Five biggest challenges in marketing the integrated system: Part I.
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Biomedical subjects
Publications and source records attributed to D Marlowe.
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This study compares perceptions of stress, cohesion, and psychological well-being among 856 male soldiers and 169 female soldiers from combat support and combat service support units deployed to the Persian Gulf during Operation Desert Storm. Three different types of stressors were measured: anticipation of combat, operational stress, and personal stress. Female soldiers scored higher than male soldiers on all three measures of stress but scored lower than males on horizontal and vertical cohesion. In a stepwise discriminant function analysis, anticipation of combat was the most significant discriminator between the genders, followed by horizontal cohesion. Anticipation of combat was a significant predictor of increased psychological symptoms for both genders, but it had a greater effect on the psychological symptoms of female soldiers compared with male soldiers.
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BACKGROUND: Studies of group debriefing after extreme events have failed to show a significant long-term effect of this technique. However, the heterogeneity of the interventions studied and the length of time between debriefing and its assessment do not allow a proper interpretation of these findings. OBJECTIVE: This study evaluates the immediate effect of debriefing in Israeli soldiers exposed to combat. METHOD: Six small units (N = 39) have undergone historical group debriefing within 72 hours of exposure. State anxiety, self-efficacy, and combat evaluation were measured before and immediately after the sessions. RESULTS: Debriefing was followed by reduction in anxiety, improvement in self-efficacy, and increased homogeneity of the group. CONCLUSION: These effects may be attributable to enhancing group cohesion or to a proper beneficial effect of debriefing.
This survey indicated that unit leaders perceived the Army Exceptional Family Member Program (EFMP) positively and considered the program beneficial to the Army, the soldiers, and their families. Furthermore, the unit leaders considered the EFMP soldiers to be well accepted in their units and their duty performance to be comparable to that of non-EFMP soldiers.
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Utilizing a retrospective analysis we examined factors correlated with preintake dropout in patients phoning to make intake appointments for cocaine treatment. Inquiries of 235 individuals calling our outpatient cocaine treatment program over a 7-month period were analyzed for relationships between patient age and gender; residence in the city where the program is located; marital status; referral source; reported problems with alcohol, marijuana, and heroin; reported last use of cocaine or other illicit stimulants; assigned counselor gender; person who made the appointment; days to the intake appointment; and attending the scheduled intake session. Only days to appointment was significantly (Wald = 12.4587, df = 1, p < .05 and chi 2 = 17.7, df = 8, p < .05) correlated with attending the scheduled intake session. Appointments scheduled the same day differed significantly (chi 2 = 4.3, n = 235, df = 1, p < .05) from appointments scheduled later. This suggests that client and situational variables are not significantly related to initial attendance and enhances the significance of systemic variables that are under a clinic's control, such as appointment delay. The results indicate that the longer the delay between the initial phone contact and the scheduled appointment, the less likely a client is to attend an appointment. Further, they suggest that the greatest decrease in initial attendance occurs in the first 24 hours following the phone inquiry. Taking a "microscopic" look at the appointment delay variable is valuable in understanding and addressing preintake dropout.
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.
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"This is an exciting time," says Eric Rechen, policy analyst in the U.S. Food and Drug Administration's (FDA) Office of Device Evaluation (ODE). "We're entering an era in which standards will have a more prominent role in the review of medical devices than ever before." During the past 10 years, there has been significant growth in the importance of standards in regulatory processes, as Donald J. Barth, regulatory staff manager for the Medical Products Group at Hewlett Packard Company, notes in setting the stage for discussion of the latest developments. Donald Marlowe, director of the FDA's Office of Science and Technology, and Rechen explain the use of standards in the regulatory review process as part of FDA efforts to ensure public safety in a time of shrinking agency resources. Marlowe discusses provisions of the FDA Modernization Act of 1997 that allow manufacturers to submit a declaration of conformity to a standard to satisfy premarket review requirements. A guidance on the recognition and use of consensus standards, a list of recognized standards, and a list of frequently asked questions are available at the Web site of the Center for Devices and Radiological Health (CDRH) at www.fda.gov/cdrh and via the AAMI Web site at www.aami.org. The information is also available by telephone via CDRH Facts on Demand at 800-899-0381. Rechen provides details about the two new approaches for premarket notifications available under the new 510(k) paradigm. Manufacturers may demonstrate substantial equivalence through special and abbreviated 510(k)s in addition to traditional 510(k)s. A copy of the new 510(k) paradigm is available at the AAMI and CDRH Web sites and through Facts on Demand. As the FDA and many manufacturers enter the new world of abbreviated and special 510(k)s, Larry Kroger, GE Medical Systems, provides his comments based on the 4 years of experience manufacturers of diagnostic x-ray products have had with simplified 510(k)s. A comparison of the European conformity assessment procedures with the new 510(k) paradigm will appear in an upcoming issue of BI&T.