The moderate decrease of total lopinavir concentrations during pregnancy is not associated with proportional decrease in free concentrations. Both reach a nadir at delivery, albeit not to an extent that would put treatment-naive women at risk of insufficient exposure to the free, pharmacologically active concentrations of lopinavir. No dosage adjustment is therefore needed during pregnancy as it is unlikely to further enhance treatment efficacy but could potentially increase the risk of maternal and fetal toxicity. Nonetheless, in case of viral resistance in treatment-experienced pregnant women, loss of virological control or questionable adherence, it is justified to consider lopinavir dosage adjustment based on total plasma concentration measurement.

OBJECTIVE. To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center.METHODS. Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in timeinterval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared with the amount consumed after the intervention. The intervention included additional staff for infection control, repeated instructions for hand hygiene, new guidelines for preoperative antibiotic prophylaxis, and isolation of patients infected or colonized with multidrug-resistant bacteria.RESULTS. The rate of nosocomial infection decreased from approximately 11.7% to 6.8% in 2 years. The rate of hand hygiene compliance increased by 20.0%; it was 59.0% before the intervention and increased to 79.0% afterward. These results correlate with data on the consumption of alcohol-based hand rub, but not with data on the use of antibiotics.CONCLUSION. Within 2 years, a multimodal infection control program intervention such as this one may reduce the rate of nosocomial infection at a tertiary care center by more than one-third and improve both the quality of care and patient outcomes. It may also generate considerable savings. Therefore, such programs should be promoted not only by hospital epidemiologists but also by hospital administrators.

This study empirically investigates the relationships of control levers (belief and boundary systems, Simons 1995) and control context (social and performance management context, Gibson and Birkinshaw 2004) with contextual ambidexterity and firm performance. Based on cross-sectional survey data from 198 listed companies in Austria, Germany, and Switzerland, a structural equation model is used to test the hypothesized relationships. We find that the emphasis on formal boundary systems and an informal social context are positively related to contextual ambidexterity, which positively affects firm performance. In contrast, belief systems and performance management context do not influence contextual ambidexterity. Further, we find no support for dynamic tensions, neither between the two control levers nor in the control context.

Organisationales Lernen (OL) ist eine der wichtigsten Quellen für Wettbewerbsvorteile und ein wichtiger Faktor für die Performance eines Unternehmens. Im Kontext von Analytics muss das bestehende personenzentrierte Verständnis weiterentwickelt und um die Datennutzung und -verwendung erweitert werden. Dadurch eröffnet sich Organisationen die Möglichkeit, Veränderungen in Umfeld und Organisation schnell zu erkennen und zu integrieren.

Das Performance Management fordert für die Leistungsmessung und -steuerung eine ganzheitliche Sichtweise. Gleichzeitig verliert die monetäre Fokussierung von Leistungsmessung zunehmend an gesellschaftlicher Legitimität. Das aus dem produktionstheoretischen IPO-Ansatz weiterentwickelte IPOOI-Modell (Input, Process, Output, Outcome, Impact) bietet hier einen Lösungsansatz.