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Fixed-Dose Blood Pressure Drugs Shown Cost-Effective

Blood pressure measurement


31 May 2017. An analysis of medical insurance claims shows fixed-dose combination drugs to be the most cost-effective medication strategy for people with hypertension, or high blood pressure. The analysis by a team from University of Florida and Auburn University appears in the June 2017 issue of the Journal of Managed Care and Specialty Pharmacy.

Researchers led by Florida health policy professor Kalyani Sonawane sought to gauge the health care cost impacts of medications prescribed for hypertension. In the U.S., high blood pressure is a widespread problem, affecting 75 million people, or about 1 in 3 adults, according to Centers for Disease Control and Prevention. But only about half (54%) of Americans have the condition under control, raising risks of heart disease and stroke, the leading causes of death in the U.S.

Getting hypertension under control, however, is tricky since combinations of drugs and their doses often need to be adjusted to find what works from one person to the next. Sonawane and colleagues assessed different medication strategies to help people with hypertension and their clinicians find the right approach, in this case focusing on economic factors.  In earlier studies, she evaluated physicians’ prescription patterns and patient outcomes, and found about half of people prescribed drugs for hypertension need to make changes in their medications in the first year of treatment.

The researchers reviewed health insurance claims kept by Blue Cross/Blue Shield of Texas, from 2008 to 2012. From these records, the team identified some 6,000 individuals with hypertension who needed adjustments in their drugs. The researchers looked specifically at the type of changes the individuals needed to make with their medications:

Fixed-dose drug combinations, where 2 drugs are combined into a single pill

Fixed-pill combinations, where people take multiple pills

Switching from one kind of drug to another

Increasing the dose or frequency of a drug

Decreasing the dose or frequency of a drug

For each of these adjustments, the authors calculated costs of the drugs, but also subsequent costs of care patients needed in the year following the start of treatment for high blood pressure, both in a clinic or hospital or out-patient care. The analysis broke out the subsequent health care costs for treating cardiovascular conditions as well as total health care services.

The results show fixed-dose drug combinations to be the most expensive medications, costing patients on average $310.00. Fixed-pill combinations cost an average of $247.00 followed by switching drugs at $135.00, increasing dosage or frequency at $63.00 and decreasing dosage or frequency at $61.00.

But when subsequent costs of care are taken into account, fixed-dose combinations emerge as the most cost-effective. In the year following initial treatment, people with fixed-dose combinations paid on average $208.00 for additional cardiovascular care, the lowest expenditure of the different strategies. Individuals with fixed pill combinations paid on average $770.00 in that period, followed by $412.00 for increasing dosage, $279.00 for switching drugs, and $222.00 for decreasing dosage.

The similar pattern appears for all health care costs. In the year following initial treatment, people with fixed-dose combinations, along with those who switched to other drugs or had their dosages increased, paid on average between $4,500 and $5,000. People with fixed-pill combinations and those whose dosages were decreased paid between $6,600 and $7,000 for all health services in the year following treatment.

The authors conclude that higher price tag for fixed-dose drug combinations may scare off some individuals and their doctors, but they appear to result in lower overall costs for the patient in as little as a year. “Even though the drug costs for fixed-dose combination appear to be extremely high,” says Sonawane in a university statement, “it is offset by savings in health services costs, saving almost seven times the cost in inpatient visits.”

More from Science & Enterprise:

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Geography Matters: Could You Be A Landlord From Afar?

– Contributed content –

Keys and pen

(Gerd Altmann, Pixabay)

30 May 2017. The cost of property is not geographically neutral, we can all agree. In some areas of the country, it’ll cost you more money than you could ever earn in a lifetime to buy a small studio property. In other areas, the same amount of money can buy you something close to a mansion. As a rule, cities are more expensive than rural areas, but the price variation between cities is huge.

It’s not even a metric than can be determined by state or even prominence of the city. It’ll cost a lot less to buy in Augusta than it will in Atlanta, for example; Chapel Hill is more expensive than Raleigh; Naples will cost more than Jacksonville. So even if you live in one of the more affordable states, there’s still a potential for price hikes purely because of location.

If you want to make property investment your business, this can be hugely problematic. If you live in an expensive area, then finding homes for sale that are within your buy-to-let budget can be a problem. You might be able to afford to live in the expensive area, but the property business is all about maximizing profit – something that might not be possible if you stay within your geographical limits.

It can therefore become tempting to consider buying investment property that’s far from your home. If you buy in a more affordable area, you reason, then you stand to gain more from the investment when the market rises – as it almost inevitably does. In the meantime, you can rent the house out and collect a monthly sum. It seems so simple, but is it?

There are benefits to operating a property business from afar, aside from the more affordable purchase prices. The biggest is how it can help create a separation between you and the property, which can be easier to deal with mentally. One issue that many landlords have is that they fail to truly see that the property is not theirs; they don’t like handing over entirely to the tenants, even though by law, that’s what a tenancy contract does. If you can’t just drive to the house to see how it’s doing, you’re able to foster a healthy level of ignorance.

However, there are a few problems to be aware of as well.

Fixing issues is more difficult

If your rental house is ten minutes away and the tenants call you at 1am saying a water pipe has burst, you can be on the scene in half an hour. That’s not the case if you live 200 miles away.

You don’t know the local market

While you can do some research about rental prices online, it’s going to be more difficult to keep abreast of the local market – and particularly how busy it is – when you don’t live near the area you have bought in. If you plan to make regular trips, of course, this can be somewhat mitigated.

Rental prices will be lower

If it’s cheaper for you to buy property in an area, then you are almost certainly going to get less in terms of rental income, too. However, you can offset this by calculating your yield before you buy. 6% rental income is a great deal regardless of the actual sums involved, so keep a strict eye on the numbers.

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Univ. Spin-Off Discovering New Antibiotics

Klebsiella pneumonia bacteria

Klebsiella pneumonia, a gram-negative bacteria (

30 May 2017. A new enterprise founded by three microbiologists at Harvard Medical School is licensing the founders’ research to find treatments for antibiotic-resistant bacteria. The company, known as X-Biotix Therapeutics, is also a spin-off from the company X-Chem, both in Waltham, Massachusetts, and plans to adapt its drug discovery technology.

The founders of X-Biotix are Harvard Medical School microbiologists Thomas Bernhardt, Stephen Lory, and John Mekalanos, who started the company to find new treatments for the continuing problem of bacteria becoming resistant to current antibiotics. Centers for Disease Control and Prevention estimates that 2 million people become infected with bacteria resistant to antibiotics, leading directly to 23,000 deaths. The company plans to target gram-negative bacteria associated with conditions such as pneumonia, bloodstream infections, wound, and surgical site infections. “Gram” refers to a classification for bacteria where the microbes either retain (gram-positive) or shed (gram-negative) a test stain on their protective cell coatings.

Under the agreement, X-Biotix is licensing the researchers’ discoveries, including drug targets and testing methods, from their labs to find new molecular scaffolds or frameworks for antibiotics to block a wide range of gram-negative bacterial cells and their pathways. Bernhardt, Lory, and Mekalanos study biological mechanisms supporting development of cell envelopes and outflow of matter from bacteria related to antibiotic resistance. Financial aspects of the license agreement were not disclosed.

X-Chem is also giving X-Biotix access to its drug discovery technology to find new treatments for antibiotic-resistant bacterial infections. That technology identifies a library of small-molecule, or low molecular weight, compounds each connected to a unique DNA identifier. X-Chem first screens candidates to find those with an affinity for specified targets, then conducts DNA sequencing to highlight candidates that interact with as well as bind to the targets. The company says results from this process usually offer families or clusters of drug candidates with both the structure and chemical activity to advance into working drugs.

X-Chem says its drug discovery process is used to identify new compounds for a number of therapeutic targets, including some diseases considered difficult to treat. In December 2016, a paper in the Proceedings of the National Academy of Sciences describes the use of this process to identify drug candidates to inhibit protein targets associated with multidrug-resistant tuberculosis.

“The formation of X-Biotix,” says Rick Wagner CEO of X-Chem in an X-Biotix statement, “comes at a critical time in the industry, where the general void in antibiotic discovery efforts combined with the lack of specific efforts to discover and develop truly novel chemical scaffolds represents a challenge waiting to be addressed using a unique discovery approach.”

“Recent advances in understanding the pathways that bacteria use to build critical components of their cells,” adds Mekalanos, “have revealed novel vulnerabilities ready to exploit for antibiotic discovery.”

More from Science & Enterprise:

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Bacteria Engineered to Act as Long-Term Gut Sensors

Petrie dish with engineered bacteria

David Riglar hold a petri dish with engineered bacteria that turn blue when exposed to inflammation signals. (Wyss Institute, Harvard University)

30 May 2017. A bioengineering team developed a synthetic form of bacteria that live in the gut, and detect inflammation in lab mice for 6 months. Researchers from the Wyss Institute, a bioengineering research center at Harvard University, and Harvard Medical School, describe their findings in yesterday’s issue of the journal Nature Biotechnology (paid subscription required).

The team led by Wyss Institute biochemistry professor Pamela Silver is seeking non-invasive methods for monitoring intestinal conditions such as inflammatory bowel disease, a collection of disorders including ulcerative colitis and Crohn’s disease, marked by inflammation in the digestive tract lining. People with inflammatory bowel disease suffer severe diarrhea, pain, fatigue, and weight loss, as well as a risk of life-threatening complications.

Diagnostics and treatments for inflammatory bowel disease can be difficult because of the gut’s inhospitable environment that can cause genetic changes live microbes, and its ability to quickly clear bacteria from the body. To overcome these obstacles, Silver and colleagues needed a solution that provides a stable long-term sensor of gut inflammation in mammals.

The researchers designed the sensor, in this case, to detect and monitor the chemical tetrathionate, produced by gut inflammation that results from Salmonella and other harmful bacterial infections. The team started with a benign form of the Escherichia coli or E. coli bacteria, and adjusted its genetic wiring to respond to the presence of tetrathionate.

The genetic modifications involve interactions of 2 genes in lab mice. The genes are designed to indicate the presence of tetrathionate, where one gene produces a characteristic protein, and blocks the expression of a second gene. When inflammation subsides and tetrathionate disappears, they trigger expression of the second gene producing its own protein, but also blocking the first gene indicating the presence of tetrathionate.

The researchers added a memory function to the genetic wiring as well as a detection mechanism. The memory function, adapted from a virus that attacks bacteria, acts as a toggle with the 2 interacting genes. In the presence of tetrathionate, the first gene becomes active and toggles the memory function to the “on” position. When the toggle is switched on, a separate reporter gene, beta galactosidase, also produces an enzyme that adds a blue color to the otherwise colorless engineered bacteria.

By turning the engineered bacteria blue in the presence of tetrathionate, gut inflammation can be monitored noninvasively by the fecal matter of the mice. The team tested the synthetic bacteria in lab mice induced with infections causing gut inflammation and other mice genetically altered to produce gut inflammation. In both cases, the researchers report the engineered bacteria were able to detect tetrathionate in mice feces for up to 6 months.

The authors conclude that the tests show engineered bacteria offer another technology for monitoring gut health with living diagnostics. “Our approach is to use the bacteria’s sensing ability to monitor the environment in unhealthy tissue or organs,” says postdoctoral researcher and first author David Riglar in a Wyss Institute statement. “By adding gene circuits that retain memory, we envision giving humans probiotics that record disease progression by a simple and non-invasive fecal test.”

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Re-inventing the Wheel? Time Hacks for Start-ups

– Contributed content –

Woman with laptop


30 May 2017. Apart from the obvious shortage of money, the thing that most start-ups struggle with is a lack of time. Starting up your own business takes the concept of multitasking to a whole new level. There will not be enough hours in the day for you to achieve all you need to. This is where technology and the clever use of existing resources are vital.

Don’t reinvent the wheel – use what’s out there

Starting from scratch is incredibly time consuming and you don’t have to. You can use free templates for your invoices and most other business paperwork. They will be available in tried and tested formats and you can adapt them to suit our own purposes and brand.

Your social media posts must look slick and professional and you can download readymade templates from Canva and personalize them with your own logo and artwork. The templates are sized and designed for all social media channels.

You can even design your own logo using custom designs and images. It takes a matter of minutes and all the ideas are there in front of you. All you have to do is choose.

Automation will save you hours

There are some tasks, including social media promotion, that must be done several times a day. You could spend your whole day trying to keep up with Facebook, Twitter, and Instagram. It is much more efficient to work in batches, rather than skipping from one platform to another.

For Facebook, it is best to schedule within the app itself. Set aside one hour a week to schedule posts for the next 7 days. Use a picture and links to your site where needed. For Twitter, you can use a scheduler such as Social Oomph. Once loaded, Tweets can be scheduled every few hours with no input from you. Sprout Social is a useful scheduler for Instagram and many businesses use Tailwind for Pinterest.

The hours that you have saved can be used to greater effect on designing new products and services and finding new niches.

Recruiting and managing employees

Once you get to the stage where you are recruiting employees you will realize how time-consuming recruitment and management is. You don’t need a full-time Human Resources executive if you only recruit once a year! Hire is a freelance HR expert when you need one.

You can spend hours having ‘informal chats’ with prospective candidates and setting up the most convenient time slots for you both. Get around this by using a calendar system such as  Calendly. Your potential candidates will get an easy email link that they can use to book a slot in your busy diary. An automatic applicant tracking system (ATS) is a cloud-based application that you can use to manage the whole recruitment process.

Once your workforce is in place, you can use technology to track their productivity. This will enable you to track hours worked and output without spending hours gazing at spreadsheets.

Burn-out is real issue for start-up owners but with a few time saving hacks, you can keep the workload under control.

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Report: Growing Tech Industry Investment in Health

Tech investment chart

(CB Insights)

29 May 2017. The information technology industry is a growing presence in health care, both financially and qualitatively, according to a new report. Tech industry market research company CB Insights released its assessment to subscribers on 22 May.

CB Insights says tech industry investments about tripled in 2016 compared to 2015, to nearly $2.8 billion in 41 separate deals. So far in 2017, says the company, the tech industry invested some $1.5 billion in 18 deals, more than half of the 2016 dollar total and on track to exceed $4 billion by the end of the year.

In addition, says CB Insights, new tech industry investments are going beyond traditional health records and telemedicine into advanced diagnostics and therapies. The company cites as examples …

Alphabet, the parent company of Google, founded Verily Life Sciences, which in the past year concluded joint-venture deals with Sanofi on diabetes management and GlaxoSmithKline on miniaturized electronic therapeutics. Alphabet’s venture capital division also in the past year made investment deals in biotechnology companies developing therapeutics, including stem cell transplantations, treatments for infectious diseases, and cancer immunotherapies.

General Electric is a tech company with a major presence in health care. GE is a long-time maker of medical devices, with more recent deals in data analytics from electronic medical records and monitors to alert for adverse health events. The company’s venture capital division in 2016 also made a $220 million investment in genomics and analytics enterprise Human Longevity Inc.

Amazon Web Services is a leading provider of database services for health care analytics, including genomics, but in March of this year, joined other venture financiers in funding GRAIL Inc., a cancer diagnostics company. In addition, the business television network CNBC reported earlier this month that Amazon began hiring executives to formulate a strategy for entering the pharmaceutical business.

Intel Corporation, says CB Insights, largely relies on its venture capital division to invest in health care and life science start-ups. As reported in Science & Enterprise, however, Intel is partnering with the Broad Institute at Harvard and MIT to produce software that speeds and streamlines analysis of genomic sequencing variations, which the partners are releasing into open-source. In addition, NIH hired the head of Intel’s life science and health care group to lead the agency’s All of Us program on precision medicine.

More from Science & Enterprise:

Disclosure: The author owns shares in General Electric

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The Science Of Bargains: Know Your Customer

– Contributed content –

29 May 2017. When you are just beginning in business, it can be difficult to see why you would ever lower the price or run a sale event. After all, you have meticulously priced these products; you know exactly what to charge to ensure you make a profit. The strategy is the same whether you have a small Etsy store online that you run in your spare time or if you have huge retail premises: you do your costs, and you charge people what you need to.

So given how laborious it can be to finally settle on a price point – why would you ever want to give a discount?

There are, of course, multiple answers to that question – or are there? At the root of it, there’s really only one reason you would run a sale.

Sales and bargains attract customers

Urban crowd

(Usplash, Pixabay)

The idea of using sales and bargains to attract customers is not a new explanation, but do you really know why it works? Understanding the science behind this established business ‘fact’ can ensure you make the most of any price reductions that you do offer.

There are several components to this, so we’ll break it down into why customers swarm to the idea of saving money – even on products they didn’t even know they wanted.

Factor 1: Exclusivity

Last chance

(Judith E. Bell, Flickr)

Despite the fact that most of us should know better, there is something in the mind of a customer that associates sales with exclusivity. If something is on sale, they reason, it might be being discontinued. This might be their last chance to get hold of an item.

This taps into one of our most primary psychological components: the desire to hunt and gather. It’s pure Id; the desire overwhelms the superego (to use Freudian terminology). The constraints, the arguments, the “but do I really need this…?” thoughts are easily brushed to one side by the sheer desire to possess something.

Factor 2: Cost

Of course, some of the factors behind why people love bargains are simple: it’s cost reduction. They want to pay less for items, so they immediately buzz with excitement at the idea of doing so.

What is worth remembering is that people will buy things for the sake of buying them if they are told they are on sale. There is a powerful sense of control that comes, psychologically, from getting an item on sale. The customer is no longer the target; they are the ones demanding the price they will actually pay, not you.

This is nonsense, of course; you still set the price! But they will feel as if they have got one up on you by beating your usual retailing price. Essentially: bargains are an appeal to the ego.

Factor 3: Victory

Winner graphic

(HypnoArt, Pixabay)

Never underestimate the feeling of victory that drives those who bargain shop. Not only do they claim the aforementioned victory over you, the retailer, but also over all the other shoppers. They got the deal. They won. They denied someone else a wanted product. And that is quite the potent feeling; the dopamine rush when we feel victorious is addictive.

So how do you make this work for you?

Understanding why people want to bargain hunt should give you some hints as to how to use price reductions, discount codes, and sales to keep your business booming.

1) Have a minimum spend

If you issue a discount code, a minimum spend to use it is one of the most powerful ways to appeal to the ego. It gives the impression that you, the retailer, don’t really want to be offering this sale – that’s why there’s the threshold, to discourage people from buying!

Thus, if a customer reaches that spend and uses their code, you will still make a bigger profit than you would without the threshold spend – and the customer gets that feeling of having ‘won’.

2) Battle for bargains

If you have a retail store, then you have probably seen some of the media coverage of ‘Black Friday’ and other sales events. Did you know that the idea of battling other people for a product that’s on sale is a great tactic for retailers? That’s why those stories get leaked.

What better way to show your products are desirable and offer a tangible sense of ‘victory’ to those who manage to buy something? It’s perfect.

You can create the same kind of buzz – without the huge crowds – during your own sales.

First, make the shop floor more cramped, so it seems like there are more people in the space than there actually are. To do this, it helps to install ball bearing casters onto displays, so you can move them with ease as you switch between regular and seasonal sales.

Couple this with another ‘win’; perhaps something along the lines of the first 20 customers get a 5% discount code for future purchases. This will bring out the competitive nature in your customers even if they don’t know it – but it will be your store that is ultimately victorious.

3) Make it limited – very limited

You want to attract more customers, so you’re going to run a sale. You might not make the profit margin you usually want, but you know you’re still going to make decent with the prices you have chosen.

When you have got to the above point, all that’s left is to decide when your sale is going to be and – crucially – its duration. As a general rule, the shorter the duration of the sale, the better.

You don’t want to take the risk of a week-long sale that gives customers time to wait. You want them to be gripped by that feeling of exclusivity, the desire to grab something right now. However, you need to balance this with practicality. For example, some people won’t have access to funds to make purchases immediately.

A sale duration of two to four days is the perfect blend of enough time, but not so much you don’t pinpoint that urgency.

Finally, it is better to host many short sales than several long ones. Space them through the year and ideally at the end of each season. That way you can offload outdated stock and capture the psychology of your shoppers’ – it’s perfect!

Sale pricetags

(Coffeebean Works, Pixabay)

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$10M Cancer Immunotherapy Research Fund Launched

Cancer in headline


26 May 2017. A foundation is sponsoring research grants for computational solutions to key questions facing cancer immunotherapy. Stand Up to Cancer, an organization based in the entertainment and media industries that raises money and awareness for cancer research, is providing a $10 million fund for the awards, which has an initial deadline of 30 June 2017 for letters of intent.

The awards are part of Stand Up to Cancer’s convergence program that seeks cross-disciplinary solutions from the life and physical sciences and engineering to address unmet needs or underserved issues in cancer care. In this Convergence 2.0 Call for Ideas, the group aims to bring together clinicians and biomedical researchers teamed with data scientists to apply computational tools to questions involving the human immune system and cancer.

According to Stand Up to Cancer, large databases are being created at cancer centers with wide variations in types of data  — e.g. genomic sequencing data and images — as well as clinical records, medication data, and patient experiences. Accessing and integrating these data sets, however, are often difficult to achieve. Thus, a key objective of the initiative is to break down silos where the data reside and develop new tools for analyzing data that can help predict the course of cancer in patients and identify effective treatments, particularly those that harness the immune system.

Through these awards, Stand Up to Cancer, hopes to address questions such as predicting responders and non-responders to therapies blocking checkpoint signals that prevent the immune system from fighting cancer cells, and chimeric antigen receptor therapies with proteins attracting antibodies that bind to and destroy blood-related cancer cells.

Other questions expected to be addressed by participants are the relationship of peptide sequences in antigens, proteins generating immune responses, to sequences of nucleic acids, like those in DNA or RNA, found in immune system B- and T-cell receptor regions. Another issue anticipated in the competition is the recognition of neo-antigens, produced from gene mutations occurring in tumor cells, by the immune system.

Stand Up to Cancer says participants may address as well more fundamental questions relating the health of the immune system to cancer, specifically the ability to quantify effects of aging or exhausted immune systems. In addition, issues involving the role of the microbiome in immunotherapy can be addressed, including signals to the immune and nervous systems.

The sponsors expect participants to propose new algorithms and use of data sets from current clinical trials to test new algorithms. Proof-of-concept tests, such as early-stage clinical trials, are also anticipated in team proposals.

Stand Up to Cancer intends to make award 4 awards of $2.5 million each to participant teams to fund research and development work over 3 years. Proposals with the most promising ideas will be invited to an “ideas lab” meeting in the Fall of 2017 to discuss their ideas further. At the ideas lab, participants will be encouraged to form teams to submit full proposals based on discussions at the meeting. The awards are expected to support postdoctoral researchers, to give younger scientists an opportunity to work with senior researchers in the field.

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Employer Ethics: Should You Use Tech To Monitor Productivity?

– Contributed content –

Monitor eyes

(Gerd Altmann, Pixabay)

26 May 2017. Privacy is an issue that more and more people are taking notice of in their personal lives, but it has considerations on a business level as well.

The idea of technology being used to monitor the productivity of employees is a controversial one. On some levels, it already exists. Companies use a variety of methods, including the likes of:

  • Using a swipeable time card in and out of the main office area. This can be used to monitor when employees are swiping out to go to the restroom or on breaks.
  • Record keeping that requires each member of staff to log what they are doing at any given point in the day.
  • Software that can show how active a member of the company has been and track what they have been doing. This can be advanced – such as with custom software – or it can be something as simple as checking through the “revision history” in Google Docs.

The above is just a taster of the huge amount of employee surveillance that is now available.

On the surface, it’s hard to see these innovations as anything but very good ideas. After all, when you are a boss or business owner, it’s your financial and business success that is on the line. If an employee is not pulling their weight, then you could directly suffer from it – so it’s completely normal for you to want to ensure they are doing all that they should be.

There’s no doubt that some employees may have a tendency to shirk work and do as little as possible. While you might be fully invested in your work and leave no stone unturned, it’s unlikely you will be able to completely surround yourself with people who think the same. For some, it will always be ‘just a job’; something to do during the day, and get out of as quickly as possible at night. Given the likelihood of this, monitoring seems the best way to make sure they stay on task and ensure they are doing what they are meant to be doing.

Surveillance camera


Nevertheless, there are numerous downsides to heavy, constant surveillance. For one thing, it is going to increase employee stress hugely. It also goes against the idea that trust should go both ways.

There is also the financial cost to consider in all this. While you can always consult sites such as for the relevant equipment, it’s essentially paying money to ensure something you’re already paying for: an employee to do their job. Isn’t that what you pay them a wage for? It can feel a little like a sunk cost in that regard, which is never a positive way of running a business.

Perhaps the best solution is found somewhere in the middle? Rather than constant, permanent, and daily surveillance – run random spot checks without staff being aware of it? This can help you identify patterns of idleness, without creating an Orwellian atmosphere in your company. It also lessens the likelihood of, through experience, employees figuring out a way to manipulate the system to their own advantage. This kind of checking also helps you stay on the right side of the law, as explained by

What do you feel about employee privacy and how it contrasts with monitoring?

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Bacteria Traffic Tracked in New Hospital

Patient hospital room

Patient room, Center for Care and Discovery (University of Chicago Medicine)

26 May 2017. The opening of a new hospital in Chicago offered an opportunity to follow the formation of bacterial communities and their movement in a health care facility. Researchers from University of Chicago that owns the hospital led the study, who reported their results in the 24 May issue of the journal Science Translational Medicine (paid subscription required).

A team led by Jack Gilbert, faculty director of the Microbiome Center at University of Chicago, used the start of a new hospital in the university health system, the Center for Care and Discovery, to track the development and movement of bacteria in health care facilities from the beginning. The Microbiome Center is a research and education center of the university and Argonne National Laboratory.

Gilbert and colleagues collected samples beginning 2 months before the hospital opened in February 2013, then from patients, clinicians, hospital rooms, and nursing stations for 10 months after the hospital started admitting patients. Overall, the researchers amassed more than 6,500 microbial samples from 10 patient hospital rooms and 2 nearby nursing stations, caring for cancer and surgical patients.

The team took swabs from patients’ hands, nostrils, and armpits, along with samples from surfaces they touched, such as bed rails and faucets, and from other room surfaces, including floors and air filters. Nursing staff and station samples came from their hands, gloves, clothing, counter tops, and electronic equipment including pagers, land line phones, and cell phones.

The results show in the two months before the hospital opened, infectious bacteria common to health care operations such as Acinetobacter and Pseudomonas began appearing. But the hospital had a thorough cleaning before it began admitting patients, which largely removed these dangerous microbes. In their place, microbes found on human skin — Corynebacterium, Staphylococcus, and Streptococcus — started to form colonies, most likely brought into the hospital by patients.

The findings show once patients are admitted, the movement of bacteria depends on the length of the patients’ stay in the hospital. In the first day, say the researchers, bacteria tend to move from surfaces in the patient’s room to the patient. After the first day, however, microbes tend to travel from the patient back to the room. “By the second day of their stay,” says Gilbert in a university statement, “the route of microbial transmission was reversed. Within 24 hours, the patient’s microbiome takes over the hospital space.”

Giving antibiotics to prevent infections seems to have mixed results. Antibiotics given as oral drugs or intravenous infusions had little effect on skin microbes, but topical antibiotics largely worked as expected on the skin. In addition, researchers found few differences in microbial patterns among the types of treatment and care provided, including emergency room, surgery, and chemotherapy.

The findings highlighted an alarming development among 92 individuals with extended stays of multiple months in the hospital. The researchers found some dangerous bacteria, including Staphylococcus aureus, Escherichia coli (E. coli), and Pseudomonas aeruginosa began acquiring genes making them more resistant to antibiotics and even more infectious. “This requires further study,” notes Gilbert, “but if it proves to be true then these genetic changes could affect the bacteria’s ability to invade tissue or to escape standard treatments.”

More from Science & Enterprise:

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