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This article focuses on the launch of a revenue management program by National Car Rental System Inc. in the U.S. In 1993, the firm faced liquidation. To improve decision making, the firm developed an integrated set of models and information systems for decision support. The core of the program is a suite of analytic models developed to manage capacity, pricing and reservation. The initial implementation produced immediate results and returned the company to profitability.

Objective: This study tested the hypothesis that patients without placement of new do-not-resuscitate (DNR) orders during the first 5 days after intracerebral hemorrhage (ICH) have lower 30-day mortality than predicted by the ICH Score without an increase in severe disability at 90 days., Methods: This was a prospective, multicenter, observational cohort study at 4 academic medical centers and one community hospital. Adults (18 years or older) with nontraumatic spontaneous ICH, Glasgow Coma Scale score of 12 or less, who did not have preexisting DNR orders were included., Results: One hundred nine subjects were enrolled. Mean age was 62 years; median Glasgow Coma Scale score was 7, and mean hematoma volume was 39 cm(3). Based on ICH Score prediction, the expected overall 30-day mortality rate was 50%. Observed mortality was substantially lower at 20.2%, absolute average difference 29.8% (95% confidence interval: 21.5%-37.7%). At 90 days, 27.1% had died, 21.5% had a modified Rankin Scale score = 5 (severe disability). A good outcome (modified Rankin Scale score 0-3) was achieved by 29.9% and an additional 21.5% fell into the moderately severe disability range (modified Rankin Scale score = 4)., Conclusions: Avoidance of early DNR orders along with guideline concordant ICH care results in substantially lower mortality than predicted. The observed functional outcomes in this study provide clinicians and families with data to determine the appropriate goals of treatment based on patients' wishes., (© 2015 American Academy of Neurology.)

Background: Asian Americans use complementary and alternative medicine (CAM) at a higher rate than Americans., Objective: This national study on Asian Indians (AIs), the third largest Asian-American subgroup in the United States, examined the CAM use by gender and its association with acculturation, health behaviors, and access to health care., Design: This was a cross-sectional survey., Subjects: The subjects consisted of 1824 AI adults in six states with higher concentration of AIs., Results: Mean age and years lived in the United States was 45.7 +/- 12.8 and 16.6 +/- 11.1 years, respectively. The respondent majority was male, immigrants, college graduates, and had access to care. Sixty three percent (63%) of AIs used at least one type of CAM; most common was a vegetarian diet, followed by use of dietary and herbal supplements and alternative medical systems. Females reported a significantly higher use of CAM, a vegetarian diet, and use of dietary and herbal supplements than AI males. Older age, female gender, having no access to care, and spirituality predicted CAM use in the logistic regression model. Older age, female gender, unmarried, and higher income was associated with use of dietary and herbal supplements; AIs who reported being vegetarian were more likely to be female, unmarried, spiritual, and self-reported their physical health to be fair or poor., Conclusions: This is the first national study of CAM use among AIs by gender and selected respondent characteristics. Results provide important information on health behaviors, beliefs, and patterns of CAM use in this ethnic subgroup to be factored into patient education.

The use of complementary and adjunctive therapy has been steadily increasing in the U.S. since the 1960s. This can be attributed to several factors, particularly because over 80 million "baby boomers" are embracing alternative medicine as a way to enhance their medical care. The perceived coldness and remoteness of conventional medicine; the entanglement of managed care in red tape; continued emphasis on "natural" which supposedly connotes "better," as well as the popularity of vegetarian practices have also contributed to the general population's increasing involvement in alternative medicine. In 1999, 40% of all Americans sought alternative medical treatment, outpacing visits to conventional primary care physicians.