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Patients interact with various health care service network partners, whereby nurses play an integral role in providing health care services on the patient level. Drawing on social exchange theory and considering citizenship and dysfunctional patient behavior from a value co-creation (and even co-destruction) perspective, the purpose of the present study is to identify drivers that promote citizenship and reduce dysfunctional patient behavior in service interactions with nurses at the same time. Using PLS-SEM and survey data from 404 inpatients, results demonstrate the importance of perceived citizenship behavior of nurses for patient citizenship behavior by showing a significant direct effect (and partially even an indirect effect mediated by patients’ positive emotions) on all identified forms. However, it provides little chances to reduce dysfunctional patient behaviors, as there hardly exists any significant (direct or indirect) effect.

Die aktive Rolle des Kunden im Rahmen der Dienstleistungserstellung und Wertschopfung ist in der Dienstleistungsforschung allgemein anerkannt. Es ist daher unbestritten, dass sowohl die Dienstleistungserstellung als auch die Wertschopfung eine unmittelbare Zusammenarbeit zwischen Anbieter und Kunde erfordern. Inzwischen werden jedoch in der Literatur zahlreiche Termini und Konzepte genutzt, um die aktive Kundenmitwirkung an der Dienstleistungserstellung und Wertschopfung zu beschreiben. Vor diesem Hintergrund ist es das Ziel dieses Beitrags, einen Uberblick uber den aktuellen Stand der Forschung zu den notwendigen kundenseitigen Wertschopfungsaktivitaten in direkten personlichen Dienstleistungsinteraktionen zu geben. Dabei werden Studien berucksichtigt, die Erkenntnisse zu kundenseitigen Wertschopfungsaktivitaten in direkten personlichen Dienstleistungsinteraktionen mit dem Kundenkontaktpersonal beinhalten, ohne die eine wertgenerierende Dienstleistungserstellung nicht moglich ist.

Customer solutions are a promising opportunity to gain competitive advantages − also in B2C markets and with the proviso that they offer customers a high value in use. However, little is known about the value that B2C customer solutions provide customers during the usage process, its drivers and its outcomes. This study’s aim is to bridge the research gap by identifying and empirically validating the individual drivers and outcomes of envisioned value in use (EVIU) of customer solutions in the electric mobility context (e-mobility solutions). Based on a literature review as well as on a qualitative and a quantitative (n = 441) study, knowledge uncertainty, multimodal usage behaviour and environmental awareness are identified as the relevant drivers of the benefits and costs of EVIU. In addition, EVIU is a strong predictor of customers’ intention to use a customer solution and pay a price premium.

Elektromobilitatslosungen stellen fur den Automobilhandel eine vielversprechende Moglichkeit zur Wettbewerbsprofilierung dar, sofern sie aus Kundensicht einen hohen wahrgenommenen Wert aufweisen. Der wahrgenommene Wert von Elektromobilitatslosungen wird nach den Ergebnissen der vorliegenden empirischen Studie als formatives Konstrukt aus dem wahrgenommenen Individualisierungs-, Integrations-, Beziehungs- und Gebrauchswert gebildet. Die empirisch vergleichende Analyse des wahrgenommenen Wertes von Elektromobilitatslosungen verschiedener Nutzertypen von Mobilitatsleistungen dokumentiert jedoch, dass neben identischen auch unterschiedliche Kombinationen der Wertkomponenten jeweils hinreichend fur einen hohen wahrgenommenen Wert der Elektromobilitatslosung der einzelnen Nutzertypen sind. Somit zeigen sich fur den Automobilhandel unterschiedliche Ansatzpunkte zur Wettbewerbsprofilierung durch Elektromobilitatslosungen bei den verschiedenen Nutzertypen von Mobilitatsleistungen als Zielgruppen, fur deren Realisierung nutzertypenspezifische Managementimplikationen abgeleitet werden.

Das Angebot von Elektromobilitatslosungen bietet dem Automobilhandel aussichtsreiche Chancen zur Wettbewerbsprofilierung. Diese Wettbewerbsprofilierung gelingt jedoch nur dann, wenn Kunden die Elektromobilitatslosung unter Berucksichtigung aller Nutzen- und Kostenaspekte positiv bewerten und somit einen hohen Wert der Elektromobilitatslosung wahrnehmen. Die Wertschopfung erfordert bei Elektromobilitatslosungen als interaktive Wertschopfung jedoch eine Zusammenarbeit zwischen Anbieter und Kunden, die aus Anbietersicht mit zahlreichen Aufgaben verbunden ist. Das zentrale Ziel dieses Beitrages besteht darin, diese Aufgaben differenziert aufzuzeigen und Gestaltungsempfehlungen zu ihrer Bewaltigung abzuleiten. Ausgehend von der Analyse kundenseitiger Nutzungsprozesse von Mobilitatsleistungen wird eine Konzeptualisierung des kundenseitig wahrgenommenen Wertes von Elektromobilitatslosungen als Zielgrose der effektiven interaktiven Wertschopfung prasentiert. Anknupfend an die identifizierten Wertkomponenten erfolgt die Ableitung spezifischer Gestaltungsempfehlungen zur effektiven interaktiven Wertschopfung. Da die Entwicklung innovativer Dienstleistungen in Zusammenarbeit mit dem Kunden eine weitere Aufgabe der interaktiven Wertschopfung darstellt, werden auch Gestaltungsempfehlungen zur kundenseitigen Mitwirkung bei der Entwicklung innovativer Dienstleistungen als integrativer Bestandteil von Elektromobilitatslosungen des Automobilhandels hergeleitet. Die praxisorientierte Relevanz der erarbeiteten Gestaltungsempfehlungen wird abschliesend mittels eines Zukunftsszenarios veranschaulicht.

In 2005, the National Institutes of Health (NIH) chronic graft-versus-host disease (cGVHD) consensus project provided diagnosis and staging criteria, based mostly on clinical experience and expert opinion. These criteria were revised in 2014, aiming to provide enhanced specificity and clarity. However, the impact of 2014 changes to the original NIH cGVHD severity scoring criteria has not been reported. In this study, 284 patients, prospectively enrolled on the National Cancer Institute's cross-sectional cGVHD natural history study, were scored using the 2005 NIH cGVHD criteria and then rescored according to the 2014 modifications. In comparing the two criteria, 2014 cGVHD global severity scoring resulted in a tendency toward being categorized as milder scores (75 vs. 72% of severe score per 2014, p = 0.0009), with a statistically significant shift in NIH liver and lung scores toward milder categories (p

Triadic service relationships comprise complex relationships in which not only the customer and provider are involved as partners but also other individuals with caregiving relationships with the customer. A triadic constellation may arise in the context of services for animal companions, for example, when veterinarians provide counsel and treatment to the animal companion and its owner. Through interviews with both owners of animal companions and providers of services for animal companions, this study explores typical constellations and characteristics of the three relationships in this service triad. In line with balance theory, the results show that four distinct types of triadic relationships exist in services for animal companions: the harmonious, the dysfunctional, the challenging, and the doubtful triad. The study highlights the potential conflicts and dynamics in the triads to advise providers on how to address customers depending on the types of triads to which they belong.

Usporedba NIH kriterija za kronični GVHD 2005 i 2014 godina.

Introduction: This case study was part of a larger programme of research in Alberta that aims to develop an evidence-based model to optimize centralized intake province-wide to improve access to care. A centralized intake model places all referred patients on waiting lists based on severity and then directs them to the most appropriate provider or service. Our research focused on an in-depth assessment of two well-established models currently in place in Alberta to 1) enhance our understanding of the roles and responsibilities of staff in current intake processes, 2) identify workforce issues and opportunities within the current models, and 3) inform the potential use of alternative providers in the proposed centralized intake model. Case description: Our case study included two centralized intake models in Alberta associated with three clinics. One model involved one clinic that focuses on rheumatoid disease. The other model involved two clinics that focus on osteoarthritis. We completed a document review and interviews with managers and staff from both models. Finally, we reviewed the scope of practice regulations for a range of health-care providers to examine their suitability to contribute to the centralized intake process of osteoarthritis and rheumatoid disease. Discussion and evaluation: Interview findings from both models suggested a need for an electronic medical record and eReferral system to improve the efficiency of the current process and reduce staff workload. Staff interviewed also spoke of the need to have a permanent musculoskeletal screener available to streamline the intake process for osteoarthritis patients. Both models relied on registered nurses, medical office assistants, and physicians throughout their intake process. Our scope of practice review revealed that several providers have the competencies to screen, assess, and provide case management at different junctures in the centralized intake of patients with osteoarthritis and rheumatoid disease. Conclusions: Using a broader range of providers in the centralized intake of osteoarthritis and rheumatoid disease has the potential to improve access and care specifically related to the assessment and management of patients. This may enhance the patient care experience and address current access issues.

An opportunity existed at our rehabilitation hospital, in preparation for Medicare's Prospective Payment System (PPS) in acute medical rehabilitation, to develop an integrated inpatient care model using all available resources. The results have been an improved practice of all staff, increased efficiency and productivity, and increased staff and patient satisfaction. This article discusses the drivers for changing the team model within a large rehabilitation hospital. It includes an overview of the process of data gathering prior to changing the team model, how the new team model functions, and follow-up data collection 9 months after to provide evidence on what changes worked and what areas required further change to meet the objectives.

INTRODUCTION: We describe characteristics of unplanned school closures (USCs) in the United States over two consecutive academic years during a non-pandemic period to provide context for implementation of school closures during a pandemic. METHODS: From August 1, 2011 through June 30, 2013, daily systematic internet searches were conducted for publicly announced USCs lasting ≥1 day. The reason for closure and the closure dates were recorded. Information on school characteristics was obtained from the National Center for Education Statistics. RESULTS: During the two-year study period, 20,723 USCs were identified affecting 27,066,426 students. Common causes of closure included weather (79%), natural disasters (14%), and problems with school buildings or utilities (4%). Only 771 (4%) USCs lasted ≥4 school days. Illness was the cause of 212 (1%) USCs; of these, 126 (59%) were related to respiratory illnesses and showed seasonal variation with peaks in February 2012 and January 2013. CONCLUSIONS: USCs are common events resulting in missed school days for millions of students. Illness causes few USCs compared with weather and natural disasters. Few communities have experience with prolonged closures for illness. Language: en

Introduction: Allogeneic hematopoietic stem cell transplantation (alloHSCT) can provide a curative therapy for hematological malignancies but may result in complications such as relapse, infection, and acute and chronic graft versus host disease (GVHD). Two divergent approaches to GVHD prophylaxis (post-HSCT depletion of donor lymphocytes vs. suppression of immune activation) in a reduced-intensity, matched-unrelated donor setting were compared in a randomized, open label, phase 2 prospective trial (NCT00520130), powered to assess the incidence of severe cGVHD using NIH criteria. Methods: Hematological malignancy patients received disease-specific induction chemotherapy DA-EPOCH-FR or FLAG (Salit et al, JCO 2012; 30:830) for disease control and host lymphodepletion to CD4+ cell target Results: 81 pts (NHL=25, HL=8, CLL=18, AML/MDS=10, CML=3, CTCL/PTCL=5, ALL=4, MM=2, other=6), median age 50 yrs (range, 21-71) were included in the study (AC=42, TMS=39). The two arms were similar in age, gender, disease, relapse risk (Kahl), HCT-comorbidity index, and donor HLA match (8/8 or 7/8). Median time to neutrophil engraftment was 9 vs. 11 days in AC vs. TMS, respectively (p=0.017). There were no differences in platelet recovery (p=0.96). One case of graft failure occurred in a myeloma patient on the AC arm. D100 mortality probabilities were 12% (95% CI, 5-25) and 10% (95% CI, 4-24) in AC and TMS, respectively (p=0.20). Median survival in AC was 18.8 mo and 41.7 mo in TMS, with a median follow-up of 53 mo in AC and 50.6 mo in TMS. 3yr OS was comparable: AC 42% (95% CI, 28-57) vs. TMS 58% (95% CI, 42-73) (p=0.20). The 3yr malignancy progression rate was higher in the AC arm (AC 51% (95% CI, 34-65) vs. TMS 21% (95% CI, 10-35), p= 0.0062). 3yr relapse related mortality rates were 29% (95% CI, 16-44) vs. 14% (95% CI, 5-29) (p=0.067) and non-relapse mortality 29% (95% CI, 16-43) vs. 28% (95% CI, 14-43) (p=0.75) in AC vs. TMS, respectively. The most common grade ≥3 adverse events (CTCAE 4.03) within 100 d post-transplant were infections (22%) with more viral infections in the AC arm (p=0.0007). Reactivation of CMV occurred earlier in the AC arm, incidence 58% (95% CI, 42-71) vs. 24% (95% CI, 12-38) by D100 (p=0.035). Rates of aGVHD were similar; Gr II-IV at 6 mo in AC 38% (95% CI, 23-53) vs. TMS 41% (95% CI, 26-57) (p=0.59); Gr III-IV at 6 mo AC 21% (95% CI, 11-35) vs. TMS 13% (95% CI, 5-26) (p=0.61). In contrast, significantly lower rates of any grade cGVHD occurred in the AC arm compared to TMS at 36 mo (27% (95% CI, 14-41) vs. 59% (95% CI, 40-74)) (p=0.0076). The incidence of severe cGVHD was strikingly different: AC 5% (95% CI, 1-15) vs. TMS 31% (95% CI, 16-47) (p=0.0007). In the Cox model, the only prognostic factor for severe or any cGVHD was the TMS treatment arm, HR 6.8 (95% CI, 1.5-30.3, p=0.012) and HR 2.3 (95% CI, 1.1-4.8, p=0.026), respectively. Lymphocyte recovery (ALC 500/µL) was markedly delayed in AC, median 76 vs. 16 d (p Conclusions: This prospective, randomized trial demonstrates that the use of AC when compared with TMS led to a significant reduction in incidence of severe and overall cGVHD. These two GVHD prophylaxis regimens had similar incidences of aGVHD but very different effects on post-alloHSCT immune reconstitution, infection and relapse. Future strategies for cGVHD prevention will need to further address these issues. Disclosures Off Label Use: There is currently no FDA approved product for GVHD prevention or therapy. The GVHD prophylaxis regimens described in this study (Alemtuzumab-Cyclosporine and Tacrolimus-Methotrexate-Sirolimus) are used off-label as GVHD prophylaxis regimens in reduced-intensity allogeneic HSCT.