The handful of companies profiled in this issue — those scrambling to build the biggest and baddest ebusiness power tools — all sit on an unmistakably huge opportunity: building the infrastructure behind the ecommerce of tomorrow. So huge, in fact, that it might leave Web firms with the notion that buying any or all of these technologies is a Net Economy panacea.

Not quite. No matter what any of these enabling technologies might do behind the electronic storefront, there’s another critical, and less tangible, ebusiness “enabler” for which you can’t just write checks: partnerships. Alliances of all stripes, in fact, account for as much as 15 percent of the typical company’s market valuation, and the global value of alliances, according to Andersen Consulting, will reach between $25 trillion and $40 trillion in the next five years.

The sober truth behind such dazzling projections, however, is that most ebusiness partnerships lack the substance and management to matter. “There are a lot of companies that have tons of partnerships,” says Yobie Benjamin, Ernst & Young strategist for emerging technologies. “But joint press releases don’t make money.”

Companies that find the right match — taking a joint venture to market, managing the relationship long term — can walk away winners. “[Venture capitalists] are beginning to prove that the multiples are higher when you go public if you have a strong partnering strategy,” says Wendy Lea, managing partner for OnTarget, a Dallas-based consulting firm. “They definitely feel risk is reduced.”

Partnerships are not only safer than acquisitions, but are easier to dissolve if things go awry. (As many as 30 percent of all partnerships fail outright.) Agendas change, cultures clash, accountability and performance are left behind. The worst culprit? “Going into it as an experiment as opposed to being committed,” says Bud Moeller, an Andersen partner in organization and change strategy. But, he says, 39 percent achieve or exceed expectations — better than the success rate for M&As.

There are as many types of partnerships as there are snowflakes, but a few attributes stand out in today’s best ebusiness alliances: speed, good teams, measured progress, networks, and innovation. Wise up.

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In addition to making suggestions for changes in programming, services and facility usage, an advisory board offers prestige and credibility. Maximize the committee’s community visibility and medical credentials by including its names in your club literature and club newsletters. Provide a brochure with information about your committee to potential and existing members.

Advisory committee members could eventually refer patients/clients to your facility if they become comfortable with your programs, staff capabilities and physical space/equipment. Mary Swanson, president of HealthCare Resources, says that it generally takes six months before physicians feel comfortable referring their patients to you. Pat Pine, executive director, Western Association of Clubs, emphasizes the need to have a credible, credentialled, well-trained staff before expecting physicians to refer patients to you.

Advisory committee members could offer lectures for your members. Each committee member can submit an outline or list of topics they feel comfortable with, and you can create a lecture series each month featuring a different committee member.

Also, encourage your advisory committee to submit articles to your newsletter. Make reprints to distribute at community meetings.

Your committee, when used to full advantage, can help grow your business significantly. Ernie Zaik, former general manager of the Western Reserve Club (WRC) in Tempe, Ariz., found that he was able to increase not only membership sales, but also revenues in wellness programs at his club.

While it is best to be honest, the tone of your comments must come from a caring place. No one serves a friend lovingly by dishing out harsh criticism. You might ask your friend why your comments are important to her, so that you have an idea what she is looking for. Some people simply want general support for their efforts; others are looking for specifics they can work with to improve their work. You may have expertise your friend values. Once again, lying can come back and bite you. Bucklin and Keil ended up in a situation where, unless Linda had told Mary the truth about how she felt about a project, Mary would have asked Linda to help her raise money for it. This would have put Linda in a far more difficult predicament than that of deciding whether or not to give her honest opinion.

Your closest friend starts spending time with another friend and neglects calling or seeing you as much as you had been accustomed to.
Truth-telling is definitely in order here. If you express your feelings to your friend that, for instance, you feel hurt by her lack of attention, you may learn something that would clarify the situation. Perhaps your friend has withheld a grievance from you that has caused her to turn away, and she was reluctant to tell you about it. Perhaps your friend and the new friend have some interest in common that you don’t share. Bringing things out in the open will help. There’s no question — friendships need time and attention to maintain closeness. When one friend moves toward another, it may be time to see if the original friendship needs freshening. On the other hand, some will say about their friendships that variety is the spice of life and simply want the pleasure of others’ company.

You confided in a friend who then betrays your trust by telling others. What do you do?

This is a case of broken trust. Trust, once broken, isn’t easy to repair. Only by expressing your feelings about what happened — and only if your friend is accountable for her actions — does the friendship stand the chance of being a healthy relationship for both of you.

A friendship without trust is, of necessity, superficial because you won’t feel safe enough to be vulnerable and intimate, two indicators of close friendship.

High blood pressure (HBP) is very common in adults, and is under-diagnosed and under-treated. It is a major risk factor in the causation of heart disease, stroke, and kidney disease, and it is more common in the African-American population. Treatments include diet, exercise, and medications. Yet, despite its potentially devastating sequelae, many HBP patients are not adequately treated: their BP remains elevated.

In recent years, doctors have recommended that HBP patients monitor their BP at home. While this is easy to do in theory, in actuality there have been substantial differences between BP measured electronically and that reported by patients themselves. It has also been shown that 24-hour BP measurement is far more accurate than occasional measurements taken by patients.

To obtain more accurate readings, Mary A.M. Rogers, Ph.D., M.S., and her colleagues at the State University of New York-Upstate Medical University in Syracuse designed a randomized, controlled trial utilizing 24-hour automatic ambulatory BP monitoring (ABPM) at baseline and at the study termination 8 weeks later, to determine BP levels and changes in those levels more accurately.

Sixty patients with diagnosed HBP were randomized to the study group, which received ABPM with centralized reporting and processing of their BP data, including weekly reports provided to their primary physician — as well as to the patients themselves. The readings were transmitted over telephone lines. Sixty-one patients were randomized to the control group, which received usual care. Their BP treatment was given according to the recommendations of the Joint National Committee on HBP, with BP measurements done at office or clinic visits.

The results showed that BP readings decreased for the study patients, but increased or remained the same for the control group. Mean (average) diastolic pressure, the lower number, decreased 2.0 mm in the study group, but increased by 2.1 mm in the controls; mean systolic (higher number) decreased 4.9 mm in the ABPM group, but increased 0.1 mm in the controls. The differences were even more significant in the African-American patients. The main reason for the difference, according to the study authors, was more frequent changes in type and dose of BP medications in the study patients.

In this randomized, controlled trial, a telecommunication service utilizing ABPM was effective in decreasing BP in patients with established HBP. BP decreased in patients who used the service, while it worsened in patients receiving usual care. The authors state, “[A]ccurate and timely information is an essential cornerstone for the provision of quality medical care. Technological advances…must be tested and, if efficacious, be made available. Our results suggest that this telecommunications service may be a useful adjunct to antihypertensive therapy and warrants investigation in larger study samples.”

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Even though friendship is good for mental and physical health, some situations between close friends can cause a great deal of stress and anguish.

Linda Bucklin and Mary Keil, co-authors of the book, “Come Rain or Shine: Friendships Between Women” (Adams Media Corporation, 1999), advise friends to be as honest with each other as possible. “If you, for instance, speak the truth and the friend can’t hear that, an obstacle has been placed between you that will impact your level of closeness,” they say. “How you handle those differences will either hold a friendship at a superficial level or provide you with the chance to become more vulnerable and intimate with each other.”

Of course, friends don’t constantly agree on everything, but the key is expressing your opinions or truth in a loving way, the authors say. Sometimes you can diffuse the tension in an awkward situation by admitting, up front, that you feel uncomfortable and are not quite sure how to proceed in voicing your feelings, priorities and values.

Bucklin and Keil offer these approaches to dealing with classic friendship dilemmas:
You spot your best friend’s husband cuddling with another woman in the back booth of a fancy restaurant on a Tuesday afternoon. What do you do?

Some women actually cover that possibility — in advance — with their closest friends and tell their friends clearly whether or not they would want to hear about it. Excepting that advance warning, however, it is important to decide whether or not to tell based on the nature of your friendship, what you know about your friend’s values and what you know about her marriage. Some experts regard this as a “damned if you do, damned if you don’t” situation. Make sure you are clear why you tell or don’t tell. Just keep in mind that, if you decide not to tell and the friend finds out you knew, you might end up having to explain why you didn’t tell her. One woman we interviewed lost a friend over that very issue. She didn’t tell her friend, and the friend wouldn’t forgive her.

To keep costs within a manageable budget, they employed several cost-saving strategies: 1) They hired a construction manager and subcontracted the various trades; 2) They utilized a steel frame building as a base; 3) They eliminated aesthetic items that didn’t contribute to member service or functionality; and 4) They bid and selected all furnishings themselves, rather than using an interior designer.

Ten months after ground-breaking, they opened a 68,748-square-foot facility that was built for $40.27 per square foot vs. the typical costs of $70 to $120 per square foot.

The community responded; the club signed up 1,440 people prior to opening, and after six months had 2,300 memberships. Their goal was 3,000 members the first year. Not only have they turned a profit in their sixth month, but they expect to break even the first year.

Small Kitchen Design Concepts

One way to redesign your kitchen is to simply reposition the appliances. Very often we put appliances in odd places or position them at strange angles. Their placement causes inconvenience, but it is hard to get motivated to move them. You will be surprised to find that this small trick can save you a lot of space in the kitchen.

Use Your Vertical Space

Most rooms in the house have a surprising amount of vertical space that goes unused. The kitchen is no exception. The counter tops and tables use plenty of space horizontally. This will result in a bit of space left over for kitchen storage. But if you use your vertical wall space wisely, you will be able to make lots of space in your kitchen. Utilize your kitchen space best by installing cupboards and shelves right up to the ceiling. Keep the items you hardly ever use up on the higher shelves.

Have Open Cabinets

If you have storage space that is open, it will make your kitchen seem more spacious. Use glass doors for your kitchen cabinets instead of wood. Then you will have a clear view of your cabinets. Additionally, because the glass reflects the light, it makes the room seem more spacious. Also you can have open cabinets for country style decor.

Some Great Features

Slide-Away, Pull-Out, Roll-Down! Incorporate these features as much as you possibly can! You can put in sliding doors, rather than the typical swinging doors, which require too much space when you open them. A pull out top can be pulled out to do a small job like cutting or chopping and then pushed back in when not in use.

Streamlined Applications

Get rid of your chunky old appliances and get some new, sleek ones! Compact appliances look beautiful and can fit into a small area. If you have your dishwasher and microwave built in, you will save a lot of kitchen space.

Cutting Down On Clutter

If you go through your kitchen with a fine-toothed comb, you will find lots of things you can simply toss out. Pots and pans that don’t have lids, just lids by themselves, misplaced handles, appliances that don’t work and anything else! You may find bottles and cans of food that are generations old. Clean this mess quickly and find out for yourself the amount of empty space you have for storage.

A New Layer of Paint

If you don’t like any of the previously mentioned suggestions for small kitchen makeovers then, you can just paint your kitchen a new color. Your kitchen will have a cleaner and more open appearance if you paint it a pastel or a lighter color. You could paint your kitchen cabinets in a matching or coordinating color.

So, giving the smaller kitchen a makeover may not always be that expensive. Basic tips and secrets will make kitchen work a more fun activity for you.

The center of the computer screen or monitor should be at or slightly below eye level and a comfortable distance from the user.

“Often, the screen is too high for kids, so that they have to tilt their head up and back,” Merrill says. “The chair seat is often too deep, so that they must either sit forward without back support, or sit so that the back of their knees is tight against the edge of the seat.” If this is the case, a footstool permits the proper posture while children grow into the chair.

While having the correct equipment is essential, people should also learn the right typing techniques. “The arm and hand technique for typing is similar to the proper technique for playing a piano,” Merrill said. “The principle is to use the whole arm rather than just the hands and the fingers. Wrists should be about level with the arms, rather than way lower or way higher.” Children should be taught to hold the mouse gently, rather than jerking it around or pressing it very hard.

Parents should monitor their children’s computer use. Hours of game playing expose a child to the same hand and eye movement over and over. “A good environment won’t take the place of frequent breaks, sufficient exercise and good nutrition, but it does eliminate the stress of placing the body in bad positions,” Merrill said.

“Kids should be getting up about every half hour or so to change positions. You don’t want them spending hours in front of the computer without a break and then going directly to the TV screen.”

Surprisingly, the odd positions that some kids assume at the computer are not all bad. One mom described her son’s behavior like this: “He puts his feet up on the desk and leans back and he takes the keyboard in his lap or props it on his knee.” Although it drives adults nuts, this type of behavior can be a blessing. “Active, fidgety kids probably are less at risk for repetitive stress injuries than the ones who stay put for hours on end,” Merrill said. “Moving often is important for children as well as for adults.”

But it doesn’t have to be this way. A well-planned computer area pays dividends in satisfaction and good health for the whole family.

Good planning consists not only of choosing a quiet spot out of the family’s daily traffic, but also in outfitting the area properly to support comfortable use.

The advantages of a quiet location are obvious, but what’s this about proper equipment? When people — whether adults or children — park themselves in front of the computer for long periods, side effects such as repetitive stress injuries, eyestrain and headaches can occur. The proper equipment can minimize such side effects.

In families where everyone uses the computer, setting up a single workspace can be tricky. But it’s doable, thanks to adjustable chairs, articulating keyboard trays that attach to a desk or table and pull out, and swing-arm supports to hold the monitor. Office supply outlets generally stock these items, along with armrests and footstools, to further customize the work area for each user.

There is one caveat to the “one-home-office-fits-all” arrangement. If very young children will also be using the computer, consider buying separate computer furniture for them and setting up two areas.

“Smaller children need tables or desks that fit them, and many furniture companies are making much smaller chairs suited for kids,” said Barbara Merrill. Merrill is physical therapist in Saratoga, Calif., and a certified ergonomist who counsels companies and individuals on physically appropriate work environments.

If you are going to create or upgrade a computer area, start with the chair, because it is the single most important item contributing to comfort. A proper chair allows the trunk to be supported while the arms can move freely.

“Good muscle tone makes it easier to sit up straight, but nobody can remain upright while seated for long periods of time without good back support from the chair,” Merrill said. The height of the chair is also important — it should permit the user to sit with his or her feet on the floor, with about three finger-widths of space between the chair edge and the back of the knees. Merrill prefers a chair with arms that can support the forearms, but comfort is key. “A good chair feels like a comfortable shoe,” she said.

One of these drugs without prescription was often prescribed in combination with an entirely different kind of appetite suppressant, phentermine (hence the term “fen-phen”). Such usage has never been sanctioned by the FDA. Despite alarming early case reports, several follow-up articles have revealed that the risk of significant adverse effects is actually quite small, especially with short-term use.

Too late, it seems, for AHP. Their attorneys chose to fight this case in court rather than settling out-of-court, as they had done in other cases, because they felt confident in a favorable outcome. As a result of this verdict, it is likely that the number of pending lawsuits will multiply from the current estimate of 10,000. Even if the average settlement or judgment of already-filed suits is “only” $1 million, the current costs of such lawsuits to AHP amounts to $10 billion. And that figure is conservative, since the number of plaintiffs will now be rising.

What does all this mean for you and me? Why should we care about AHP? Here’s why: The drugs involved here went through the same rigorous testing and FDA review that all American pharmaceuticals have to undergo before approval and marketing. It takes many years and millions of dollars to get a drug to the public, and many fall by the wayside during the process. This example will prove chilling to the pharmaceutical industry as a whole.

After all, who wants to expend years of scientific and technical expertise, millions of dollars, and other less well defined assets, to get a useful drug to market, only to have some completely unknown and unpredictable adverse reaction sabotage the product, and even perhaps the whole company? Innovation is the core reason why we have benefited from hundreds of new medications without prescriptions during the past 60 years, extending our life span and improving our health into the golden years. If pharmaceutical companies, fearing litigation for rare, unknown reactions, decline to develop and market beneficial unique products, the state of the art will stagnate, to the profound detriment of the public’s health.

And, most ironic of all, we have the opposite situation involving the tobacco industry, which has long evaded accountability for its dangerous products. In contrast to AHP and other pharmaceutical companies, whose intent has always been to produce safe and beneficial products — albeit, of course, profitable ones — Big Tobacco has consistently held profits to be the only goal.

Theirs is the only product that is harmful when used as intended, plus they have a 50-year history of deception and concealment concerning the health effects and addictiveness of their product. Until very recently they were seemingly immune from successful litigation, mostly due to the protection of the warning label and protectors in Congress. That is starting to change, at long last.

The liability system in this country functions well, usually, to force corporations to act responsibly; for if they do not, they risk huge financial judgments. In the case of fen-phen and AHP, the system has not worked to benefit the public. The combination of greedy attorneys and “junk science” has once more taken its toll. (A similar scenario played out in the 1992 silicone-implant settlements-the major difference being that the earlier claims have been thoroughly trashed as the junk science they were. Again, too late for Dow-Corning). Why won’t the same fate befall the lords of tobacco, who, in contrast to AHP, so richly deserve to learn this lesson?