95 research outputs found
Effects of SR insurance company marketing strategy on their sales
No full text<p>In recent years, with the opening of the market and the relaxation of national policies, China's bancassurance market has developed rapidly. SR Company is one of the earliest foreign insurance companies established in China. With the rise of domestic bancassurance businesses, the growth of corporate premiums has been showing a rapid development trend. However, with the increase in market players, the impact of foreign financial institutions, and the impact of the financial crisis, SR's bancassurance business is facing the dilemma of reduced premium income and a shrinking market share. Improving the core competitiveness of the company's products has become a strategic choice for the company to deal with the changes in the banking market. This paper, based on the work experience and thinking of planning, supervision, training, and other posts in the bancassurance business of SR Company, combined with the theoretical knowledge and the detailed investigation, deeply analyzed the problems existing in the bancassurance business of SR Company and the causes of the problems, and on the basis of studying and referring to the successful experiences of peers at home and abroad, put forward the development ideas of innovative marketing as well as better carrying out the bancassurance business marketing strategy and business philosophy. First of all, the article expounds the basic theory and function of bancassurance business, the concept, characteristics, and strategies of insurance marketing, and on this basis analyzes the external opportunities and threats, internal strengths and weaknesses faced by the company, and analyzes the strengths and opportunities strategy, weaknesses and opportunities strategy, strengths and threats strategy, and weaknesses and threats strategy, and puts forward corresponding countermeasures. Secondly, it analyzes the basic status quo of the bancassurance business of SR Company in terms of business scale, marketing channels, main products, customer relations, and sales teams, and deeply analyzes the problems in the product structure, bancassurance cooperation, marketing channels, and product promotion of the bancassurance business marketing of the company. Finally, in view of the outstanding problems in the marketing of bancassurance products, the company proposed marketing countermeasures and improvement measures for bancassurance business in four aspects: product innovation, marketing channel innovation, marketing team building, and brand promotion strategy.</p>
Easy prognostic assessment of concomitant organ failure in critically ill patients undergoing mechanical ventilation
No full textBackground: Acute respiratory distress syndrome (ARDS) is a life-threatening disease. We evaluated the prognostic utility of Model for End-stage Liver Disease excluding INR (MELD-XI) score for predicting mortality in a cohort of critically ill patients on mechanical ventilation. Methods: In total, 11,091 mechanically ventilated patients were included in our post-hoc retrospective analysis, a subgroup of the VENTILA study (NCT02731898). Evaluation of associations with mortality was done by logistic and Cox regression analysis, an optimal cut-off was calculated using the Youden Index. We divided the cohort in two sub-groups based on their MELD-XI score at the optimal cut-off (12 score points). Results: Peak-, plateau- and positive end-expiratory pressure were higher in patients with MELD-XI>12. Patients with MELD-XI>12 had higher driving pressures (14 ± 6 cmH2O versus 13 ± 6; p < 0.001). MELD-XI was associated with 28-day mortality after correction for relevant cofounders including SAPS II and ventilation pressures (HR 1.04 95%CI 1.03–1.05; p [removed]12 evidenced both increased hospital (46% versus 27%; p < 0.001) and 28-day mortality (39% versus 22%). Conclusions: MELD-XI is independently associated with mortality and constitutes a useful and easily applicable tool for risk stratification in critically ill patients receiving mechanical ventilation. Trial registration: NCT02731898, registered 4 April 2016
The influence of the travel experience of network virtual community on tourists: A life experience
No full text<p>Nowadays, with the rapid development of information technology, the tourism virtual community not only plays the role of information dissemination and exchange but also becomes a new tool for people to organize tourism activities. The characteristics of tourists and service management are the main factors that affect the perception of Wuyuan tourists in the online virtual community. Among them, pleasant natural landscapes and antique cultural landscapes are the most important influencing factors of the Wuyuan tourism experience, while other factors include season, weather, transportation, and consumption price. The Internet is a virtual space with remarkable characteristics of agglomeration and withdrawal. The interaction in the network can derive cohesive interpersonal trust through the dissemination of fragmented information. However, due to the virtual nature of the network, trust between community users is much more fragile than in offline communities, and it is also more difficult to establish. The development of the entire virtual community will be seriously constrained by the loss of trust in the network community. Therefore, it is necessary to deeply study the influencing factors of online interpersonal trust in the tourism virtual community and how to build a high-trust online community.</p>
Prediction and Outcome of Intensive Care Unit-Acquired Paresis
No full textBACKGROUND:
Intensive care unit-acquired paresis (ICUAP) is associated with poor outcomes. Our objective was to evaluate predictors for ICUAP and the short-term outcomes associated with this condition.
METHODS:
A secondary analysis of a prospective study including 4157 mechanically ventilated adults in 494 intensive care units from 39 countries. After sedative interruption, patients were screened for ICUAP daily, which was defined as the presence of symmetric and flaccid quadriparesis associated with decreased or absent deep tendon reflexes. A multinomial logistic regression was used to create a predictive model for ICUAP. Propensity score matching was used to estimate the relationship between ICUAP and short-term outcomes (ie, weaning failure and intensive care unit [ICU] mortality).
RESULTS:
Overall, 114 (3%) patients had ICUAP. Variables associated with ICUAP were duration of mechanical ventilation (relative risk ratio [RRR] per day, 1.10; 95% confidence interval [CI] 1.08-1.12), steroid therapy (RRR 1.8; 95% CI, 1.2-2.8), insulin therapy (RRR 1.8; 95% CI 1.2-2.7), sepsis (RRR 1.9; 95% CI: 1.2 to 2.9), acute renal failure (RRR 2.2; 95% CI 1.5-3.3), and hematological failure (RRR 1.9; 95% CI: 1.2-2.9). Coefficients were used to generate a weighted scoring system to predict ICUAP. ICUAP was significantly associated with both weaning failure (paired rate difference of 22.1%; 95% CI 9.8-31.6%) and ICU mortality (paired rate difference 10.5%; 95% CI 0.1-24.0%).
CONCLUSIONS:
Intensive care unit-acquired paresis is relatively uncommon but is significantly associated with weaning failure and ICU mortality. We constructed a weighted scoring system, with good discrimination, to predict ICUAP in mechanically ventilated patients at the time of awakening
Multicenter International Cohort Validation of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale
No full textOBJECTIVE: In a multicenter, international cohort, we aimed to validate a modified Sequential Organ Failure Assessment (mSOFA) using the Richmond Agitation-Sedation Scale, hypothesized as comparable to the Glasgow Coma Scale (GCS)-based Sequential Organ Failure Assessment
(SOFA).
SUMMARY BACKGROUND DATA: The SOFA score, whose neurologic component is based on the GCS, can predict ICU mortality. But, GCS is often missing in lieu of other assessments, such as the also reliable and validated RASS. Single center data suggested a RASS-based SOFA (mSOFA) predicted ICU mortality.
METHODS: Our nested cohort within the prospective 2016 Fourth International Study of Mechanical Ventilation contains 4,120 ventilated patients with daily RASS and GCS assessments (20,023 patient-days, 32 countries). We estimated GCS from RASS via a proportional odds
model without adjustment. ICU mortality logistic regression models and c-statistics were constructed using SOFA (measured GCS) and mSOFA (measured RASS-estimated GCS), adjusted for age, sex, body-mass index, region (Europe, USA-Canada, Latin America, Africa, Asia, Australia-
New Zealand), and post-operative status (medical/surgical).
RESULTS: Cohort-wide, the mean SOFA=9.4+/-2.8 and mean mSOFA=10.0+/-2.3, with ICU mortality=31%. Mean SOFA and mSOFA similarly predicted ICU mortality (SOFA: AUC=0.784, 95%CI=0.769-0.799; mSOFA: AUC=0.778, 95%CI=0.763-0.793, P=0.139). Across models, other predictors of mortality included higher age, female sex, medical patient, and African region (all P< 0.001).
CONCLUSIONS: We present the first SOFA modification with RASS in a “real-world” international cohort. Estimating GCS from RASS preserves predictive validity of SOFA to predict ICU mortality. Alternative neurologic measurements like RASS can be viably integrated into severity of illness scoring systems like SOFA
Impact of sedation and analgesia during noninvasive positive pressure ventilation on outcome: a marginal structural model causal analysis
No full textPURPOSE: There are limited data available about the role of sedation and analgesia during noninvasive positive pressure ventilation (NPPV). The objective of study was to estimate the effect of analgesic or sedative drugs on the failure of NPPV.
METHODS: We studied patients who received at least 2 h of NPPV as first-line therapy in a prospective observational study carried out in 322 intensive care units from 30 countries. A marginal structural model (MSM) was used to analyze the association between the use of analgesic or sedative drugs and NPPV failure (defined as need for invasive mechanical ventilation).
RESULTS: 842 patients were included in the analysis. Of these, 165 patients (19.6%) received analgesic or sedative drugs at some time during NPPV; 33 of them received both. In the adjusted analysis, the use of analgesics (odds ratio 1.8, 95% confidence interval 0.6-5.4) or sedatives (odds ratio 2.8, 95% CI 0.85-9.4) alone was not associated with NPPV failure, but their combined use was associated with failure (odds ratio 5.7, 95% CI 1.8-18.4).
CONCLUSIONS: Slightly less than 20% of patients received analgesic or sedative drugs during NPPV, with no apparent effect on outcome when used alone. However, the simultaneous use of analgesics and sedatives may be associated with failure of NPPV
The Impact of Temperature and Concentration on SC2 Cost and Performance in a production Environment
No full textABSTRACTRecent studies have shown that extremely dilute HCl mixtures can offer
considerable cost savings and improved particle performance relative to
traditional SC2 formulations. This work indicates, however, that extreme
levels of dilution are not necessary to secure many of the benefits
suggested for dilute HCI. Significant benefit can be attained by pursuing
moderate concentration and temperature alterations. In this study, an
intermediate dilution and temperature reduction are evaluated to assess
potential production advantage. Comparison of a 1:1:20 formulation at 60 C
is made to a more traditional 1:1:6 mixture at 85 C. The impact of the
chemistry and temperature alteration on peroxide decomposition rate is shown
to be dramatic. While initial pour-up ratios suggest that the dilute recipe
could require 1/3 as much peroxide as the traditional chemistry, chemical
savings are significantly more dramatic due to the ability of the solution
to maintain concentration over time. An additional benefit associated with
the alternative pour-up is a marked reduction in particle levels on silicon
surfaces; particle levels on thermal oxide wafers have not shown the same
trend. VPD-ICPMS measurements are used in this study to illustrate that the
recipe change results in comparable metallic removal efficiency.</jats:p
A Proposed marketing plan for Del Monte Sweet Style Spaghetti Sauce, Del Monte Philippines, Inc.
No full textDel Monte Sweet Style Spaghetti Sauce currently holds 3.7% market share and has been available to consumers for almost a year now. For fiscal year 1996, it is proposed that product improvements be done to make it more competitive in the market and thus capture a more significant portion of the total industry.
Del Monte Sweet Style Spaghetti Sauce needs to be produced in bigger 580 gram can size to satisfy varying consumer preferences. The proposed introduction of Del Monte Sweet Style Spaghetti Sauce with Hotdog Bits will challenge competing brands in the meat category and create a new market for the spaghetti sauce line of Del Monte. Both products will be backed by heavy advertising via television, print, and grocery shopping carts to constantly remind consumers about the product even during off seasons.
It is recommended that distribution be intensified outside the Greater Manila Area and beyond supermarkets. Cash incentives have been provided for all cash van salesmen to increase distribution in sari-sari stores and market stalls.
Adoption of strategic promotions such a Big Sforks for the Big Sweet Cans and Matamis na Pamasko ng Del Monte will help generate incremental sales of 8,064 cans of 580 gram Del Monte Sweet Style Spaghetti Sauce.
Low pricing strategy will be maintained for Del Monte Sweet Style Spaghetti Sauce products.
Net Income after Tax is projected to soar to P 4.280M, up by P3.199M over fiscal year 1995. While Investment is estimated at P5.971M
Unrecognized Left Ventricular Heart Failure Deteriorates Outcome in Mechanically Ventilated Patients with COPD.
No full textInternational Analgesia, Sedation, and Delirium Practices: a prospective cohort study
No full textAbstract Background While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions. Methods We performed a retrospective analysis of two multicenter, international, prospective cohort studies. Mechanically ventilated adults were followed for up to 28 days in 2010 and 2016. Proportion of days utilizing sedation, analgesia, and performance of a spontaneous awakening trial (SAT), and occurrence of delirium were described for each year and region and compared between years. Results A total of 14,281 patients from 6 international regions were analyzed. Proportion of days utilizing analgesia and sedation increased from 2010 to 2016 (p < 0.001 for each). Benzodiazepine use decreased in every region but remained the most common sedative in Africa, Asia, and Latin America. Performance of SATs increased overall, driven mostly by the US/Canada region (24 to 35% of days with sedation, p < 0.001). Any delirium during admission increased from 7 to 8% of patients overall and doubled in the US/Canada region (17 to 36%, p < 0.001). Conclusions Analgesia and sedation practices varied widely across international regions and significantly changed over time. Opportunities for improvement in care include increasing delirium monitoring, performing SATs, and decreasing use of sedation, particularly benzodiazepines
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