By 2010, 16 percent of all spending in the United States is projected to be for health care. In 1997, it was 13.6 percent.
With this upward trend, along with an aging population, health care companies must do more than they are today, because the demands won’t simply be for more volume of care, but better quality and speedier delivery.
PricewaterhouseCoopers recently commissioned a worldwide study on the future of health care. The findings illustrate several implications health care companies need to consider if they are to survive in this future world:
- Health care organizations that are consumer friendly will be winners. Organizations must change their processes, technology and organizational structure with an emphasis on delivery systems, attitudes and self-training. They must integrate eligibility, claims, referrals and authorizations into a customer-friendly process.
Consumers will be stratified between e-health and traditional patients. Companies must have systems to deal with both of these groups.
- Organizations must distinguish themselves through branding. Consumerism will blur the lines between wellness, acute care, chronic care and long-term care.
All health care companies will need to brand both at the corporate and sub-brand levels to attract capital, customers and market share.
- Service and speed will be keys to consumer satisfaction. The Internet has fostered the notion of I-time. To compete in I-time, health care organizations must develop virtual brains also known as knowledge management so workers and management can learn from each other in a fast-changing industry.
Through knowledge management, they must collect, consolidate and analyze information to better understand their consumers, decision-making processes and perceptions of services relative to competitors.
- New e-business models will emerge and challenge present-day medicine delivery vehicles. The Internet gives the advantage to speed over size.
Bureaucratic health care organizations will fail in this race to smaller, adaptive entrepreneurial ventures.
- The race for capital will hinge on the ability to demonstrate quality, efficiency and customer focus. Organizations will compete for capital on the basis of current, quantifiable and competitive data.
Their investors, whether they are government or private sources, will demand prudent expenditures in facilities, technology and organizational relationships. Losing the information race will mean losing the capital race.
- Functional silos in health care must be eliminated and replaced with seamless service. Professionals may impede change as they cling to traditional frameworks. Physicians are becoming more coherently organized, which benefits purchasers who are trying to work toward efficient models of quality care.
But as physicians form larger networks, health networks are often destabilized and consumers are unsure about who their providers are.
- Resources must be reallocated to retrain the work force to deal with empowered consumers and technology.
- Payers must stress prevention, because early detection and intervention will increase costs. As a result of the Human Genome Project, consumers may begin getting their own individual genetic maps by 2010.
Their risks for different diseases will be clearer, and they’ll want to do something about those risks.
- Consumers will want more and won’t want to pay for it. There will be increasing demand on health care providers and purchasers to spend more on information technology and skilled workers to serve demanding consumers.
- New opportunities for private health insurers outside the U.S. will expand rapidly.
- Medical professionals need to work toward global standards of medical treatment.
- Ethical dilemmas will proliferate for consumers, providers and purchasers. The Human Genome Project will push the envelope in terms of how medical information is collected, disseminated and organized.
In addition, new waves of medical devices and drugs will elevate questions of medical necessity, personal responsibility and rationing.
Todd Shryock (firstname.lastname@example.org) is SBN’s special reports editor.
Chemical dependency of any kind, whether on drugs or alcohol, can be one of the most difficult things to change in your life.
The constant cravings make it easy to fall back into old habits, and relapses mean starting the recovery process over again.
But one clinic is finding success through nontraditional means.
“What separates us from others is the way we put a variety of therapeutic methods together in a unique way,” says William Steiniger, managing director of Desert Canyon Treatment Center in Sedona, Ariz. “Our approach is a whole-body approach, encompassing the body, mind and spirit. This is more than a program that helps people stop drinking or using drugs. It’s about people getting their lives back.
“We try to get them to radically shift their whole perception of what life is about.”
The system is radically different than traditional 12-step programs. Desert Canyon’s philosophy is that the addiction can be ended permanently.
Patients are taught to understand why they are abusing drugs and that they can control these urges. They are treated with a combination of counseling, meditation, dietary changes and exercise.
“As a result of the exercise, they start to get their strength back,” says Steiniger. “The physical body affects the emotions and vice versa.”
People feel better about themselves and realize how low they were, and make a conscious choice to not use drugs and drag themselves back down to where they were before.
While a small number of people lapse after leaving treatment, the effects are short-lived.
“Instead of lapsing again, they do the reverse,” says Steiniger. “They remember how awful it is and end the addiction permanently.”
Steiniger compares the variety of treatments to assembling a toolbox. Once patients are taught to use these healing tools, they can use them to help “fix” themselves. Different tools work for different people, and each person can draw on what is most effective for him or her.
“You are either doing one of two things: reacting to life or creating,” says Steiniger. “When you are in the creative process, you are the master of manifesting what you want in life. People with addictions, they have lost their ability to create, and spend their life pushing up against something.”
The therapy process takes four consecutive weeks to complete. Patients have access to a call-in support system for as long as they need it, but Steiniger notes that few people use it more than once or twice immediately after leaving, because they simply don’t need the help anymore.
They have the tools to help themselves.
How to reach: Desert Canyon Treatment Center, (888) 811-8371, or www.desert-canyon.com
Todd Shryock (email@example.com) is SBN’s special reports editor.
As a result, Performance was one of nine public companies in Ohio recognized with a 1999 Governor’s Excellence in Workers’ Compensation award.
Performance Site Management, based in Columbus with an office in Cincinnati, is a site development contractor employing about 380 people. Its projects include commercial shopping centers, office buildings, apartment complexes, street reconstruction and water and sewage work. Recent projects include work on the Columbus Convention Center Parking Garage and the renovated Scioto Amphitheater.
Safety is paramount in what can be a very dangerous business, says marketing manager Linda Peck, and the company is always looking for ways to ensure its workers are as safe as possible on the job.
“Yes, we recognize the danger involved, but these are human beings we’re talking about, not numbers,” Peck says. “We don’t do it for the numbers’ sake. We do it for the people.”
The company has an experience modification rating (EMR) of .67. With a base of one, that means it experiences only two-thirds of the number of injuries the Bureau of Workers’ Compensation expects of companies in its industry.
Performance has done several things to create a safer workplace, including:
Hiring two full-time safety personnel.
Safety director Tom Obert and a safety coordinator conduct on-site safety inspections to ensure equipment is working properly and safety procedures are being followed.
They also carry extra safety equipment, including fire extinguishers, glasses and ear plugs, so “if a crew is running low, we can replace it right there,” Obert says. “We do take safety very seriously.”
The also go over all performance safety policies and procedures with each crew at least once a month.
Conducting weekly safety awareness talks.
Tool Box Safety Talks cover topics relating to projects, equipment and seasons, among other things.
“In cold weather, we discuss hypothermia, driving on ice, keeping warm,” Obert says. “In summer, it’s heat stress, rigging, hand tools. They’re things they’re already familiar with, but they’re getting reminders. When you do something day in and day out,” it can be easy to overlook the basics.
Creating an employee recognition program for individual safety achievements.
Employees are awarded T-shirts after six months without an injury; those who are not injured in a year receive sweatshirts.
“Everyone wants to be able to wear the shirts and say, ‘Look what I’ve done,’” Obert says. The design is changed each year, so long-term employees with good safety records have a variety of shirts.
Performance used to award shirts on a crew basis, but “there was peer pressure. If one guy got hurt, no one on that crew got shirts,” Obert said.
That occasionally led to workers limping around with an injury, deciding to live with instead of report it, so that his or her crew would qualify for the award shirts, says Peck.
Requiring workers to immediately report an injury.
The supervisor at the scene determines whether an injured worker needs an ambulance, should be transported to the hospital by someone on the crew, or can be treated on-site with a first aid kit, says Obert.
If the worker must go to the hospital, one of the safety personnel meets him or her there and stays until the worker is released.
Convening a safety committee each month.
The committee is composed of workers from every area of the company and addresses safety issues, including accidents, to see if there is a pattern and if training might be lacking in a certain area.
Requiring all workers to undergo periodic substance abuse testing.
In addition to pre-hire drug screening and randomly testing about one-quarter of its work force each year, Performance administers tests on suspicion. And if a worker is injured on the job and has to go to the hospital, a drug test is mandatory. If another worker is responsible for the injury, that person will be tested as well.
“Workers in the field don’t want to be around someone who puts them in harm’s way. If someone is high, they’re taking a risk,” Obert says.
Placing injured workers with restrictions in light-duty positions.
The goal is to get the worker back on the job as quickly as possible, and the patient resource coordinator follows up with the doctor and the worker almost daily, Obert says.
Light duty options include some positions on the crew, working as a parts runner, and helping around the shop, sweeping floors and answering phones, but the important thing is getting the person back on the job and involved with the company.
Offering classes on hazardous materials.
Obert teaches an annual HAZMAT refresher course to all field and shop personnel, instructs OSHA-mandated classes and offers CPR instruction.
Ensuring all employees understand the daily job situation.
In what the company calls 10/10 meetings, each crew gathers in the morning “to talk about what is happening that day,” Obert says. “They address any hazards” they may face, and how to handle them. The group meets for another 10 minutes after lunch to address the jobs scheduled in the afternoon.
Offering a rewards program which compensates employees who suggest a better way to do things.
In addition to keeping its workers safe, taking precautions presents an added bonus for Performance.
“Safety sells,” Peck says. “It’s a big selling point to clients” if the company can point to a low rate of on-the-job injuries.
But despite its success, the company can still do better, Obert says.
“There’s always room for improvement,” Obert says. “We’re taking additional safety classes, providing more training, constantly looking at new technology to make work a safer place.”
“Our people are our most valuable resource, and we take safety very seriously. Our emphasis is on having our employees go home unharmed at the end of every day.”
And the winners are ...
Other 1999 Governor’s Excellence public winners include:
- Medical College of Ohio, Toledo;
- Hamilton County;
- City of Chillicothe;
- Herr Foods Inc., Columbus and Chillicothe;
- Lithko Contracting Inc., Hamilton;
- Reitter Stucco Inc., Columbus;
- Royster-Clark Inc.;
- Traub Container/MacMillan Bloedel Packaging, Bedford Heights.
Less than a decade ago, someone cheating the Bureau of Workers’ Compensation had little chance of being caught.
That changed in 1993, when the insurance industry as a whole began recognizing the huge amounts of money lost to fraud and the crime became a felony in Ohio. Before that, offenders could only be charged under general theft standards.
With the change in the law, the BWC established its first special investigators unit with just three investigators to police the entire state. Today, the 125 staff members in that unit identify about $100 million in fraud savings per year, says J.C. Benton, BWC spokesman.
“That’s money we’ve identified that did not go out (in fraudulent payments) to injured workers and medical providers,” Benton says. “We estimate a 900 percent return on investment in the area of fraud. For every dollar we invest, we recover nine.”
When CEO Jim Conrad joined the bureau in 1995, he beefed up the fraud unit, added investigators and began looking into fraud committed outside the state against the Ohio bureau.
“There’s nothing illegal about it if you’re injured and collecting workers’ comp and you move out of the state, but what we’ve found is people moving out of he state, then taking other jobs,” Benton says.
The BWC trades files with other agencies, including those in other states, to run cross checks on people collecting workers’ comp. If another agency has evidence that someone is working, the bureau investigates. It also checks prison records, because those serving time are not eligible to collect benefits.
“You have the right to collect if you’re injured on the job, but you give up that right when you go to jail,” Benton says.
In addition to automated detection systems, the BWC relies heavily on tips to catch those cheating the system.
“A lot of referrals come in around the holidays,” Benton says. “Relatives turn in other relatives. They’ve been spending time together over the holidays and someone hears Uncle Larry telling the story about how he’s collecting workers’ comp and is working somewhere else, but he’ll never be caught.”
Ex-wives and ex-husbands are also a rich source of tips, as are suspicious employers, Benton says.
In November 1999 alone, the BWC received 400 allegations, and is currently investigating about 1,800 cases. In 1999, it referred 246 offenders for prosecution and identified more than $101 million in fraudulent activities.
Although some offenders are jailed for committing fraud, the BWC’s biggest priority is recouping its money.
“As soon as someone pleads guilty in court, we make arrangements with the injured worker, or, in some cases, the medical provider, for a payment plan,” Benton said. “If someone doesn’t make a good faith effort to return the funds, we go back to the court. Sometimes a few days in jail will speed up our process of collecting money.”
It’s not only injured workers who commit fraud. Relatives have been caught cashing the workers’ comp checks of deceased relatives. And the health care provider unit focuses solely on fraud committed by health care organizations, which bill for services not related to a worker’s injury.
In the largest bust to date, a Florida provider was arrested for allegedly billing the BWC for $1.68 million for services not provided to an injured worker living in that state. And in Ohio, the owner of a chiropractic center was found guilty of conspiracy to commit mail fraud. In addition to fines and jail time, he was ordered to pay $250,000 in restitution, $230,000 of that to the BWC.
Benton stresses that cheating the system is stealing from the Ohio employers who pay into it. He encourages employers to pay careful attention to injured workers and report suspicious claims.
Anyone who suspects fraud can anonymously phone the BWC hotline at (800) OHIOBWC.
Technology has created a world in which you are always in touch with the office. Cell phones, voice mail, e-mail, pagers, smart phones and PDAs all keep you up to date with what’s happening while you’re away.
But while all these chips and circuits have made your life simpler, they have also made it more complex.
The problem is that messaging comes in so many different forms, over so many different systems. Workers use landlines and wireless phones to receive calls and check voice mail. They must go to a fax machine for faxes. E-mail comes to their computer desktop, and often workers must go online to check mail.
Messages in different formats often turn out to be redundant. A customer couldn’t reach somebody on the phone, so he paged. When the page wasn’t answered, he e-mailed and/or faxed. The business user must go to different systems to find the messages.
Multitudes of passwords, user codes and product-specific instructions slow the retrieval of information to a crawl. Checking messages and returning calls shouldn’t require two computer consultants and an electrical engineer. That is the idea behind InternetPBX from COM2001.com.
“We developed a phone system that takes advantage of the full power of Microsoft NT,” says David Perez, president and CEO of COM2001.com. “It integrates traditional voice, unified messaging, e-mail and fax. It utilizes Microsoft Outlook and Explorer, along with a personal assistant with voice recognition features.
“For the small business guy who is away from the office or working from home, he will have every feature there as he would in the office.”
All messaging is handled through the server, so when the system administrator backs up your computer data, he or she is also backing up your voice mail and faxes. The virtual personal assistant, Alexis, can access e-mail, voice mail and faxes; manage calendars; compose and send messages; and even screen your calls. Users can set single number “find-me, follow me” service.
Users gain real-time call control and screening on their computer screens. An integrated Outlook database provides information on identified callers. A single mouse click lets users place, accept or transfer calls. Users can arrange four-way conference calls and set up high quality digital conference bridges for team meetings.
The toolbar will display all the participants and their contact information from Outlook.
The same interface delivers unified messaging to users of InternetPBX. Outlook captures and displays all voice mail, e-mail, paging and fax mail grouped together and available over the same system. Any message can be played, saved or attached to other messages for forwarding.
The profile of the company that would benefit the most from the InternetPBX is one with 10 to 100 employees and a basic need for mobility. This could be sales people, medical staff, accountants or attorneys, for instance.
“Anyone who needs to constantly be in touch with the office could benefit,” says Perez. “If all you have are clerks, then it probably won’t work well. But if you fit the profile, it costs 1/10th the price of a Lucent system with the same features.”
A system optimized for 10 people would cost about $300 a month with all the options. The servers come prebuilt from Dell.
How to reach: COM2001.com, www.com2001.com
Todd Shryock (firstname.lastname@example.org) is SBN’s special reports editor.
You’re on your way to a sales meeting when your phone beeps. You have an urgent e-mail from the office, your favorite stock is at a record high and you were just outbid in an online auction for a collectible Swiss watch.
You sell the stock and up your bid, all using only your phone.
Far-fetched? Hardly. It’s all possible now, and you’ll being seeing more of it. The only question is how many devices and which applications will stick, and which will not.
If you’re trying to determine which wireless weapon to add to your road warrior armory, you might want to consider a digital phone. A recent report by Mark Zohar of Forrester Research predicts that digital wireless phones will be the big winners of the mobile device race because:
Users reject mutant devices. Users will choose one device that is optimized for the primary function of making phone calls but also offers new data features.
Alternate devices are capped. Mobile consumers won’t carry around a utility pack of multiple devices. Other devices, such as wireless PDAs and video terminals that don’t provide the mobility or core voice function that mobile consumers demand, will remain niche products.
The information provided by these devices will also be simple in nature, and get to the point quickly. Zohar says users will demand devices that:
Provide timely information. Mobile consumers will want to receive customized information that is timely and time-sensitive. Consumers will not spend the time to read general news on their phones when they can do that at the office.
Enable simple transactions. Consumers won’t use their phones to conduct complex and time-consuming transactions like ordering a new computer or researching products. Rather, they will focus on simple transactions that are easily actionable.
Are location relevant. By 2001, wireless carriers will implement Automatic Location Identification technologies, including GPS solutions from SnapTrack and SiRF. Content providers such as MapQuest will capitalize on these technologies to provide personal navigational services. With a simple query, smart Yellow Pages will locate the nearest Hilton hotel or Vietnamese restaurant.
Personal information, including credit card numbers, will be pre-entered and stored. Users can choose who they receive alerts from and be notified accordingly. For example, Ticketmaster might alert you when your favorite artist schedules a concert in your area and enable you to purchase tickets with the touch of a button.
You can also expect instant messaging, similar to what online providers AOL and Yahoo! offer on the computer, to move over to phones as well.
This means you’ll have more and more of the features you have on your office computer contained albeit in a simpler format on your mobile phone. E-commerce will be in the palm of your hand no matter where you are airport, sales conference or lunch.
Other predictions by Zohar include:
Billing will become profitable. Customers and merchants seeking simple and secure methods of payment for mobile e-commerce will turn to carriers for the solution. Customers will be able to add their purchases to their wireless bill, and have the carrier act as the billing and collections agent for the merchant.
New safety issues will arise. Israel and Spain already ban the use of cell phones while driving and Japan is in the process of implementing such as law. As mobile Internet services emerge, pressure will mount on U.S. state and federal governments to ban the use of mobile phones in cars. To avoid new legislative action, the wireless industry will roll out voice XML services that will let consumers use voice access to browse Internet content on a hands-free basis.
How to reach: Forrester Research, www.forrester.com
Todd Shryock (email@example.com) is SBN’s special reports editor.
Experiencing an illness, such as the flu, causes psychological stress that can make people feel mildly depressed. It can also trigger depression in those who are prone to it.
If someone is already depressed, that person is less likely to take care of themselves, such as getting a flu vaccine, said Dr. Toby Goldsmith, clinical assistant professor of psychiatry at the University of Florida. Like any stress, the stress associated with being ill, such as missing work, may trigger depression in someone who is prone to depression.
Goldsmith said a study shows those who are chronically stressed do not respond to the flu vaccine as well as others, and may be more vulnerable to the flu.
Warning signs can indicate if you are heading down a slippery slope toward being overstressed and include not sleeping well, fatigue and avoiding your usual day-to-day activities, such as watching television and eating.
If you are not back to your normal routine one month after having the flu, Goldsmith recommends talking with your physician to make sure something else might not be causing your symptoms. Source: Dr.Koop.com
A recent study by Canadian scientists showed that highly stressed heart patients did not respond as well as others to medication for angina and chest pain. The American Heart Association says patients with heart failure should take steps to reduce and manage stress to reduce strain on their hearts.
Of stress management in general, though, the American Heart Association (AHA) says that the available data do not yet support specific recommendations for its use as a proven [prevention or treatment] for heart disease.
How you cope with stressful situations may make a difference, especially if you habitually react to stress in ways that feed physically harmful emotions such as chronic hostility. Stress management is not about avoiding stress but, rather, learning to manage its recurring effects.
Everyone who drives gets cut off in traffic now and then and gets a burst of adrenaline produced by fear or anger. Some people can quickly relax and return to a normal physical state. Others stew about the incident, and make things worse by discussing it with others who share their hostility and feed it with stories of their own.
In heart failure, the heart muscle is weakened and the patient needs to take care not to make it work harder than necessary. Its important to reduce physical symptoms of stress a pounding heart and heavy breathing as much as possible. Though avoiding all stress may be impossible, you may be able to adjust your activities to avoid stress triggers such as rush-hour traffic or long hours at work. Source: Lifescape.com
While cigarette smoking has been well established as a major cause of heart disease and stroke, some studies have suggested that its harmful effects are muted in smokers with low cholesterol levels.
Now, a study published in The Journal of the American Medical Association reveals that cigarette smoking significantly increases the risk of these diseases even in low-cholesterol populations.
Look in the bottom drawer
Dont skip meals. Eat a variety of foods every four or five hours. Keep snacks such as power bars, trail mix or dried fruits handy to fill in when time doesnt permit a real meal.
For some people, asthma is a minor annoyance just a cough or two after they run. For others, its a life-threatening condition they live with every day. The number of cases is on the rise more than 17 million people in the U.S. have the disease, an increase of more than 75 percent since 1980. As the number of patients has risen, so have the larger consequences of the disease.
Today, asthma is one of the top reasons for hospitalization of children, causing kids to miss more than 10 million school days a year and adults to miss 3 million days at work. It is responsible for more than 10 million doctor visits a year and will be responsible for more than 5,600 deaths this year, more than twice as many as 20 years ago.
Smoke is not a nutrient
Secondhand smoke, also called passive smoking, can have terrible effects on kids. Children who are exposed to smoke have more ear infections, asthma, pneumonia, bronchitis and a respiratory virus called RSV than children of nonsmokers. Children exposed to smoke have lower lung capacity and slower lung development than unexposed children, says Dr. Nancy Snyderman.
Over the long term, these kids are at increased risk of developing lung cancer and other conditions associated with smoking and stand a much greater chance of becoming smokers themselves.
Many parents may be unwilling or unable to quit smoking. But if they understand the dangers to their child, they may at least be willing to stop smoking around their children and inside the home.
The piercing truth
The American Dental Association doesnt sugarcoat its opposition to oral piercing, which it deems a public health hazard. In fact, oral piercing would be obsolete if the decision rested solely in the hands of the ADA, according to Dr. Gary C. Armitage, a dentist and chairman of the ADAs Council on Scientific Affairs.
That the topic had a place on the agenda of the groups 139th annual session, held recently in pierce-happy San Francisco, says a mouthful about the widespread popularity of the practice, even among folks who floss every day. Oral piercing can result in a number of adverse oral and systemic conditions, according to the ADA.
Common symptoms after piercing include pain, swelling, infection, increased salivary flow and gum injury. In addition to the risk of infection, which is especially high due to the vast amounts of bacteria in the mouth, problems include airway obstruction after swallowing jewelry, prolonged bleeding, chipped or cracked teeth after biting jewelry, scar tissue, speech impediment and interference with X-rays.
The ADA joins other venerable medical institutions and organizations that have seen fit to address a wide range of concerns about puncturing body parts, including but by no means limited to ears, eyes, mouths and noses, as well as necks, nipples, navels and sundry genitalia.
The American Academy of Dermatology has taken a position against all forms of body piercing with one exception: the ear lobe. Skin specialists cited nickel allergies, cyst formations, chronic local infections and granulation tissue (fleshy bumps that form during the healing process of some wounds) as reasons not to pierce.
The ear lobe has been singled out because it's made of fibro-fatty tissue and has a good blood supply, which is crucial in case infection sets in, says Dr. Ronald Wheeland, a Santa Fe dermatologist. The piercing sites deemed especially problematic by the academy involve cartilage which, once infected, can whither and shrink because of a paltry blood supply, and complex tissue structures such as the nipples, which are more than simple skin and fatty layers.
The uncomplicated navel, although it has no ducts like the nipple or cartilage like the nose, has not received the same tacit approval from the academy as the ear lobe. However, individual doctors seem not to be as concerned about piercing the umbilicus as they are about other body parts.
As a precaution against the transmission of blood-borne diseases, the U.S. and Canadian Red Cross wont accept blood donations from anyone who has had a body piercing or tattoo within a year. The Centers for Disease Control and Prevention have deemed nonsterile piercing a serious health risk.
Although HIV transmission is a theoretical possibility the virus that causes AIDS dies at room temperature hepatitis is the real worry. Hepatitis B and C can be transmitted in as little as 0.00004 milliliter of blood and can survive on blood-contaminated surfaces, such as instruments and doorknobs.
Cancer or clueless?
An estimated 4 to 6 percent of a doctors patients are considered hypochondriacs, says Dr. Brian Fallon, an associate professor of psychiatry at Columbia University in New York and co-author of Phantom Illness: Shattering the Myths of Hypochondria.
For them, a headache is not caused by stress, but a brain tumor. Fatigue is not attributable to a poor nights sleep, but AIDS. In a desperate quest to reassure themselves, they may visit doctor after doctor. Even after tests rule out a particular disease, they feel little relief.
The new wonder drug.
A recent study suggests that vitamin C may actually help people with hypertension, or high blood pressure.
A report in a recent issue of the Lancet, an international medical journal published in Britain, presents the results of a small trial of vitamin C as a treatment for high blood pressure. Researchers from the Boston University Medical School and Oregon State University studied the effect of daily 500-milligram doses of vitamin C on the blood pressure of 39 people with high blood pressure.
The study subjects included 20 women and 19 men who were approximately 48 years old. At the beginning of treatment, their systolic blood pressure, measured when the heart contracts to pump blood, averaged 155 millimeters of mercury. Their diastolic pressure, measured between heart contractions, was about 87 millimeters of mercury. A person is considered hypertensive if his or her systolic pressure is greater than 140 millimeters and diastolic pressure is greater than 90 millimeters.
Patients were randomly assigned to receive either the daily dose of vitamin C or a placebo. Neither the researchers nor the subjects knew which pills were given to which patient.
Subjects took the pills for one month, after which their blood pressure and vitamin C blood levels were measured. As expected, vitamin C supplementation significantly increased the vitamins blood levels. In addition, there was a significant decrease of 13 millimeters of mercury in the systolic pressure of subjects taking vitamin C. Those who received vitamin C also had a small decrease in their diastolic blood pressure, but this decrease was not statistically significant. The greater the change in the blood level of vitamin C, the greater the decrease in blood pressure.
How about a friendly wager?
The following signs and symptoms indicate compulsive gambling:
- increasing the frequency and the amount of money gambled;
- spending the majority of free time thinking about gambling;
- spending an excessive amount of time gambling at the expense of personal or family time;
- being preoccupied with gambling or with obtaining money with which to gamble;
- feeling a sense of euphoria, an aroused sense of action or a high from gambling;
- continuing to gamble despite negative consequences such as large losses, or work or family problems;
- gambling as a means to cope with uncomfortable feelings;
- chasing, or the urgent need to keep gambling, often with larger bets or greater risks to make up for losses;
- borrowing money to gamble, taking out secret loans or maximizing credit cards;
- bragging about wins but not talking about losses;
- frequent mood swings higher when winning, lower when losing;
- gambling for longer periods of time with more money than originally planned;
- lying or secretive behavior to cover up extent of gambling. Source: Drkoop.com.
Robert Thompson walked into the small manufacturing plant and was amazed.
“This company did some very, very technical types of manufacturing,” says Thompson, COO of Complient Services Group, an organization that provides solutions to workplace compliance issues. “This was a beautiful, pristine, gorgeous facility. You’d walk in there and you’d think it was the safest place in the world.”
It wasn’t. An audit by a Complient safety inspectors revealed serious OSHA violations, not the least of which was a lack of an updated emergency preparedness plan, an Occupational Safety and Health Administration requirement.
“There are all kinds of emergencies,” Thompson says. “But there are four major categories: weather, nonweather, fire and medical emergency. The types of emergencies are almost unlimited. You can’t be perfect, but you need a prudent and reasonable system for your employees to prevent injuries.”
But in the normal course of a business day, many people take basic safety issue for granted, focusing instead on larger issues, such as whether noxious fumes are escaping in the plant or whether safety rails are properly secured.
“People, in many instances, think that they’re complying with OSHA by posting something on the bulletin board or making sure that they’ve got a written document somewhere, or maybe they’ve shown a safety training videotape,” Thompson says. “All those are elements of a program, but people really should think in terms of having an effective program. And having an effective program is getting a perspective and understanding all the things that you’re required to do and understand how it fits your workplace.”
Every preparedness plan must incorporate four components a written preparedness program; an employee alarm system to alert employees in the event of an emergency; identification of the types of evacuation used in an emergency; and the training of a sufficient number of persons to assist in safe and orderly evacuation.
This was missing at the manufacturing plant.
“In order to make these little tiny parts out of metal, they had to use a lot of very sophisticated machinery to do it,” Thompson says. “And some of the machinery that they had was very high quality machinery that had been manufactured maybe 40 years ago. These machines, even though they ran well and they did what they were supposed to do, didn’t have some of the safety (devices) on them. They weren’t required 40 years ago.”
There were no shields to protect fingers, hair or clothing from getting caught in spinning cogs or rotating drive belts.
The company had other problems as well. As the business grew, its electrical needs increased. Instead of laying the proper conduits and grounded receptacles, it had simply run heavy-duty extension cords.
It was one of those “things that you learned when you were a kid,” Thompson says. “You’re not supposed to put 15 plugs in an outlet. It will overheat and blow up and potentially cause a fire. It had become so common that they were doing this that they really didn’t notice it anymore.”
That attitude is not unusual, he says.
“It requires a lot of discipline and it requires constant vigilance to ensure a safe workplace,” Thompson warns. “And in some cases, it isn’t high on the list, because people are busy doing other things or distracted. Somebody has to be responsible for safety in the workplace and you want to get that responsibility down to every employee.
“You want everybody to understand that management is concerned about safety in the workplace. And you want the employees to understand that management cares and wants them to care about safety in the workplace.”
If that manufacturing plant did have an emergency, even a minor one, it wouldn’t have been prepared.
“They had a first aid kit,” Thompson recalls. “And there were like three Band Aids, some adhesive tape and a tube of ointment that had been expired for two years. Did they do that because they were mean, bad people? No. They used up the stuff and it wasn’t somebody’s job to go take care of the first aid kit.
“It’s not going to do you any good if somebody slices their hand. What are you going to do? Wrap a dirty rag around it?”
There are other considerations that affect the health of employees, but most people don’t think about the consequences.
“If something bad happens in the workplace, it’s not only going to injure somebody, or perhaps that person will lose their life; what’s going to happen is that it’s going to lower morale, it’s going to lower productivity and it’s going to raise insurance costs,” Thompson says. “There are lots of other things that you don’t really think about. If you have an effective program, people feel that they’ve been trained well, that management cares, and if something does happen and it’s responded to in the appropriate way, they’re going to think, ‘Hey this is great. We did the right thing.’
“People want to do the right thing.”
Thompson suggests that companies bring in a safety expert to complete an audit of the facilities, both internally and externally. It’s important to know not only what hazards your employees face in your workplace, but hazards your neighbors may pose, as well, that might have an effect your operations.
“It’s a real easy thing to not be aware,” Thompson says. “But not being aware isn’t an excuse, particularly if something happens and people don’t respond to it properly.”
How to reach: Complient Service Group, (440) 498-8800
Daniel G. Jacobs (firstname.lastname@example.org) is senior editor of SBN.
But no more. Technology, as it has so many times in the past, is rapidly making telephone surveys as outdated as eight-track tapes.
“It has to do with the fact that it’s harder and harder to talk to people on the phone,” says Amy Yoffie, vice president of market research with Research Connections, a firm specializing in Web-based research. “People have answering machines and caller ID, and a lot of people are associating market research with sales calls. Response is going down dramatically.”
As the masses continue adding bricks to their electronic wall to keep out unwanted calls, they are also going online. Companies are inviting customers to fill out surveys via the Web. Retailers are forming virtual focus groups. Marketers are doing more research while spending less.
“Companies using the Web get a higher response and higher quality information,” says Yoffie. “People are able to answer the surveys when they want. They can be thoughtful about the questions, as opposed to being interrupted in the middle of dinner.”
Response to telephone surveys can be 40 percent or less. Web surveys fare worse, with only about 20 percent responding to an invitation.
While this should increase as more people go online, consider one important difference: “You don’t have the labor cost of interviewers making phone calls. The cost of doing another increment of interviews is much lower. To do another 100 interviews is a negligible cost compared to the phone.”
So while phone surveys have a better response rate initially, it’s cheaper to do it by Web.
Research firms use a variety of methods to develop a pool of candidates. Some have the general populace fill out their demographic information and invite them to specific surveys for a chance to win cash or other prizes. A company might have an e-mail list of its customers, or a pop-up window can be utilized to entice visitors at a Web site to fill out a survey.
Turnaround time is fairly quick. A survey can be put up overnight, with thousands of invitations sent out simultaneously. A more specific survey, aimed at a narrow demographic group, might take longer both in designing the survey and finding enough qualified candidates.
Most of the larger online research firms have established pools of people to choose from to invite to take a survey. If a particular population isn’t on file, there are opt-in e-mail lists that can be purchased to meet the need.
So is the phone survey doomed?
“I think there will always be a certain amount of market research done by phone,” says Yoffie. “It may be for hard-to-find populations, like people that don’t have Internet access. I expect within three to five years that the phone survey industry will be cut in half.
“Door-to-door interviews used to be very common, but now are dead. I don’t believe the phone survey will ever be dead, but people that think it will stay at the level it’s at now are kidding themselves.”
How to reach: Research Connections (which has recently been acquired by Talk City), www.researchconnections.com
Todd Shryock (email@example.com) is SBN’s special reports editor.
In a spacious hardwood-floored studio office along Euclid Avenue stacked high with film equipment and computers, Greg Petusky and Johnny Wu spent the last 18 months building their electronic media company from the ground up.
They became business partners in 1998, with hopes of opening a photography business. When it promptly flopped, they decided to give the media business a try, tapping into Petuskys love of filmmaking and Wus knowledge of computers.
Since then, Media Design Imaging has gone the low-key, independent route. The pair recently completed an action film called Twisted, a music video that is being delivered to homes across the nation on Media Ones Road Runner high-speed cable modem and a television commercial for an underdog Internet company.
Given MDIs independent spirit, it is ironic the company is garnering attention from a new project inspired by corporate giants such as Microsoft and Budweiser digital business cards. The specially cut, three-inch compact discs play in any personal computer with a CD-ROM drive and can be packed with up to 50 megabytes of information the equivalent of 9,000 simple pages of text or a dozen Web pages.
Cleveland-based Paratus Inc. an Internet technology and marketing services firm went to MDI last year with an offer to partner on a project for Washington, D.C. Mayor Anthony Williams, asking the small firm to help develop the content for the discs.
We finished it in a week, turned it in and they loved it and want to do more, says Wu. So, slowly from there, we got more business. Its a very cool concept.
The work has been a benefit for MDI, which can now sink profits from the digital business cards back into its filmmaking ventures, as well as generate awareness about the company.
We dont just want to concentrate on one target, says Wu, But, at the same time, we dont mind outsourcing ourselves to do some work and market ourselves.
So, while its main focus remains films, it appears MDI has more digital business card work heading its way, if the rising buzz about the new technology is any indication. Paratus CEO Frank Sulka says he is has already heard from several local companies considering an investment in digital business cards, now that it has become a cost-effective marketing strategy.
As with traditional business cards, the more you buy, the better the price. The design and burning of 1,000 digital business costs about $3,000, while an order of 10,000 comes in around $1 each.
How to reach: MDI, (216) 623-0822; Paratus, (440) 796-8536
Jim Vickers (firstname.lastname@example.org) is an associate editor at SBN.