Assessing the health care needs of a rural community

This article describes the methods used to complete a recent community health needs assessment study in a rural area. It illustrates the strategic marketing and management value of conducting this type of assessment by examining selected results from the study and discussing their implications for the local health care delivery system.     

The selling of health care services: are all sales jobs the same?

The selling activities of 272 salespeople were identified by polling 122 health care services organizations nationwide. A taxonomy of sales jobs was developed to classify the range of selling tasks within health care. The taxonomy is presented, discussed, and compared with a similar industrial one. Managerial implications and suggestions for future research are discussed.     

Therapy-related acute nonlymphoblastic leukemia following mitoxantrone therapy in a patient with multiple sclerosis

A 58-year-old male with migraine headaches, complex partial epilepsy, and secondary progressive multiple sclerosis treated with mitoxantrone was admitted to our facility in August 2005 with febrile neutropenia, worsening ataxia, aphasia, cough, and declining mental status. Bone marrow aspirate was consistent with acute nonlymphoblastic leukemia. Review of the literature reveals ten reported cases of nonlymphoblastic leukemias following treatment with mitoxantrone. Although de novo leukemia cannot be fully excluded, the likelihood of de novo disease is low given the patient's medical history. This case continues the important discussion of efficacy versus toxicity when selecting mitoxantrone as a therapeutic option for patients with multiple sclerosis. Although leukemia is rarely seen, the potential for this outcome warrants careful consideration before initiating this therapy.     

An fMRI framework for identifying statistical differences in blood oxygenated level dependent response levels: a brain injury demonstration

OBJECTIVE: The general concept surrounding fMRI data analysis for decision support is leveraging previously hidden knowledge from publicly available metadata sources with a high degree of precision. METHODS AND MATERIALS: Normalized fMRI scans are used to calculate cumulative voxel intensity curves for every subject in the dataset that fits chosen demographic criteria. The voxel intensity curve has a direct linear relationship to the subject's neuronal activity. In the case of head trauma, a subject's voxel intensity curve would be statistically compared to the weighted average curve for every subject in dataset that is demographically similar. If the new subject's neuronal activity falls below the threshold for their demographic group, the brain injury detection (BID) system would then pinpoint the areas of deficiency based on Broadmann's cortical areas. ANALYSIS: The analysis presented in this paper indicates that statistical differences among demographic groups exist in BOLD fMRI responses. CONCLUSION: Useful knowledge can in fact be leveraged from mining stockpiled fMRI data without the need for unique human identifiers. The BID system offers the radiologist a statistically based decision support for brain injury.     

Organization culture and the marketing concept: diagnostic keys for hospitals.

For successful adaptation to changing environmental conditions, hospital organizational cultures must incorporate the marketing concept to enhance flexibility and orientation toward the external environment. The authors propose procedures for diagnosing a hospital's culture and determining how well it has adopted and implemented the marketing concept.     

Pediatric and adult H3 K27M-mutant diffuse midline glioma treated with the selective DRD2 antagonist ONC201

Journal of Neuro-Oncology - Smoking is agreed to be a major health risk factor, but it is debated whether it has an influence on perioperative adverse events (AEs) in elective cranial tumor...     

Outcome after bevacizumab clinical trial therapy among recurrent grade III malignant glioma patients

Although outcome following bevacizumab among recurrent grade IV malignant glioma patients is documented as poor by several analyses, outcome for recurrent grade III patients following bevacizumab therapy has not been specifically evaluated. We performed a pooled analysis of 96 recurrent grade III malignant glioma patients enrolled on three consecutive phase II bevacizumab salvage trials to evaluate overall outcome following bevacizumab trial discontinuation. Outcome on the three bevacizumab trials, which included similar eligibility, treatment and assessment criteria, was comparable. Forty-nine patients who progressed on bevacizumab trial therapy and remained alive for at least 30 days elected to receive additional therapy. These patients achieved a median PFS-6 and OS of 30.6% (95% CI: 18.4, 43.6) and 10.3 months (95% CI: 5.2, 11.7), respectively. Among patients who continued bevacizumab therapy (n = 23) after study progression, PFS-6 and median OS were 39.1% (95% CI: 19.9, 58.0) and 9.2 months (95% CI: 5.2, 13.6), respectively, compared to 23.1% (95% CI: 9.4, 40.3; P = 0.51) and 10.3 months (95% CI: 2.5, 14.4; P = 0.91) for patients who initiated non-bevacizumab containing therapy (n = 26). Outcome after discontinuation of bevacizumab therapy for recurrent grade III malignant glioma patients is associated with improved outcome compared to historical data for recurrent grade IV malignant glioma patients. Salvage therapies following bevacizumab failure have modest activity for grade III malignant glioma patients that is independent of further bevacizumab continuation.     

Hospital challenge: using change theory and processes to adopt and implement the marketing concept.

Getting the marketing concept understood and accepted is one of the biggest challenges faced by a hospital. The authors discuss a variety of issues related to the process of changing a hospital's internal cultural values and managing those changes needed to embrace the marketing concept as part of the overall hospital culture.