Moderating effects of contextual factors on relationship between pharmaceutical marketing strategies and physician prescription decision: A review

Decision–making by physicians on patients’ treatment has received increased research attention. Research on the effect of marketing strategies on prescription behaviour has tended to generate controversial results. While some researchers reported a strong influence, some found only moderate effects, while others find no influence at all. The main objective of this paper is to review the influence of the marketing strategies by pharmaceutical firms and contextual factors on physician attitude to drug prescription. The paper presents comprehensive information on pharmaceutical marketing efforts through exhaustive review of relevant literature, and identifies the moderating effects of contextual factors on physician prescribing decisions. It also presents a crucial conceptual model for explaining the theoretical linkages between marketing strategies of pharmaceutical firms, contextual factors and the decision of the physician regarding drug prescription.

MILITARY VEHICLE OPTIMIZATION AND CONTROL

It is remarkable that there are no deployed military hybrid vehicles since battlefield fuel is approximately 100 times the cost of civilian fuel. In the commercial marketplace, where fuel prices are much lower, electric hybrid vehicles have become increasingly common due to their increased fuel efficiency and the associated operating cost benefit. An absence of military hybrid vehicles is not due to a lack of investment in research and development, but rather because applying hybrid vehicle architectures to a military application has unique challenges. These challenges include inconsistent duty cycles for propulsion requirements and the absence of methods to look at vehicle energy in a holistic sense. This dissertation provides a remedy to these challenges by presenting a method to quantify the benefits of a military hybrid vehicle by regarding that vehicle as a microgrid. This innovative concept allowed for the creation of an expandable multiple input numerical optimization method that was implemented for both real-time control and system design optimization. An example of each of these implementations was presented. Optimization in the loop using this new method was compared to a traditional closed loop control system and proved to be more fuel efficient. System design optimization using this method successfully illustrated battery size optimization by iterating through various electric duty cycles. By utilizing this new multiple input numerical optimization method, a holistic view of duty cycle synthesis, vehicle energy use, and vehicle design optimization can be achieved.

The significant role of third-party logistics (3pl) operators as fosterers of organizational performance in colombian companies

La eliminación de barreras entre países es una consecuencia que llega con la globalización y con los acuerdos de TLC firmados en los últimos años. Esto implica un crecimiento significativo del comercio exterior, lo cual se ve reflejado en un aumento de la complejidad de la cadena de suministro de las empresas. Debido a lo anterior, se hace necesaria la búsqueda de alternativas para obtener altos niveles de productividad y competitividad dentro de las empresas en Colombia, ya que el entorno se ha vuelto cada vez más complejo, saturado de competencia no sólo nacional, sino también internacional. Para mantenerse en una posición competitiva favorable, las compañías deben enfocarse en las actividades que le agregan valor a su negocio, por lo cual una de las alternativas que se están adoptando hoy en día es la tercerización de funciones logísticas a empresas especializadas en el manejo de estos servicios. Tales empresas son los Proveedores de servicios logísticos (LSP), quienes actúan como agentes externos a la organización al gestionar, controlar y proporcionar actividades logísticas en nombre de un contratante. Las actividades realizadas pueden incluir todas o parte de las actividades logísticas, pero como mínimo la gestión y ejecución del transporte y almacenamiento deben estar incluidos (Berglund, 2000). El propósito del documento es analizar el papel de los Operadores Logísticos de Tercer nivel (3PL) como promotores del desempeño organizacional en las empresas colombianas, con el fin de informar a las MIPYMES acerca de los beneficios que se obtienen al trabajar con LSP como un medio para mejorar la posición competitiva del país.

Impact on hip fracture mortality after the establishment of an orthogeriatric care program in a colombian hospital

El objetivo del estudio es evaluar la mortalidad a un año en pacientes con fractura de cadera, mayores de 65 años tratados en un programa establecido de orto-geriatría. 298 se trataron de acuerdo al protocolo de orto-geriatría, se calculo la mortalidad a un año, se establecieron los predictores de mortalidad orto-geriátrico. La sobrevida anual se incremento de 80% a 89% (p = .039) durante los cuatro años de seguimiento del programa y disminuyo el riesgo de mortalidad anual postoperatorio (Hazard Ratio = 0.54, p = .049). La enfermedad cardiaca y la edad maor a 85 años fueron predictores positivos para mortalidad.

Evaluación de costo efectividad de la profilaxis versus tratamiento a demanda en pacientes con Hemofilia A moderada y severa para prevenir sangrado articular de una aseguradora en Colombia

Introducción: En Colombia existe un protocolo de manejo para pacientes con hemofilia A severa sin inhibidores que recomienda el manejo de profilaxis primaria y secundaria con FVIII. Objetivos: Estimar la relación incremental de costo-efectividad (RICE) de la profilaxis con Factor VIII vs tratamiento a demanda para prevenir sangrados articulares en pacientes con hemofilia A moderada y severa de una aseguradora en Colombia. Materiales y Métodos: Se adaptó un modelo de Markov desde la perspectiva del tercer pagador. Las probabilidades de transición se ajustaron mediante un modelo de regresión logística multinomial explicadas por la edad y el peso. Las tasas de eventos son anuales. Las efectividades se extrajeron de la cohorte de la aseguradora y de la literatura. Los costos incluyeron el FVIII, medicamentos, hospitalización, procedimientos quirúrgicos, apoyo diagnóstico y consultas médicas. La tasa de descuento fue del 3%. Resultados: En pacientes con hemofilia A moderada y severa la profilaxis con FVIII evitará en promedio 7 sangrados articulares, el RICE para el sangrado articular es de $303.457. Conclusiones: La profilaxis con Factor VIII es una estrategia costo-efectiva en el manejo de pacientes con hemofilia A moderada y severa para la aseguradora, disminuyendo el número de sangrados articulares al año.

Plan de medios y posicionamiento digital

El principal objetivo de este trabajo de grado ha sido diseñar un plan estratégico de medios digitales para el lanzamiento de un nuevo producto para una compañía. En este trabajo, se han establecido parámetros como presupuesto, qué tipos de medios digitales serán usados y el porqué de ellos, se estableció las actividades por cada red social a usar y se muestra la relación costo – beneficio de realizar pauta publicitaria en redes sociales.

Ri-costruire per ri-generare. Un modello per le periferie urbane

In Italia, quasi il 90% delle abitazioni esistenti sono state edificate prima degli anni Settanta del Novecento, se consideriamo la tipologia costruttiva, le normative per la sicurezza strutturale in ambito sismico e il comportamento energetico, ne deriva che la maggior parte non risponde agli standard vigenti. A questo si aggiunge la consapevolezza che il patrimonio residenziale costruito in quel periodo, e che occupa le prime periferie delle città, non si presta per sua natura costitutiva ad essere oggetto di interventi di riqualificazione che siano giustificabili in termini di costi-benefici dal punto di vista economico e per ottimizzazione ingegneristica. È opportuno ripensare piani e programmi di rinnovamento non circoscritti alle categorie di risanamento, efficientamento, manutenzione, adeguamento, ma che siano in grado di assumere in positivo il tema della sostituzione secondo il paradigma del ri-costruire per ri-generare per sviluppare strategie a medio-lungo termine per soddisfare un quadro esigenziale-prestazionale coerente con la legislazione europea, in termini di sicurezza, efficienza e impatto ambientale, e promuovere la pianificazione e lo sviluppo sostenibile delle città. L’edilizia circolare è qui intesa come un’attività finalizzata alla costruzione e gestione degli edifici all’interno di un ecosistema economico basato sulla circolarità dei processi. L’obiettivo della ricerca è duplice: (i) metodologico, rivolto alla formalizzazione di un modello innovativo d’intervento associato ai principi della circolarità e basato sulla conoscenza approfondita del patrimonio esistente; e (ii) progettuale, prevede la progettazione di un prototipo di unità abitativa e l’applicazione del modello ad un caso di studio, che viene assunto come applicazione sperimentale ad un contesto reale e momento conclusivo del processo. La definizione di una matrice valutativa consente di formulare indicazioni operative nella fase precedente l’intervento per rendere espliciti, attraverso un indice sintetico di supporto decisionale, i criteri su cui fondare le scelte tra le due macro-categorie di intervento (demolizione con ricostruzione o rinnovo).

Municipal solid waste management in the Caribbean: a benefit-cost analysis

Includes bibliography

Benefit-cost evaluations as applied to aid financed water or related land use projects : supplement no. 1 to Feasibility studies , economic and technical soundness analysis, capital projects.

Mode of access: Internet.

Climate Change Adaptation Case Study: Benefit-Cost Analysis of Coastal Flooding Hazard Mitigation

The damage Hurricane Sandy caused had far-reaching repercussions up and down the East Coast of the United States. Vast coastal flooding accompanied the storm, inundating homes, businesses, and utility and emergency facilities. Since the storm, projects to mitigate similar future floods have been scrutinized. Such projects not only need to keep out floodwaters but also be designed to withstand the effect that climate change might have on rising sea levels and increased flood risk. In this study, we develop an economic model to assess the costs and benefits of a berm (sea wall) to mitigate the effects of flooding from a large storm. We account for the lifecycle costs of the project, which include those for the upfront construction of the berm, ongoing maintenance, land acquisition, and wetland and recreation zone construction. Benefits of the project include avoided fatalities, avoided residential and commercial damages, avoided utility and municipal damages, recreational and health benefits, avoided debris removal expenses, and avoided loss of function of key transportation and commercial infrastructure located in the area. Our estimate of the beneficial effects of the berm includes ecosystem services from wetlands and health benefits to the surrounding community from a park and nature system constructed along the berm. To account for the effects of climate change and verify that the project will maintain its effectiveness over the long term, we allow the risk of flooding to increase over time. Over our 50-year time horizon, we double the risk of 100- and 500-year flood events to account for the effects of sea level rise on coastal flooding. Based on the economic analysis, the project is highly cost beneficial over its 50-year timeframe. This analysis demonstrates that climate change adaptation investments can be cost beneficial even though they mitigate the impacts of low-probability, high-consequence events.

Value creation in capital waterway projects: Application of a transaction cost and transaction benefit framework for the Miami River and the New Orleans Inner Harbour Navigation Canal

Waterways have many more ties with society than as a medium for the transportation of goods alone. Waterway systems offer society many kinds of socio-economic value. Waterway authorities responsible for management and (re)development need to optimize the public benefits for the investments made. However, due to the many trade-offs in the system these agencies have multiple options for achieving this goal. Because they can invest resources in a great many different ways, they need a way to calculate the efficiency of the decisions they make. Transaction cost theory, and the analysis that goes with it, has emerged as an important means of justifying efficiency decisions in the economic arena. To improve our understanding of the value-creating and coordination problems for waterway authorities, such a framework is applied to this sector. This paper describes the findings for two cases, which reflect two common multi trade-off situations for waterway (re)development. Our first case study focuses on the Miami River, an urban revitalized waterway. The second case describes the Inner Harbour Navigation Canal in New Orleans, a canal and lock in an industrialized zone, in need of an upgrade to keep pace with market developments. The transaction cost framework appears to be useful in exposing a wide variety of value-creating opportunities and the resistances that come with it. These insights can offer infrastructure managers guidance on how to seize these opportunities.

Functionality of the approach of hierarchical analysis in the full cost accounting in the IRP of a metropolitan airport

This work shows the application of the analytic hierarchy process (AHP) in the full cost accounting (FCA) within the integrated resource planning (IRP) process. For this purpose, a pioneer case was developed and different energy solutions of supply and demand for a metropolitan airport (Congonhas) were considered [Moreira, E.M., 2005. Modelamento energetico para o desenvolvimento limpo de aeroporto metropolitano baseado na filosofia do PIR-O caso da metropole de Sao Paulo. Dissertacao de mestrado, GEPEA/USP]. These solutions were compared and analyzed utilizing the software solution ""Decision Lens"" that implements the AHP. The final part of this work has a classification of resources that can be considered to be the initial target as energy resources, thus facilitating the restraints of the IRP of the airport and setting parameters aiming at sustainable development. (C) 2007 Elsevier Ltd. All rights reserved.

Refining the risk-benefit equation for thrombolysis: How to identity the low risk patient before administering thrombolytic therapy

In view of the relative risk of intracranial haemorrhage and major bleeding with thrombolytic therapy, it is important ro identify as early as possible the low risk patient who may not have a net clinical benefit from thrombolysis in the setting of acute myocardial infarction. An analysis of 5434 hospital-treated patients with myocardial infarction in the Perth MONICA study showed that age below 60 and absence of previous infarction or diabetes, shock, pulmonary oedema, cardiac arrest and Q-wave or left bundle branch block on the initial ECG identified a large group of patients with a 28 day mortality of only 1%, and one year mortality of only 2%. Identification of baseline risk in this way helps refine the risk-benefit equation for thrombolytic therapy, and may help avoid unnecessary use of thrombolysis in those unlikely to benefit.