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Only Hope (only + hope)
Selected AbstractsOptimizing Service Attributes: The Seller's Utility Problem,DECISION SCIENCES, Issue 2 2001Fred F. Easton Abstract Service designers predict market share and sales for their new designs by estimating consumer utilities. The service's technical features (for example, overnight parcel delivery), its price, and the nature of consumer interactions with the service delivery system influence those utilities. Price and the service's technical features are usually quite objective and readily ascertained by the consumer. However, consumer perceptions about their interactions with the service delivery system are usually far more subjective. Furthermore, service designers can only hope to influence those perceptions indirectly through their decisions about nonlinear processes such as employee recruiting, training, and scheduling policies. Like the service's technical features, these process choices affect quality perceptions, market share, revenues, costs, and profits. We propose a heuristic for the NP-hard service design problem that integrates realistic service delivery cost models with conjoint analysis. The resulting seller's utility function links expected profits to the intensity of a service's influential attributes and also reveals an ideal setting or level for each service attribute. In tests with simulated service design problems, our proposed configurations compare quite favorably with the designs suggested by other normative service design heuristics. [source] The Swedish Conservative Party and the Welfare State: Institutional Change and Adapting Preferences1GOVERNMENT AND OPPOSITION, Issue 4 2008Anders Lindbom After the 2006 elections, a bourgeois government came to power in Sweden. This article argues that the popularity of the ,universal' Swedish welfare state has led the dominant ,neoliberal' party (Moderaterna) to adapt its policies; the party has accepted that the modern welfare state is irreplaceable. In the short run the party can only hope to achieve incremental changes, but at the same time the party wants to change society (lower taxes) in the long run. The differences between the allegedly neoliberal 1980s and 2006 should not conceal that the mechanism of welfare popularity remains largely the same. The party's policy proposals tend to suggest only incremental changes in both periods. [source] Predictable and unpredictable evolution of antibiotic resistanceJOURNAL OF INTERNAL MEDICINE, Issue 1 2008P. Courvalin Abstract. Evolution of bacteria towards antibiotic resistance is unavoidable as it represents a particular aspect of the general evolution of bacteria. Thus, at the very best, the only hope we can have in the field of resistance is to delay dissemination of resistant bacteria or resistance genes. Resistance to antibiotics in bacteria can result from mutations in resident structural or regulatory genes or from horizontal acquisition of foreign genetic information. In this review, we will consider the predictable future of the relationship between bacteria and antibiotics. [source] Combined liver and inferior vena cava resection for hepatic malignancyJOURNAL OF SURGICAL ONCOLOGY, Issue 3 2007Spiros G. Delis MD Abstract Objective The experience from a single center, in combined liver and inferior vena cava (IVC) resection for liver tumors, is presented. Methods Twelve patients underwent a combined liver resection with IVC replacement. The median age was 45 years (range 35,67 years). Resections were carried out for hepatocellular carcinoma (n,=,4), colorectal metastases (n,=,6), and cholangiocarcinoma (n,=,2). Liver resections included eight right lobectomies and four left trisegmentectomies. The IVC was reconstructed with ringed Gore-Tex tube graft. Results No perioperative deaths were reported. The median operative blood transfusion requirement was 2 units (range 0,12 units) and the median operative time was 5 hr. Median hospital stay was 10 days (range 8,25 days). Three patients had evidence of postoperative liver failure, resolved with supportive management. Two patients developed bile leaks, resolved conservatively. With a median follow up of 24 months, all vascular reconstructions were patent and no evidence of graft infection was documented. Conclusions Aggressive surgical management of liver tumors, offer the only hope for cure or palliation. We suggest that liver resection with vena cava replacement may be performed safely, with acceptable morbidity, by specialized surgical teams. J. Surg. Oncol. 2007;96: 258,264. © 2007 Wiley-Liss, Inc. [source] Primary bronchopulmonary leiomyosarcoma of the left main bronchus in a child presenting with wheezing and atelectasis of the left lungPEDIATRIC PULMONOLOGY, Issue 4 2002Dong-Shang Lai M.D. Abstract Primary lung tumors are rare in children, and primary bronchopulmonary leiomyosarcomas are very rare in children, with only 10 cases reported in the English-language literature. We report on the eleventh case of primary bronchopulmonary leiomyosarcoma in a child, and it is the first case in Taiwan, and also in Asia. In addition, this is the second case of this tumor arising in the left main bronchus. Before the present case, there were only 2 cases of this tumor in the main bronchus: one was in the right main-stem bronchus, and the other in the left-stem main bronchus. Ours is the second case showing pleural effusion. Chest roentgenogram and bronchoscopy are helpful in the diagnosis of primary bronchopulmonary tumors, but a definitive diagnosis can only be made by biopsy. The tumor is potentially curable if total excision is possible; irradiation has little therapeutic value, and early excision offers the only hope of cure. The child is alive and well 19 months after pneumonectomy, without having received radiotherapy or chemotherapy. Pediatr Pulmonol. 2002; 33:318-321. © 2002 Wiley-Liss, Inc. [source] Posterior pelvic exenteration for primary rectal cancerCOLORECTAL DISEASE, Issue 4 2006G. C. Bannura Abstract Background, Indications for and the prognosis of posterior pelvic exenteration (PPE) in rectal cancer patients are not clearly defined. The aim of this study was to analyse the indications, complications and long-term results of PPE in patients with primary rectal cancer. Methods, A retrospective review included patient demographics, tumour and treatment variables, and morbidity, recurrence, and survival statistics. These results were compared with a group of female patients who underwent standard resection for primary rectal cancer in the same period (non PPE group). Results, The series included 30 women with an average age of 56.7 years (range 22,78). Tumour location was recorded in three cases in the upper rectum, 13 cases in the medium rectum and 14 cases in the lower rectum. A sphincter-preserving procedure was performed in 70% of the patients. Mean operative time was 4.2 h (range 2,7.5 h). Overall major morbidity rate in this series was 50% and mean hospital stay was 19.7 days (range 9,60 days). There was no hospital mortality. Pathological reports showed direct invasion of uterus, vagina or rectovaginal septum in 19 cases, involvement of perirectal tissue in 25 cases and positive lymph nodes in 18 cases. Comparison between PPE and non PPE groups showed no differences in mean tumour diameter, histological grade and tumour stage, but patients in the first group were younger. Although low tumours were seen more frequently in the PPE group (P = 0.003), the rate of sphincter-preserving procedure was comparable in both groups. Operative time was longer (P = 0.04) and morbidity was higher (P = 0.0058) in the PPE group. Local recurrence with or without distant metastases for the whole series was 30%. Five-year survival rate for patients who underwent curative resections (TNM I,III) was 48% in the PPE group vs 62% in the non PPE group (P = 0.09). Conclusions, In the present series, PPE prolonged operative time, increased postoperative complications and showed a trend toward poor prognosis in recurrence and survival. However, PPE offers the only hope for cure to patients with a primary rectal cancer that is adherent or invades reproductive organs. [source] | ||||||||||