Continuity of care for people with psychotic illness: its relationship to clinical and social functioning.

Background: The relationship between continuity of care and user characteristics or outcomes has rarely been explored. The ECHO study operationalized and tested a multi-axial definition of continuity of care, producing a seven-factor model used here. Aims: To assess the relationship between user characteristics and established components of continuity of care, and the impact of continuity on clinical and social functioning. Methods: The sample comprised 180 community mental health team users with psychotic disorders who were interviewed at three annual time-points, to assess their experiences of continuity of care and clinical and social functioning. Scores on seven continuity factors were tested for association with user-level variables. Results: Improvement in quality of life was associated with better Experience & Relationship continuity scores (better user-rated continuity and therapeutic relationship) and with lower Meeting Needs continuity factor scores. Higher Meeting Needs scores were associated with a decrease in symptoms. Conclusion: Continuity is a dynamic process, influenced significantly by care structures and organizational change.

Adapted customer relationship management implementation framework:facilitating value creation in nursing homes

This paper proposes a framework to support Customer Relationship Management (CRM) implementation in nursing homes. The work extends research by Cheng et al. (2005) who conducted in-depth questionnaires to identify critical features (termed value-characteristics), which are areas identified as adding the most value if implemented. Although Cheng et al. did proposed an implementation framework, summary of, and inconsistent inclusion of value-characteristics, limits the practical use of this contribution during implementation. In this paper we adapt the original framework to correct perceived deficiencies. We link the value characteristics to operational, analytical, strategic and/or collaborative CRM solution types, to allow consideration in context of practical implementation solutions. The outcome of this paper shows that, practically, a 'one solution meets all characteristic' approach to CRM implementation within nursing homes is inappropriate. Our framework, however, supports implementers in identifying how value can be gained when implementing a specific CRM solution within nursing homes; which subsequently support project management and expectation management.

Apheresis donors and platelet function: inherent platelet responsiveness influences platelet quality

BACKGROUND: Process-induced platelet (PLT) activation occurs with all production methods, including apheresis. Recent studies have highlighted the range and consistence of interindividual variation in the PLT response, but little is known about the contribution of a donors' inherent PLT responsiveness to the activation state of the apheresis PLTs or the effect of frequent apheresis on donors' PLTs. STUDY DESIGN AND METHODS: The relationship between the donors' PLT response on the apheresis PLTs was studied in 47 individuals selected as having PLTs with inherently low, intermediate, or high responsiveness. Whole-blood flow cytometry was used to measure PLT activation (levels of bound fibrinogen) before donation and in the apheresis PLTs. The effects of regular apheresis on the activation status of donors' PLTs were studied by comparing the in vivo activation status of PLTs from apheresis (n = 349) and whole-blood donors (n = 157), before donation. The effect of apheresis per se on PLT activation was measured in 10 apheresis donors before and after donation. RESULTS: The level of PLT activation in the apheresis packs was generally higher than in the donor, and the most activated PLTs were from high-responder donors. There was no significant difference in PLT activation before donation between the apheresis and whole-blood donors (p = 0.697), and there was no consistent evidence of activation in the donors immediately after apheresis. CONCLUSION: The most activated apheresis PLTs were obtained from donors with more responsive PLTs. Regular apheresis, however, does not lead to PLT activation in the donors.

Made in Italy. Made in Britain. Quality, brands and innovation in the European poultry market, 1950-1980.

This paper compares the development of the poultry industry in Italy with the UK. Earlier research has suggested that the UK poultry industry developed a symbiotic relationship with the emerging supermarket retailers. Italy had a retarded supermarket sector. Its distribution system favoured small-scale, independent butchers rather than chains of self-service supermarkets. Despite this the Italian poultry industry also modernised, adopting US technologies. The catalyst for this modernisation was technological innovation in refrigeration technologies that enabled Italian consumers and independent retailers to be persuaded of the merits of the new ‘technological’ chicken. While the Italian market has become dominated by AIA and Amadori in recent years, the key innovators were the entrepreneurs that created the company called Arena.

Fairness quality: the role of fairness in a social and ethically oriented marketing landscape

Research into the dark side of customer management and marketing is progressively growing. The marketing landscape today is dominated with suspicion and distrust as a result of practices that include hidden fees, deception and information mishandling. In such a pessimistic economy, marketers must reconceptualise the notion of fairness in marketing and customer management, so that the progress of sophisticated customisation schemes and advancements in marketing can flourish, avoiding further control and imposed regulation. In this article, emerging research is drawn to suggest that existing quality measures of marketing activities, including service, relationships and experiences may not be comprehensive in measuring the relevant things in the social and ethically oriented marketing landscape, and on that basis does not measure the fairness which truly is important in such an economy. The paper puts forward the concept of Fairness Quality (FAIRQUAL), which includes as well as extends on existing thinking behind relationship building, experience creation and other types of customer management practices that are believed to predict consumer intentions. It is proposed that a fairness quality measure will aid marketers in this challenging landscape and economy.

Effect of blending Jersey and Holstein-Friesian milk on Cheddar cheese processing, composition and quality

The aim of this study was to investigate the effects of numerous milk compositional factors on milk coagulation properties using Partial Least Squares (PLS). Milk from herds of Jersey and Holstein- Friesian cattle was collected across the year and blended (n=55), to maximise variation in composition and coagulation. The milk was analysed for casein, protein, fat, titratable acidity, lactose, Ca2+, urea content, micelles size, fat globule size, somatic cell count and pH. Milk coagulation properties were defined as coagulation time, curd firmness and curd firmness rate measured by a controlled strain rheometer. The models derived from PLS had higher predictive power than previous models demonstrating the value of measuring more milk components. In addition to the well-established relationships with casein and protein levels, CMS and fat globule size were found to have as strong impact on all of the three models. The study also found a positive impact of fat on milk coagulation properties and a strong relationship between lactose and curd firmness, and urea and curd firmness rate, all of which warrant further investigation due to current lack of knowledge of the underlying mechanism. These findings demonstrate the importance of using a wider range of milk compositional variables for the prediction of the milk coagulation properties, and hence as indicators of milk suitability for cheese making.

Negative online consumer reviews: effects of different responses

Purpose When consumers buy online, they are often confronted with consumer reviews. A negative consumer review on an online shopping website may keep consumers from buying the product. Therefore, negative online consumer reviews are a serious problem for brands. This paper aims to investigate the effects of different response options to a negative consumer review. Design/methodology/approach In an online experiment of 446 participants different response options towards a negative consumer review on an online shopping website are examined. The experimental data is analysed with simple linear regression models using product purchase intentions as the outcome variable. Findings The results indicate that a positive customer review counteracts a negative consumer review more effectively than a positive brand response, whereas brand strength moderates this relationship. Including a reference to an independent, trusted source in a brand or a customer response is only a limited strategy for increasing the effectiveness of a response. Research limitations/implications Additional research in other product categories and with other subjects than students is suggested to validate the findings. In future research, multiple degrees of the phrasing’s strength of the reference could be used. Practical implications Assuming high quality products, brands should encourage their customers to write reviews. Strong brands can also reassure consumers by responding whereas weak brands cannot. Originality/value This research contributes to the online consumer reviews literature with new insights about the role of brand strength and referencing to an independent, trusted source.

The brand likeability scale: an exploratory study of likeability in firm-level brands

We develop a new measurement scale to assess consumers’ brand likeability in firm-level brands. We present brand likeability as a multidimensional construct. In the context of service experience purchases, we find that increased likeability in brands results in: (1) greater amount of positive association; (2) increased interaction interest; (3) more personified quality; and (4) increased brand contentment. The four-dimensional multiple-item scale demonstrates good psychometric properties, showing strong evidence of reliability as well as convergent, discriminant and nomological validity. Our findings reveal that brand likeability is positively associated with satisfaction and positive word of mouth. The scale extends existing branding research, providing brand managers with a metric so that likeability can be managed strategically. It addresses the need for firms to act more likeably in an interaction-dominated economy. Focusing on likeability acts as a differentiator and encourages likeable brand personality traits. We present theoretical implications and future research directions on the holistic brand likeability concept.

Exploring brand attachment, its determinants and outcomes

Brand attachment has been regarded as a powerful and salient construct in marketing, argued to predict favourable consumer behaviours. Nevertheless, research trying to understand what are the determinants and outcomes of it is still limited. Using semi-structured interviews and projective techniques, this work identifies that self-congruity, experience, responsiveness, quality, reputation and trust are found to be the determinants of strong brand attachment. The outcomes of brand attachment are intention to recommend, purchase, revisit, resilience to negative information and act of defending the brand. This research sheds light for marketers in understanding the conceptualisation of attachment from the consumers' perspectives, so adopting an important perspective largely under-researched. In addition, this study guides marketers in the important factors regarding how to build stronger attachment and benefit from its outcomes.

Impact of socioeconomic and clinical factors on child oral health-related quality of life (COHRQoL)

Child oral health-related quality of life (COHRQoL) has been increasingly assessed; however, few studies appraised the influence of socioeconomic status on COHRQoL in developing countries. This study assessed the relationship of COHRQoL with socioeconomic backgrounds and clinical factors. This study followed a cross-sectional design, with a multistage random sample of 792 schoolchildren aged 12 years, representative of Santa Maria, a southern city in Brazil. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)), their parents or guardians answered questions on socioeconomic status, and a dental examination provided information on the prevalence of caries, dental trauma and occlusion. The assessment of association used hierarchically adjusted Poisson regression models. Higher impacts on COHRQoL were observed for children presenting with untreated dental caries (RR 1.20; 95% CI 1.07-1.35) and maxillary overjet (RR 1.19; 95% CI 1.02-1.40). Socioeconomic factors also associated with COHRQoL; poorer scores were reported by children whose mothers have not completed primary education (RR 1.30; 95% CI 1.17-1.44) and those with lower household income (RR 1.13; 95% CI 1.02-1.26). Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population.

Relationship between the somatic cell count in raw milk and the casein fractions of UHT milk

The relationship between somatic cell count (SCC) in raw milk and casein fractions of 15 batches of the corresponding ultra-high-temperature (UHT) milk was examined. Raw milk was collected, pasteurised and submitted to UHT treatment. Samples of the UHT milk were taken on days 8, 30, 60, 90 and 120 of storage at room temperature and their casein fractions analysed by high performance liquid chromatography. SCC ranged from 197,000 to 800,000 cells/mL. No correlation (p>0.05) was found between SCC and K-casein concentrations in raw or UHT milks. The alpha(s2) and P-casein concentrations in raw milk were negatively correlated with SCC (p<0.05). In UHT milk, negative correlations were observed for a,1-casein (p<0.05) and beta-casein (p<0.05) on the 8th day, and for alpha S-2-casein (p<0.01) on the 60th day of storage. Results indicate that higher SSC in raw milk is associated with substantial degradation of beta-casein and alpha(s)-casein, which may lead to quality defects in UHT milk during storage. Aust. J. Dairy Technol. 63, 45-49

Reactivity of Nellore steers in two feedlot housing systems and its relationship with plasmatic cortisol

To evaluate reactivity to assess the temperament of Nellore steers in two feedlot housing systems (group pen or individual pen) and its relationship with plasmatic cortisol, 36 experimental units were observed five times at 28-day intervals of weight management during a 112-day feedlot confinement. A reactivity score scale ranging from 1 to 5 was applied when an animal was in the chute system. To the calmest animal, a reactivity score of 1 was ascribed and to the most agitated, 5. Blood samples were collected for cortisol analysis. No differences were found in reactivity and feedlot system. There was a relationship noted between reactivity and feedlot time in both housing systems (P < 0.01). There was a relation between reactivity and cortisol levels for group animals (P = 0.0616) and for individual ones (P < 0.01). Cortisol levels varied among housing systems (P < 0.01). Feedlot time influenced the cortisol levels (P < 0.09 individual; P < 0.01 group) and when variable time was included, these levels changed, decreasing in the group pen and increasing in individual pens. The continuous handling reduces reactivity and plasmatic cortisol, and group pen system seems to be less stressfully than individual pens. (C) 2010 Elsevier B.V. All rights reserved.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

The relationship between school violence and student proficiency

School violence has recently become a central concern among teachers, students, students' parents and policymakers. Violence can induce behaviors on educational agents that go against the goals of improving the quality of education and increasing school attendance. In fact, there is evidence that school environmental characteristics and student performance and behavior at school are related. Although school violence may have a direct impact on students’ performance, such impact has not yet been quantified. In this paper, we investigate this issue using Brazilian data and show that, on average, students who attended more violent schools had worse proficiency on a centralized test carried out by the Brazilian Ministry of Education, even when we controlled for school, class, teachers and student characteristics. We also show that school violence affects more the students from the bottom of the proficiency distribution. Furthermore, we find out that besides the direct effect on student proficiency, it seems that school violence has an indirect effect on it operating through teacher turnover. Indeed, we show that the occurrence of violent episodes in a school decreases the probability of a class in that school having only one teacher during the academic year, and increases the probability of that class having more than one teacher (teacher turnover).

A força da marca na decisão de compra de sandálias masculinas: um estudo exploratório

o presente estudo objetiva verificar a força da marca na decisão de compra de sandálias masculinas, estudando o caso das sandálias Rider da empresa Grendene. A marca torna-se cada vez mais uma fonte de vantagem competitiva, pois ela é mais do que apenas um nome ou símbolo. É ela que diferencia os produtos de uma empresa em relação à concorrência. É ela que é o elo de ligação ente a empresa e o consumidor. Os atributos do produto, as tecnologias, são fáceis de serem alcançados pelos concorrentes e tornam-se obsoletos rapidamente. No entanto, a criação de uma marca forte que gere lealdade por parte dos consumidores é algo mais complexo e poucas empresas alcançam esse patamar de valor. No cenário atual em que a cada momento surgem novas marcas, novos produtos, cada uma oferecendo atributos diferentes, o consumidor acaba se protegendo atrás das marcas conhecidas e fortes e que levam associadas a si uma imagem de qualidade, reconhecimento no mercado e certo nível de status e prestígio, facilitando assim a sua decisão. A marca Rider é uma dessas poucas marcas que conseguiu chegar a este nível, criando uma série de associações favoráveis, como conforto, inovação, diferenciação, qualidade (durabilidade) e beleza, que vem à mente dos consumidores no momento da decisão de compra. O processo de decisão de compra de sandálias masculinas não é complexo se caracterizando por um baixo envolvimento pela maioria dos consumidores, no entanto, em função de ser um item que está ligado ao modo de ser e agir das pessoas, se caracteriza por uma busca mediana de informações relacionadas ao produto. Assim, os resultados da pesquisa sugerem que a marca exerce influência na decisão de compra de sandálias masculinas, e que a marca Rider tem brand equity, ou seja, tem valor para os clientes, tem recall de marca e reconhecimento no mercado o que gera um relacionamento duradouro entre a marca e os consumidores.