Contingencies and characteristics of service recovery system design: insights from retail banking

Purpose: this paper explores the contingencies and characteristics of service recovery system (SRS) design. Design/methodology/approach: informed by extensive case study data from two large Italian retail banks, our theory-building study builds on the seven design characteristics proposed by Smith et al. (2009). Nineteen sub-dimensions are identified that provide a finergrain view of the SRS at the operational level. The design characteristics and the corresponding sub-dimensions comprise the SRS design framework. These sub-dimensions are then analysed across the two cases. Specific attention is given to sub-dimensions that are contingent upon service recovery strategy. Findings: the findings suggest that the extended set of SRS sub-dimensions (providing greater specificity) contributes to identifying commonality and difference between SRS configurations. This specificity facilitates the identification of two sets of SRS design characteristics (S-Type; C-Type) that correspond with SR strategy. Two propositions have been formulated with respect to this SR strategy – SRS contingency. An additional set of subdimensions, common to both cases, is explained by conformance to regulatory control. Originality/value: the paper provides novel theoretical insights into SRS design. The increased specificity of the SRS framework and the sets of sub-dimensions contingent on SR strategy extend current theory in OM. This provides opportunities for both practicing managers and for future theoretical development

Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort.

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced ≥1 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with ≥1 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not ≥5. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin.This study was sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Support for third-party writing assistance for this manuscript, furnished by Blair Jarvis MSc, ELS, of Health Interactions, was provided by F. Hoffmann-La Roche Ltd, Basel, Switzerland

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. Results: SVR24 rates were 46.1 % (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1,2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. Conclusions: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginter-feron alfa-2a/ribavirin

Il Miglioramento nei Processi Produttivi. Come raggiungere alte prestazioni di tempo, qualita, costi e flessibilita'

Quali sono le indicazioni che si possono fornire alle imprese che decidono di avviare iniziative di miglioramento in produzione? Oggigiorno le iniziative, di tipo sia tecnologico che organizzativo-gestionale, a disposizione di un\u2019impresa per migliorare le attivit\ue0 operative sono molte - dalla qualit\ue0, JIT, automazione flessibile, empowerment, etc. - e il problema, in regime di risorse e tempi limitati, \ue8 quindi che cosa privilegiare, dove iniziare, quali priorit\ue0 soddisfare, ovvero come proseguire e quali vincoli rispettare. Inoltre, quali sono i risultati di tali investimenti? Veramente, come molti sostengono, le imprese che hanno avviato pi\uf9 iniziative di miglioramento su molti fronti hanno ottenuto le prestazioni migliori sulla qualit\ue0, tempi di consegna e puntualit\ue0, costi di produzione, flessibilit\ue0 e rigiro delle scorte? Questo lavoro presenta i risultati dello studio dei percorsi di miglioramento e dei risultati ottenuti, analizzando, per il periodo 1973-1994, 134 imprese giapponesi, americane, tedesche, inglesi e italiane, operanti nei settori dell\u2019elettronica, della meccanica e della componentistica auto. Una riflessione sulle esperienze aziendali maturate da imprese, molte delle quali sono assoluti leader nei loro settori, consente di evidenziare alcuni punti fermi, che, confidiamo, possano essere di una qualche utilit\ue0 per molte imprese italiane che considerano le operations fondamentali per la sfida della competizione globale

Dissemination of invasive aspergillosis: diagnostic and management dilemmas

Invasive aspergillosis is a highly lethal opportunistic infection that poses a significant threat to immunocompromised patients. With studies suggesting that the incidence of this disease is increasing, and mortality rates remain high, early diagnosis and treatment are very important to improve patient survival. We present a case of a 63-year-old woman on an immunosuppression regimen with methylprednisolone and azathioprine for the treatment of autoimmune hepatitis, who presented with neurological and respiratory symptoms leading to a rapid clinical decline. A final diagnosis of disseminated invasive aspergillosis was made at autopsy. This case emphasises the importance in maintaining a high index of suspicion to ensure that the proper workup, diagnosis and treatment can be initiated earlier in the clinical presentation in an effort to decrease the extremely high mortality in these cases

Hidradenocarcinoma Treated with Mohs Micrographic Surgery

Hidradenocarcinomas are very uncommon malignant tumors of sweat gland origin that exhibit a high potential for local recurrence, metastasis, and poor outcome. These neoplasms typically resemble benign appearing dermal nodules that lack distinguishable features. We present the case of hidradenocarcinoma in a 39-year-old male with a 5-year history of a slow growing nodule along his right eyebrow. Excisional biopsy of the lesion was taken with pathology showing nuclear pleomorphism, increased mitoses, and foci of necrosis. Immunohistochemical analysis revealed reactivity for Ki-67/MIB1 and strong diffuse staining for p63, CK5/6, and CK7. Mohs micrographic surgery was performed and clear margins were obtained after one stage. Compared to traditional treatment with wide local excision, Mohs micrographic surgery is a potentially advantageous alternative therapy as there have been no reported cases of tumor recurrence or metastasis to date