The emergence of User-Generated-Content (UGC) is challenging the equilibrium of reputation management practices prompting widespread change and organizational restructuring. Formal accreditation ...schemes mingle with less formal mechanisms which place users in the middle making them draw their own conclusions about products and services. This paper explores how UGC reviews and ratings have intensified the contingency of organizational reputation in the travel sector. The findings are based upon a corpus of data including: a field study at the offices of the largest travel user-generated website, TripAdvisor, and a netnographic approach. In particular we discuss the shift from Word-Of-Mouth to eWOM, the consequences for the sector and provide a balanced view of the role of reviews, ratings and lists. We are concluding with a conceptual model for managing online reputation in the era of UGC, while acknowledging the current process of transformation in reputation management.
•UGC in travel places reputation management on the front line of everyday practices.•We propose a conceptual model to manage online reputation in the era of UGC.•Changes in rankings have had an impact on booking rates.•Managers must develop a thorough understanding of the nuances of reputation ratings.•In the era of UGC the offline and online worlds are entangled and inseparable.
The paper explores how valuing devices and verification mechanisms such as user-generated content (UGC) websites partake in performing placeness. The findings are based upon a corpus of data ...including a case study at the offices of the largest user-generated travel website, TripAdvisor, a longitudinal netnographic approach and a conceptual review. Originally inspired by theorists of space we treat places as sites of becoming that are performed through everyday practices. In claiming that places become meaningful only in and through practices we stress the importance of treating rating and ranking mechanisms as generative, rather than merely reductive algorithmically produced representations. By juxtaposing traditional enactments of traveling, we are discussing how placeness has been transformed and how this has fueled a series of further revisions to valuing tourism. We conclude the paper by appreciating the multiplicity of performativity as being implicated in the algorithmic configurations on contemporary valuing devices and enacted as we read, interpret, write, imagine. It is suggested that although earlier valuing devices have evoked place-making in various ways, the rise of UGC websites has converted the travel experience into a constant negotiation process whereby both the value of places and the value of valuing devices are contested.
The aim of this study was to characterize the 16S rRNA methylase (RMT) genes in aminoglycoside-resistant Enterobacterales and
Pseudomonas aeruginosa
isolates in 2015–2016 in hospitals in Athens, ...Greece. Single-patient, Gram-negative clinical isolates resistant to both amikacin and gentamicin (
n
= 292) were consecutively collected during a two-year period (2015–2016) in five tertiary care hospitals in Athens. RMT genes were detected by PCR. In all RMT-producing isolates, ESBL and carbapenemase production was confirmed by PCR, and the clonal relatedness and the plasmid contents were also characterized. None of the 138
P. aeruginosa
isolates harbored any of the RMT genes surveyed although some were highly resistant to aminoglycosides (MICs > = 512 mg/L). Among 154 Enterobacterales, 31
Providencia stuartii
(93.9%), 42
Klebsiella pneumoniae
(37.8%), six
Proteus mirabilis
(75%), and two
Escherichia coli
(100%) isolates were confirmed as highly resistant to amikacin, gentamicin, and tobramycin with MICs ≥ 512 mg/L, harboring mainly the
rmtB
(98.8%). All were carbapenemase producers.
P. stuartii
,
P. mirabilis
, and
E. coli
produced VIM-type carbapenemases.
K. pneumoniae
produced KPC- (
n
= 34, 81.0%), OXA-48 (
n
= 4, 9.5%), KPC- and VIM- (
n
= 3, 7.1%), or only VIM-type (
n
= 1, 2.4%) enzymes. Two groups of similar IncC plasmids were detected one harboring
rmtB1
,
bla
VEB-1
,
bla
OXA-10
, and
bla
TEM-1
, and the other additionally
bla
VIM-1
and
bla
SHV-5
. Among RMT-producing Enterobacterales,
rmtB1
predominated and was associated with carbapenemase-encoding gene(s). Similar IncC plasmids carrying a multiresistant region, including ESBL genes, and in the case of VIM-producing isolates, the
bla
VIM-1
, were responsible for this dissemination. The co-dissemination of these genes poses a public health threat.
We report the case of a 67-year-old man who was admitted to our Intensive Care Unit because of traumatic brain injury. During his prolonged hospitalization, gradual darkening of the skin all over his ...body was observed. An excess corticotropin (ACTH) production syndrome was considered. The patient's hormone study showed high levels of ACTH (978 pg/ml) with normal cortisol levels. Extensive clinical and laboratory investigations revealed adenocarcinoma of the colon, which was likely the site of the ectopic ACTH production. This is a very rare manifestation of paraneoplastic syndrome during the course of colon adenocarcinoma. The most important feature of this case report is that this rare syndrome was accidentally discovered, in a patient hospitalized for unrelated reasons, by simple clinical investigation.
Careful physical examination can provide valuable information which can lead to the diagnosis of rare and unexpected syndromes.Common clinical wisdom says that all signs and symptoms must fit one diagnosis, but in some cases there is more than one diagnosis.
The desire to create innovative organizational spaces has led to various instantiations of innovation ecosystems. Towards this direction, there is a growing interest in establishing corporate ...innovation ecosystems in the form of ‘corporate coworking spaces’ (CWS). From a relational ontological standpoint, this study builds on the collaborative spaces literature with the aim to investigate the emerging dynamics between corporates and start-ups in an innovation ecosystem. Through an abductive research strategy (ARS) as well as service design methods, we explore how co-creation between corporates and start-ups emerges (or not) in an innovation ecosystem that serves as a collaborative space in Denmark. Our empirical findings challenge the mostly overenthusiastic connotations and thus the study contributes to the critical coworking research stream. More specifically, we give emphasis on the co-constructive entanglement of socio-spatial arrangements and we propose a framework for revisiting the design of CWS through 1) balancing the engineered and evolving parts of the ecosystem, 2) facilitating stakeholder alignment, 3) adopting a service-oriented approach and 4) developing inclusive strategies. Apart from the implications for scholars and practitioners who study and design CWS, we argue that future research would especially benefit from building on a service-oriented approach of innovation ecosystems and we call for more interdisciplinary research.
•A case study of an innovation ecosystem where a large corporation was intending to co-create with start-ups.•The empirical findings showcase the dynamics between corporates and start-ups in the innovation ecosystem.•We propose a framework for achieving co-creation in CWS through a four-step strategy.•We suggest that strategies related to coworking spaces need to be designed from a service-oriented approach.•Service design methods such as Ecosystem Mapping, Service Value Proposition and Personas were employed for data visualisation.
Candida auris was sporadically detected in Greece until 2019. Thereupon, there has been an increase in isolations among inpatients of healthcare facilities.
We aim to report active surveillance data ...on MALDI-TOF confirmed Candida auris cases and outbreaks, from November 2019 to September 2021.
A retrospective study on hospital-based Candida auris data, over a 23-month period was conducted, involving 11 hospitals within Attica region. Antifungal susceptibility testing and genotyping were conducted. Case mortality and fatality rates were calculated and p-values less than 0.05 were considered statistically significant. Infection control measures were enforced and enhanced.
Twenty cases with invasive infection and 25 colonized were identified (median age: 72 years), all admitted to hospitals for reasons other than fungal infections. Median hospitalisation time until diagnosis was 26 days. Common risk factors among cases were the presence of indwelling devices (91.1 %), concurrent bacterial infections during hospitalisation (60.0 %), multiple antimicrobial drug treatment courses prior to hospitalisation (57.8 %), and admission in the ICU (44.4 %). Overall mortality rate was 53 %, after a median of 41.5 hospitalisation days. Resistance to fluconazole and amphotericin B was identified in 100 % and 3 % of tested clinical isolates, respectively. All isolates belonged to South Asian clade I. Outbreaks were identified in six hospitals, while remaining hospitals detected sporadic C. auris cases.
Candida auris has proven its ability to rapidly spread and persist among inpatients and environment of healthcare facilities. Surveillance focused on the presence of risk factors and local epidemiology, and implementation of strict infection control measures remain the most useful interventions.
Purpose To evaluate the in vitro efficacy of several anti-staphylococcal agents against a nationwide collection of contemporary Staphylococcus aureus clinical isolates from several healthcare centres ...in Greece. Methods Thirty hospitals throughout Greece (18 in Attica) provided all clinical isolates of S.aureus from April 2012 to May 2013 to a central lab to be re-submitted to susceptibility testing. The MICs were evaluated by Vitek® 2 with the exception of ceftaroline (OXOID M.I.C. Evaluator™). Vancomycin and daptomycin MICs were also evaluated by Etest®. Heterogeneously vancomycin-intermediate strains (hVISA) were detected by the Etest® GRD. VISA phenotype was confirmed by PAP-AUC. Results A total of 1005 isolates (39% MRSA) were studied. Susceptibility rates were: erythromycin 66.5%, clindamycin 79.2%, SXT 98.9%, rifampicin 97.3%, fusidic acid 67%, moxifloxacin 78.8%, vancomycin 99.9%, ceftaroline 92.9% and linezolid, tigecycline and daptomycin 100%. For mupirocin, high level resistance could be excluded for 98.9% of isolates. Vancomycin Etest® MIC
50/90
were 1.5/1.5 mg/L, 58.5% of isolates exhibited a MIC > 1 and 8.7% a MIC of 2 mg/L, while Vitek® MIC
50/90
were 1/1 and 3.1% showed MIC > 1 mg/L. One VISA strain was detected. Among the selected 175 isolates that were screened for hVISA phenotype, six (3.4%) were positive. In 315 bloodstream isolates, 64.1% had a vancomycin Etest® MIC > 1 mg/L. Conclusions This multi-centre surveillance study revealed that a significant percentage of contemporary S.aureus isolates from Greek patients have a vancomycin MIC (> 1 mg/L) that may compromise the clinical efficacy of the drug for the treatment of serious infections. The in vitro activity of SXT, rifampicin, mupirocin, linezolid, tigecycline, daptomycin and ceftaroline remains excellent.
We report the case of a 67-year-old man who was admitted to our Intensive Care Unit because of traumatic brain injury. During his prolonged hospitalization, gradual darkening of the skin all over his ...body was observed. An excess corticotropin (ACTH) production syndrome was considered. The patient's hormone study showed high levels of ACTH (978 pg/ml) with normal cortisol levels. Extensive clinical and laboratory investigations revealed adenocarcinoma of the colon, which was likely the site of the ectopic ACTH production. This is a very rare manifestation of paraneoplastic syndrome during the course of colon adenocarcinoma. The most important feature of this case report is that this rare syndrome was accidentally discovered, in a patient hospitalized for unrelated reasons, by simple clinical investigation. LEARNING POINTSCareful physical examination can provide valuable information which can lead to the diagnosis of rare and unexpected syndromes.Common clinical wisdom says that all signs and symptoms must fit one diagnosis, but in some cases there is more than one diagnosis.
This thesis explores the concept of reputation-making with the aim of explaining how the rise of user-generated content websites has influenced organizational reputationmaking practices in the travel ...sector. The findings are based upon a corpus of data including: a field study at the offices of the largest travel user-generated website operator, TripAdvisor and an adaptation of virtual ethnography called “netnography”. Rating and ranking of hotels on social media websites has not only disturbed the established reputation-making practices of professionals in the travel sector and contributed to a significant redirection of reservation revenue but has performative consequences for tourist encounters. In other words, it is argued that if key assumptions underpinning the rating and ranking of travel change, the enactment of travel itself is reconfiguring and this has important implications for how reputationmaking occurs. The reconfigurations documented in the study are theorized using the lens of Process Theory. Originally inspired by philosophers such as Bergson and Whitehead and adopted in the work of organizational theorists such as Tsoukas, Chia, Langley, and Nayak, the choice of Process Theory to inform the conduct of this study resonates with key streams of existing reputation research that view it as a dynamic phenomenon. Core concepts within Process Theory, such as “becoming” enable further investigation into the precise nature of this dynamism by focusing on relations as always fluid and on the move. The challenge, even for literature that acknowledges phenomena as dynamic, is how to temporarily pause the flow for the purpose of analysis and thereby approach becoming without disturbing its inherent nature. This is taken up in the first analysis chapter which uses the notion of place to illustrate and analyze reputation-making using the process of becoming. The chapter argues the importance of recognizing the temporary pauses produced by rating and ranking mechanisms as generative rather than merely reductive algorithmically produced representations. In this way, we get closer to understanding the performativity of phenomena such as TripAdvisor and produce fundamental insights informing organizational reputation-making. It is argued that the organizational devices through which travellers’ engage with the places they visit are not only “making” reputations but are also making formative differences to the practice of travelling. In the second analysis chapter, a key issue associated with these changes - the intensification in focus on service – is explored further and in-depth examination of the field data is used to highlight ways in which TripAdvisor amplifies attention given to the specific characteristics of practices when they are performed. This provides evidence to ground Tsoukas and Chia’s (2002) proposal that organizational change is achieved through ‘microscopic changes’ thus reinforcing the processual nature of change. In so doing, key insights are generated to inform organizational reputation-making. Returning to the tenet of becoming in the third analysis chapter, the “circle of (il)legitimacy” embraces processual principles - for the nature of the circle is to have no beginning or end – but acknowledges the cumulative outcome of configuring practices for hoteliers through a discussion of key issues emerging in the travel sector. The relationship between reputation-making and legitimation is highlighted with examples of the additional processes through which reputation can now be made vulnerable within multiple jurisdictional contexts. The thesis concludes with the assertion that if we aim to understand the phenomenon of reputation-making, we have to develop a more nuanced and sophisticated way to conceptualize its formativeness. It is suggested that this extends beyond snap shot assessments or post-hoc crisis management to on-going maintenance of its emergence and development as well as processual changes across time and space.
This thesis explores the concept of reputation-making with the aim of explaining how the rise of user-generated content websites has influenced organizational reputationmaking practices in the travel ...sector. The findings are based upon a corpus of data including: a field study at the offices of the largest travel user-generated website operator, TripAdvisor and an adaptation of virtual ethnography called “netnography”. Rating and ranking of hotels on social media websites has not only disturbed the established reputation-making practices of professionals in the travel sector and contributed to a significant redirection of reservation revenue but has performative consequences for tourist encounters. In other words, it is argued that if key assumptions underpinning the rating and ranking of travel change, the enactment of travel itself is reconfiguring and this has important implications for how reputationmaking occurs. The reconfigurations documented in the study are theorized using the lens of Process Theory. Originally inspired by philosophers such as Bergson and Whitehead and adopted in the work of organizational theorists such as Tsoukas, Chia, Langley, and Nayak, the choice of Process Theory to inform the conduct of this study resonates with key streams of existing reputation research that view it as a dynamic phenomenon. Core concepts within Process Theory, such as “becoming” enable further investigation into the precise nature of this dynamism by focusing on relations as always fluid and on the move. The challenge, even for literature that acknowledges phenomena as dynamic, is how to temporarily pause the flow for the purpose of analysis and thereby approach becoming without disturbing its inherent nature. This is taken up in the first analysis chapter which uses the notion of place to illustrate and analyze reputation-making using the process of becoming. The chapter argues the importance of recognizing the temporary pauses produced by rating and ranking mechanisms as generative rather than merely reductive algorithmically produced representations. In this way, we get closer to understanding the performativity of phenomena such as TripAdvisor and produce fundamental insights informing organizational reputation-making. It is argued that the organizational devices through which travellers’ engage with the places they visit are not only “making” reputations but are also making formative differences to the practice of travelling. In the second analysis chapter, a key issue associated with these changes - the intensification in focus on service – is explored further and in-depth examination of the field data is used to highlight ways in which TripAdvisor amplifies attention given to the specific characteristics of practices when they are performed. This provides evidence to ground Tsoukas and Chia’s (2002) proposal that organizational change is achieved through ‘microscopic changes’ thus reinforcing the processual nature of change. In so doing, key insights are generated to inform organizational reputation-making. Returning to the tenet of becoming in the third analysis chapter, the “circle of (il)legitimacy” embraces processual principles - for the nature of the circle is to have no beginning or end – but acknowledges the cumulative outcome of configuring practices for hoteliers through a discussion of key issues emerging in the travel sector. The relationship between reputation-making and legitimation is highlighted with examples of the additional processes through which reputation can now be made vulnerable within multiple jurisdictional contexts. The thesis concludes with the assertion that if we aim to understand the phenomenon of reputation-making, we have to develop a more nuanced and sophisticated way to conceptualize its formativeness. It is suggested that this extends beyond snap shot assessments or post-hoc crisis management to on-going maintenance of its emergence and development as well as processual changes across time and space.
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