declined since 2000. This study addresses whether managed care and hospital competition continued to show positive effects on hospital cost and quality performance in the "post-managed care era." Using data for 1,521 urban hospitals drawn from the Healthcare Cost and Utilization Project, we examined hospital cost per stay and mortality rate in relation to HMO penetration and hospital competition between 2001 and 2005, controlling for patient, hospital, and other market characteristics. Regression analyses were employed to examine both cross-sectional and longitudinal variation in hospital performance. We found that in markets with high HMO penetration, increase in hospital competition over time was associated with decrease in mortality but no change in cost. In markets without high HMO penetration, increase in hospital competition was associated with increase in cost but no change in mortality. Overall, hospitals in high HMO penetration markets consistently showed lower average costs, and hospitals in markets with high hospital competition consistently showed lower mortality rates. Hospitals in markets with high HMO penetration also showed lower mortality rates in 2005 with no such difference found in 2001. Our findings suggest that while managed care may have lost its strength in slowing hospital cost growth, differences in average hospital cost associated with different levels of HMO penetration across markets still persist. Furthermore, these health plans appear to put quality of care on a higher priority than before.

  8. Market reforms in health care and sustainability of the welfare state

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1995-01-01

    and therefore their evaluation of the services in the welfarist sense equally important. That loyalty was however threatened in a situation where cost-containment policies were applied while equity principles were still a strong priority. Health care utilization was increasing among the very old and chronically...

  9. The management of external marketing communication instruments in health care services.

    Science.gov (United States)

    Bobocea, L; Spiridon, St; Petrescu, L; Gheorghe, C M; Purcarea, V L

    2016-01-01

    In order to become known and attract consumers, a health care organization has to develop suitable external communication campaigns. Consequently, management instruments are employed to effectively evaluate the success of a campaign. The BCG Matrix, SWOT analysis and the Gantt Diagram were used in this paper to ensure the consistency and accuracy of the external communication process at an empirical level.

  10. Niche Marketing: Branding Your Early Child Care and Education Business without Getting Burned

    Science.gov (United States)

    Wassom, Julie

    2004-01-01

    Branding in the early child care and education marketplace is very similar to branding on the farm. It refers to the specific image the company develops and promotes to make services unique, recognizable, and memorable in the minds of prospects and customers. This article discusses how to establish a niche in a business, develop a brand, and…

  11. E-health business model dynamics in long term care: case studies in the Dutch market

    NARCIS (Netherlands)

    Hein Roelfsema; Roderick Udo; Dr. H.S.M. Kort

    2012-01-01

    Full text via link One of the most important drivers of change in the health care sector is the desire of elderly people to age in place. The growing use of internet applications and communication technology together with innovations in buildings have created new commercial opportunities to cater

  12. The role of the sickness funds in the Belgian health care market

    NARCIS (Netherlands)

    W. Nonneman (Nonneman); E.K.A. van Doorslaer (Eddy)

    1994-01-01

    textabstractThis article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance

  13. Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

    Science.gov (United States)

    Séror, Ann C

    2002-12-01

    The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

  14. Market Power in Laboratory Emission Permit Markets

    International Nuclear Information System (INIS)

    Godby, R.

    2002-01-01

    Many proposals suggesting the use of markets to control pollution assume markets will be competitive. When markets do not exhibit competitive characteristics, however, should they still be expected to result in efficiency improvement relative to traditional approaches? This paper employs experimental economic methods to examine the effect of market structure on the use of marketable emissions permits. Results indicate that in a market with one dominant firm and a number of fringe firms, strategic manipulation occurs repeatedly in the laboratory as predicted by market power models, undermining the allocative and dynamic efficiency benefits such markets offer. When firms compete in a downstream product market dominated by the same single firm, market efficiency can actually be reduced with the implementation of permit markets. Final market efficiencies reflect initial endowments and are influenced by competitive conditions elsewhere in the economy, indicating that policy-makers should carefully consider whether markets are appropriate in such circumstances

  15. Development and pilot study of a marketing strategy for primary care/internet-based depression prevention intervention for adolescents (the CATCH-IT intervention).

    Science.gov (United States)

    Van Voorhees, Benjamin W; Watson, Natalie; Bridges, John F P; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A; Ellis, Justin; Prochaska, Micah; Bell, Carl

    2010-01-01

    Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. The marketing plan focused on "resiliency building" rather than "depression intervention" and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1-10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

  16. The Rise and Need for Mobile Apps for Maternal and Child Health Care in China: Survey Based on App Markets.

    Science.gov (United States)

    Zhang, Puhong; Dong, Le; Chen, Huan; Chai, Yanling; Liu, Jianbo

    2018-06-08

    Mobile health services are thriving in the field of maternal and child health in China due to expansions in the field of electronic health and the introduction of the two-child policy. There are numerous maternal and child health apps in computer stores, but the exact number of apps, number of downloads, and features of these apps is not known. This study aimed to explore the use of maternal and child health apps in Android and iOS app stores and to describe the key functional features of the most popular apps, with the purpose of providing insight into further research and development of maternal and child health mobile health products. The researchers conducted a search in the 3 most popular Android app stores (Tencent MyApp, Baidu Mobile Assistant, and 360 Mobile Assistant) and the iTunes App Store in China. All apps regarding family planning (contraception and preparing for pregnancy), pregnancy and perinatal care, neonatal care and health, and development for children under 6 years were included in the initial analysis. Maternal and child health mobile apps with predominant features of product marketing, children's songs, animation, or games were excluded from the study. The 50 most frequently used apps in each of the Android stores as well as the iTunes store (a total of 78 deduplicated apps) were selected and downloaded for an in-depth analysis. A total of 5276 Android apps and 877 iOS apps developed for maternal and child health care were identified. Of the 78 most frequently used apps, 43 (55%) apps focused on one stage of MCH care, mainly targeting child care (25 apps) and before pregnancy care (11 apps), whereas 35 (45%) of the apps covered 2 or more stages, most of which (32 apps) included both pregnancy and child care services. The app features that were commonly adopted by the popular apps were health education, communication, health status self-monitoring, a diary, reminders, and counseling. Within the app feature of "health status self

  17. Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

    Science.gov (United States)

    Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

    2017-01-01

    This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability. PMID:28634428

  18. The emotional costs of caring incurred by men and women in the British labour market.

    Science.gov (United States)

    Barron, David Nicholas; West, Elizabeth

    2007-11-01

    This study investigates whether men and women in caring occupations experience more negative job-related feelings at the end of the day compared to the rest of the working population. The data are from Wave Nine of the British Household Panel Survey (1999) where respondents were asked whether, at the end of the working day, they tended to keep worrying or have trouble unwinding, and the extent to which work left them feeling exhausted or "used up." Their responses to these questions were used to develop ordinal dependent variables. Control variables in the models include: number of children, age, hours worked per week, managerial responsibilities and job satisfaction, all of which have been shown in previous research to be significantly related to "job burnout." The results are that those in caring occupations are more likely to feel worried, tense, drained and exhausted at the end of the working day. Women in particular appear to pay a high emotional cost for working in caring occupations. Men do not emerge unscathed, but report significantly lower levels of worry and exhaustion at the end of the day than do women.

  19. Photographic zoom fisheye lens design for DSLR cameras

    Science.gov (United States)

    Yan, Yufeng; Sasian, Jose

    2017-09-01

    Photographic fisheye lenses with fixed focal length for cameras with different sensor formats have been well developed for decades. However, photographic fisheye lenses with variable focal length are rare on the market due in part to the greater design difficulty. This paper presents a large aperture zoom fisheye lens for DSLR cameras that produces both circular and diagonal fisheye imaging for 35-mm sensors and diagonal fisheye imaging for APS-C sensors. The history and optical characteristics of fisheye lenses are briefly reviewed. Then, a 9.2- to 16.1-mm F/2.8 to F/3.5 zoom fisheye lens design is presented, including the design approach and aberration control. Image quality and tolerance performance analysis for this lens are also presented.

  20. Optical architecture of HoloLens mixed reality headset

    Science.gov (United States)

    Kress, Bernard C.; Cummings, William J.

    2017-06-01

    HoloLens by Microsoft Corp. is the world's first untethered Mixed Reality (MR) Head Mounted Display (HMD) system, released to developers in March 2016 as a Development Kit. We review in this paper the various display requirements and subsequent optical hardware choices we made for HoloLens. Its main achievements go along performance and comfort for the user: it is the first fully untethered MR headset, with the highest angular resolution and the industry's largest eyebox. It has the first inside-out global sensor fusion system including precise head tracking and 3D mapping all controlled by a fully custom on-board GPU. Based on such achievements, HoloLens came out as the most advanced MR system today. Additional features may be implemented in next generations MR headsets, leading to the ultimate experience for the user, and securing the upcoming fabulous AR/MR market predicted by most analysts.

  1. Investigation into photostability of soybean oils by thermal lens spectroscopy

    Science.gov (United States)

    Savi, E. L.; Malacarne, L. C.; Baesso, M. L.; Pintro, P. T. M.; Croge, C.; Shen, J.; Astrath, N. G. C.

    2015-06-01

    Assessment of photochemical stability is essential for evaluating quality and the shelf life of vegetable oils, which are very important aspects of marketing and human health. Most of conventional methods used to investigate oxidative stability requires long time experimental procedures with high consumption of chemical inputs for the preparation or extraction of sample compounds. In this work we propose a time-resolved thermal lens method to analyze photostability of edible oils by quantitative measurement of photoreaction cross-section. An all-numerical routine is employed to solve a complex theoretical problem involving photochemical reaction, thermal lens effect, and mass diffusion during local laser excitation. The photostability of pure oil and oils with natural and synthetic antioxidants is investigated. The thermal lens results are compared with those obtained by conventional methods, and a complete set of physical properties of the samples is presented.

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not been properly fitted by an eye care professional, the lenses stuck to my eye like a ... prescription and proper fitting by an eye-care professional. Retailers that sell contacts without a prescription are ...

  3. 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

  4. Crystalline lens radioprotectors

    International Nuclear Information System (INIS)

    Belkacemi, Y.; Pasquier, D.; Castelain, B.; Lartigau, E.; Warnet, J.M.

    2003-01-01

    During more than a half of century, numerous compounds have been tested in different models against radiation-induced cataract. In this report, we will review the radioprotectors that have been already tested for non-human crystalline lens protection. We will focus on the most important published studies in this topic and the mechanisms of cyto-protection reported in. vitro and in. vivo from animals. The most frequent mechanisms incriminated in the cyto-protective effect are: free radical scavenging, limitation of lipid peroxidation, modulation of cycle progression increase of intracellular reduced glutathione pool, reduction of DNA strand breaks and limitation of apoptotic cell death. Arnifostine (or Ethyol) and anethole dithiolethione (or Sulfarlem), already used clinically as chemo- and radio-protectants, could be further test?r for ocular radioprotection particularly for radiation-induced cataract. (author)

  5. Wedged multilayer Laue lens

    International Nuclear Information System (INIS)

    Conley, Ray; Liu Chian; Qian Jun; Kewish, Cameron M.; Macrander, Albert T.; Yan Hanfei; Maser, Joerg; Kang, Hyon Chol; Stephenson, G. Brian

    2008-01-01

    A multilayer Laue lens (MLL) is an x-ray focusing optic fabricated from a multilayer structure consisting of thousands of layers of two different materials produced by thin-film deposition. The sequence of layer thicknesses is controlled to satisfy the Fresnel zone plate law and the multilayer is sectioned to form the optic. An improved MLL geometry can be created by growing each layer with an in-plane thickness gradient to form a wedge, so that every interface makes the correct angle with the incident beam for symmetric Bragg diffraction. The ultimate hard x-ray focusing performance of a wedged MLL has been predicted to be significantly better than that of a nonwedged MLL, giving subnanometer resolution with high efficiency. Here, we describe a method to deposit the multilayer structure needed for an ideal wedged MLL and report our initial deposition results to produce these structures

  6. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    Science.gov (United States)

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-04-03

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

  7. A report card on the physician work force: Israeli health care market--past experience and future prospects.

    Science.gov (United States)

    Toker, Asaf; Shvarts, Shifra; Glick, Shimon; Reuveni, Haim

    2010-09-01

    The worldwide shortage of physicians is due not only to the lack of physicians, but also to complex social and economic factors that vary from country to country. To describe the results of physician workforce planning in a system with unintended policy, such as Israel, based on past experience and predicted future trends, between 1995 and 2020. A descriptive study of past (1995-2009) and future (through 2020) physician workforce trends in Israel. An actuarial equation was developed to project physician supply until 2020. In Israel a physician shortage is expected in the very near future. This finding is the result of global as well as local changes affecting the supply of physicians: change in immigration pattern, gender effect, population growth, and transparency of data on demand for physicians. These are universal factors affecting manpower planning in most industrial countries all over the world. We describe a health care market with an unintended physician workforce policy. Sharing decision makers' experience in similar health care systems will enable the development of better indices to analyze, by comparison, effective physician manpower planning processes, worldwide.

  8. The effect of provider control of Blue Shield plans on health care markets.

    Science.gov (United States)

    Arnould, R J; DeBrock, L M

    1985-07-01

    Blue Shield plans often are granted regulatory advantages by the states in which they operate. Run efficiently, such not-for-profit firms should use these lower costs to eliminate their less advantaged rivals, the commercial insurers. However, these higher-cost commercial providers have been able to offer insurance coverage at prices competitive with the Blues, as evidenced by the fact that Blue plans have, on average, less than 50 percent market share. Similar prices with lower overall costs implies that economic rents are being earned, rents which a not-for-profit firm cannot distribute to owners. In this paper we argue that when there are competing goals among the groups controlling the Blue Shield plans, the different possible "uses" of the regulatory advantage become endogenously determined, necessitating the use of simultaneous equation estimation. Testing this model we find the major effect of doctor-control of Blue Shield plans is to raise doctors' fees while lowering the amount of rents captured by both consumers and administrators.

  9. Bifocal liquid lens zoom objective for mobile phone applications

    Science.gov (United States)

    Wippermann, F. C.; Schreiber, P.; Bräuer, A.; Craen, P.

    2007-02-01

    Miniaturized camera systems are an integral part of today's mobile phones which recently possess auto focus functionality. Commercially available solutions without moving parts have been developed using the electrowetting technology. Here, the contact angle of a drop of a conductive or polar liquid placed on an insulating substrate can be influenced by an electric field. Besides the compensation of the axial image shift due to different object distances, mobile phones with zoom functionality are desired as a next evolutionary step. In classical mechanically compensated zoom lenses two independently driven actuators combined with precision guides are needed leading to a delicate, space consuming and expansive opto-mechanical setup. Liquid lens technology based on the electrowetting effect gives the opportunity to built adaptive lenses without moving parts thus simplifying the mechanical setup. However, with the recent commercially available liquid lens products a completely motionless and continuously adaptive zoom system with market relevant optical performance is not feasible. This is due to the limited change in optical power the liquid lenses can provide and the dispersion of the used materials. As an intermediate step towards a continuously adjustable and motionless zoom lens we propose a bifocal system sufficient for toggling between two effective focal lengths without any moving parts. The system has its mechanical counterpart in a bifocal zoom lens where only one lens group has to be moved. In a liquid lens bifocal zoom two groups of adaptable liquid lenses are required for adjusting the effective focal length and keeping the image location constant. In order to overcome the difficulties in achromatizing the lens we propose a sequential image acquisition algorithm. Here, the full color image is obtained from a sequence of monochrome images (red, green, blue) leading to a simplified optical setup.

  10. Towards the marketization of early childhood education and care? Recent developments in Sweden and the United Kingdom

    Directory of Open Access Journals (Sweden)

    Ingela Naumann

    2011-06-01

    Full Text Available Normal 0 21 false false false NO-BOK X-NONE X-NONE MicrosoftInternetExplorer4 st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Vanlig tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Vanlig tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Extensive public debate is being waged across mature welfare states as to whether social services are best provided by the state or the market. This article examines developments in Early Childhood Education and Care (ECEC policy in Sweden and the United Kingdom, identifying trends towards marketization and universalization of ECEC that suggest a complex picture of competing policy logics and goals in the restructuring of welfare states. This article first

  11. Customer loyalty among daily disposable contact lens wearers.

    Science.gov (United States)

    Patel, Neelam I; Naroo, Shehzad A; Eperjesi, Frank; Rumney, Nicholas J

    2015-02-01

    Optometric practices offer contact lenses as cash sale items or as part of monthly payment plans. With the contact lens market becoming increasingly competitive, patients are opting to purchase lenses from supermarkets and Internet suppliers. Monthly payment plans are often implemented to improve loyalty. This study aimed to compare behavioural loyalty between monthly payment plan members and non-members. BBR Optometry Ltd offers a monthly payment plan (Eyelife™) to their contact lens wearers. A retrospective audit of 38 Eyelife™ members (mean±SD: 42.7±15.0 years) and 30 non-members (mean±SD: 40.8±16.7 years) was conducted. Revenue and profits generated, service uptake and product sales between the two groups were compared over a fixed period of 18 months. Eyelife™ members generated significantly higher professional fee revenue (Ployalty among contact lens wearers, particularly service uptake and volume of lens purchases. Additionally the greater professional fees generated, render monthly payment plans an attractive business model and practice builder. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Athermal design and analysis of glass-plastic hybrid lens

    Science.gov (United States)

    Yang, Jian; Cen, Zhaofeng; Li, Xiaotong

    2018-01-01

    With the rapid development of security market, the glass-plastic hybrid lens has gradually become a choice for the special requirements like high imaging quality in a wide temperature range and low cost. The reduction of spherical aberration is achieved by using aspherical surface instead of increasing the number of lenses. Obviously, plastic aspherical lens plays a great role in the cost reduction. However, the hybrid lens has a priority issue, which is the large thermal coefficient of expansion of plastic, causing focus shift and seriously affecting the imaging quality, so the hybrid lens is highly sensitive to the change of temperature. To ensure the system operates normally in a wide temperature range, it is necessary to eliminate the influence of temperature on the hybrid lens system. A practical design method named the Athermal Material Map is summarized and verified by an athermal design example according to the design index. It includes the distribution of optical power and selection of glass or plastic. The design result shows that the optical system has excellent imaging quality at a wide temperature range from -20 ° to 70 °. The method of athermal design in this paper has generality which could apply to optical system with plastic aspherical surface.

  13. Patient Protection and Affordable Care Act; exchange and insurance market standards for 2015 and beyond. Final rule.

    Science.gov (United States)

    2014-05-27

    This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (``Exchanges''), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio

  14. Contact Lens Safety (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-08-18

    Contact lenses are a convenient alternative to glasses, but improper care and use can result in infections which can lead to eye damage. This podcast discusses contact lens safety.  Created: 8/18/2016 by MMWR.   Date Released: 8/18/2016.

  15. Mechanically assisted liquid lens zoom system for mobile phone cameras

    Science.gov (United States)

    Wippermann, F. C.; Schreiber, P.; Bräuer, A.; Berge, B.

    2006-08-01

    Camera systems with small form factor are an integral part of today's mobile phones which recently feature auto focus functionality. Ready to market solutions without moving parts have been developed by using the electrowetting technology. Besides virtually no deterioration, easy control electronics and simple and therefore cost-effective fabrication, this type of liquid lenses enables extremely fast settling times compared to mechanical approaches. As a next evolutionary step mobile phone cameras will be equipped with zoom functionality. We present first order considerations for the optical design of a miniaturized zoom system based on liquid-lenses and compare it to its mechanical counterpart. We propose a design of a zoom lens with a zoom factor of 2.5 considering state-of-the-art commercially available liquid lens products. The lens possesses auto focus capability and is based on liquid lenses and one additional mechanical actuator. The combination of liquid lenses and a single mechanical actuator enables extremely short settling times of about 20ms for the auto focus and a simplified mechanical system design leading to lower production cost and longer life time. The camera system has a mechanical outline of 24mm in length and 8mm in diameter. The lens with f/# 3.5 provides market relevant optical performance and is designed for an image circle of 6.25mm (1/2.8" format sensor).

  16. Contact Lens-Related Eye Infections

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Contact Lens-Related Eye Infections Sections Contact Lens-Related Eye ... Six Steps to Avoid Contact Lens Infections Contact Lens-Related Eye Infections Leer en Español: Infecciones relacionadas ...

  17. 21 CFR 886.1375 - Bagolini lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bagolini lens. 886.1375 Section 886.1375 Food and... OPHTHALMIC DEVICES Diagnostic Devices § 886.1375 Bagolini lens. (a) Identification. A Bagolini lens is a device that consists of a plane lens containing almost imperceptible striations that do not obscure...

  18. Straylight Measurements in Contact Lens Wear

    NARCIS (Netherlands)

    van der Meulen, Ivanka J. E.; Engelbrecht, Leonore A.; van Vliet, Johannes M. J.; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; Mourits, Maarten P.; Schlingemann, Reinier O.; van den Berg, Thomas J. T. P.

    2010-01-01

    Purpose: (1) To quantify the effect of contact lens wear on straylight in rigid and soft contact lens wearers and (2) to relate findings to morphological changes and subjective complaints. Methods: Straylight was measured using the Oculus C-Quant during contact lens wear and after contact lens

  19. Immunohistochemical studies of lens crystallins in the dysgenetic lens (dyl) mutant mice

    NARCIS (Netherlands)

    Brahma, S.K.; Sanyal, S.

    1984-01-01

    The lens in the dyl mutant mice shows a persistent lens-ectodermal connection as well as degeneration and extrusion of lens materials after the initial differentiation of the fibres. Immunohistochemical investigation of the ontogeny of the lens crystallins in this developing mutant lens has been

  20. A Study on Sources of Health Financing in Nigeria: Implications for Health care Marketers and Planners

    Directory of Open Access Journals (Sweden)

    Rotimi Ayodele Gbadeyan

    2016-01-01

    Full Text Available There have been increasing difficulties in providing qualitative health care services to the public in Nigeria. The development has called for the need to examine ways through which government and other stakeholders resolve these crises in the health sector. The objective of this paper is to examine the level of Government spending to total Health expenditures in Nigeria. This study basically employs secondary data for analysis. The secondary data are provided from the World Bank Development indicators and Internet. The data was analyzed using the Pearson Correlation Coefficient Statistical technique. The result revealed a strong positive Correlation (r = 0.634 between Government Health Spending and Total Health Spending. This indicates that Government Health Spending constitutes a significant proportion of the Total Health Expenditures in Nigeria; despite complains about inadequate health financing. In conclusion, the Nigerian Health sector would become more vibrant, if the Government and the Private sector are ready to give the necessary commitments required to achieve the laudable objective of qualitative health for all. The study recommends for more Government Health funding towards tackling the prevalence of some chronic diseases such as HIV, Asthma, Tuberculosis, Meningitis and Paralysis, etc.

  1. Contact Lens Related Corneal Ulcer

    OpenAIRE

    Loh, KY; Agarwal, P

    2010-01-01

    A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are: overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. Th...

  2. Crystalline lens and refractive development.

    Science.gov (United States)

    Iribarren, Rafael

    2015-07-01

    Individual refractive errors usually change along lifespan. Most children are hyperopic in early life. This hyperopia is usually lost during growth years, leading to emmetropia in adults, but myopia also develops in children during school years or during early adult life. Those subjects who remain emmetropic are prone to have hyperopic shifts in middle life. And even later, at older ages, myopic shifts are developed with nuclear cataract. The eye grows from 15 mm in premature newborns to approximately 24 mm in early adult years, but, in most cases, refractions are maintained stable in a clustered distribution. This growth in axial length would represent a refractive change of more than 40 diopters, which is compensated by changes in corneal and lens powers. The process which maintains the balance between the ocular components of refraction during growth is still under study. As the lens power cannot be measured in vivo, but can only be calculated based on the other ocular components, there have not been many studies of lens power in humans. Yet, recent studies have confirmed that the lens loses power during growth in children, and that hyperopic and myopic shifts in adulthood may be also produced by changes in the lens. These studies in children and adults give a picture of the changing power of the lens along lifespan. Other recent studies about the growth of the lens and the complexity of its internal structure give clues about how these changes in lens power are produced along life. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Single lens laser beam shaper

    Science.gov (United States)

    Liu, Chuyu [Newport News, VA; Zhang, Shukui [Yorktown, VA

    2011-10-04

    A single lens bullet-shaped laser beam shaper capable of redistributing an arbitrary beam profile into any desired output profile comprising a unitary lens comprising: a convex front input surface defining a focal point and a flat output portion at the focal point; and b) a cylindrical core portion having a flat input surface coincident with the flat output portion of the first input portion at the focal point and a convex rear output surface remote from the convex front input surface.

  4. The market will take care of that. Real Investment Practices on the Deregulated Electricity Market; Det daer ordnar marknaden. Investeringspraktik paa den avreglerade marknaden

    Energy Technology Data Exchange (ETDEWEB)

    Roennborg, Petter (Univ. of Gothenburg, Goeteborg (Sweden). School of Business, Economics and Law)

    2009-06-15

    This dissertation deals with market actors' motives and the overall driving forces for undertaking real investments in electricity-generation facilities. Two factors induce interest in this subject. Firstly, the stationary electricity industry faces tremendous real-investment challenges. Secondly, these investments are to be undertaken within the institutional logic of the free market. Thus, the electricity company has to make decisions in a completely new setting. The market logic suggests that actors should maximize profits and respond to market price-signals. Most previous studies on real-investments in the stationary electricity industry apply this perspective. However, empirical research on real investments and organizational decisions-making, emphasizes that this is a normative perspective and it does not represent a valid description of reality when examining decision-making. Therefore, the purpose of the study is to empirically describe how the market- actors develop plausible argumentation and how they act, in practical real-investment situations, thereby enriching our understanding of motives and driving forces. Building on institutional theory, the undertaking of real-investments is considered as the result of a specific social practice, here called real-investment-practice. This theoretical perspective holds that three detailed elements constitute the real-investment-practice: one interpretative-oriented, one process-oriented, and one decision-oriented. Applying this perspective thus allows us to capture the contextual settings; the pattern of behavior characterizing the real-investments' course of events; and the application and the interpretation of analytical evaluation models. In line with this perspective, this PhD Thesis explores three questions: 1) How do the market actors construe the contextual settings, and how is the act of construing translated into real-investments in production capacity? 2) How do the market actors proceed in

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines ... Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines ...

  6. Colored Contact Lens Dangers

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    Full Text Available ... and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment ... and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment ...

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Get follow up exams with your eye care provider. If you notice redness, swelling, excessive discharge, pain or discomfort from wearing contact lenses, remove the lenses and seek immediate medical attention from an ophthalmologist. Related resources: Learn how to properly care for contact lenses . ...

  8. Colored Contact Lens Dangers

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    Full Text Available ... Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines Museum of Vision Ophthalmology Job ... Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines Museum of Vision Ophthalmology Job ...

  9. Colored Contact Lens Dangers

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    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  10. Colored Contact Lens Dangers

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    Full Text Available ... Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines Museum ... Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines Museum ...

  11. Colored Contact Lens Dangers

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    Full Text Available ... Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare ... Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS Registry Medicare ...

  12. Colored Contact Lens Dangers

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    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  13. A course in lens design

    CERN Document Server

    Velzel, Chris

    2014-01-01

    A Course in Lens Design is an instruction in the design of image-forming optical systems. It teaches how a satisfactory design can be obtained in a straightforward way. Theory is limited to a minimum, and used to support the practical design work. The book introduces geometrical optics, optical instruments and aberrations. It gives a description of the process of lens design and of the strategies used in this process. Half of its content is devoted to the design of sixteen types of lenses, described in detail from beginning to end. This book is different from most other books on lens design because it stresses the importance of the initial phases of the design process: (paraxial) lay-out and (thin-lens) pre-design. The argument for this change of accent is that in these phases much information can be obtained about the properties of the lens to be designed. This information can be used in later phases of the design. This makes A Course in Lens Design a useful self-study book, and a suitable basis for an intro...

  14. Development and Pilot Study of a Marketing Strategy for Primary Care/Internet–Based Depression Prevention Intervention for Adolescents (The CATCH-IT Intervention)

    Science.gov (United States)

    Watson, Natalie; Bridges, John F. P.; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A.; Ellis, Justin; Prochaska, Micah; Bell, Carl

    2010-01-01

    Background: Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. Objective: To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. Method: A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. Results: The marketing plan focused on “resiliency building” rather than “depression intervention” and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1–10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Conclusions: Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care. PMID:20944776

  15. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

  16. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

    Science.gov (United States)

    Chon, Yongho

    2013-01-01

    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

  17. Colored Contact Lens Dangers

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    Full Text Available ... Cleveland. "This is far from the truth." Real People, Real Problems with Colored Contact Lenses Julian: Teenager ... about the members of the eye-care team . Consumer warning about the improper use of colored contact ...

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... about the members of the eye-care team . Consumer warning about the improper use of colored contact ... About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of ...

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... about the members of the eye-care team . Consumer warning about the improper use of colored contact ... a laser pointer several times, according to a report published this month in the New England Journal ...

  20. Colored Contact Lens Dangers

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    Full Text Available ... EyeCare America Help IRIS Registry Medicare Physician Payment Meetings and Deadlines Museum of Vision Ophthalmology Job Center ... Ophthalmology Guide Find an Ophthalmologist Advanced Search Annual Meeting Clinical Education Practice Management Member Services Advocacy Foundation ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Services Advocacy Foundation About Subspecialties & More Eye Health Home Annual Meeting Clinical Education Practice Management Member Services ... had not been properly fitted by an eye care professional, the lenses stuck to my eye like ...

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... these lenses . "Most people believe that decorative lenses do not require the same level of care or ... Ophthalmologists APR 20, 2018 By Dan T. Gudgel Do you know what the difference is between ophthalmologists ...

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Cleveland. "This is far from the truth." Real People, Real Problems with Colored Contact Lenses Julian: Teenager ... the lenses. Never share contact lenses with another person. Get follow up exams with your eye care ...

  4. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... seek immediate medical attention from an ophthalmologist. Related resources: Learn how to properly care for contact lenses . ... have given blind patients some functional vision, using human embryonic stem cells. Two blind patients regained enough ...

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... that decorative lenses do not require the same level of care or consideration as a standard contact ... By Kate Rauch In a small but intriguing study, scientists in England have given blind patients some ...

  6. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... the United States. All contact lenses are medical devices that require a prescription and proper fitting by ... Care Apr 23, 2018 How long does it take the eye to go back to its original ...

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... about the members of the eye-care team . Consumer warning about the improper use of colored contact ...

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... the United States. All contact lenses are medical devices that require a prescription and proper fitting by an eye-care professional. Retailers that sell contacts without a ...

  9. The Risk of Contact Lens Wear and the Avoidance of Complications

    Directory of Open Access Journals (Sweden)

    Farihah Tariq

    2013-11-01

    Full Text Available Contact lenses are lenses placed on the surface of the cornea to correct refractive errors such as myopia (short-sightedness, hypermetropia (far-sightedness and astigmatism. Lens-related complications are becoming a greater health concern as increasing number of individuals are using them as an alternative to spectacles. Contact lenses alter the natural ocular environment and reduce the efficacy of the innate defences. Although many complications are minor, microbial keratitis is potentially blinding and suspected cases should be rapidly diagnosed and referred to an ophthalmologist for treatment. Several risk factors have been identified with extended wear, poor hand hygiene, inadequate lens and lens-case care being the most significant. Promotion of good contact lens hygiene and practices are essential to reduce the adverse effects of contact lens wear.

  10. Using the 'Social Marketing Mix Framework' to explore recruitment barriers and facilitators in palliative care randomised controlled trials? A narrative synthesis review.

    Science.gov (United States)

    Dunleavy, Lesley; Walshe, Catherine; Oriani, Anna; Preston, Nancy

    2018-05-01

    Effective recruitment to randomised controlled trials is critically important for a robust, trustworthy evidence base in palliative care. Many trials fail to achieve recruitment targets, but the reasons for this are poorly understood. Understanding barriers and facilitators is a critical step in designing optimal recruitment strategies. To identify, explore and synthesise knowledge about recruitment barriers and facilitators in palliative care trials using the '6 Ps' of the 'Social Marketing Mix Framework'. A systematic review with narrative synthesis. Medline, CINAHL, PsycINFO and Embase databases (from January 1990 to early October 2016) were searched. Papers included the following: interventional and qualitative studies addressing recruitment, palliative care randomised controlled trial papers or reports containing narrative observations about the barriers, facilitators or strategies to increase recruitment. A total of 48 papers met the inclusion criteria. Uninterested participants (Product), burden of illness (Price) and 'identifying eligible participants' were barriers. Careful messaging and the use of scripts/role play (Promotion) were recommended. The need for intensive resources and gatekeeping by professionals were barriers while having research staff on-site and lead clinician support (Working with Partners) was advocated. Most evidence is based on researchers' own reports of experiences of recruiting to trials rather than independent evaluation. The 'Social Marketing Mix Framework' can help guide researchers when planning and implementing their recruitment strategy but suggested strategies need to be tested within embedded clinical trials. The findings of this review are applicable to all palliative care research and not just randomised controlled trials.

  11. Tinting of intraocular lens implants

    Energy Technology Data Exchange (ETDEWEB)

    Zigman, S.

    1982-06-01

    Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users.

  12. Tinting of intraocular lens implants

    International Nuclear Information System (INIS)

    Zigman, S.

    1982-01-01

    Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users

  13. Automated Fresnel lens tester system

    Energy Technology Data Exchange (ETDEWEB)

    Phipps, G.S.

    1981-07-01

    An automated data collection system controlled by a desktop computer has been developed for testing Fresnel concentrators (lenses) intended for solar energy applications. The system maps the two-dimensional irradiance pattern (image) formed in a plane parallel to the lens, whereas the lens and detector assembly track the sun. A point detector silicon diode (0.5-mm-dia active area) measures the irradiance at each point of an operator-defined rectilinear grid of data positions. Comparison with a second detector measuring solar insolation levels results in solar concentration ratios over the image plane. Summation of image plane energies allows calculation of lens efficiencies for various solar cell sizes. Various graphical plots of concentration ratio data help to visualize energy distribution patterns.

  14. Projecting the effects of long-term care policy on the labor market participation of primary informal family caregivers of elderly with disability: insights from a dynamic simulation model.

    Science.gov (United States)

    Ansah, John P; Matchar, David B; Malhotra, Rahul; Love, Sean R; Liu, Chang; Do, Young

    2016-03-23

    Using Singapore as a case study, this paper aims to understand the effects of the current long-term care policy and various alternative policy options on the labor market participation of primary informal family caregivers of elderly with disability. A model of the long-term care system in Singapore was developed using System Dynamics methodology. Under the current long-term care policy, by 2030, 6.9 percent of primary informal family caregivers (0.34 percent of the domestic labor supply) are expected to withdraw from the labor market. Alternative policy options reduce primary informal family caregiver labor market withdrawal; however, the number of workers required to scale up long-term care services is greater than the number of caregivers who can be expected to return to the labor market. Policymakers may face a dilemma between admitting more foreign workers to provide long-term care services and depending on primary informal family caregivers.

  15. Electro-optically actuated liquid-lens zoom

    Science.gov (United States)

    Pütsch, O.; Loosen, P.

    2012-06-01

    Progressive miniaturization and mass market orientation denote a challenge to the design of dynamic optical systems such as zoom-lenses. Two working principles can be identified: mechanical actuation and application of active optical components. Mechanical actuation changes the focal length of a zoom-lens system by varying the axial positions of optical elements. These systems are limited in speed and often require complex coupled movements. However, well established optical design approaches can be applied. In contrast, active optical components change their optical properties by varying their physical structure by means of applying external electric signals. An example are liquidlenses which vary their curvatures to change the refractive power. Zoom-lenses benefit from active optical components in two ways: first, no moveable structures are required and second, fast response characteristics can be realized. The precommercial development of zoom-lenses demands simplified and cost-effective system designs. However the number of efficient optical designs for electro-optically actuated zoom-lenses is limited. In this paper, the systematic development of an electro-optically actuated zoom-lens will be discussed. The application of aberration polynomials enables a better comprehension of the primary monochromatic aberrations at the lens elements during a change in magnification. This enables an enhanced synthesis of the system behavior and leads to a simplified zoom-lens design with no moving elements. The change of focal length is achieved only by varying curvatures of targeted integrated electro-optically actuated lenses.

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... eye-care professional. Retailers that sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. "Many of the lenses found online or in beauty salons, novelty shops or in pop-up ... contact lenses from a retailer that does not ask for a prescription. ...

  17. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Services Advocacy Foundation About Subspecialties & More Eye Health ... W.Va., had "extreme pain in both eyes," she said. "Because I had not been properly fitted by an eye care professional, the lenses stuck to my eye like ...

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... eye-care team . Consumer warning about the improper use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are considering buying approved by the FDA? Check the FDA's database of approved contact lenses . Related Stories Prevent Infection ...

  19. Compliance and hygiene behaviour among soft contact lens wearers in the Maldives.

    Science.gov (United States)

    Gyawali, Rajendra; Nestha Mohamed, Fathimath; Bist, Jeewanand; Kandel, Himal; Marasini, Sanjay; Khadka, Jyoti

    2014-01-01

    Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behaviour of soft contact lens wearers in the Maldives. Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behaviour (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices. Out of 107 participants, 79 (74.8 per cent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 ± 4.4 years. Mean duration of lens wear was 28.04 ± 8.36 months. Most of them were using spherical lenses (86.9 per cent) on a daily wear basis (96.3 per cent). Major reported forms of non-compliance were poor hand hygiene (60.7 per cent), lack of aftercare awareness (39.3 per cent), water exposure (35.5 per cent) and over-use of lenses (24.3 per cent). While females were more likely to overuse their lenses than males (p hygienic behaviour. A significant number of Maldivian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  20. Lens system for SIMS analysis

    International Nuclear Information System (INIS)

    Martinez, G.; Sancho, M.; Garcia-Galan, J.C.

    1987-01-01

    A powerful version of the charge-density method is applied to the study of a combined objective and emission lens, suitable for highly localized analysis of a flat sample surface. This lens can extract secondary ions of equal or opposite polarity to that of the primary particles. A computer simulation of the ion trajectories for both modes is made. The behaviour for different values of the geometric parameters and polarizations is analyzed and useful data for design such as primary beam demagnification and secondary image position are given. (author) 4 refs

  1. Differences in daily disposable circle lens performance characteristics

    Directory of Open Access Journals (Sweden)

    Schafer JM

    2014-04-01

    Full Text Available Jeffery M Schafer, William T Reindel, Marjorie J Rah, Osbert Chan, Lening Zhang Bausch & Lomb Incorporated, Rochester, NY, USA Purpose: The purpose of this evaluation was to compare the performance characteristics of two cosmetically tinted contact lenses in the circle lens category that differ in lens design, lens material, and pigment print pattern: etafilcon A (1-Day Acuvue Define; Johnson & Johnson Vision Care and hilafilcon B (Naturelle; Bausch & Lomb Incorporated. Methods: Two hundred Asian subjects (400 eyes were enrolled in this 1-month parallel, bilateral, randomized study at ten investigative sites. Study lenses were dispensed at a screening/dispensing visit, and follow-up visits occurred at 2 weeks and 1 month. Lenses were worn on a daily disposable basis. Fit characteristics were evaluated at each visit, and slit-lamp evaluations were completed at each follow-up visit. Results: Of the 200 patients enrolled, 172 (344 eyes completed the study. The proportion of eyes with fully centered lenses was statistically significantly higher for the hilafilcon B group at the 2-week and 1-month visits, P<0.05. Over all visits, 0.6% of hilafilcon B eyes demonstrated incomplete corneal coverage, whereas for the etafilcon A group, 8.5% of eyes demonstrated incomplete corneal coverage and/or edge lift. The proportion of eyes with adequate lens movement was statistically significantly higher for the hilafilcon B group, P<0.05. Over all visits, none of the hilafilcon B eyes was reported to have excessive movement, whereas for etafilcon A lenses, 10.2% of eyes were reported to have excessive movement. Conclusions: Etafilcon A lenses were significantly less likely to be fully centered and significantly more likely to have incomplete corneal coverage and/or edge lift compared with the hilafilcon B lenses. Keywords: cosmetic contact lens, circle contact lens

  2. Refractive lens exchange with a multifocal diffractive aspheric intraocular lens

    Directory of Open Access Journals (Sweden)

    Teresa Ferrer-Blasco

    2012-06-01

    Full Text Available PURPOSE: To evaluate the safety, efficacy and predictability after refractive lens exchange with multifocal diffractive aspheric intraocular lens implantation. METHODS: Sixty eyes of 30 patients underwent bilateral implantation with AcrySof® ReSTOR® SN6AD3 intraocular lens with +4.00 D near addition. Patients were divided into myopic and hyperopic groups. Monocular best corrected visual acuity at distance and near and monocular uncorrected visual acuity at distance and near were measured before and 6 months postoperatively. RESULTS: After surgery, uncorrected visual acuity was 0.08 ± 0.15 and 0.11 ± 0.14 logMAR for the myopic and hyperopic groups, respectively (50% and 46.67% of patients had an uncorrected visual acuity of 20/20 or better in the myopic and hyperopic groups, respectively. The safety and efficacy indexes were 1.05 and 0.88 for the myopic and 1.01 and 0.86 for the hyperopic groups at distance vision. Within the myopic group, 20 eyes remained unchanged after the surgery, and 3 gained >2 lines of best corrected visual acuity. For the hyperopic group, 2 eyes lost 2 lines of best corrected visual acuity, 21 did not change, and 3 eyes gained 2 lines. At near vision, the safety and efficacy indexes were 1.23 and 1.17 for the myopic and 1.16 and 1.13 for the hyperopic groups. Best corrected near visual acuity improved after surgery in both groups (from 0.10 logMAR to 0.01 logMAR in the myopic group, and from 0.10 logMAR to 0.04 logMAR in the hyperopic group. CONCLUSIONS: The ReSTOR® SN6AD3 intraocular lens in refractive lens exchange demonstrated good safety, efficacy, and predictability in correcting high ametropia and presbyopia.

  3. Marketing the pathology practice.

    Science.gov (United States)

    Berkowitz, E N

    1995-07-01

    Effective marketing of the pathology practice is essential in the face of an increasingly competitive market. Successful marketing begins with a market-driven planning process. As opposed to the traditional planning process used in health care organizations, a market-driven approach is externally driven. Implementing a market-driven plan also requires recognition of the definition of the service. Each market to which pathologists direct their service defines the service differently. Recognition of these different service definitions and creation of a product to meet these needs could lead to competitive advantages in the marketplace.

  4. Stretchable Binary Fresnel Lens for Focus Tuning

    NARCIS (Netherlands)

    Li, X.; Wei, L.; Poelma, R.H.; Vollebregt, S.; Wei, J.; Urbach, Paul; Sarro, P.M.; Zhang, G.Q.

    2016-01-01

    This paper presents a tuneable binary amplitude Fresnel lens produced by wafer-level microfabrication. The Fresnel lens is fabricated by encapsulating lithographically defined vertically aligned carbon nanotube (CNT) bundles inside a polydimethyl-siloxane (PDMS) layer. The composite lens material

  5. 21 CFR 886.1400 - Maddox lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Maddox lens. 886.1400 Section 886.1400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1400 Maddox lens. (a) Identification. A Maddox lens is a device...

  6. Crystalline lens power and refractive error.

    Science.gov (United States)

    Iribarren, Rafael; Morgan, Ian G; Nangia, Vinay; Jonas, Jost B

    2012-02-01

    To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 13.9-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P lens opacity grade (β = -0.42; P lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity (β = -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity. Variations in refractive error in adults aged 50+ years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.

  7. 21 CFR 886.3600 - Intraocular lens.

    Science.gov (United States)

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to replace the natural lens of an eye. (b) Classification. Class III. (c) Date PMA or notice of completion of a...

  8. Harm reduction through a social justice lens.

    Science.gov (United States)

    Pauly, Bernadette

    2008-02-01

    People who are street involved such as those experiencing homelessness and drug use face multiple inequities in health and access to health care. Morbidity and mortality are significantly increased among those who are street involved. Incorporation of a harm reduction philosophy in health care has the potential to shift the moral context of health care delivery and enhance access to health care services. However, harm reduction with a primary focus on reducing the harms of drug use fails focus on the harms associated with the context of drug use such as homelessness, violence and poverty. Ethical analysis of the underlying values of harm reduction and examination of different conceptions of justice are discussed as a basis for action that addresses a broad range of harms associated with drug use. Theories of distributive justice that focus primarily on the distribution of material goods are limited as theoretical frameworks for addressing the root causes of harm associated with drug use. Social justice, reconceptualised and interpreted through a critical lens as described by Iris Marion Young, is presented as a promising alternative ethical framework. A critical reinterpretation of social justice leads to insights that can illuminate structural inequities that contribute to the harms associated with the context of drug use. Such an approach provides promise as means of informing policy that aims to reduce a broad range of harms associated with drug use such as homelessness and poverty.

  9. The Ultrawideband Leaky Lens Antenna

    NARCIS (Netherlands)

    Bruni, S.; Neto, A.; Marliani, F.

    2007-01-01

    A novel directive and nondispersive antenna is presented: the ultrawideband (UWB) leaky lens. It is based on the broad band Cherenkov radiation occurring at a slot printed between different infinite homogeneous dielectrics. The first part of the paper presents the antenna concept and the UWB design.

  10. ECTOPIC LENS EXTRACTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Vladimir Pfeifer

    2002-12-01

    Full Text Available Background. Ectopia lentis continues to be a therapeutic challenge for ophthalmologists. It can occur as an isolated condition, after ocular trauma, in association with other ocular disorders, as part of a systemic mesodermal disease or a complication of general metabolic disorders. Minimal subluxation of the lens may cause no visual symptoms, but in more advanced cases serious optical disturbances arise. The most important is amblyopia. Surgical treatment options include iris manipulation, lens discission, aspiration, intracapsular or extracapsular extraction, and pars plana lensectomy. The choice of surgical technique remains controversial, in part because of the historically poor visual results and high rate of perioperative complications, including vitreous loss and retinal detachment.Methods. We describe a surgical technique based on the use of the Cionni endocapsular tension ring, dry irrigation aspiration of lens material, centration of the capsular bag and foldable intraocular lens implantation into the bag. With mentioned surgical technique 8 patients were operated; 4 boys and 4 girls, together 11 eyes.Results. The final BCVA after follow up period improved in 9 eyes and it remained the same as before operation in one eye. Statistical comparison of preoperative and postoperative visual acuities showed significant improvement. On the other hand there was no correlation between preoperative and postoperative visual acuity.Conclusions. This surgical procedure is an alternative approach in solving this challenging cases of ectopia lentis with good postoperative visual rehabilitation.

  11. Understanding attitudes toward information and communication technology in home-care: Information and communication technology as a market good within Norwegian welfare services.

    Science.gov (United States)

    Øyen, Karianne Røssummoen; Sunde, Olivia Sissil; Solheim, Marit; Moricz, Sara; Ytrehus, Siri

    2018-09-01

    The aim of this study was to better understand nurses' and other staff members' attitudes toward the usefulness of information and communication technology in home-care settings. Research has found that beliefs about the expected benefits of information and communication technology impact the use of technology. Furthermore, inexperience with using information and communication technology may cause negative attitudes. This article is based on a questionnaire to 155 nurses and other staff members in home-care in Sogn og Fjordane county in Norway. The results revealed minimal use of information and communication technology at work; however, participants had positive attitudes regarding the potential benefits of information and communication technology use in home-care. Individuals' extensive use of and familiarity with different solutions in private lives could be an important context for explaining employees' attitudes. Given that information and communication technology is both a welfare service and a market good, this may explain individuals' positive attitudes toward information and communication technology despite their lack of experience with it at work. Experiences with information and communication technology as a market good and the way new technologies can affect work routines will affect the implementation of information and communication technology in home-care.

  12. Effect of Social Media Marketing on Customer Engagement and its Impact on Brand Loyalty in Caring Colours Cosmetics, Martha Tilaar

    Directory of Open Access Journals (Sweden)

    Brian Garda Muchardie

    2016-05-01

    Full Text Available The purpose of this research was to determine the influence of social media marketing against customer engagement and its impact on brand loyalty. Methods applied is a quantitative method by distributing questionnaire to 100 customers. Data analysis was applied path analysis. The results of this study shows that social media marketing has a positive and significant impact on customer engagement, on brand loyalty, and on customer engagement, and its impact on brand loyalty where customer engagement has a greater influence on brand loyalty than social media marketing.

  13. Lens stem cells may reside outside the lens capsule: an hypothesis

    Directory of Open Access Journals (Sweden)

    Meyer Rita A

    2007-06-01

    Full Text Available Abstract In this paper, we consider the ocular lens in the context of contemporary developments in biological ideas. We attempt to reconcile lens biology with stem cell concepts and a dearth of lens tumors. Historically, the lens has been viewed as a closed system, in which cells at the periphery of the lens epithelium differentiate into fiber cells. Theoretical considerations led us to question whether the intracapsular lens is indeed self-contained. Since stem cells generate tumors and the lens does not naturally develop tumors, we reasoned that lens stem cells may not be present within the capsule. We hypothesize that lens stem cells reside outside the lens capsule, in the nearby ciliary body. Our ideas challenge the existing lens biology paradigm. We begin our discussion with lens background information, in order to describe our lens stem cell hypothesis in the context of published data. Then we present the ciliary body as a possible source for lens stem cells, and conclude by comparing the ocular lens with the corneal epithelium.

  14. Modern lens antennas for communications engineering

    CERN Document Server

    Thornton, John

    2012-01-01

    The aim of this book is to present the modern design principles and analysis of lens antennas. It gives graduates and RF/Microwave professionals the design insights in order to make full use of lens antennas.  Why do we want to write a book in lens antennas? Because this topic has not been thoroughly publicized, its importance is underestimated. As antennas play a key role in communication systems, recent development in wireless communications would indeed benefit from the characteristics of lens antennas: low profile, and low cost etc.  The major advantages of lens antennas are na

  15. Perubahan Sosial Berbasis Tasawuf: Studi Kasus Fethullah Gülen Dan Gülen Movement

    Directory of Open Access Journals (Sweden)

    Sulaiman Sulaiman

    2016-06-01

    Full Text Available Abstract: This article aims at analyzing Fethullah Gülen and the Gülen Movement which have succeeded in performing social change based on the teaching of Sufism. He did Sufism creativity in order that Sufism teaching was able to respond the changes that occur in the modernlife. He believed that, only by reinterpretation and contextualization of Sufism, the spiritual dimension of Islam would be able to perform the transformation or social change among the Muslims. Therefore, by using Max Weber’s theory of social action, this paper will analyze three key teachings of Sufism of Gülen: ascetic (zuhd, inbisat (expansion, and hizmet. Based on the Weber's theory, Gülen occupied a very central and authoritative position: agent/actor, action and meaning. As a source of meaning and interpreter of meaning, the key concepts of Sufism were transformed by Gülen to the internal and external communities so that they had made a move to do social movements and humanity. For the followers of Gülen, the movement was called the Gülen Movement or the Hizmet Movement which was engaged in the fields of education, health care, humanitarian assistance, and the mass media. All forms of movement were entirely based on the spiritual values of Islam that had been formulated by Gülen. الملخص: يهدف هذا البحث إلى تحليل شخصية فتح الله غولن وحركته الذي تمكن من القيام بالتغيير الاجتماعي على أساس التعاليم الصوفية. إن فتح الله غولن قام بإحياء التصوف في صورته الجدّية والحيوية في حياة الإنسان المعاصر. ويعتقد أن إعادة التفسير لتعاليم التصوف مع مراعاة الواقع قادرة على التغيير الاجتماعي بين المسلمين. من أجل ذلك، أن استخدام نظرية ويبر، يمكن تحليل تعاليم التصوف الثلاثة

  16. Effect of Social Media Marketing on Customer Engagement and its Impact on Brand Loyalty in Caring Colours Cosmetics, Martha Tilaar

    OpenAIRE

    Brian Garda Muchardie; Nabila Hanindya Yudiana; Annetta Gunawan

    2016-01-01

    The purpose of this research was to determine the influence of social media marketing against customer engagement and its impact on brand loyalty. Methods applied is a quantitative method by distributing questionnaire to 100 customers. Data analysis was applied path analysis. The results of this study shows that social media marketing has a positive and significant impact on customer engagement, on brand loyalty, and on customer engagement, and its impact on brand loyalty where customer engag...

  17. Use of marketing to disseminate brief alcohol intervention to general practitioners: promoting health care interventions to health promoters.

    Science.gov (United States)

    Lock, C A; Kaner, E F

    2000-11-01

    Health research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. Thus, a dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. Social marketing techniques can be utilized to aid successful dissemination of research findings and to speed the process by which new information reaches practice. Principles of social marketing include manipulating the marketing mix of product, price, place and promotion. This paper describes the development of a marketing approach and the outcomes from a trial evaluating the effectiveness and cost-effectiveness of manipulating promotional strategies to disseminate actively a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). The promotional strategies consisted of postal marketing, telemarketing and personal marketing. The study took place in general practices across the Northern and Yorkshire Regional Health Authority. Of the 614 GPs eligible for the study, one per practice, 321 (52%) took the programme and of those available to use it for 3 months (315), 128 (41%) actively considered doing so, 73 (23%) actually went on to use it. Analysis of the specific impact of the three different promotional strategies revealed that while personal marketing was the most effective overall dissemination and implementation strategy, telemarketing was more cost-effective. The findings of our work show that using a marketing approach is promising for conveying research findings to GPs and in particular a focus on promotional strategies can facilitate high levels of uptake and consideration in this target group.

  18. Contact lens surface by electron beam

    International Nuclear Information System (INIS)

    Shin, Jung Hyuck; Lee, Suk Ju; Hwang, Kwang Ha; Jeon Jin

    2011-01-01

    Contact lens materials needs good biocompatibility, high refractive index, high optical transparency, high water content etc. Surface treat method by using plasma and radiation can modify the physical and/or chemical properties of the contact lens surface. Radiation technology such as electron beam irradiation can apply to polymerization reaction and enhance the functionality of the polymer.The purpose of this study is to modify of contact lens surface by using Eb irradiation technology. Electron beam was irradiated to the contact lens surface which was synthesized thermal polymerization method and commercial contact lens to modify physical and chemical properties. Ft-IR, XP, UV-vis spectrophotometer, water content, oxygen trans-metastability were used to characterize the surface state, physicochemical, and optical property of the contact lens treated with Eb. The water content and oxygen transmissibility of the contact lens treated with Eb were increased due to increase in the hydrophilic group such as O-C=O and OH group on the contact lens surface which could be produced by possible reaction between carbon and oxygen during the Eb irradiation. All of the lenses showed the high optical transmittance above 90%. In this case of B/Es, TES, Ti contact lens, the optical transmittance decreased about 5% with increasing Eb dose in the wavelength of UV-B region. The contact lens modified by Eb irradiation could improve the physical properties of the contact lens such as water content and oxygen transmissibility

  19. Lens decenter and tilt measurement by interferogram

    Science.gov (United States)

    Hung, Min-Wei; Wu, Wen-Hong; Huang, Kuo-Cheng

    2009-11-01

    For the recent years, the vigorous development of the electro-optic industry, particularly the digital camera and the cellular phone camera, has placed a larger and larger demand for the optical devices. Among the optical lens, the aspherical optical lens plays the key component because the aspherical lens may provide better imaging quality then the spherical lens does. For the manufacturing reason, the aspherical lens is prone to a decenter or tilt issue with respect to the optical axes of its two surfaces. To measure decenter and tile error specifically would help to obviate the deficient lens, but most of the present measuring method can't provide this function. This paper proposed a new method to specifically measure the decenter and tile of lens by observing the interferogram of each surface. And the corresponding measuring instrument, which contains interferometer and motion stages, was introduced as well.

  20. Plasma Lens for Muon and Neutrino Beams

    Science.gov (United States)

    Kahn, Stephen; Korenev, Sergey; Bishai, Mary; Diwan, Milind; Gallardo, Juan; Hershcovitch, Ady; Johnson, Brant

    2008-04-01

    The plasma lens is examined as an alternate to focusing horns and solenoids for use in a neutrino or muon beam facility. The plasma lens concept is based on a combined high-current lens/target configuration. The current is fed at electrodes located upstream and downstream from the target where pion capturing is needed. The current flows primarily in the plasma, which has a lower resistivity than the target. A second plasma lens section, with an additional current feed, follows the target to provide shaping of the plasma stability. The geometry of the plasma is shaped to provide optimal pion capture. Simulations of this plasma lens system have shown a 25% higher neutrino production than the horn system. A plasma lens has additional advantage: larger axial current than horns, minimal neutrino contamination during antineutrino running, and negligible pion absorption or scattering. Results from particle simulations using a plasma lens will be presented.

  1. Lens artifacts in human fetal eyes - the challenge of interpreting the histomorphology of human fetal lenses.

    Science.gov (United States)

    Herwig, Martina C; Müller, Annette M; Klarmann-Schulz, Ute; Holz, Frank G; Loeffler, Karin U

    2014-01-01

    Evaluation of the lens, including cataractous changes, is often of paramount importance in the classification of fetal syndromes or forensic questions. On histology, the crystalline lens is - especially in fetal and infant eyes - an organ susceptible to numerous artifacts. Thus, the aim of our study was to study various factors (including fixatives) that might have an impact on lens histomorphology. Twenty eyes from ten fetuses (formalin fixation: n = 10, glutaraldehyde fixation: n = 10), matched for gestational age and abortion (spontaneous vs. induced), were investigated macroscopically and by light microscopy. Sections were stained with routine hematoxylin & eosin (H&E), and periodic acid schiff (PAS). The age of the fetal eyes ranged from 15 to 36 weeks of gestation. Lens artifacts were analyzed and compared to fetal and adult lenses with definitive cataractous changes. In addition, 34 eyes from 27 fetuses with trisomy 21 were investigated for lens changes. All lenses showed artifacts of varying extent, in particular globules, vacuoles, clefts, anterior/posterior capsular separation, subcapsular proteinaceous material, fragmentation of the lens capsule/epithelium, and a posterior umbilication. Glutaraldehyde-fixed lenses displayed less artifacts compared to those fixed in formalin. Slight differences in the appearance of artifacts were found dependent on the fixative (formaldehyde vs glutaraldehyde) and the kind of abortion (iatrogenous vs spontaneous). The gestational age did not have a significant influence on the type and extent of lens artifacts. The lenses from fetuses with trisomy 21 displayed similar lens artifacts with no specific findings. Alterations in fetal lens morphology are extremely frequent and variable. These artifacts have to be carefully taken into account when interpreting post-mortem findings. Thus, the postmortem diagnosis of a fetal cataract should be made with great caution, and should include, in adherence to our proposed

  2. Atmospherics, the marketing concept, and a marketing tool for hospitals.

    Science.gov (United States)

    Fugate, D L

    1991-01-01

    Researchers have demonstrated that the conscious use of atmospheric structuring can induce marketer-desired behaviors in service consumers. This may be particularly relevant to marketers of hospital care since consumer judgments often depend upon peripheral rather than core evidences of quality and satisfaction. Under these circumstances, health care marketers have an obligation to explore the phenomenon of atmospherics and its practical implications in the health care marketing mix.

  3. Intraocular camera for retinal prostheses: Refractive and diffractive lens systems

    Science.gov (United States)

    Hauer, Michelle Christine

    The focus of this thesis is on the design and analysis of refractive, diffractive, and hybrid refractive/diffractive lens systems for a miniaturized camera that can be surgically implanted in the crystalline lens sac and is designed to work in conjunction with current and future generation retinal prostheses. The development of such an intraocular camera (IOC) would eliminate the need for an external head-mounted or eyeglass-mounted camera. Placing the camera inside the eye would allow subjects to use their natural eye movements for foveation (attention) instead of more cumbersome head tracking, would notably aid in personal navigation and mobility, and would also be significantly more psychologically appealing from the standpoint of personal appearances. The capability for accommodation with no moving parts or feedback control is incorporated by employing camera designs that exhibit nearly infinite depth of field. Such an ultracompact optical imaging system requires a unique combination of refractive and diffractive optical elements and relaxed system constraints derived from human psychophysics. This configuration necessitates an extremely compact, short focal-length lens system with an f-number close to unity. Initially, these constraints appear highly aggressive from an optical design perspective. However, after careful analysis of the unique imaging requirements of a camera intended to work in conjunction with the relatively low pixellation levels of a retinal microstimulator array, it becomes clear that such a design is not only feasible, but could possibly be implemented with a single lens system.

  4. Implementing marketing strategy (Part four).

    Science.gov (United States)

    Dodson, D C; Dotson, M; McIlwain, T F; Young, D

    1993-01-01

    Every organization must monitor and evaluate the performance of its marketing strategies. The health care marketer must continually develop effective measures related to outcomes so that marketing efforts can be justified and garnish the support and resources they deserve. A major task for the marketing executive for the next decade is to develop marketing strategies and prove that those strategies are being met and that they help the health care organization carry out its objective to meet its mission.

  5. Positioning marketing in the hospital's power structure.

    Science.gov (United States)

    Beckham, D

    1984-08-01

    Although hospitals are increasingly recognizing the importance of marketing, many have difficulty assimilating what has been primarily an industrial concern into a health care environment. The author explains the function of marketing in health care, the outlook and expectations of a good marketing executive, and why hospital management and the medical staff may have difficulty accepting marketing and the expectations of the marketing executive.

  6. Trends in ageing and ageing-in-place and the future market for institutional care: scenarios and policy implications.

    Science.gov (United States)

    Alders, Peter; Schut, Frederik T

    2018-05-21

    In several OECD countries the percentage of elderly in long-term care institutions has been declining as a result of ageing-in-place. However, due to the rapid ageing of population in the next decades future demand for institutional care is likely to increase. In this paper we perform a scenario analysis to examine the potential impact of these two opposite trends on the demand for institutional elderly care in the Netherlands. We find that the demand for institutional care first declines as a result of the expected increase in the number of low-need elderly that age-in-place. This effect is strong at first but then peters out. After this first period the effect of the demographic trend takes over, resulting in an increase in demand for institutional care. We argue that the observed trends are likely to result in a growing mismatch between demand and supply of institutional care. Whereas the current stock of institutional care is primarily focussed on low-need (residential) care, future demand will increasingly consist of high-need (nursing home) care for people with cognitive as well as somatic disabilities. We discuss several policy options to reduce the expected mismatch between supply and demand for institutional care.

  7. A theory of physician-hospital integration: contending institutional and market logics in the health care field.

    Science.gov (United States)

    Rundall, Thomas G; Shortell, Stephen M; Alexander, Jeffrey A

    2004-01-01

    This article proposes a theory of physician-hospital integration. The theory is developed by building on three streams of scholarship: "new" institutionalism, "old" institutionalism, and the theory of economic markets. The theory uses several key concepts from these theoretical frameworks, including the notions of environmental demands for legitimacy, market demands for efficiency, and agency. To enhance the predictive power of the theory, two new concepts are introduced: directionality of influence between institutional and market forces at the macro-societal level, and degree of separation of institutional and market domains at the local level--which add important predictive power to the theory. Using these concepts, a number of hypotheses are proposed regarding the ideal types of physician-hospital arrangements that are likely to emerge under different combinations of directionality of influence and institutional and market domain separation. Moreover, the theory generates hypotheses regarding organizational dynamics associated with physician-hospital integration, including the conditions associated with high and low prevalence of physician-hospital integration, the extent to which the integrated organization is physician-centric or hospital-centric, and whether physician-hospital integration is likely to be based on loose contractual arrangements or tight, ownership-based arrangements.

  8. Lens Coupled Quantum Cascade Laser

    Science.gov (United States)

    Hu, Qing (Inventor); Lee, Alan Wei Min (Inventor)

    2013-01-01

    Terahertz quantum cascade (QC) devices are disclosed that can operate, e.g., in a range of about 1 THz to about 10 THz. In some embodiments, QC lasers are disclosed in which an optical element (e.g., a lens) is coupled to an output facet of the laser's active region to enhance coupling of the lasing radiation from the active region to an external environment. In other embodiments, terahertz amplifier and tunable terahertz QC lasers are disclosed.

  9. Looking beyond the perfect lens

    International Nuclear Information System (INIS)

    Wee, W H; Pendry, J B

    2010-01-01

    The holy grail of imaging is the ability to see through anything. From the conservation of energy, we can easily see that to see through a lossy material would require lenses with gain. The aim of this paper therefore is to propose a simple scheme by which we can construct a general perfect lens, with gain-one that can restore both the phases and amplitudes of near and far fields.

  10. Price elasticities in the German Statutory Health Insurance market before and after the health care reform of 2009.

    Science.gov (United States)

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

    2015-05-01

    This paper investigates the change in price elasticity of health insurance choice in Germany after a reform of health insurance contributions. Using a comprehensive data set of all sickness funds between 2004 and 2013, price elasticities are calculated both before and after the reform for the entire market. The general price elasticity is found to be increased more than 4-fold from -0.81 prior to the reform to -3.53 after the reform. By introducing a new kind of health insurance contribution the reform seemingly increased the price elasticity of insured individuals to a more appropriate level under the given market parameters. However, further unintended consequences of the new contribution scheme were massive losses of market share for the more expensive sickness funds and therefore an undivided focus on pricing as the primary competitive element to the detriment of quality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. CONTACT LENS RELATED CORNEAL ULCER

    Directory of Open Access Journals (Sweden)

    AGARWAL P

    2010-01-01

    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  12. Glycation precedes lens crystallin aggregation

    International Nuclear Information System (INIS)

    Swamy, M.S.; Perry, R.E.; Abraham, E.C.

    1987-01-01

    Non-enzymatic glycosylation (glycation) seems to have the potential to alter the structure of crystallins and make them susceptible to thiol oxidation leading to disulfide-linked high molecular weight (HMW) aggregate formation. They used streptozotocin diabetic rats during precataract and cataract stages and long-term cell-free glycation of bovine lens crystallins to study the relationship between glycation and lens crystallin aggregation. HMW aggregates and other protein components of the water-soluble (WS) and urea-soluble (US) fractions were separated by molecular sieve high performance liquid chromatography. Glycation was estimated by both [ 3 H]NaBH 4 reduction and phenylboronate agarose affinity chromatography. Levels of total glycated protein (GP) in the US fractions were about 2-fold higher than in the WS fractions and there was a linear increase in GP in both WS and US fractions. This increase was parallelled by a corresponding increase in HMW aggregates. Total GP extracted by the affinity method from the US fraction showed a predominance of HMW aggregates and vice versa. Cell-free glycation studies with bovine crystallins confirmed the results of the animals studies. Increasing glycation caused a corresponding increase in protein insolubilization and the insoluble fraction thus formed also contained more glycated protein. It appears that lens protein glycation, HMW aggregate formation, and protein insolubilization are interrelated

  13. The impact of hospital market structure on patient volume, average length of stay, and the cost of care.

    Science.gov (United States)

    Robinson, J C; Luft, H S

    1985-12-01

    A variety of recent proposals rely heavily on market forces as a means of controlling hospital cost inflation. Sceptics argue, however, that increased competition might lead to cost-increasing acquisitions of specialized clinical services and other forms of non-price competition as means of attracting physicians and patients. Using data from hospitals in 1972 we analyzed the impact of market structure on average hospital costs, measured in terms of both cost per patient and cost per patient day. Under the retrospective reimbursement system in place at the time, hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments.

  14. The Effect of the Crystalline Lens on Central Vault After Implantable Collamer Lens Implantation.

    Science.gov (United States)

    Qi, Meng-Ying; Chen, Qian; Zeng, Qing-Yan

    2017-08-01

    To identify associations between crystalline lens-related factors and central vault after Implantable Collamer Lens (ICL) (Staar Surgical, Monrovia, CA) implantation. This retrospective clinical study included 320 eyes from 186 patients who underwent ICL implantation surgery. At 1 year after surgery, the central vault was measured using anterior segment optical coherence tomography. Preoperative anterior chamber depth, lens thickness, lens position (lens position = anterior chamber depth + 1/2 lens thickness), and vault were analyzed to investigate the effects of lens-related factors on postoperative vault. The mean vault was 513 ± 215 µm at 1 year after surgery. Vault was positively correlated with preoperative anterior chamber depth (r = 0.495, P lens position (r = 0.371, P lens thickness (r = -0.262, P lens position than eyes in the other two vault groups (which had vaults ≥ 250 µm) (P lens position less than 5.1 mm had greatly reduced vaults (P lens could have an important influence on postoperative vault. Eyes with a shallower anterior chamber and a forward lens position will have lower vaults. [J Refract Surg. 2017;33(8):519-523.]. Copyright 2017, SLACK Incorporated.

  15. Locality, Mobility and Labour Market Citizenship: Reflections of Finnish Vocational Students in Social Services and Health Care

    Science.gov (United States)

    Lappalainen, Sirpa

    2014-01-01

    In the current economic order, the basic duty of citizens is to find placements in the internationalising labour market. Internationalism has been a common educational objective throughout Europe. Previously associated as a feature of middle-class subjectivities and academic education, it is implemented in the agenda of vocational education as…

  16. Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial

    Science.gov (United States)

    Javanbakht, Mehdi; Azuara-Blanco, Augusto; Burr, Jennifer M; Ramsay, Craig; Cooper, David; Cochran, Claire; Norrie, John; Scotland, Graham

    2017-01-01

    Objective To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon. Setting 22 hospital eye services in the UK. Population Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions Lens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care. Results The mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67–89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. Trial registration number ISRCTN44464607; Results. PMID:28087548

  17. Growth of the human lens in the Indian adult population: Preliminary observations

    Directory of Open Access Journals (Sweden)

    Ashik Mohamed

    2012-01-01

    Full Text Available Context: The eye lens grows throughout life by the addition of new cells inside the surrounding capsule. How this growth affects the properties of the lens is essential for understanding disorders such as cataract and presbyopia. Aims: To examine growth of the human lens in the Indian population and compare this with the growth in Western populations by measuring in vitro dimensions together with wet and dry weights. Settings and Design: The study was conducted at the research wing of a tertiary eye care center in South India and the study design was prospective. Materials and Methods: Lenses were removed from eye bank eyes and their dimensions measured with a digital caliper. They were then carefully blotted dry and weighed before being placed in 5% buffered formalin. After 1 week fixation, the lenses were dried at 80 °C until constant weight was achieved. The constant weight was noted as the dry weight of the lens. Statistical Analysis Used: Lens parameters were analyzed as a function of age using linear and logarithmic regression methods. Results: Data were obtained for 251 lenses, aged 16-93 years, within a median postmortem time of 22 h. Both wet and dry weights increased linearly at 1.24 and 0.44 mg/year, respectively, throughout adult life. The dimensions also increased continuously throughout this time. Conclusions: Over the age range examined, lens growth in the Indian population is very similar to that in Western populations.

  18. Take Care Of Home And Family, Honey, And Let Me Take Care Of The Money. Gender Bias And Credit Market Barriers For Female Entrepreneurs

    OpenAIRE

    Ongena, S.; Popov, A.

    2013-01-01

    Abstract We identify the causal effect of gender bias on access to finance. We extract an exogenous measure of gender bias from survey responses by descendants of US immigrants on questions about the role of women in society. We then investigate a detailed dataset on small business firms from 17 countries and find that the inherited component of gender bias is associated with gender-based discrimination in the credit market of the immigrants' country of origin. In particular, in countries wit...

  19. Primary intraocular lens implantation for penetrating lens trauma in Africa.

    Science.gov (United States)

    Bowman, R J; Yorston, D; Wood, M; Gilbert, C; Foster, A

    1998-09-01

    This study aimed to audit the surgical strategy of primary posterior chamber intraocular lens implantation for cases of recent penetrating trauma involving the lens in an African population. Retrospective, noncomparative case series. Seventy-two cases are reported, including all patients who underwent primary intraocular lens implantation for traumatic cataract extraction performed within 1 month of injury between 1988 and 1996. Demographic characteristics and follow-up attendance rates are analyzed. Surgical technique and the occurrence of intraoperative and postoperative complications are reported. Visual outcomes are reported with detailed analysis for cases of poor visual outcome. Mean age was 14.3 years (standard deviation = 11.1), 57 (79%) were male and 15 (21%) were female (chi-square = 23.66, P capsule had been breached by the trauma in 27 (38%) cases, and 15 of these required anterior vitrectomy. Capsular fixation of the implant was achieved in 49% of patients, the remainder having sulcus fixation. Intraoperative rupture of the posterior capsule occurred in four cases. The only common postoperative complication was acute fibrinous anterior uveitis, which occurred in 29 (40%) patients, and 32% of patients followed up for at least 6 months required secondary posterior capsulotomy. This was more common in younger patients (chi-square = 4.2, P < 0.05). Corrected postoperative visual acuities were available for 51 patients, of which 71% achieved 20/60 or better visual acuity. Patients 6 years of age or younger were less likely to achieve 20/60 (chi-square = 6.61, P = 0.01). This surgical strategy has proved successful, producing good visual results and causing no sight-threatening complications. Primary posterior capsulotomy may be appropriate for younger patients.

  20. Modern marketing approach: Concept of viral marketing

    Directory of Open Access Journals (Sweden)

    Mihailović Lidija B.

    2017-01-01

    Full Text Available Today, viral marketing is one of the most effective forms of marketing and it can be used to raise awareness about the product/service of a specific company. This type of marketing thrives in a modern environment, where final users (buyers/clients dominate by spreading messages within themselves. Boosted by the advantages that modern technology brings, viral marketing is booming in the online world. For the first time, small brands have a chance to make their appearance in the global market ad challenge the dominating position of the historically top brands. All they need is content that draws attention and modern, digital culture will help spread their message. Viral marketing is the future. And with the growth of social media and other channels, marketing managers need to be careful, because it is a thin line between a good and a bad (backfired viral campaign.

  1. DISSECTING THE GRAVITATIONAL LENS B1608+656. I. LENS POTENTIAL RECONSTRUCTION

    NARCIS (Netherlands)

    Suyu, S. H.; Marshall, P. J.; Blandford, R. D.; Fassnacht, C. D.; Koopmans, L. V. E.; McKean, J. P.; Treu, T.

    2009-01-01

    Strong gravitational lensing is a powerful technique for probing galaxy mass distributions and for measuring cosmological parameters. Lens systems with extended source-intensity distributions are particularly useful for this purpose since they provide additional constraints on the lens potential (

  2. Development of a Fresnel lens for cold neutrons based on neutron refractive optics

    International Nuclear Information System (INIS)

    Oku, T.; Morita, S.; Moriyasu, S.; Yamagata, Y.; Ohmori, H.; Takizawa, Y.; Shimizu, H.M.; Hirota, T.; Kiyanagi, Y.; Ino, T.; Furusaka, M.; Suzuki, J.

    2001-01-01

    We have developed compound refractive lenses (CRLs) for cold neutrons, which are made of vitreous silica and have an effective potential of (90.1-2.7x10 -4 i) neV. In the case of compound refractive optics, neutron absorption by the material deteriorates lens performance. Thus, to prevent an increase in neutron absorption with increasing beam size, we have developed Fresnel lenses using the electrolytic in-process dressing grinding technique. The lens characteristics were carefully investigated with experimental and numerical simulation studies. The lenses functioned as a neutron focusing lens, and the focal length of 14 m was obtained with a 44-element series of the Fresnel lenses for 10 A neutrons. Moreover, good neutron transmission of 0.65 for 15 A neutrons was obtained due to the shape effect. According to comprehensive analysis of the obtained results, it is possible to realize a CRL for practical use by choosing a suitable lens shape and material

  3. Consumer electronic optics: how small can a lens be: the case of panomorph lenses

    Science.gov (United States)

    Thibault, Simon; Parent, Jocelyn; Zhang, Hu; Du, Xiaojun; Roulet, Patrice

    2014-09-01

    In 2014, miniature camera modules are applied to a variety of applications such as webcam, mobile phone, automotive, endoscope, tablets, portable computers and many other products. Mobile phone cameras are probably one of the most challenging parts due to the need for smaller and smaller total track length (TTL) and optimized embedded image processing algorithms. As the technology is developing, higher resolution and higher image quality, new capabilities are required to fulfil the market needs. Consequently, the lens system becomes more complex and requires more optical elements and/or new optical elements. What is the limit? How small an injection molded lens can be? We will discuss those questions by comparing two wide angle lenses for consumer electronic market. The first lens is a 6.56 mm (TTL) panoramic (180° FOV) lens built in 2012. The second is a more recent (2014) panoramic lens (180° FOV) with a TTL of 3.80 mm for mobile phone camera. Both optics are panomorph lenses used with megapixel sensors. Between 2012 and 2014, the development in design and plastic injection molding allowed a reduction of the TTL by more than 40%. This TTL reduction has been achieved by pushing the lens design to the extreme (edge/central air and material thicknesses as well as lens shape). This was also possible due to a better control of the injection molding process and material (low birefringence, haze and thermal stability). These aspects will be presented and discussed. During the next few years, we don't know if new material will come or new process but we will still need innovative people and industries to push again the limits.

  4. Role of Aquaporin 0 in lens biomechanics

    International Nuclear Information System (INIS)

    Sindhu Kumari, S.; Gupta, Neha; Shiels, Alan; FitzGerald, Paul G.; Menon, Anil G.; Mathias, Richard T.; Varadaraj, Kulandaiappan

    2015-01-01

    Maintenance of proper biomechanics of the eye lens is important for its structural integrity and for the process of accommodation to focus near and far objects. Several studies have shown that specialized cytoskeletal systems such as the beaded filament (BF) and spectrin-actin networks contribute to mammalian lens biomechanics; mutations or deletion in these proteins alters lens biomechanics. Aquaporin 0 (AQP0), which constitutes ∼45% of the total membrane proteins of lens fiber cells, has been shown to function as a water channel and a structural cell-to-cell adhesion (CTCA) protein. Our recent ex vivo study on AQP0 knockout (AQP0 KO) mouse lenses showed the CTCA function of AQP0 could be crucial for establishing the refractive index gradient. However, biomechanical studies on the role of AQP0 are lacking. The present investigation used wild type (WT), AQP5 KO (AQP5 −/− ), AQP0 KO (heterozygous KO: AQP0 +/− ; homozygous KO: AQP0 −/− ; all in C57BL/6J) and WT-FVB/N mouse lenses to learn more about the role of fiber cell AQPs in lens biomechanics. Electron microscopic images exhibited decreases in lens fiber cell compaction and increases in extracellular space due to deletion of even one allele of AQP0. Biomechanical assay revealed that loss of one or both alleles of AQP0 caused a significant reduction in the compressive load-bearing capacity of the lenses compared to WT lenses. Conversely, loss of AQP5 did not alter the lens load-bearing ability. Compressive load-bearing at the suture area of AQP0 +/− lenses showed easy separation while WT lens suture remained intact. These data from KO mouse lenses in conjunction with previous studies on lens-specific BF proteins (CP49 and filensin) suggest that AQP0 and BF proteins could act co-operatively in establishing normal lens biomechanics. We hypothesize that AQP0, with its prolific expression at the fiber cell membrane, could provide anchorage for cytoskeletal structures like BFs and together they help to

  5. Freeform lens design for LED collimating illumination.

    Science.gov (United States)

    Chen, Jin-Jia; Wang, Te-Yuan; Huang, Kuang-Lung; Liu, Te-Shu; Tsai, Ming-Da; Lin, Chin-Tang

    2012-05-07

    We present a simple freeform lens design method for an application to LED collimating illumination. The method is derived from a basic geometric-optics analysis and construction approach. By using this method, a highly collimating lens with LED chip size of 1.0 mm × 1.0 mm and optical simulation efficiency of 86.5% under a view angle of ± 5 deg is constructed. To verify the practical performance of the lens, a prototype of the collimator lens is also made, and an optical efficiency of 90.3% with a beam angle of 4.75 deg is measured.

  6. Changes in lens stiffness due to capsular opacification in accommodative lens refilling

    NARCIS (Netherlands)

    Nibourg, Lisanne M.; Sharma, Prashant K.; van Kooten, Theo G.; Koopmans, Steven A.

    Accommodation may be restored to presbyopic lenses by refilling the lens capsular bag with a soft polymer. After this accommodative lens refilling prevention of capsular opacification is a requirement, since capsular opacification leads to a decreased clarity of the refilled lens. It has been

  7. Exchange of tears under a contact lens is driven by distortions of the contact lens.

    Science.gov (United States)

    Maki, Kara L; Ross, David S

    2014-12-01

    We studied the flow of the post-lens tear film under a soft contact lens to understand how the design parameters of contact lenses can affect ocular health. When a soft contact lens is inserted, the blinking eyelid causes the lens to stretch in order to conform to the shape of the eye. The deformed contact lens acts to assume its un-deformed shape and thus generates a suction pressure in the post-lens tear film. In consequence, the post-lens tear fluid moves; it responds to the suction pressure. The suction pressure may draw in fresh fluid from the edge of the lens, or it may eject fluid there, as the lens reassumes its un-deformed shape. In this article, we develop a mathematical model of the flow of the post-lens tear fluid in response to the mechanical suction pressure of a deformed contact lens. We predict the amount of exchange of fluid exchange under a contact lens and we explore the influence of the eye's shape on the rate of exchange of fluid. © The Author 2014. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  8. Lens design and local minima

    International Nuclear Information System (INIS)

    Brixner, B.

    1981-01-01

    The widespread belief that local minima exist in the least squares lens-design error function is not confirmed by the Los Alamos Scientific Laboratory (LASL) optimization program. LASL finds the optimum-mimimum region, which is characterized by small parameter gradients of similar size, small performance improvement per iteration, and many designs that give similar performance. Local minima and unique prescriptions have not been found in many-parameter problems. The reason for these absences is that image errors caused by a change in one parameter can be compensated by changes in the remaining parameters. False local minima have been found, and four cases are discussed

  9. Primary anterior chamber intraocular lens for the treatment of severe crystalline lens subluxation.

    Science.gov (United States)

    Hoffman, Richard S; Fine, I Howard; Packer, Mark

    2009-10-01

    Subluxated cataractous and clear lenses are commonly treated by limbal or pars plana lensectomy followed by primary or secondary intraocular lens (IOL) implantation. Adjunctive capsular prosthetic devices have facilitated lens removal and IOL centration in these challenging cases but have also added complexity and potential complications to the procedure. Although crystalline lens extraction may be required to clear the visual axis in mild to moderate lens subluxations, we propose insertion of a primary anterior chamber IOL without lens extraction in severe subluxations when the eye is optically aphakic or can be made functionally aphakic following neodymium:YAG laser zonulysis. Two cases demonstrating this approach are presented.

  10. Fabricating customized hydrogel contact lens

    Science.gov (United States)

    Childs, Andre; Li, Hao; Lewittes, Daniella M.; Dong, Biqin; Liu, Wenzhong; Shu, Xiao; Sun, Cheng; Zhang, Hao F.

    2016-10-01

    Contact lenses are increasingly used in laboratories for in vivo animal retinal imaging and pre-clinical studies. The lens shapes often need modification to optimally fit corneas of individual test subjects. However, the choices from commercially available contact lenses are rather limited. Here, we report a flexible method to fabricate customized hydrogel contact lenses. We showed that the fabricated hydrogel is highly transparent, with refractive indices ranging from 1.42 to 1.45 in the spectra range from 400 nm to 800 nm. The Young’s modulus (1.47 MPa) and hydrophobicity (with a sessile drop contact angle of 40.5°) have also been characterized experimentally. Retinal imaging using optical coherence tomography in rats wearing our customized contact lenses has the quality comparable to the control case without the contact lens. Our method could significantly reduce the cost and the lead time for fabricating soft contact lenses with customized shapes, and benefit the laboratorial-used contact lenses in pre-clinical studies.

  11. Protection of the eye lens

    International Nuclear Information System (INIS)

    2015-01-01

    The limit of radiation exposure for eye lens is going to decrease dramatically from 150 to 20 mSv as a transposition into the French law of a CIPR (International Commission for Radiation Protection) directive. Sanitary studies have shown that radiologists are more likely by a factor of 3.8 to get eye lens opacities than the rest of the population. The wearing of protective glasses is recommended and in order to get a better monitoring of the radiation dose new dosimeters have been designed, they can be worn on the glass frame of directly stuck on the skin near the eyes. A study has shown that veterinary surgeons that are accustomed to stay near animals to keep them quiet during radiological exams are prone to receive high doses as well as physicians that use hypnosis to decrease the level of anxiety of their patients during radiological exams. Radiation exposure of radiologists can be mitigated through: the use of protective shields and equipment and the optimization of the dose delivered to the patient. (A.C.)

  12. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    Directory of Open Access Journals (Sweden)

    Lin Blossom Yen-Ju

    2007-06-01

    Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

  13. Color corrected Fresnel lens for solar concentration

    International Nuclear Information System (INIS)

    Kritchman, E.M.

    1979-01-01

    A new linear convex Fresnel lens with its groove side down is described. The design philosophy is similar to the highly concentrating two focal Fresnel lens but including a correction for chromatic aberration. A solar concentration ratio as high as 80 is achieved. For wide acceptance angles the concentration nears the theoretical maximum. (author)

  14. Analysis of a Thin Optical Lens Model

    Science.gov (United States)

    Ivchenko, Vladimir V.

    2011-01-01

    In this article a thin optical lens model is considered. It is shown that the limits of its applicability are determined not only by the ratio between the thickness of the lens and the modules of the radii of curvature, but above all its geometric type. We have derived the analytical criteria for the applicability of the model for different types…

  15. Mathematical Lens: How Much Can You Bench?

    Science.gov (United States)

    Bolognese, Chris A.

    2013-01-01

    "How Much Can You Bench?" appears in the "Mathematical Lens" section of "Mathematics Teacher." "Mathematical Lens" uses photographs as a springboard for mathematical inquiry and appears in every issue of "Mathematics Teacher." This month the mathematics behind the photograph includes finding areas…

  16. Plasma Lens for Muon and Neutrino Beams

    International Nuclear Information System (INIS)

    Kahn, S.A.; Korenev, S.; Bishai, M.; Diwan, M.; Gallardo, J.C.; Hershcovitch, A.; Johnson, B.M.

    2008-01-01

    The plasma lens is examined as an alternate to focusing horns and solenoids for use in a neutrino or muon beam facility. The plasma lens concept is based on a combined high-energy lens/target configuration. The current is fed at electrodes located upstream and downstream from the target where pion capturing is needed. The current flows primarily in the plasma, which has a lower resistivity than the target. A second plasma lens section, with an additional current feed, follows the target to provide shaping of the plasma for optimum focusing. The plasma lens is immersed in an additional solenoid magnetic field to facilitate the plasma stability. The geometry of the plasma is shaped to provide optimal pion capture. Simulations of this plasma lens system have shown a 25% higher neutrino production than the horn system. Plasma lenses have the additional advantage of negligible pion absorption and scattering by the lens material and reduced neutrino contamination during anti-neutrino running. Results of particle simulations using plasma lens will be presented

  17. Co-creation of market expansion in point-of-care testing in the United States: Industry leadership perspectives on the community pharmacy segment.

    Science.gov (United States)

    Hohmeier, Kenneth C; McDonough, Sharon L K; Wang, Junling

    Point-of-care testing (POCT) is a specialty of laboratory medicine that occurs at the bedside or near the patient when receiving health services. Despite its established clinical utility and consumer demand in the community pharmacy, the implementation of POCT within this setting has remained modest for a variety of reasons. One possible solution to this problem is the concept of co-creation - the partnership between consumer and manufacturer in the development of value for a service or device. Using the theoretical underpinning of co-creation, this study aimed to investigate perceptions of point-of-care-testing (POCT) industry leadership on the community pharmacy market in the United States to uncover reasons for limited implementation within community pharmacies. Participants were recruited for this study through the use of snowball sampling. A series of semi-structured interviews were conducted with the participants via telephone. Interviews were recorded, transcribed, and entered into a qualitative analysis software program to summarize the data. Five key themes were uncovered: gaps in understanding, areas of positive impact, barriers to implementation, facilitators of implementation, and community pharmacy - a potential major player. Through uncovering gaps in perceptions, it may be possible to leverage the U.S. pharmacy industry's size, potential for scalability, and ease of patient access to further patient care. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Hospital usage of marketing research over a ten year period.

    Science.gov (United States)

    Sanchez, P M

    1995-01-01

    The acceptance and use of marketing techniques and concepts in the health care area is a phenomenon well known to most marketers. Prior to 1979, marketing in the health care field was relatively unknown. Since that time, however, the growth of health care marketing has not been accompanied by commensurate growth in marketing research efforts.

  19. Incomplete Markets and Imperfect Institutions: Some Challenges Posed by Trust for Contemporary Health Care and Health Policy.

    Science.gov (United States)

    Schlesinger, Mark; Gray, Bradford H

    2016-08-01

    As contemporary health policy promotes evidence-based practices using targeted incentives, policy makers may lose track of vital aspects of care that are difficult to measure. For more than a half century, scholars have recognized that these latter aspects play a crucial role in high-quality care and equitable health system performance but depend on the potentially frail reed of providers' trustworthiness: that is, their commitment to facets and outcomes of care not easily assessed by external parties. More recently, early experience with pay for performance in health settings suggests that enhancing financial rewards for the measurable undermines providers' commitment to the unmeasurable, degrading the trustworthiness of their practices. Reformers have looked to revised professional norms or reorganized practice arrangements to bolster the intrinsic motivations required for trustworthiness. We suggest here that these responses are likely to prove inadequate. We propose that they be complemented by a renewed policy-making commitment to nonprofit ownership among health care providers, insurers, and integrated delivery systems. We identify some of the concerns raised in the past with ownership-based policies and propose a set of responses. If these are pursued in combination, they hold the promise of a sustainable ownership-based policy reform for the United States. Copyright © 2016 by Duke University Press.

  20. LensEnt2: Maximum-entropy weak lens reconstruction

    Science.gov (United States)

    Marshall, P. J.; Hobson, M. P.; Gull, S. F.; Bridle, S. L.

    2013-08-01

    LensEnt2 is a maximum entropy reconstructor of weak lensing mass maps. The method takes each galaxy shape as an independent estimator of the reduced shear field and incorporates an intrinsic smoothness, determined by Bayesian methods, into the reconstruction. The uncertainties from both the intrinsic distribution of galaxy shapes and galaxy shape estimation are carried through to the final mass reconstruction, and the mass within arbitrarily shaped apertures are calculated with corresponding uncertainties. The input is a galaxy ellipticity catalog with each measured galaxy shape treated as a noisy tracer of the reduced shear field, which is inferred on a fine pixel grid assuming positivity, and smoothness on scales of w arcsec where w is an input parameter. The ICF width w can be chosen by computing the evidence for it.

  1. DotLens smartphone microscopy for biological and biomedical applications (Conference Presentation)

    Science.gov (United States)

    Sung, Yu-Lung; Zhao, Fusheng; Shih, Wei-Chuan

    2017-02-01

    Recent advances in inkjet-printed optics have created a new class of lens fabrication technique. Lenses with a tunable geometry, magnification, and focal length can be fabricated by dispensing controlled amounts of liquid polymer onto a heated surface. This fabrication technique is highly cost-effective, and can achieve optically smooth surface finish. Dubbed DotLens, a single of which weighs less than 50 mg and occupies a volume less than 50 μL. DotLens can be attached onto any smartphone camera akin to a contact lens, and enable smartphones to obtain image resolution as fine as 1 µm. The surface curvature modifies the optical path of light to the image sensor, and enables the camera to focus as close as 2 mm. This enables microscopic imaging on a smartphone without any additional attachments, and has shown great potential in mobile point-of-care diagnostic systems, particularly for histology of tissue sections and cytology of blood cells. DotLens Smartphone Microscopy represents an innovative approach fundamentally different from other smartphone microscopes. In this paper, we describe the application and performance of DotLens smartphone microscopy in biological and biomedical research. In particular, we show recent results from images collected from pathology tissue slides with cancer features. In addition, we show performance in cytological analysis of blood smear. This tool has empowered Citizen Science investigators to collect microscopic images from various interesting objects.

  2. Lens-free imaging of magnetic particles in DNA assays.

    Science.gov (United States)

    Colle, Frederik; Vercruysse, Dries; Peeters, Sara; Liu, Chengxun; Stakenborg, Tim; Lagae, Liesbet; Del-Favero, Jurgen

    2013-11-07

    We present a novel opto-magnetic system for the fast and sensitive detection of nucleic acids. The system is based on a lens-free imaging approach resulting in a compact and cheap optical readout of surface hybridized DNA fragments. In our system magnetic particles are attracted towards the detection surface thereby completing the labeling step in less than 1 min. An optimized surface functionalization combined with magnetic manipulation was used to remove all nonspecifically bound magnetic particles from the detection surface. A lens-free image of the specifically bound magnetic particles on the detection surface was recorded by a CMOS imager. This recorded interference pattern was reconstructed in software, to represent the particle image at the focal distance, using little computational power. As a result we were able to detect DNA concentrations down to 10 pM with single particle sensitivity. The possibility of integrated sample preparation by manipulation of magnetic particles, combined with the cheap and highly compact lens-free detection makes our system an ideal candidate for point-of-care diagnostic applications.

  3. Target marketing strategies for occupational therapy entrepreneurs.

    Science.gov (United States)

    Kautzmann, L N; Kautzmann, F N; Navarro, F H

    1989-01-01

    Understanding marketing techniques is one of the skills needed by successful entre renews. Target marketing is an effective method for occupational therapy entrepreneurs to use in determining when and where to enter the marketplace. The two components of target marketing, market segmentation and the development of marketing mix strategies for each identified market segment, are described. The Profife of Attitudes Toward Health Care (PATH) method of psychographic market segmentation of health care consumers is presented. Occupational therapy marketing mix strategies for each PATH consumer group are delineated and compatible groupings of market segments are suggested.

  4. Comparative cost analysis of insecticide-treated net delivery strategies: sales supported by social marketing and free distribution through antenatal care.

    Science.gov (United States)

    De Allegri, Manuela; Marschall, Paul; Flessa, Steffen; Tiendrebéogo, Justin; Kouyaté, Bocar; Jahn, Albrecht; Müller, Olaf

    2010-01-01

    Insecticide-treated nets (ITNs) are effective in substantially reducing malaria transmission. Still, ITN coverage in sub-Saharan Africa (SSA) remains extremely low. Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage. Little is known, however, on the comparative costs of alternative ITN distribution strategies. This paper aimed to fill this gap in knowledge by developing such a comparative cost analysis, looking at the cost per ITN distributed for two alternative interventions: subsidized sales supported by social marketing and free distribution to pregnant women through antenatal care (ANC). The study was conducted in rural Burkina Faso, where the two interventions were carried out alongside one another in 2006/07. Cost information was collected prospectively to derive both a financial analysis adopting a provider's perspective and an economic analysis adopting a societal perspective. The average financial cost per ITN distributed was US$8.08 and US$7.21 for sales supported by social marketing and free distribution through ANC, respectively. The average economic cost per ITN distributed was US$4.81 for both interventions. Contrary to common belief, costs did not differ substantially between the two interventions. Due to the district's ability to rely fully on the use of existing resources, financial costs associated with free ITN distribution through ANC were in fact even lower than those associated with the social marketing campaign. This represents an encouraging finding for SSA governments and points to the possibility to invest in programmes to favour free ITN distribution through existing health facilities. Given restricted budgets, however, free distribution programmes are unlikely to be feasible.

  5. Targeting the Online Market

    Institute of Scientific and Technical Information of China (English)

    MARKGODFREY

    2004-01-01

    Many marketing executives did adouble take in April whenChanel tested a marketing medium previously shunned by most premium brands: permission email. Shanghai-based marketing firm 2i Communications created the opt-in email campaign to draw customers to Chanel's new skin care product Precision. The company emailed ecoupons 120,000 young women earning more than 3,000 yuan (US$362.4) per month in five cities across China.

  6. MARKET WATCH

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Pork prices in Beijing remained relatively stable despite the swine flu outbreak in Mexico. China’s job market is still in the doldrums with the registered urban jobless rising slightly in the first quarter. The government is preparing to issue the third tranche of its stimulus package. China Minmetals Corp. received approval from the Australian Treasury to buy the assets of Oz Minerals Ltd. There were signs that international hot money has started to leave China. Surveys indicate that new Chinese parents are shunning foreign baby-care products.

  7. Ineffable Cultures or Material Devices: What Valuation Studies can Learn from the Disappearance of Ensured Solidarity in a Health Care Market

    Directory of Open Access Journals (Sweden)

    Teun Zuiderent-Jerak

    2015-10-01

    Full Text Available Valuation studies addresses how values are made in valuation practices. A next - or rather previous - question becomes: what then makes valuation practices? Two oppositional replies are starting to dominate how that question can be answered: a more materially oriented focus on devices of valuation and a more sociologically inclined focus on ineffable valuation cultures. The debate between proponents of both approaches may easily turn into the kind of leapfrog debates that have dominated many previous discussions on whether culture or materiality would play a decisive role in driving history. This paper explores a less repetitive reply. It does so by analyzing the puzzling case of the demise of solidarity as a core value within the recent Dutch health care system of regulated competition. While "solidarity among the insured" was both a strong cultural value within the Dutch welfare-based health system, and a value that was built into market devices by health economists, within a fairly short time "fairness" became of lesser importance than "competition". This makes us call for a more historical, relational, and dynamic understanding of the role of economists, market devices, and of culture in valuation studies.

  8. Marketing mobile imaging services.

    Science.gov (United States)

    McCue, P

    1987-09-01

    Competition in the mobile imaging arena has put radiologists, radiology directors, and other health care professionals in the unfamiliar position of being marketing agents for their services. Mobile imaging is being promoted through consumer advertising as well as through the traditional route of physician referral. This article offers some of the marketing lessons being learned in the mobile arena.

  9. Lessons learned: wrong intraocular lens.

    Science.gov (United States)

    Schein, Oliver D; Banta, James T; Chen, Teresa C; Pritzker, Scott; Schachat, Andrew P

    2012-10-01

    To report cases involving the placement of the wrong intraocular lens (IOL) at the time of cataract surgery where human error occurred. Retrospective small case series, convenience sample. Seven surgical cases. Institutional review of errors committed and subsequent improvements to clinical protocols. Lessons learned and changes in procedures adapted. The pathways to a wrong IOL are many but largely reflect some combination of poor surgical team communication, transcription error, lack of preoperative clarity in surgical planning or failure to match the patient, and IOL calculation sheet with 2 unique identifiers. Safety in surgery involving IOLs is enhanced both by strict procedures, such as an IOL-specific "time-out," and the fostering of a surgical team culture in which all members are encouraged to voice questions and concerns. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  10. Radiation studies in Lens culinaris

    International Nuclear Information System (INIS)

    Sinha, S.S.N.

    1977-01-01

    Estimation of chromosomal aberrations in flowers of Lens culinaris according to their sequence of development in the plants at 4, 8 and 12 Kr in the M 1 generation, showed that the later formed flowers had smaller percentages of cells with aberrations than those developed earlier. It is suggested that this may be the result of competition between more damaged and less damaged cells during the development of the shoot. There is consequently a decrease of sterility in successive flowers. The numbers of karyotypes taking part in the formation of lower and uppermost flowers were estimated cytologically at 4, 8 and 12 Kr. It was found that more karyotypes were involved in the formation of the lower flowers than in the upper ones. It appeared that at lower doses larger numbers of karyotypes were taking part in the formation of the chimaera than at higher doses. (auth.)

  11. Marketing; Il marketing

    Energy Technology Data Exchange (ETDEWEB)

    Muscigna, M [ENEA, Centro Ricerche Casaccia, S. Maria di Galeria, RM (Italy). Dipt. Innovazione

    1999-07-01

    The report discusses marketing strategies oriented to the organizations and analyzes its critical factors, which determine the success of the organization activity. [Italian] Il rapporto analizza i caratteri delle strategie del marketing orientato all'impresa. Vengono infine analizzati i fattori critici che determinano il successo o l'insuccesso delle scelte aziendali.

  12. Marketing; Il marketing

    Energy Technology Data Exchange (ETDEWEB)

    Muscigna, M. [ENEA, Centro Ricerche Casaccia, S. Maria di Galeria, RM (Italy). Dipt. Innovazione

    1999-07-01

    The report discusses marketing strategies oriented to the organizations and analyzes its critical factors, which determine the success of the organization activity. [Italian] Il rapporto analizza i caratteri delle strategie del marketing orientato all'impresa. Vengono infine analizzati i fattori critici che determinano il successo o l'insuccesso delle scelte aziendali.

  13. Social Justice as a Lens for Understanding Workplace Mistreatment.

    Science.gov (United States)

    Moffa, Christine; Longo, Joy

    2016-01-01

    Workplace mistreatment can be viewed as a social injustice that prohibits one from achieving optimal well-being. Cognitive and interpersonal skills required of nurses can be impacted by workplace mistreatment, thus extending injustices by violating the rights of patients to optimal care. The purpose of this article is to view workplace mistreatment through the lens of Powers and Faden's theory of social justice. Workplace mistreatment is explored through the 6 dimensions of well-being, including health, personal security, reasoning, respect, attachment, and self-determination, identified in the theory. The implications for practice and policy are discussed and recommendations for research made.

  14. Precision lens assembly with alignment turning system

    Science.gov (United States)

    Ho, Cheng-Fang; Huang, Chien-Yao; Lin, Yi-Hao; Kuo, Hui-Jean; Kuo, Ching-Hsiang; Hsu, Wei-Yao; Chen, Fong-Zhi

    2017-10-01

    The poker chip assembly with high precision lens barrels is widely applied to ultra-high performance optical system. ITRC applies the poker chip assembly technology to the high numerical aperture objective lenses and lithography projection lenses because of its high efficiency assembly process. In order to achieve high precision lens cell for poker chip assembly, an alignment turning system (ATS) is developed. The ATS includes measurement, alignment and turning modules. The measurement module is equipped with a non-contact displacement sensor (NCDS) and an autocollimator (ACM). The NCDS and ACM are used to measure centration errors of the top and the bottom surface of a lens respectively; then the amount of adjustment of displacement and tilt with respect to the rotational axis of the turning machine for the alignment module can be determined. After measurement, alignment and turning processes on the ATS, the centration error of a lens cell with 200 mm in diameter can be controlled within 10 arcsec. Furthermore, a poker chip assembly lens cell with three sub-cells is demonstrated, each sub-cells are measured and accomplished with alignment and turning processes. The lens assembly test for five times by each three technicians; the average transmission centration error of assembly lens is 12.45 arcsec. The results show that ATS can achieve high assembly efficiency for precision optical systems.

  15. Bioinspired adaptive gradient refractive index distribution lens

    Science.gov (United States)

    Yin, Kezhen; Lai, Chuan-Yar; Wang, Jia; Ji, Shanzuo; Aldridge, James; Feng, Jingxing; Olah, Andrew; Baer, Eric; Ponting, Michael

    2018-02-01

    Inspired by the soft, deformable human eye lens, a synthetic polymer gradient refractive index distribution (GRIN) lens with an adaptive geometry and focal power has been demonstrated via multilayer coextrusion and thermoforming of nanolayered elastomeric polymer films. A set of 30 polymer nanolayered films comprised of two thermoplastic polyurethanes having a refractive index difference of 0.05 were coextruded via forced-assembly technique. The set of 30 nanolayered polymer films exhibited transmission near 90% with each film varying in refractive index by 0.0017. An adaptive GRIN lens was fabricated from a laminated stack of the variable refractive index films with a 0.05 spherical GRIN. This lens was subsequently deformed by mechanical ring compression of the lens. Variation in the optical properties of the deformable GRIN lens was determined, including 20% variation in focal length and reduced spherical aberration. These properties were measured and compared to simulated results by placido-cone topography and ANSYS methods. The demonstration of a solid-state, dynamic focal length, GRIN lens with improved aberration correction was discussed relative to the potential future use in implantable devices.

  16. FPscope: a field-portable high-resolution microscope using a cellphone lens.

    Science.gov (United States)

    Dong, Siyuan; Guo, Kaikai; Nanda, Pariksheet; Shiradkar, Radhika; Zheng, Guoan

    2014-10-01

    The large consumer market has made cellphone lens modules available at low-cost and in high-quality. In a conventional cellphone camera, the lens module is used to demagnify the scene onto the image plane of the camera, where image sensor is located. In this work, we report a 3D-printed high-resolution Fourier ptychographic microscope, termed FPscope, which uses a cellphone lens in a reverse manner. In our platform, we replace the image sensor with sample specimens, and use the cellphone lens to project the magnified image to the detector. To supersede the diffraction limit of the lens module, we use an LED array to illuminate the sample from different incident angles and synthesize the acquired images using the Fourier ptychographic algorithm. As a demonstration, we use the reported platform to acquire high-resolution images of resolution target and biological specimens, with a maximum synthetic numerical aperture (NA) of 0.5. We also show that, the depth-of-focus of the reported platform is about 0.1 mm, orders of magnitude longer than that of a conventional microscope objective with a similar NA. The reported platform may enable healthcare accesses in low-resource settings. It can also be used to demonstrate the concept of computational optics for educational purposes.

  17. Fabrication of MTF measurement system for a mobile phone lens using multi-square objects

    Science.gov (United States)

    Hong, Sung Mok; Jo, Jae Heung; Lee, Hoi Youn; Yang, Ho Soon; Lee, Yun Woo; Lee, In Won

    2007-12-01

    The mobile phone market grows rapidly and the performance estimation about camera module is required. Accordingly, we fabricate the MTF measurement system for a mobile phone lens having extremely small diameter and large f-number. The objective lens with the magnification of X20 for MTF measurement for high resolution lens and a detector of CCD that is pixel size of 7.4 um are adapted to the system. Also, the CCD is translated by using a linear motor to reduce measurement errors. The measurement lens is placed at the most suitable imaging point by a precise auto-focusing motor. The measuring equipment which we developed for off-axis MTF measurement of a mobile phone lens used the multi-square objects. The square objects of measuring equipment are arranged a unit in the on-axis and total 12 units (0.3 field: 4 units, 0.5 field: 4 units, 0.7 field: 4 units) in the off-axis. When the measurement is started, the linear motors of signal detection part are transferred from on-axis to off-axis. And a detected signals from the each square objects are used for MTF measurement. System driver and MTF measure are using application program that developed us. This software can be measure the on-axis and the off-axis sequentially. In addition to that it did optimization of motor transfer for measurement time shortening.

  18. Metropolitan Innovation and Sustainability in China—A Double Lens Perspective on Regional Development

    Directory of Open Access Journals (Sweden)

    Xiangdong Chen

    2018-02-01

    Full Text Available This study proposes and integrates a double lens investigation framework on sustainability and diversities of innovation at the city level in China. Lens I concerns economic performance with the energy intensiveness of the production mode and Lens II involves a four-dimensional model with the current and potential elements of innovation at the city level. Based on 106Chinese cities data, sample cities grouped in Traditional Regions (TRs, Top Economic Regions (TEs and New Economy Regions (NEs of the 9 groups are clarified via the Investigation Lens I, with respect to production power, market openness and energy intensive use. The further research findings through the Investigation Lens II show that there are clear connections between innovation and sustainability and such connections are diversified due to economic reasons but also importantly, due to potential factors of human resource and knowledge creation. Cities in TEs group and especially NEs group in China are important on innovation and sustainability while southern cities in China are more innovative, with a higher potentiality of economic growth than cities in northern China. Industrial tradition and business culture can be one of the key factors influencing local innovation and sustainability.

  19. Design of a hyperbolic microwave metallic lens

    International Nuclear Information System (INIS)

    Uckan, T.

    1979-12-01

    Due to problems caused by multiple reflections in the cavity walls of the EBT fusion research device, the use of a horn becomes important for the directivity of waves in the millimetric range. An ordinary dielectric lens cannot be used because of plasma-wall interactions. Microwave metallic lenses, designed to focus the energy into a plane wave, can improve the directivity considerably. By implementing a 70-GHz standard-gain horn with a delay-type hyperbolic lens, which consists of a solid metallic disk with a number of equal size small holes has indicated a gain of 15 dB over the no lens case

  20. Accelerating convergence in automatic lens design

    International Nuclear Information System (INIS)

    Brixner, B.

    1981-01-01

    Among the various factors that slow lens optimization-insufficient performance targets, the absence of a unique solution, false local minima, a poorly scaled change vector, failure to find the optimum damping number, and failure to equalize the parameter gradients-the importance of parameter gradient equalization has been insufficiently recognized. Gradients can be approximately equalized by scaling the lens to a suitable size while it is being optimized. For best results, the size of the damping number should also be optimized during each iteration. If these two procedures are followed, scaling the change vector is usually not crucial. To illustrate the importance of parameter equalization, a lens optimization is analyzed

  1. A new quadruple gravitational lens system : CLASS B0128+437

    NARCIS (Netherlands)

    Phillips, PM; Norbury, MA; Koopmans, LVE; Browne, IWA; Jackson, NJ; Wilkinson, PN; Biggs, AD; Blandford, RD; de Bruyn, AG; Fassnacht, CD; Helbig, P; Mao, S; Marlow, DR; Myers, ST; Pearson, TJ; Readhead, ACS; Rusin, D; Xanthopoulos, E

    2000-01-01

    High-resolution MERLIN observations of a newly discovered four-image gravitational lens system, B0128+437, are presented. The system was found after a careful re-analysis of the entire CLASS data set. The MERLIN observations resolve four components in a characteristic quadruple-image configuration;

  2. MORPHOLOGICAL ASPECTS OF HUMAN LENS CAPSULES - A COMPARATIVE LM, SEM AND TEM EXAMINATION

    NARCIS (Netherlands)

    JONGEBLOED, WL; KALICHARAN, D; LOS, LI; VANDERVEEN, G; WORST, JGF

    1991-01-01

    Lens capsules of patients of advanced age, obtained after extracapsular cataract surgery, were carefully prepared for a combined LM, TEM and SEM investigation, after preliminary washing and mounting onto a holder in a buffer solution. After pre-fixation with GA, samples were postfixed for LM/TEM and

  3. Perspectives on the ‘lens of risk’ interview series: interview with Nick Pidgeon

    NARCIS (Netherlands)

    Heyman, B.; Brown, P.

    2012-01-01

    This article is the first in a series which will appear in 2012 in the special issue series Health Care Through the `Lens of Risk'. It provides a quasi-verbatim transcript of an interview with Nick Pidgeon, one of the main contributors to the social science component of The Royal Society Risk Report

  4. Livestock Marketing.

    Science.gov (United States)

    Futrell, Gene; And Others

    This marketing unit focuses on the seasonal and cyclical patterns of livestock markets. Cash marketing, forward contracting, hedging in the futures markets, and the options markets are examined. Examples illustrate how each marketing tool may be useful in gaining a profit on livestock and cutting risk exposure. The unit is organized in the…

  5. Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective.

    Science.gov (United States)

    Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

    2017-06-01

    The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

  6. Who cares about physics today? A marketing strategy for the survival of fundamental science and the benefit of society

    Science.gov (United States)

    Cannella, Umberto

    2013-04-01

    It is often said that the major stumbling block for doing scientific outreach is money because of funding issues. Ignoring that the true issue is the lack of time and/or inclination on the part of practicing scientists, this statement is too generic to be quantitative or even complete: in fact, as for every project or investment, the discussion should be based on context and impact. Initiatives are at hand to do outreach that cost nothing more than the budget already in place for a University, its Departments and its scientific research groups: it is more a matter of capitalizing existing assets at a University in a concerted way and taking full advantage of these assets by means of synergetic collaborations. I will describe one such collaboration among the School of Dance and the Astronomy and Physics Departments at the University of Maryland: the dance performance ``Gravity,'' inspired by gravitational-wave astronomy. Similar types of partnerships represent new promising ways of doing science communications according to what can be rightly called a marketing strategy (http://arxiv.org.abs/1210.0082).

  7. 21 CFR 886.1395 - Diagnostic Hruby fundus lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic Hruby fundus lens. 886.1395 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1395 Diagnostic Hruby fundus lens. (a) Identification. A diagnostic Hruby fundus lens is a device that is a 55 diopter lens intended for use in the...

  8. 21 CFR 886.5844 - Prescription spectacle lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prescription spectacle lens. 886.5844 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5844 Prescription spectacle lens. (a) Identification. A prescription spectacle lens is a glass or plastic device that is a lens intended to be worn by...

  9. 21 CFR 886.1390 - Flexible diagnostic Fresnel lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Flexible diagnostic Fresnel lens. 886.1390 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1390 Flexible diagnostic Fresnel lens. (a) Identification. A flexible diagnostic Fresnel lens is a device that is a very thin lens which has...

  10. Measurement of Crystalline Lens Volume During Accommodation in a Lens Stretcher.

    Science.gov (United States)

    Marussich, Lauren; Manns, Fabrice; Nankivil, Derek; Maceo Heilman, Bianca; Yao, Yue; Arrieta-Quintero, Esdras; Ho, Arthur; Augusteyn, Robert; Parel, Jean-Marie

    2015-07-01

    To determine if the lens volume changes during accommodation. The study used data acquired on 36 cynomolgus monkey lenses that were stretched in a stepwise fashion to simulate disaccommodation. At each step, stretching force and dioptric power were measured and a cross-sectional image of the lens was acquired using an optical coherence tomography system. Images were corrected for refractive distortions and lens volume was calculated assuming rotational symmetry. The average change in lens volume was calculated and the relation between volume change and power change, and between volume change and stretching force, were quantified. Linear regressions of volume-power and volume-force plots were calculated. The mean (± SD) volume in the unstretched (accommodated) state was 97 ± 8 mm3. On average, there was a small but statistically significant (P = 0.002) increase in measured lens volume with stretching. The mean change in lens volume was +0.8 ± 1.3 mm3. The mean volume-power and volume-load slopes were -0.018 ± 0.058 mm3/D and +0.16 ± 0.40 mm3/g. Lens volume remains effectively constant during accommodation, with changes that are less than 1% on average. This result supports a hypothesis that the change in lens shape with accommodation is accompanied by a redistribution of tissue within the capsular bag without significant compression of the lens contents or fluid exchange through the capsule.

  11. AutoLens: Automated Modeling of a Strong Lens's Light, Mass and Source

    Science.gov (United States)

    Nightingale, J. W.; Dye, S.; Massey, Richard J.

    2018-05-01

    This work presents AutoLens, the first entirely automated modeling suite for the analysis of galaxy-scale strong gravitational lenses. AutoLens simultaneously models the lens galaxy's light and mass whilst reconstructing the extended source galaxy on an adaptive pixel-grid. The method's approach to source-plane discretization is amorphous, adapting its clustering and regularization to the intrinsic properties of the lensed source. The lens's light is fitted using a superposition of Sersic functions, allowing AutoLens to cleanly deblend its light from the source. Single component mass models representing the lens's total mass density profile are demonstrated, which in conjunction with light modeling can detect central images using a centrally cored profile. Decomposed mass modeling is also shown, which can fully decouple a lens's light and dark matter and determine whether the two component are geometrically aligned. The complexity of the light and mass models are automatically chosen via Bayesian model comparison. These steps form AutoLens's automated analysis pipeline, such that all results in this work are generated without any user-intervention. This is rigorously tested on a large suite of simulated images, assessing its performance on a broad range of lens profiles, source morphologies and lensing geometries. The method's performance is excellent, with accurate light, mass and source profiles inferred for data sets representative of both existing Hubble imaging and future Euclid wide-field observations.

  12. Placement of a crystalline lens and intraocular lens: Retinal image quality.

    Science.gov (United States)

    Siedlecki, Damian; Nowak, Jerzy; Zajac, Marek

    2006-01-01

    The influence of changes of both crystalline lens and intraocular lens (IOL) misalignment on the retinal image quality was investigated. The optical model of the eye used in investigations was the Liou-Brennan model, which is commonly considered as one of the most anatomically accurate. The original crystalline lens from this model was replaced with an IOL, made of rigid polymethylmethacrylate, in a way that recommend obligatory procedures. The modifications that were made both for crystalline lens and IOL were the longitudinal, the transversal, and the angular displacement.

  13. Development of Fresnel lens for improvement of rear visibility; Shikai kojo Fresnel lens no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, K; Sanada, C; Tsukino, M [Nissan Motor Co. Ltd., Tokyo (Japan)

    1997-10-01

    Fresnel lenses have been widely used to increase the visual field around vehicles for drivers. However, internal reflection in these lenses has been an obstacle in producing dear images. This internal glow is generated by incident light from an unexpected direction reflecting on the non-lens surface or radiating from the non-lens surface of the Fresnel lens. The cause of internal glow has been made dear combining louver film with the lens. The newly developed technology removes obstacles in producing dear images by reducing internal glow. 7 figs.

  14. Disinfection capacity of PuriLens contact lens cleaning unit against Acanthamoeba.

    Science.gov (United States)

    Hwang, Thomas S; Hyon, Joon Young; Song, Jae Kyung; Reviglio, Victor E; Spahr, Harry T; O'Brien, Terrence P

    2004-01-01

    The PuriLens contact lens system is indicated for cleaning and disinfection of soft (hydrophilic) contact lenses by means of subsonic agitation to remove lens deposits and microorganisms, and ultraviolet irradiation of the storage solution for disinfection. The capacity of the PuriLens system to disinfect storage solutions contaminated with known concentrations of Staphylococcus aureus, Pseudomonas aeruginosa, and Acanthamoeba species was evaluated. An in vitro assessment of the antibacterial and antiparasitic efficacy of the PuriLens system was performed. Separated batches of the storage solution for the cleansing system were contaminated with stock strains of S. aureus and P. aeruginosa. A comparison of the microbiologic content was made between the solution before and after the cycle. The PuriLens system effectively eradicated S. aureus and P. aeruginosa organisms after a 15-minute cycle. However, viable cysts of acanthamoeba were recovered in the solution after the 15-minute cycle. The PuriLens system is highly efficient in protecting against contamination with common bacterial ocular pathogens. Acanthamoeba cysts, however, can survive in the solution or contact lens bath undergoing integrated subsonic debridement and indirect ultraviolet light disinfection. Use of chemical disinfecting solutions that contain agents such as chlorhexidine or other cationic antiseptics may be advisable in conjunction with use of the PuriLens device, especially in high-risk settings.

  15. [Actual medical care situation and therapeutic needs in multiple sclerosis: Impact of the Pharmaceutical Market Restructuring Act (AMNOG)].

    Science.gov (United States)

    Bittner, S; Meuth, S G

    2016-04-01

    The treatment of patients with multiple sclerosis (MS) is associated with constantly rising costs for the healthcare system and pharmaceuticals constitute 60 % of the direct medical costs. The Pharmaceutical Market Restructuring Act (Arzneimittelmarkt-Neuordnungsgesetz, AMNOG) came into force on 1 January 2011 with the aim of limiting the costs of pharmaceuticals by obligating newly approved products to be subjected to an early evaluation of the additional benefits by the Federal Joint Committee (FJC, Gemeinsamer Bundesausschuss, G‑BA). The majority of products evaluated up to October 2015 in neurology (5 out of 8) were approved for treatment of MS. Has the AMNOG been able to fulfill the original aims? Analysis of available information on MS therapies evaluated by the FJC between December 2010 and October 2015. For various reasons an additional benefit could be shown in only 2 out of 5 assessment procedures for MS drugs. It is obvious that some methodological shortcomings of the process have to be improved. Additionally requirements for pivotal clinical trials have to be harmonized with AMNOG requirements taking the best available evidence and real-life data into consideration (e.g. non-interventional studies) and a closer collaboration between the FJC, healthcare providers and the neurological societies is necessary. The AMNOG procedure currently only partially fulfills the original aims, which could be the reason why guidelines play a more important role for therapy decision-making than FJC decisions. As the early evaluation procedure is an adaptive process methodological shortcomings might be overcome in the future; however, this requires a much closer collaboration between the FJC and neurological societies.

  16. Night Vision Goggles Objectives Lens Focusing Methodology

    National Research Council Canada - National Science Library

    Pinkus, Alan; Task, H. L

    2000-01-01

    ...: interpupillary distance, tilt, eye relief, height, eyepiece and objective lens focus. Currently, aircrew use a Hoffman 20/20 test unit to pre-focus their NVG objective lenses at optical infinity before boarding their aircraft...

  17. Characteristics of soft X-ray lens

    International Nuclear Information System (INIS)

    Qin Yi

    2007-12-01

    A soft X-lens was devised with waveguide X-ray optics of total external reflection (TER). The lens consists of a stack of 1 387 TER waveguides with inner diameter of 0.45 mm and outer diameter of 0.60 mm. With the help of plasma sources of soft X-ray radiation, high density of pure soft X-ray radiation (without plasma expansion fragments) with broad-band spectral range can be obtained at the focus of the lens. As laser-plasma is considered, the radiation density of 1.3 x 10 5 W/cm 2 is obtained, the transmission coefficient is 18.6%, the ratio of the density at the focus with and without the lens is 1000 and the radiation capture is 28.9 degree. The density of 0.5 TW/cm 2 can be obtained as far as Qiang-Guang I facility is considered. (authors)

  18. Gravitational lens effect and pregalactic halo objects

    International Nuclear Information System (INIS)

    Bontz, R.J.

    1979-01-01

    The changes in flux, position, and size of a distant extended (galaxy, etc.) source that result from the gravitational lens action of a massive opaque object are discussed. The flux increase is described by a single function of two parameters. One of these parameters characterizes the strength of the gravitational lens, the other describes the alignment of source and lens object. This function also describes the relative intensity of the images formed by lens. ( A similar formalism is discussed by Bourassa et al. for a point source). The formalism is applied to the problem of the galactic halo. It appears that a massive (10 1 2 M/sub sun/) spherical halo surrounding the visible part of the galaxy is consistent with the observable properties of extragalactic sources

  19. Discovery of two new gravitation lens systems

    International Nuclear Information System (INIS)

    Guertler, J.

    1988-01-01

    The discovery of new quasar and radio galaxy double images produced by the gravitation lens effect is reported. The light deflecting galaxies acting as gravitational lenses could be made visible by means of image processing procedures

  20. A Plasma Lens for Magnetron Sputtering

    International Nuclear Information System (INIS)

    Anders, Andre; Brown, Jeff

    2010-01-01

    A plasma lens, consisting of a solenoid and potential-defining ring electrodes, has been placed between a magnetron and substrates to be coated. Photography reveals qualitative information on excitation, ionization, and the transport of plasma to the substrate.