Massive corals maintain a positive carbonate budget of a Maldivian upper reef platform despite major bleaching event.

Coral reefs experienced the third global bleaching event in 2015-2016 due to high sea-surface temperature (SST) anomalies. Declines in net carbonate production associated with coral bleaching are implicated in reef structural collapse and cascading impacts for adjacent coral reef islands. We present the first carbonate budget study of a reef platform surface (reef crest and reef flat) in the southern Maldives and the first record of upper reef flat condition in the central Indian Ocean post the 2015-2016 coral bleaching event. Scleractinian corals were the primary carbonate producers, with live coral cover averaging between 11.1 ± 6.5 and 31.2 ± 21.8% and dominated by massive corals. Gross carbonate production rates averaged 5.9 ± 2.5 G (kg CaCO3 m2 yr-1). Bioerosion was estimated at 3.4 ± 0.4 G, resulting in an average net carbonate production rate of 2.5 ± 2.4 G. Comparison of results with a study of the fore-reef slope highlights major differences in post-bleaching carbonate budget state between the fore-reef slope and the reef platform surface. The positive reef flat carbonate budget is attributed to the persistence of massive corals (Porites spp. and Heliopora spp.) through the bleaching event.

Marketing home health care medical services: the physician's view.

The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner.

Measuring customer perceptions of emergency facility services: a qualitative approach.

The purpose of this study was to use a qualitative research technique and define problems faced by one hospital that was attempting to increase demand for its emergency services. A telephone survey of 450 affluent and well-educated suburban residents was conducted to determine their perceptions of six major facilities. Topics included actual and preferred facility use by injury type, general perceptions concerning staff and facility, and other components of service quality. Results indicated that a variety of sociological, psychological, environmental, and situational factors interacted when the respondents formed attitudes concerning hospital emergency use and service. They were often uncertain of their real attitudes and conveyed varying opinions about the desirability or effectiveness of similar services. Health care providers should note these differences and modify the marketing mixes in a manner that best conveys their unit's competitive advantages. They could also benefit from using the qualitative research technique described in this paper and from adopting the marketing concept.