Resource utilization and charges of patients with and without diagnosed venous thromboembolism during primary hospitalization and after elective inpatient surgery: a retrospective study

Aims: To assess incremental charges of patients experiencing venous thromboembolisms (VTE) across various types of elective inpatient surgical procedures with administration of general anesthesia in the US.

Methods: The authors performed a retrospective study utilizing data from a nationwide hospital operational records database from July 2014 through June 2015 to compare a group of inpatients experiencing a VTE event post-operatively to a propensity score matched group of inpatients who did not experience a VTE. Patients included in the analysis had a hospital admission for an elective inpatient surgical procedure with the use of general anesthesia. Procedures of the heart, brain, lungs, and obstetrical procedures were excluded, as these procedures often require a scheduled ICU stay post-operatively. Outcomes examined included VTE events during hospitalization, length of stay, unscheduled ICU transfers, number of days spent in the ICU if transferred, 3- and 30-day re-admissions, and total hospital charges incurred.

Results: The study included 17,727 patients undergoing elective inpatient surgical procedures. Of these, 36 patients who experienced a VTE event were matched to 108 patients who did not. VTE events occurred in 0.2% of the study population, with most events occurring for patients undergoing total knee replacement. VTE patients had a mean total hospital charge of $60,814 vs $48,325 for non-VTE patients, resulting in a mean incremental charge of $11,979 (p?<?.05). Compared to non-VTE patients, VTE patients had longer length of stay (5.9 days vs 3.7 days, p?<?.001), experienced a higher rate of 3-day re-admissions (3 vs 0 patients) and 30-day re-admissions (7 vs 2 patients).

Conclusions: Patients undergoing elective inpatient surgical procedures with general anesthesia who had a VTE event during their primary hospitalization had a significantly longer length of stay and significantly higher total hospital charges than comparable patients without a VTE event.     

Factors Influencing the Physically Active Leisure of Children and Youth: A Qualitative Study

A phenomenological framework guided data collection and analysis of the prevalent influences on attitudes and behaviors of elementary, junior, and secondary school students towards their physically active leisure. Twenty-two students participated in individual in-depth interviews. Parental influence and outdoor play effected choice and level of physically active leisure for elementary students. Opportunities for organized and non-structured physically active leisure and friends were significant for junior students. Academic responsibilities and organized physically active leisure were influential for secondary students. Common threads were parental influence and the belief that the students were too old to start new activities. These findings highlight the importance of providing opportunities in safe environments for children and youth to participate in a variety of structured and non-structured forms of physically active leisure.     

The impact of entry modes on the organisational design of international hotel chains

This paper reports on a study of organisation design within the international hotel chains that simultaneously employ multiple market entry modes. A multiple case study reveals the use of different divisional designs for different types of entry mode within individual chains. These are driven by the desire to maintain strong control over hotel brands. The study concludes that current designs may inhibit the international hotel chains from achieving their organisational potential and recommends that managers look to break down these ‘communities of design’ barriers.     

Customer satisfaction,corporate image,and service quality in professional services

This study explores the impact of corporate image and service quality on customer satisfaction in the professional service industries. Data were collected on audit firms, sending a questionnaire to financial executives of leading Italian companies. The results show that the most important variable explaining customer satisfaction was the apparent effectiveness of the audit firm. In relation to service quality, managers' satisfaction was primarily driven by their perception of audit firm's work as a useful value-adding service. The length of audit firm–auditee relation, the location of the auditor's office, and the financial executive's personal characteristics were also significant drivers of customer satisfaction.     

More than a feeling: using hotel room attendants to improve understanding of job quality

Recent research by Adler and Adler reveals contradictory claims about the job quality of hotel room attendants; suggesting that an objectively ‘bad’ job can be perceived as subjectively ‘good’ by workers. This contradiction resonates with wider issues about how job quality is conceived – objectively and/or subjectively. Drawing on empirical research of room attendant jobs in upper market hotels in three cities in the UK and Australia, this paper addresses the contradiction by examining both the objective and subjective dimensions of job quality for room attendants. In doing so it refines Adler and Adler's work, constructs a new typology of workers and a new categorisation of job quality informed by workers characteristics and preferences. This categorisation improves conceptual understanding of job quality by enjoining its objective and subjective dimensions.     

The diffusion of exporting in Brazilian industrial clusters

The present research aimed at understanding the process by which firms in a cluster start to export based on systemic interactions, and the process of diffusion of exporting as a business strategy within the cluster. Diffusion was defined, following Rogers’ (1995: 5) seminal work, as ‘the process by which an innovation is communicated through certain channels over time among the members of a social system’. The research method used was industry case studies and the unit of analysis selected was the cluster. Two manufacturing industries were chosen to be investigated, and within each geographic area clusters were identified as the origin of dynamic export growth in the industry. Players in each industrial cluster, as well as other significant actors, were interviewed. Extensive secondary data research was done to study clusters’ historical development. Detailed analysis and a comparison of the experiences permitted the extraction of some general conclusions concerning the similarities and differences between the clusters in terms of the adoption and diffusion of exporting. Results showed that the diffusion of exporting in an industrial cluster is quite similar to the dissemination of technical innovation. Social ties were important to facilitate the diffusion of exporting in one of the clusters studied. Also, the role of domestically-owned flagship firms in leading the internationalization process proved to be important in only one of the clusters, while the role of external actors was fully supported in the two industries studied. Finally, a number of support institutions, private and public, interfered in different stages of the internationalization process. In both industries, the federal government had only a late and limited impact on export initiation and development.     

Ethical Beliefs of Business Professionals: A Study of Gender, Age and External Factors

The present study examined how ethical beliefs and external factors affecting ethical beliefs are related to age and gender of business professionals. The results indicated that business professionals in the younger age group exhibited a lower standard of ethical beliefs. In the younger age groups, the females demonstrated a higher level of ethical beliefs, while in the older age group, the results suggested that the males had a slightly higher level of ethical beliefs. With regards to the influence of external factors on ethical beliefs, the results yielded a significant interaction between age and gender. The younger age groups, males in particular, were more susceptible to external factors. People at home had the most influence on beliefs about ethics, while the individual's supervisor had the least impact. The results were discussed in terms of theories of moral development.     

The carbon footprint of UK households 1990-2004: A socio-economically disaggregated, quasi-multi-regional input-output model

This paper presents a socio-economically disaggregated framework for attributing CO₂ emissions to people's high level functional needs. Based around a quasi-multi-regional input-output (QMRIO) model, the study, in theory, takes into account all CO₂ emissions that arise from energy used in production of goods and services to satisfy UK household demand, whether the emissions occur in the UK or abroad. Results show that CO₂ emissions attributable to households were 15% above 1990 levels in 2004, and that although absolute decoupling occurred between household expenditure and CO₂ during the UK's switch from coal to gas in the early 1990s, since then only slight relative decoupling is evident. The proportion of CO₂ that arises outside UK borders in support of UK consumption is rising, and reducing these emissions is particularly problematic in a global trading system. Investigation into the carbon footprint of different segments of the UK population shows wide variation: the segment with the highest carbon footprint emits 64% more CO₂ than the segment with the lowest. Results show that recreation and leisure are responsible for over one quarter of CO₂ emissions in a typical UK household in 2004. We conclude that expanding lifestyle aspirations are significant factors in driving household CO₂ emissions, but the study also emphasizes that attention must be paid to the infrastructures and institutions that result in considerable amounts of CO₂ being locked up in basic household activities through which people meet their everyday needs for subsistence, protection, and communication with family and friends. The findings highlight the sheer scale of the challenge facing UK policy-makers, and suggest that policies should be targeted towards segments of society responsible for the highest carbon footprints.     

世博巡展2008：云南首站告捷

1月7日,中国2010年上海世博会2008年在全国各省区市宣传周的第一站——云南宣传周暨"走进世博会"展览在昆明金碧广场正式拉开序幕。上海世博会执委会常务副主任、中共上海市委常委、副市长杨雄,中共云南省委常