Macro sales force research

The call for more macro sales force research where the sales force as a whole is the unit of analysis, which was raised in “The Strategic Role of the Sales Force,” is revisited in this article. Technology, consolidation, government policies, the evolution of organizational strategy are dramatically changing the role of the sales force and the daily lives of salespeople. Yet, it is estimated that no more than 5%, and probably less, of sales and sales management research examines these developments. To shine a light on this, a case study of a health-care company that has changed its strategic focus from a product to a solutions provider is presented. Changes in the role of the sales force are examined within the five sales force capabilities identified in the “The Strategic Role” article. Research questions are raised about sales force capabilities.     

Ethical Considerations for Clinical Research and Off-label Use of Ketamine to Treat Mood Disorders: The Balance Between Risks and Benefits

Previous research conducted in 1999 highlighted ethical concerns behind challenge studies inducing psychosis with ketamine and made recommendations to enhance ethical standards. Recently, a plethora of clinical trials have evaluated the efficacy of ketamine to treat mood disorders, which lead to complex ethical issues. Pharmaceutical companies and researchers hope to profit by developing patentable variations on ketamine for treating depression. Media have labeled ketamine as a “miracle” antidepressant. Some clinics offer expensive off-label use of ketamine to treat mood disorders. This article examines the ecological validity of ketamine trials, measures to protect patients, informed consent procedures, financial inducements to participants and conflict of interest of researchers, therapeutic misconception, concealment, and deception. Further recommendations are purposed to improve ethical standard of clinical research involving ketamine.     

Betrayal Trauma,Health Care Relationships,and Health in Patients with a Chronic Neurovascular Condition

Individuals who have been exposed to trauma are at a greater risk of developing a chronic physical health condition and use health services more frequently than individuals who have not experienced trauma. The mechanism by which trauma affects health is not fully understood, but relationships with health care providers could be important in understanding this association. The purpose of this study was to explore the relationships among betrayal trauma, health care relationships, and physical and mental health in a chronic medical population. Participants (N = 272) diagnosed with a chronic neurovascular condition (cavernous malformation) completed an online survey. Questionnaires assessed self-rated health, instances of betrayal trauma, posttraumatic stress disorder (PTSD) and depression symptoms, income, and other demographic factors, and health care relationships. Level of income and the experience of betrayal trauma predicted mental health symptoms (depression, PTSD, or both) and also predicted health care relationships. After controlling for income and previous trauma, mental health symptoms significantly predicted health care relationships. Finally, mental health symptoms, health care relationships, and income predicted self-rated health, although the associations were not straightforward. These results suggest complex interrelations among trauma, mental health, income, health care relationships, and physical health, and a model is proposed for explaining these associations.     

Experiences of the health care delivery system in a rural South African setting

This exploratory study aimed to examine health care provider work-related experiences in a rural South African context. Participants were a convenient sample of 12 medical practitioners (private sector = 55%). The practitioners responded to an open-ended question on their health care delivery-related experiences. Thematic analysis of the data revealed that the medical officers experienced both care provider fatigue and satisfaction from their work roles. Experiences of care provider fatigue were characterised by stress, anxiety, hopelessness, depression, burnout, frustration, and anger. Care provider satisfaction was associated with happiness, ability to cope, security, conscience, and commitment. Job retention and satisfaction of the health care providers were dependent on material and manpower resourcing of health services.     

Protecting older adults in the Israeli health system: Cross-cultural interactions involved in legal and social elder abuse interventions

ABSTRACT

In 2002 the World Health Organization published a categorical definition of “Elder Abuse,” but the relevant social and legal interventions differ markedly even among Western-oriented countries. This article compares and contrasts approaches to this widespread and very serious problem in the New York City and the Israeli health-care systems. In today’s world, the members of a family do not all necessarily live on the same continent, so professionals must be aware of the way things are done in countries other than their own. The differences in the interventions employed, or not employed, in these two specific systems highlight the need to understand not only how elder abuse is dealt with in each place, but the conceptual framework that governs it. The present article can serve as a guide for American professionals and others concerned with the problems of elder abuse who function within the Israeli health care system.     

Time‐limited therapy in a Community Mental Health Team setting

This study examines time‐limited therapy in a Community Mental Health Team (CMHT) setting. This work is a key tension for CMHTs who are under pressure to focus on clients with a serious mental illness as a priority as opposed to clients who might be deemed the ‘psychologically distressed’. The development of CMHTs in the UK is described. Limited research on time‐limited therapy in a CMHT setting is identified. Results suggest that time‐limited therapy has a positive impact on the mental health needs of clients referred to a CMHT by GPs. It is concluded that it is appropriate to justify the use of time‐limited therapy in a CMHT‐based setting. Suggestions for further research are made.     

Policy Frames, Metaphorical Reasoning, and Support for Public Policies

This article evaluates the predictive value of a new theory for understanding public support for alternative solutions to policy problems, which we call policy metaphors. A policy metaphor represents a particular form of cognitive framing that makes use of commonly understood social institutions and judgments about their effectiveness to form "archetypes" against which proposed solutions to new policy problems are compared. We test the extent to which both understanding of and preference for particular policy frames predicts the nature and strength of policy choices by a representative sample of the American public. After controlling for factors that past research has shown to be important in understanding public opinion, including general partisan and ideological attitudes, self-interest, political values, and emotions, the cognitive frames specified by the general theory of policy metaphors are shown to strongly predict public support for hypothetical solutions to three different policy problems. These frames also predict support for President Clinton's 1993–94 health care reforms after controlling for those same conventional predictors. Most importantly, we demonstrate that these cognitive frames help constrain the beliefs of even the least politically aware members of the general public. Discussion centers on the implications of this new approach for understanding public opinion.     

人文关怀视野中的医院发展

医院人文关怀表现为作为医疗主体的医生必须具备广博的人文素养;医院应当遵循"救死扶伤,实行革命人道主义"的医疗原则;实行人文关怀的目的在于"以患者为上帝".由于受现代性的后果--抽象性和市场经济的影响,医院人文关怀缺失和被疏漏.人文关怀视野中的医院发展要求,医院硬件建设要以"以人为本"为指导思想;内涵发展要以医疗技术与人文关怀有机统一为关键;制度建设要以"以患者为中心"为宗旨.     

中国的安乐死观念与卫生保健

把在荷兰福利体制下狭义的安乐死概念移植到中国是不适当的.对于临终病人医疗上的缺陷不能用他们临终时的体面、尊严这一标准来衡量.这一问题的解决不是迅速地结束生命,而是要通过中国卫生医疗决策中的分配公正来提高生命的质量,需要建立一个跨国框架来讨论安乐死的特性与共性.