Silverman, M R; Gregoire, M B; Lafferty, L J; Dowling, R A
To identify current operational practices and expectations for future practices in hospital foodservice; establish the probability that current practices will change; and determine whether differences in practices exist on the basis of profit status and hospital size. A questionnaire, to determine current practices, probability of change, and expectations for future practices, was mailed to foodservice directors. A random sample of 500 foodservice directors in US hospitals with 200 or more beds. A total of 214 questionnaires were returned for a response rate of 43%. Descriptive statistics were used to report current practices, probability of change, and expectations for future practices. The Kruskal-Wallis test was conducted to examine whether the probability of change ratings differed on the basis of hospital profit status and size. chi 2 Analysis was used to examine whether expectations for future practices differed based on hospital profit status and size. Currently 81% of hospital foodservice departments have fewer than 100 employees; 73% have revenue budgets of less than $2 million; 49% have expense budgets greater than $2 million; 55% use a selective menu, often (43%) 1-week in length; 74% use conventional food production technology; 81% have a centralized, hot tray line; 91% operate a cafeteria; 96% do on-site catering; 69% have differential pricing for employee meals; 58% have subsidized employee meals; and 19% have coffee kiosks. Changes in current practices are expected in several areas. Foodservice directors expect to serve meals to fewer inpatients (71%), employ less staff (73%), have smaller expense budgets (70%), and generate more revenue (61%). Kruskal-Wallis and chi 2 analyses indicated few differences on the basis of hospital profit status and size. There was little consensus among directors on how to best respond to these environmental changes. Hospital foodservice practices will change in the future. Foodservice directors are using a variety of
Gregoire, Mary B; Sames, Karoline; Dowling, Rebecca A; Lafferty, Linda J
To determine perceived importance of selected competencies for the role of hospital foodservice director and explore whether registered dietitians (RDs) are perceived competent in these areas. Data were collected through a mailed questionnaire. A random sample of 500 hospital foodservice directors and 500 hospital executives to whom the directors report. Chi2, Mann-Whitney, and Kruskall-Wallis tests were used to examine differences among ratings by and demographic characteristics of foodservice directors and the executives with whom they work. All competencies were perceived to be important for someone in the role of hospital foodservice director. RDs were perceived to be somewhat competent in all areas studied but were only perceived to be competent to expert in a few of the areas. Directors who were RDs and hospital executives who had worked with RDs rated the competence level of RDs higher than did non-RD directors and hospital executives who had not worked with RDs. Unique competencies appear to be important for those aspiring to become hospital foodservice directors. Hospital executives who had worked with RDs perceived the competency level of RDs to be higher than did executives who had not worked with RDs. Often, areas rated as most important for the role of hospital foodservice director were not areas in which RDs were perceived to be highly competent. Additional competency development may be needed to better prepare RDs to assume the role of hospital foodservice director.
Pickens, C W; Shanklin, C W
The purposes of this study were to identify the state of the art relative to the utilization of marketing techniques within hospital foodservice departments throughout the United States and to determine whether any relationships existed between the degree of utilization of marketing techniques and selected demographic characteristics of the foodservice administrators and/or operations. A validated questionnaire was mailed to 600 randomly selected hospital foodservice administrators requesting information related to marketing in their facilities. Forty-five percent of the questionnaires were returned and analyzed for frequency of response and significant relationship between variables. Chi-square was used for nominal data and Spearman rho for ranked data. Approximately 73% of the foodservice administrators stated that marketing was extremely important in the success of a hospital foodservice department. Respondents (79%) further indicated that marketing had become more important in their departments in the past 2 years. Departmental records, professional journals, foodservice suppliers, observation, and surveys were the sources most often used to obtain marketing data, a responsibility generally assumed by the foodservice director (86.2%). Merchandising, public relations, and word-of-mouth reputation were regarded as the most important aspects of marketing. Increased sales, participation, good will, departmental recognition, and employee satisfaction were used most frequently to evaluate the success of implemented marketing techniques. Marketing audits as a means of evaluating the success of marketing were used to a limited extent by the respondents.
Jilcott Pitts, S B; Graham, J; Mojica, A; Stewart, L; Walter, M; Schille, C; McGinty, J; Pearsall, M; Whitt, O; Mihas, P; Bradley, A; Simon, C
Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings. © 2016 The British Dietetic Association Ltd.
Justesen, Lise; René, Michael; Kristensen, Marianne Boll
% of the protein requirements on CCP compared to 33 % on BTS (p=0,216). Conclusions A new foodservice system (CCP) which increases availability and choice of food 24/7 does not show a significant improvement of energy and protein intake in hospitalized patients and patients at nutritional risk. However, further......Background Insufficient dietary intake is common among hospitalised patients and may affect prognosis negatively. Hence hospital meals are central in the treatment, and their efficacy in ensuring adequate intake is crucial. This study aimed to compare patients’ dietary intake from a cook......-serve buffet-trolley serving system (BTS) to a new cook-chill pre-plated concept (CCP) allowing patients to choose from a static menu 24/7. Methods A quasi-experimental study was conducted at two orthopaedic surgical and a gynaecological surgical ward at a Danish Hospital. 57patients (≥3 days) were served...
Angelillo, I F; Viggiani, N M; Greco, R M; Rito, D
To determine adherence to Hazard Analysis and Critical Control Points (HACCP) methods and to evaluate knowledge, attitudes, and practices of food-services staff with regard to food hygiene in hospitals. A survey. Hospital medical directors and food-services staff of 36 hospitals in Calabria, Italy. A questionnaire about hospital characteristics, food-services organization, and measures and procedures for the control and prevention of foodborne diseases was sent to medical directors; a questionnaire about demographic and practice characteristics, knowledge, attitudes, and behaviors about control and prevention of foodborne diseases was sent to food-services staff. Multiple logistic regression analysis was performed. Only 54% of the 27 responding hospitals were using the HACCP system and, of those using HACCP, 79% adopted a food-hygiene-practice manual; more than one half already had developed written procedures for food storage, personal hygiene, cleaning and disinfection; one half or less performed microbiological assessment of foods and surfaces. Of the 290 food-services staff who responded, 78.8% were aware of the five leading foodborne pathogens; this knowledge was significantly higher among those with a higher educational level and those who worked in hospitals that had implemented the HACCP system. Younger staff and those who had attended continuing educational courses about food hygiene and hospital foodborne diseases had a significantly higher knowledge of safe temperatures for food storage. A positive attitude toward foodborne-diseases prevention was reported by the great majority, and it was significantly higher in older respondents and in those working in hospitals with a lower number of beds. Only 54.9% of those involved in touching or serving unwrapped raw or cooked foods routinely used gloves during this activity; this practice was significantly greater among younger respondents and in those working in hospitals using HACCP. Full implementation of the
Goonan, Sarah; Mirosa, Miranda; Spence, Heather
Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Lesser, Lenard I; Hunnes, Dana E; Reyes, Phedellee; Arab, Lenore; Ryan, Gery W; Brook, Robert H; Cohen, Deborah A
Marketing strategies and food offerings in hospital cafeterias can impact dietary choices. Using a survey adapted to assess food environments, the purpose of this study was to assess the food environment available to patients, staff, and visitors at the food-service venues in all 14 California children's hospitals. We modified a widely-used tool to create the Nutritional Environment Measures Survey for Cafeterias (NEMS-C) by partnering with a hospital wellness committee. The NEMS-C summarizes the number of healthy items offered, whether calorie labeling is present, if there is signage promoting healthy or unhealthy foods, pricing structure, and the presence of unhealthy combination meals. The range of possible scores is zero (unhealthy) to 37 (healthy). We directly observed the food-service venues at all 14 tertiary care children's hospitals in California and scored them. Inter-rater reliability showed 89% agreement on the assessed items. For the 14 hospitals, the mean score was 19.1 (SD = 4.2; range, 13-30). Analysis revealed that nearly all hospitals offered diet drinks, low-fat milk, and fruit. Fewer than one-third had nutrition information at the point of purchase and 30% had signs promoting healthy eating. Most venues displayed high calorie impulse items such as cookies and ice cream at the registers. Seven percent (7%) of the 384 entrees served were classified as healthy according to NEMS criteria. Most children's hospitals' food venues received a mid-range score, demonstrating there is considerable room for improvement. Many inexpensive options are underused, such as providing nutritional information, incorporating signage that promotes healthy choices, and not presenting unhealthy impulse items at the register. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
The hospitality industry is one that is not adversely affected by the information revolution. As tourism is stimulated by government economic development efforts, opportunities in the food service and hospitality occupations are increasing, both for the young and for the unemployed who need retraining. (SK)
.... According to Chicago-based Technomic Inc's 2011 Top Fast-Casual Chain Restaurant Report, the foodservice segment outpaced the rest of the restaurant industry in 2010, with the top 100 chains growing 6% to nearly $18.9 billion...
fifth generation was global benchmarking, which was "a global application where international trade, cultural, and business process distinctions...religious dietary needs of inmates. In the financial area of foodservice, usage offood cost percentage, labor cost percentage, supply cost percentage
Though hospital studies have often focused on the vertical relationships between patients and medical staff, the interactions between patients have received much less attention. Whereas interaction with staff members is episodic, patients often spend long hours sharing intimate space and daily
Fitzgerald, Patricia L.
Examines trends identified in the American School Food Service Association's research-based "1998-2000 Strategic Plan." Forecasters are projecting that student enrollments will rise over the next five years, labor shortages will continue, competition from fast-food providers is increasing, food-service providers' roles are expanding, and…
Weiss, Rachel; Vittinghoff, Eric; Fang, Margaret C; Cimino, Jenica E W; Chasteen, Kristen Adams; Arnold, Robert M; Auerbach, Andrew D; Anderson, Wendy G
To assess the association between the frequency of empathic physician responses with patient anxiety, ratings of communication, and encounter length during hospital admission encounters. Analysis of coded audio-recorded hospital admission encounters and pre- and postencounter patient survey data. Two academic hospitals. Seventy-six patients admitted by 27 attending hospitalist physicians. Recordings were transcribed and analyzed by trained coders, who counted the number of empathic, neutral, and nonempathic verbal responses by hospitalists to their patients' expressions of negative emotion. We developed multivariable linear regression models to test the association between the number of these responses and the change in patients' State Anxiety Scale (STAI-S) score pre- and postencounter and encounter length. We used Poisson regression models to examine the association between empathic response frequency and patient ratings of the encounter. Each additional empathic response from a physician was associated with a 1.65-point decline in the STAI-S anxiety scale (95% confidence interval [CI], 0.48-2.82). Frequency of empathic responses was associated with improved patient ratings for covering points of interest, feeling listened to and cared about, and trusting the doctor. The number of empathic responses was not associated with encounter length (percent change in encounter length per response 1%; 95% CI, -8%-10%). Responding empathically when patients express negative emotion was associated with less patient anxiety and higher ratings of communication but not longer encounter length.
Cook, Charlotte C.; Casey, Ralph
This study determined the extent to which a course in foodservice sanitation using National Institute for the Foodservice Industry materials affected the postcourse sanitation inspection scores in selected establishments. Both experimental and control establishments had significantly higher inspection scores after the course than they had prior to…
Full Text Available In this essay I discuss the issue of Kantian hospitality and how Katrin Flikschuh’s arguments in “Kant’s Nomads: Encountering Strangers” offer us a framework for dealing with certain problems that seem to arise out of the Kantian account, namely, problems of dealing with cultures unlike modern liberal states, such as nomadic and indigenous communities. I look at some criticisms of Kant’s position on hospitality and cosmopolitan right and on how Flikschuh’s discussion helps to resolve these criticisms. I focus especially on her discussion of respectful interaction and openness in the course of encountering cultural others, encounters that inherently and positively contain a large element of unexpectedness.
Full Text Available This article argues that Anglican foundation schools have a positive impact on pupils’ sense of belonging to the wider community by creating safe spaces within which to encounter difference in a positive and transformative manner. The paper is divided into three main sections. First, the context in which the article was written is outlined. Details of the author's two years of fieldwork in a multi cultural Anglican primary school are set out and an understanding of Anglican schools as places which display an authentic outworking of a Christian worldview is explained. Second, the role of Anglican schools as places of encounter is discussed, with reference both to relevant Anglican literature and to the author's own experience of Anglican schools. This includes a substantial discussion of the Anglican understanding of hospitality as the foundation for creating safe spaces for transformative encounters. Hospitality is understood solely in a religious sense, of a Christian school acting as host to those of all faiths and none. Third, the core values of respect, forgiveness and freedom, which support the status of Anglican schools as safe spaces of encounter are elucidated. This involves both examples from the author's fieldwork and also published literature on the topic. Respect is discussed as a foundational value for any encounter with difference, which must be balanced with a willingness to forgive those who react negatively to such encounters. Freedom is understood specifically in the context of freedom of religious belief, reinforcing an understanding that Anglican schools do not engage in proselytising activity. The article concludes by reinforcing the central argument of the paper that Anglican faith schools contribute to a sense of belonging to a wider community through creating safe spaces to encounter the other and taking deliberate steps to engage with that other.
Nilsson, Åsa; Skär, Lisa; Söderberg, Siv
To describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden. Shortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being. A qualitative design was used in the study. Three focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis. The results are presented in two themes. The first theme, 'Disregard for the patient's unique nursing needs', describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, 'Difficulty managing obstacles', nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability. The findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff. Nurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care. © 2015 John Wiley & Sons Ltd.
Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth
REVIEW QUESTION / OBJECTIVE The objective of this systematic review is to identify, appraise and synthesize the best available evidence on nursing students’ experiences of professional patient care encounters in a hospital unit. More specifically the research questions are: How do nursing students...... describe their experiences of professional patient care in a hospital unit? What kinds of experiences do nursing students have in professional patient care encounters? INCLUSION CRITERIA Types of participants This review will consider studies that include undergraduate and postgraduate nursing students....... The range of participants includes all nursing students independently of the level of their clinical period. There will be no limitations regarding the age, gender or ethnicity of participants. Types of phenomena of interest This review will consider studies that investigate nursing students' learning...
Paasch, Bettina Sletten
The use of wireless phones in hospital units are increasing, inducing practitioners to carry a working phone each. A qualitative study was performed in a medical hospital unit, investigating their effect on client-professional encounters and interprofessional communication. Participant observations...
Control Point ( HACCP ) inspections in foodservice operations throughout the state. The HACCP system, which first emerged in the late 1960s, is a rational...has been adopted for use in the foodservice industry. The HACCP system consists of three main components which are the: (1) Assessment of the hazards...operations. This manual was developed to assist local sanitarians in conducting HACCP inspections and in educating foodservice operators and employees
Raymund B. Moreno
Full Text Available This study aimed to determine the practices of foodservice establishments in Iloilo City. The subjects of this study were selected foodservice establishments in Iloilo City which were selected purposively. The findings of the study showed that the number of foodservice establishments as respondents was equally divided into fast foods and specialty foodservice establishments in Iloilo City. Majority of the foodservice establishment was located uptown or outside of the City of Iloilo and has operated for more than five years. All specialty establishments have undergone accreditation by the Department of Tourism. Since the foodservice establishments practiced all times the different foodservice practices in purchasing, receiving, storage, inventory and safety it is recommended that the owners and managers should continue to perform the different practices to ensure quality service and satisfaction to the customers. It is recommended that the hotel and restaurant management teachers should disseminate the result of the study through their lecture and discussion so that the students could be aware of the good practices employed in the foodservice establishments and enable them to apply this in their future career as effective and productive foodservice worker. Similar study can be conducted to validate the results of this study using other variables and respondents.
Saws Vertical Food Mixers Pressure Cookers Steam Jacketed Kettles Fundamentals of Steam Procedures to Clean Coffee Urns A List of Foodservice...Evaluation System for Pressure Cookers 90 Evaluation Form for Pressure Cookers 92 Pressure Cooker Evaluation Form Guide 93 Evaluation System for Steam...cleaned. Other tasks include maintenance of the gas jets , thermostat calibration, and cleaning of under burner area. Compare manufacture requirements
Parham, E S; Benes, B A
To determine the development needs of foodservice management (FSM) faculty originally prepared in other fields. Application of qualitative research methodologies to description and comparison of the perspective of three groups: faculty themselves, leaders in foodservice industry, and educators in advanced-degree programs. Purposive sampling of organization directories was used to recruit faculty members for two surveys (142 and 62 respondents) and four focus groups; 15 representatives from industry, professional organizations, and education (through an advisory committee); and 11 foodservice administration advanced-degree programs (through survey and study of program catalogs). Faculty competencies needed were compared from the three perspectives. Descriptive statistics plus chi 2 determinations were used to make comparisons. All three sources identified needs that could be classified into one of three groups: acquisition of theory, mastery of applications, and personal qualities. Theoretical groundwork needed included food science/quantity food production, financial and personnel management, marketing, customer satisfaction, and use of computer and other technologies. Although only 44% of faculty respondents had advanced degrees in FSM, their graduate study in other areas was applicable in meeting many of the competencies. Almost all faculty had some FSM industry experience-a high priority from all perspectives. Most faculty were involved in development activities and reported success in acquiring knowledge and application competence. The faculty members' lack of identification with FSM and their feelings of isolation were more problematic.
National Restaurant Association, Chicago, IL.
Firms representing four segments of the foodservice industry (institutional foodservice (9 jobs), commercial restaurants (19 jobs), hotel foodservice (100 jobs), and airline foodservice (10 jobs), participated in a career and training study to test the feasibility of designing and implementing career progression (c.p.) systems within these…
Sherrin, A. Rachelle; Bednar, Carolyn; Kwon, Junehee
Purpose: Purpose of this research was to investigate utilization of labor productivity standards and variables that affect productivity in Texas school foodservice operations. Methods: A questionnaire was developed, validated, and pilot tested, then mailed to 200 randomly selected Texas school foodservice directors. Descriptive statistics for…
Full Text Available Introduction: Repair mechanisms, both marked and unmarked, are present in institutional interactions including family doctor-patient and hospital teacher-student encounters. While in most of the cases unmarked repair is carried out by the dominant partner, sometimes marked repair mechanisms are initiated by the client. The present study was undertaken to throw light upon these marked repairs. The aim of the study is to compare two interactions, the first is between a GP and a patient and the second is between a hospital teacher and a student.
Paasch, Bettina Sletten
The use of wireless phones in hospital units are increasing, inducing practitioners to carry a working phone each. A qualitative study was performed in a medical hospital unit, investigating their effect on client-professional encounters and interprofessional communication. Participant observations...... were conducted in accordance to Spradleys methodology. A total of 30 hours were observed, and ethnographic interviews including 5 practitioners and 10 patients were performed. A hermeneutic approach was maintained during data analysis. The study demonstrates a change in the way health care...
Degrie, Liesbet; Gastmans, Chris; Mahieu, Lieslot; Dierckx de Casterlé, Bernadette; Denier, Yvonne
In our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients. A systematic search was conducted for papers published between 2000 and 2015. Analysis and synthesis were guided by the critical interpretive synthesis approach. Fifty one articles were included. Four dimensions emerged, describing the intercultural care encounter as (1) a meeting of two different cultural contexts of care, (2) in a dynamic and circular process of (3) balancing between the two cultural contexts, which is (4) influenced by mediators as concepts of being human, communication, family members and the hospital's organizational culture. This review provides in-depth insight in the dynamic process of establishing intercultural care relationships in the hospital. We call for a broader perspective towards cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way.
Sneed, Jeannie; Strohbehn, Catherine H
Food safety in retail foodservice is increasingly important to consumers. Trends that impact food safety concerns include the increasing number of meals eaten away from home, increasing consumer awareness about food safety, an aging population, changes in the foodservice workforce, changing technology in work environments, changes in food procurement, foodservice risk factors, and food defense concerns. Each of these trends has implications for dietetics practice, both in working with consumers and managing foodservice operations.
Faris Fauze Ahmed
Full Text Available Abstract Background Total hip replacements conduct highly effective in relieving pain dysfunction for patients who suffer from hip inflammation and a variety of reasons however after several decades of success in hip replacement there was also an increase in cases of fractures after you perform a detailed switch and attributed this The increase in the prevalence of a large fraction of the increase in the number of switch detailed and increasing age and poverty operations. Objectives The study aims toAssess the pre operation physical and psychosocial problems of patients with total hip replacement. To Assess the post operation physical and psychosocial problems of patients with total hip replacement. To find out the relationship between pre post physical and psychosocial problems with age gender duration of illness and type of operation. Design of the study A descriptive design study was carried out in Nursing Home hospital and Ghazi AL-Hariri for specialized surgical hospitals starting from January 13th 2015 to September 1st 2015 The study Sample A non- probability purposive sample of 50 patients undergoing total hip replacement surgery who have several problems before and after surgery. The study Instrument The study instrument was composed of three parts which as socio demographic information was included age group gender marital status level of education occupational economic part two consist of medical information was comprised of 7 items and part three contain physical and psychosocial problems through Hamilton anxiety scale consist of 84 items. Validity and Reliability The content validity of the instrument was established through a panel of 14 experts the reliability of the items was based on the internal consistency of the questionnaire was assessed by calculating Cronbach s Coefficient alpha which as 0.73. Statistical Analysis The researchers used the appropriate statistical methods for data analysis which include the descriptive data
Lesikar, B J; Garza, O A; Persyn, R A; Kenimer, A L; Anderson, M T
Food-service establishments that use on-site wastewater treatment systems are experiencing pretreatment system and/or drain field hydraulic and/or organic overloading. This study included characterization of four wastewater parameters (five-day biochemical oxygen demand [BOD5]; total suspended solids [TSS]; food, oil, and grease [FOG]; and flow) from 28 restaurants located in Texas during June, July, and August 2002. The field sampling methodology included taking a grab sample from each restaurant for 6 consecutive days at approximately the same time each day, followed by a 2-week break, and then sampling again for another 6 consecutive days, for a total of 12 samples per restaurant and 336 total observations. The analysis indicates higher organic (BOD5) and hydraulic values for restaurants than those typically found in the literature. The design values for this study for BOD5, TSS, FOG, and flow were 1523, 664, and 197 mg/L, and 96 L/day-seat respectively, which captured over 80% of the data collected.
Price, Sarah; Hartwell, Heather; Hemingway, Ann; Chapleo, Chris
In settings such as workplaces there is a growing acceptance that the food provided has a significant impact on health and wellbeing. This is a captive environment where the overall contribution of the meal served could be an important element of the overall diet and represents an under researched area. Despite growing demand, little information is available; time pressure when making food choice alongside the challenge of understanding information provided can act as barriers for healthy selection and can also decrease confidence in the food system. We would also argue that the fundamental human right of informing consumers what they are eating is not currently being addressed and is underscored. This study used focus groups to explore criteria that motivate peoples' food choice in a workplace foodservice setting. Thematic analysis was applied to categorise data according to frequently occurring responses. Data were collected from four focus groups in Germany and the UK with a total of 23 participants. Although there is little expectation in the quality of food served in the workplace, respondents valued any transparency of information and the opportunity to socialise with other work colleagues. Criteria of importance were identified as: Value for money, Variety, Naturalness, Nutrition, Portion Size, Taste, Visual Appearance, Origin, Animal welfare, Environmental impact, Fair Trade and Organic. Gaining insight into these criteria can enable operators to meet the needs and expectations of their customers in order to increase confidence in the food provided and in addition signpost a healthier selection. Copyright © 2015 Elsevier Ltd. All rights reserved.
Meyer, M K; Conklin, M T
To determine if student satisfaction with high school foodservice is directly related to participation in the foodservice. A valid and reliable survey was conducted in a variety of classes such as English, history, and health science in grades 9 through 12, representing students aged 13 through 19 years. Students were asked 38 questions concerning variety of food, food quality, foodservice staff, aesthetics of the serving and dining area, and demographics. The study was conducted with 1,823 students from 9 schools representing 4 geographic regions. Stepwise multiple regression was used to determine the independent variables (attributes desired by the students) that most highly correlated with the dependent variable (satisfaction with the school foodservice overall). Variables most highly correlated with overall satisfaction were variety of food offered, flavor of food, attractiveness of food on the serving line, staff smiling and greeting students, quality of food choices, choices that allow students to meet cultural and ethnic preferences, courteousness of the staff, and quality of ingredients. Variety of food offered was the best predictor of satisfaction. A statistically significant difference was found (Pnutrition programs are critically important for providing nutrition to millions of our future leaders. Today it is not enough to prepare healthful, good-tasting food. High school students are sophisticated and are exposed at an early age to a variety of dining experiences including fast foods, ethnic cuisine, and fine dining. These factors have influenced the attributes students use to evaluate school foodservice. To maintain participation levels and financial stability, school foodservice professionals should evaluate student satisfaction with food quality, variety, and other variables that affect overall satisfaction and participation. These data may then be incorporated into continuous quality improvement and strategic planning. Marketing must be
Full Text Available Taro Takeshima,1,2 Maki Kumada,3,4 Junichi Mise,5 Yoshinori Ishikawa,6 Hiromichi Yoshizawa,4 Takashi Nakamura,3,4 Masanobu Okayama,1 Eiji Kajii11Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan; 2Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan; 3Division of The Project for Integration of Community Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan; 4Department of General Internal Medicine, Chikusei City Hospital, Chikusei, Japan; 5Division of Human Resources Development for Community Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan; 6Department of Surgery, Chikusei City Hospital, Chikusei, JapanPurpose: Although many new patients are seen at small hospitals, there are few reports of new health problems from such hospitals in Japan. Therefore, we investigated the reasons for encounter (RFE and diagnoses of new outpatients in a small hospital to provide educational resources for teaching general practice methods.Methods: This observational study was conducted at the Department of General Internal Medicine in a small community hospital between May 6, 2010 and March 11, 2011. We classified RFEs and diagnoses according to component 1, “Symptoms/Complaints”, and component 7, “Diagnosis/Diseases”, of the International Classification of Primary Care, 2nd edition (ICPC-2. We also evaluated the differences between RFEs observed and common symptoms from the guidelines Model Core Curriculum for Medical Students and Goals of Clinical Clerkship.Results: We analyzed the data of 1,515 outpatients. There were 2,252 RFEs (1.49 per encounter and 170 ICPC-2 codes. The top 30 RFE codes accounted for 80% of all RFEs and the top 55 codes accounted for 90%. There were 1,727 diagnoses and 196 ICPC-2 codes. The top 50 diagnosis codes accounted for
School foodservice workers (SFW) are a direct link to children eating school meals. SFW who perceive positive and supportive organizational culture at their school nutrition departments also may perceive that such environments foster their own promotion of healthful food choices by students. To date...
Mikkelsen, Bent Egberg; Nielsen, Thorkild; Kristensen, Niels Heine
is the idea that the large-scale foodservice such as hospital food service should adopt a buy organic policy due to their large buying volume. But whereas implementation of organic foods has developed quite unproblematically in smaller institutions such as kindergartens and nurseries, introduction of organic....... Since one of the most important areas both socially and environmentally is production and consumption of food, some individual European governments have worked out action plans setting out concrete goals for conversion of arable land from conventional to organic. One of the emerging areas for attention...... foods into large-scale foodservice such as that taking place in hospitals and larger homes for the elderly, has proven to be quite difficult. The very complex planning, procurement and processing procedures used in such facilities are among reasons for this. Against this background an evaluation...
Wang, Yang; Grunow, Martin
Consumers have become more and more demanding with regards to food quality, food safety, sustainability, and associated product attributes. Looking at food supply chains from an integrated point of view has therefore become an industry paradigm. The overall aim of this thesis is to contribute...... to the literature with regards to the development of efficient, high-quality, and sustainable food supply chains; especially focusing on integrated methodologies. In this thesis, research is presented on the inclusion of the specifics of the food industry, food engineering related knowledge, and sustainability...... assessment methodology into food supply chain management. This thesis builds on a case from the foodservice industry, which is used throughout the thesis to illustrate the proposed methodologies. As an important part of the food industry, the foodservice industry connects agricultural producers, food...
Sultemeier, P M; Gregoire, M B; Spears, M C; Downey, R
This study examined managerial roles in college and university foodservice at three organizational levels. The study population included foodservice managers at National Association of College and University Food Services (NACUFS) member schools with a minimum annual budget of +3 million. The 999 managers from 80 colleges and universities who participated were categorized into three groups: assistant, associate, or director of foodservice; unit manager; and manager reporting to unit manager. They rated 51 activity statements on importance and time demand. Maintaining standards of quality was rated most important and most time demanding by all three groups of managers. Perceived importance and time demand of activities increased as managerial level increased. Activity statements were categorized into Mintzberg's 10 managerial roles. Significant differences in importance and time demand ratings among the three managerial groups were indicated for all 10 roles. However, perceived importance and time demand of roles increased as managerial level increased with two exceptions. Disturbance handler and leader roles were rated more time consuming by lower level managers.
Brashear, Gary L.
This study examined foodservice outsourcing in the State of Illinois. School administrators currently outsourcing foodservice were surveyed about their perceptions of HB1347 and its components. This study looked at HB1347 in Illinois, and its effects on outsourcing in school districts. Data for this study was collected from a survey sent to 100%…
Mikkelsen, Bent Egberg; Nielsen, Thorkild; Kristensen, Niels Heine
. Since one of the most important areas both socially and environmentally is production and consumption of food, some individual European governments have worked out action plans setting out concrete goals for conversion of arable land from conventional to organic. One of the emerging areas for attention...... foods into large-scale foodservice such as that taking place in hospitals and larger homes for the elderly, has proven to be quite difficult. The very complex planning, procurement and processing procedures used in such facilities are among reasons for this. Against this background an evaluation...... was carried out of the change process related implementation of organic foods in large-scale foodservice facilities in Greater Copenhagen county in order to study the effects of such a change. Based on the findings, a set of guidelines has been developed for the successful implementation of organic foods...
Full Text Available Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care.To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments.Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals.7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014.Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week and hospital outpatient volume in the first half of 2014.Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only.Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.
Koefoed, Lasse Martin; Christensen, Mathilde Dissing; Simonsen, Kirsten
The paper explores modes of encounters in the everyday practice of bus travel. Particularly, it addresses cross-cultural encounters located in the tension between familiarity and difference, between inclusion and exclusion. The paper is located in contemporary thoughts, approaching public transport...... not only as a moving device but also as a social arena. Furthermore, the bus is simultaneously perceived as a public space, at once composite, contradictory and heterogeneous, and as a meeting place involving ‘Throwntogetherness’. The encounters analysed are bodily, emotional charged and outspoken meetings...
DHT researcher Connie Svabo and artist Charlotte Grum did a joint performance presentation titled Becoming Sheep, Becoming Animal at the international conference Encountering Materiality – Transdisciplinary Conversations, held in Geneve, Schwitzerland, June 23-25 2016.......DHT researcher Connie Svabo and artist Charlotte Grum did a joint performance presentation titled Becoming Sheep, Becoming Animal at the international conference Encountering Materiality – Transdisciplinary Conversations, held in Geneve, Schwitzerland, June 23-25 2016....
Soler, Carla; Esteban, J Guillermo; Jiménez, Ricardo; Mañes, Jordi; Soriano, José Miguel
The transmission of harmful pathogens by arthropods is an increasing health concern. More concretely, flies are known to be able to transmit the infectious agent mechanically. The present work shows a case report occurred from foodservice establishments where were isolated and identified, at the first time, Megaselia spp. in the food preparation place. Furthermore, microorganisms were analyzed from these flies. It is based in entomological and microbiological analysis. Mesophilic aerobic flora and Enterobacteriaceae were found in all the samples, exceeding the limits established from food commodities on 41.7% (5/12) for mesophilic aerobic bacteria and 66.7% (8/12) for Enterobacteriaceae. Furthermore, 25% (3/12) of analyzed flies were found positive to Escherichia coli, data that can be linked with the microbiological food results. The most surprising results were the presence of S. aureus in 66.7% (8/12) of the analyzed flies. A binomial relationship among Megaselia spp. and bacteria is demonstrated being an important study to demonstrate that must be checked more hygienically measurement in foodservice. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Ju, Seyoung; Chang, Hyeja
Sustainable practices in foodservice organizations including commercial and noncommercial ones are critical to ensure the protection of the environment for the future. With the rapid growth of the foodservice industry, wiser usage of input sources such as food, utilities, and single use packaging should be reconsidered for future generations. Therefore, this study aims to investigate the customer's perceptions on sustainable practices and to identify the relationship among sustainable practices, social contribution and purchase intention. The study was conducted using content analyses by reviewing articles on sustainable food service practices published domestically and abroad. Thereafter, data were collected with a face-to-face survey using a questionnaire and analyzed with factor analyses and multiple regressions. Sustainable practices classified with factor analysis consisted of 6 dimensions of green food material procurement, sustainable food preparation, green packaging, preservation of energy, waste management, and public relations on green activity, with a total of 25 green activities in foodservice operations. Consumers were not very familiar with the green activities implemented in the foodservice unit, with the lowest awareness of "green food material procurement (2.46 out of 5 points)", and the highest awareness of "green packaging (3.74)" and "waste management (3.28). The factors influencing the perception of social contribution by foodservice organizations among 6 sustainable practice dimensions were found to be public relations on green activity (β = 0.154), waste management (β = 0.204) and sustainable food preparation (β = 0.183). Green packaging (β = 0.107) and the social contribution of the foodservice organization (β = 0.761) had strong relationships with the image of the organization. The purchase intentions of customers was affected only by the foodservice image (β = 0.775). The results of this study suggest that sustainable practices by
Plage, Stefanie; Willing, Indigo; Woodward, Ian
This study contributes to the growing research on everyday cosmopolitanism in diverse societies. We employ a cosmopolitan encounters framework to explore the reflexive openness people perform and the ethical reasoning they draw on to get along with each other. In particular, we look beyond pleasu...
This study investigated the management importance and performance level of foodservice managers at senior centers. Using the survey, perceived importance and performance levels of seven foodservice management areas were evaluated and analyzed. Data showed the foodservice facilities were being managed by dietitians (61.6%) or non-dietitians (38.9%). The result indicated that overall importance level (3.43) was higher than performance level (3.02) (psenior centers and find out which management area should be concentrated for more effective foodservice management. PMID:20016702
Bar-On, Elhanan; Blumberg, Nehemia; Joshi, Amit; Gam, Arnon; Peyser, Amos; Lee, Evgeny; Kashichawa, Shree Krishna; Morose, Alexander; Schein, Ophir; Lehavi, Amit; Kreiss, Yitshak; Bader, Tarif
Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments. Data were obtained from IDF records and analyzed using SPSS™ software. 1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake. The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning
Story, Cyndie; Sneed, Jeannie; Oakley, Charlotte B; Stretch, Theresa
Managers of onsite retail foodservice operations, particularly those in centralized school foodservice operations, are called on to provide meals during emergencies, yet there is a paucity of research on their readiness to handle emergencies. Qualitative research and a cross-sectional survey design were used to conduct a needs assessment for emergency preparedness (emergency readiness, food recalls, and food defense) in centralized school foodservice operations, including warehousing. An open-ended written questionnaire was mailed to eight foodservice directors, and responses were used to develop a written questionnaire that was mailed to school foodservice directors in 200 districts identified as having centralized food production and warehousing. Directors from 78 districts responded (39% response rate). Most districts (n=72) had an emergency response team, and foodservice was included as part of 63 of those teams. Not all districts had written procedures for food recalls (47 of 73), natural disasters (37 of 74), or food defense (30 of 74). Barriers to implementing emergency preparedness policies and procedures included limited money, emergency equipment, and time. Most current training related to food safety with little training related to emergency preparedness. Training on the emergency preparedness plan was done in 61 of 78 districts. Training on emergency procedures was done by less than half of the districts during the previous year. This study identified best practices related to emergency preparedness that can be implemented in onsite retail foodservice operations. Results indicate a need to emphasize emergency preparedness, develop written standard operating procedures, and train employees to be prepared to respond to emergencies.
Collins, Jorja; Porter, Judi; Truby, Helen; Huggins, Catherine E
effective strategies are required to support the nutritional status of patients. to evaluate a foodservice nutrition intervention on a range of participant outcomes and estimate its cost. parallel controlled pilot study. subacute hospital ward. all consecutively admitted adult patients were eligible for recruitment under waiver of consent. the intervention was a modified hospital menu developed by substituting standard items with higher energy options. The control was the standard menu. All participants received usual multidisciplinary care. Outcomes were change in weight and hand grip strength (HGS) between admission and day 14 and; energy and protein intake and patient satisfaction with the foodservice at day 14. The additional cost of the intervention was also estimated. the median (interquartile range) age of participants (n = 122) was 83 (75-87) years and length of stay was 19 (11-32) days. One-third (38.5%) were malnourished at admission. There was no difference in mean (SD) HGS change (1.7 (5.1) versus 1.4 (5.8) kg, P = 0.798) or weight change (-0.55 (3.43) versus 0.26 (3.33) %, P = 0.338) between the intervention and control groups, respectively. The intervention group had significantly higher mean (SD) intake of energy (132 (38) versus 105 (34) kJ/kg/day, P = 0.003) and protein (1.4 (0.6) versus 1.1 (0.4) g protein/kg/day, P = 0.035). Both groups were satisfied with the foodservice. The additional cost was £4.15/participant/day. in this pilot, the intervention improved intake and may be a useful strategy to address malnutrition. Further consideration of clinical and cost implications is required in a fully powered study.
Full Text Available This essay explores my experience of losing an authoritative speaking position – that is, ‘falling on my face’ in a research encounter with the Brazilian Landless Worker’s Movement (O Movimento dos Trabalhadores Rurais sem Terra, or MST. My specific movements through this locale invoke Gayatri Chakravorty Spivak’s concept of ‘unlearning one’s privilege as a loss’; and Sara Ahmed’s theory of ‘stranger fetishism’. In writing my brief loss, I also; of course, recover my speaking position, meaning that I can always efface the loss by re-writing it as a source of ethnographic authority. This essay is written in two voices in order to reflect this paradox: one which describes the encounter, and one that critically ruminates upon it. I note, for example, that the MST as a variegated conglomerate of people takes the form of particular ‘Others’ when they are represented in the scholarship and polemic of ‘first world’ activists in the so called ‘global justice movement’. ‘Falling on my face in the street’ of these Others locates particular processes of fetishization within the global justice movement and the relationships across power and difference that are contained herein; processes that impact on the idea of a ‘global’ solidarity against systemic ‘global’ oppressions.
Pitter, Cynthia Pearl
Gender-based violence (GBV) can have devastating consequences for pregnancy because both mother and child are at risk. Midwives are in a strategic position to identify and empower pregnant women experiencing GBV; however, currently midwives in Jamaica are not required to screen for GBV, neither are they prepared to do so. This study forms the baseline of a larger study designed to improve the capacity of midwives to identify and treat pregnant women experiencing GBV in Jamaica. This specific component assessed midwives' knowledge and attitudes when encountering GBV in their practice in Kingston, Jamaica. A qualitative study design was used. Six practicing midwives were purposely selected to participate in a focus group discussion at the antenatal clinic of a hospital in Kingston, Jamaica. All six respondents said it was very important to screen for GBV among pregnant women in their care. The findings from their report revolved around six themes, namely midwives have suboptimal knowledge, are exposed to women experiencing GBV in pregnancy, lack professional preparedness, report gaps in the institutional framework to guide their practice, are concerned for their safety and security, and are willing to intervene. This study confirmed that midwives are aware of the problem and are willing to intervene but are faced with lack of formal procedures to detect and treat pregnant women who are experiencing GBV. Findings could be used to inform a protocol which is being developed to guide midwives' practice. Findings could also be incorporated in the national strategy to eliminate GBV.
Cynthia Pearl Pitter
Full Text Available Introduction: Gender-based violence (GBV can have devastating consequences for pregnancy because both mother and child are at risk. Midwives are in a strategic position to identify and empower pregnant women experiencing GBV; however, currently midwives in Jamaica are not required to screen for GBV, neither are they prepared to do so. Aim: This study forms the baseline of a larger study designed to improve the capacity of midwives to identify and treat pregnant women experiencing GBV in Jamaica. This specific component assessed midwives’ knowledge and attitudes when encountering GBV in their practice in Kingston, Jamaica. Methods: A qualitative study design was used. Six practicing midwives were purposely selected to participate in a focus group discussion at the antenatal clinic of a hospital in Kingston, Jamaica. Results: All six respondents said it was very important to screen for GBV among pregnant women in their care. The findings from their report revolved around six themes, namely midwives have suboptimal knowledge, are exposed to women experiencing GBV in pregnancy, lack professional preparedness, report gaps in the institutional framework to guide their practice, are concerned for their safety and security, and are willing to intervene. Conclusion: This study confirmed that midwives are aware of the problem and are willing to intervene but are faced with lack of formal procedures to detect and treat pregnant women who are experiencing GBV. Findings could be used to inform a protocol which is being developed to guide midwives’ practice. Findings could also be incorporated in the national strategy to eliminate GBV.
..., contact John Endahl, Senior Program Analyst, Office of Research and Analysis, Food and Nutrition Service... Food and Nutrition Service Agency Information Collection Activities: Proposed Collection; Comment Request--School Foodservice Indirect Cost Study AGENCY: Food and Nutrition Service (FNS), United States...
Chu, Yen Li; Orsted, Mary; Marquart, Len; Reicks, Marla
Objective: To describe how school foodservice personnel use current labeling methods to identify whole-grain products and the influence on purchasing for school meals. Methods: Focus groups explored labeling methods to identify whole-grain products and barriers to incorporating whole-grain foods in school meals. Qualitative analysis procedures and…
Diabetes is increasing in youth, presenting a serious public health threat. Although type 1 diabetes has historically been more common in children, type 2 diabetes is on the rise, linked to increases in overweight and obesity among American youth, particularly those of high risk racial and ethnic groups. Foodservice personnel, along with other…
Thomson, Jessica L.; Tussing-Humphreys, Lisa M.; Martin, Corby K.; LeBlanc, Monique M.; Onufrak, Stephen J.
Objective Determine school characteristics associated with healthy/unhealthy foodservice offerings or healthy food preparation practices. Design Retrospective analysis of cross-sectional data. Setting Nationally representative sample of public and private elementary, middle and high schools. Participants 526 and 520 schools with valid data from the 2006 School Health Policies and Practices Study (SHPPS) Food Service School Questionnaire. Main Outcome Measure(s) Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Analysis Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Results Public schools and schools participating in USDA Team Nutrition reported more healthy offerings and preparation than private or non-participating schools, respectively. Elementary schools reported less unhealthy offerings than middle or high schools; middle schools reported less unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation while those requiring completion of a foodservice training program reported less unhealthy offerings and more healthy preparation than schools without these requirements. Conclusions and Implications Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. PMID:22963956
were training in communications, culinary arts , how to teach, and how to discipline subordinates. Indicators of Quality of Management FMT members...ashore. The majority in both cases were cooks or storeroom workers (Jacks of the Dust). The average grade afloat was E-3.4, while that ashore was E...Present Foodservice Operation ITEM AFLOAT ASHORE a. Food preparation of USN cooks 4-.69 5.73 b. Supervision from watch captain 4.69 5.56 c
Justesen, Lise; Overgaard, Svend Skafte
This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...
I was requested by Nihon University to contribute to the official journal of the Japanese Society of Laboratory Medicine (Rinsho Byori). A special review of the final lecture at Surugadai Nihon University Hospital was requested by the editorial board of the Japanese Society of Laboratory Medicine. I submitted a review under the heading of "I have carried out upon retirement, ..." based on the final lecture at Surugadai Nihon University Hospital. The contents of the lecture were how to widely disseminate the FAB classification of acute leukemia and how to establish an additional laboratory management fee. Finally, I showed how to charge an additional management fee correctly based on a laboratory physician's activities in Surugadai Nihon University Hospital. I summarize the lecture in this article.
Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William
Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care.The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training
Mirosa, Miranda; Loh, Joanne; Spence, Heather
College administrative and management leaders, foodservice personnel, and student residents value social, nutritional, financial, and environmental sustainability in their dining expectations. Menu choice reduction looks promising as a strategy to achieve these goals. However, foodservice research about dominant attitudes across these stakeholders is limited. To identify qualitative views from all stakeholders about choice reduction to ensure that any changes to the meal service are not to the detriment of consumer satisfaction. A comprehensive list of 74 statements representing the spectrum of attitudes surrounding choice was generated by searching a variety of resources, including academic literature and Internet sites, and by conducting semistructured interviews with stakeholders. A final set of 42 statements resulted from researcher scrutiny for optimum balance, clarity, appropriateness, simplicity, and applicability. A new sample of participants was then asked to sort these 42 statements into a normal distribution grid from "strongly disagree" to "strongly agree." A purposive convenience sample of stakeholders (staff n=5 and residents n=4) was used to identify statements about choice reduction. A second sample of stakeholders (staff n=6 and residents n=29) were recruited to sort the final 42 statements. Q methodology analysis techniques were used. This involved conducting a by-person factor analysis, using the centroid factor extraction method because of the permissiveness it allows for data exploration. A varimax factor rotation to enhance interpretability of the results identified shared viewpoints. Three dominant viewpoints toward the possibility of choice reduction in the meal service were identified. Factor 1 was "health driven" (in which healthiness was paramount). Factor 2 was "variety seekers" (in which choice had instrumental value). Factor 3 was "choice lovers" (in which choice had intrinsic value). Although participants could see a number of
Intervenção nas situações de trabalho em um serviço de nutrição hospitalar e repercussões nos sintomas osteomusculares Intervention in a hospital foodservice and its effects on musculoskeletal symptoms
Full Text Available OBJETIVO: Analisar as situações de trabalho em serviço de nutrição hospitalar, antes e depois da implantação de ações de intervenções ergonômicas, e seu impacto na prevalência de sintomas osteomusculares relacionados ao trabalho. MÉTODOS: Trata-se de estudo de caso desenvolvido em hospital público especializado em cardiologia, localizado em São Paulo, com a participação de 115 trabalhadores. A abordagem metodológica foi a da Análise Ergonômica do Trabalho e da ergonomia participativa. A coleta de dados foi realizada por meio da aplicação de questionários e da análise ergonômica do trabalho, antes e depois da intervenção. A análise dos dados incluiu testes estatísticos para verificar se houve mudança da prevalência de sintomas antes e depois das intervenções, com nível de significância de 5%, por meio dos Programas Statistical Package for Social Sciences 13.0 e Excel 2003. RESULTADOS: A população constitui-se, em sua maioria, de mulheres, na faixa etária de 25 a 34 anos, com grau médio de escolaridade, casadas, com filhos, e que ocupavam o cargo de atendente de nutrição. Os principais problemas observados foram espaço físico reduzido, equipamentos e materiais de trabalho inadequados, deficit de pessoal, volume excessivo de trabalho com elevado esforço mental e alta prevalência de sintomas osteomusculares, principalmente nos membros inferiores e ombros. Após as intervenções realizadas, houve melhora na situação de trabalho, com redução dos sintomas osteomusculares, bem como os profissionais perceberam mudanças em termos de ambiente físico, equipamentos e organização do trabalho. CONCLUSÃO: As intervenções repercutiram em melhorias, principalmente quanto ao ambiente e equipamentos, e na redução dos sintomas osteomusculares nos membros inferiores, ombros, pescoço/região cervical, antebraço e região lombar, apesar de a redução não ter sido estatisticamente significativa
Providing food safety training to an audience whose native language is not English is always a challenge. In the study reported here, minimal-text visuals in Spanish were used to train Hispanic foodservice workers about proper handwashing technique and glove use based on the 2005 Food Code requirements. Overall, results indicated that visuals…
Back, Ki Joon; Shanklin, Carol W.
In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given. PMID:21487500
Feldman, Charles; Harwell, Heather; Brusca, Joseph
The potential for Universities and Colleges to be settings that promote health and wellbeing has become the subject for debate where the role of foodservice has been acknowledged as influential. The aim of this research was to evaluate an effective design to promote healthy selections from university foodservice menus. The research was designed around a grounded theory approach utilizing semiological prompts based on different existing nutrition labeling schemes. A total of 39 students (17 male, 22 female) participated in seven focus groups at Montclair State University, US. The participants of this study clearly called for nutrition labeling on college menus and a prototype design had been agreed. The students also itemized five nutrients they wanted listed in a Traffic Light system of colors and then quantified on the menu: calories, sodium, sugar, fat and carbohydrates, plus beneficial ingredients or nutrients for display in menu icons. The nutrients and display order varies somewhat from industry and government standards, though the student recommendations are suggestive of common understandings of published nutrient guidelines. Students have a stake in how menu information is presented on campus and their opinions could positively impact the general selection of healthy foods. Copyright © 2013 Elsevier Ltd. All rights reserved.
Christiansen, Lene Bull; Galal, Lise Paulsen; Hvenegård-Lassen, Kirsten
The article introduces the special issue by presenting the concept of organised cultural encounters that are encounters organised to manage and/or transform problems perceived to originate in or include cultural differences. Inspired by Pratt’s conceptualisation of the contact zone, a critical...
Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.
Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk
Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and
Voges, K L; Mason, C L; Brooks, J C; Delmore, R J; Griffin, D B; Hale, D S; Henning, W R; Johnson, D D; Lorenzen, C L; Maddock, R J; Miller, R K; Morgan, J B; Baird, B E; Gwartney, B L; Savell, J W
Beef from retail and foodservice establishments in 11 US cities was evaluated using Warner-Bratzler shear (WBS) and consumer evaluation panels. Postmortem aging times ranged from 3 to 83d for retail and 7 to 136d for foodservice with mean aging times of 22.6d and 30.1d, respectively. For retail, the three cuts from the round - top round, bottom round, and eye of round - had the highest (P<0.05) WBS values compared to cuts from the chuck, rib, and loin. Top loin steaks had the lowest (P<0.05) WBS value compared to ribeye and top sirloin foodservice steaks. Retail bone-in top loin, top loin, ribeye, T-bone, and porterhouse received the highest (P<0.05) ratings by consumers for overall like and like tenderness. Quality grade had little or no effect on foodservice sensory evaluations. Improvements in round tenderness are needed to increase consumer acceptability.
Department of Veterans Affairs — Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on...
Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig
OBJECTIVES: To explore the challenges that Danish community pharmacy staff encounter when serving non-Western immigrant customers. Special attention was paid to similarities and differences between the perceptions of pharmacists and pharmacy assistants. METHODS: A questionnaire was distributed...... companies. CONCLUSIONS: Community pharmacy staff report poorer quality in their encounters with immigrant customers, including sub-optimal counselling and frequent use of under-aged children as interpreters. Our study also reveals certain differences across personnel groups, which may be explained...
Sneed, Jeannie; Strohbehn, Catherine; Gilmore, Shirley A; Mendonca, Aubrey
A study of 40 assisted-living facilities in Iowa was conducted to assess the microbiological quality of food-contact surfaces (work tables/counters, cooking equipment such as mixing bowls, and cutting boards) and a surface that could cross-contaminate food (refrigerator or freezer handles) to determine the effectiveness of cleaning and sanitation. Standards were set for foodservice for aerobic plate count, Enterobacteriaceae, and Staphylococcus aureus . Two facilities met standards for all five surfaces for each of the three tests. Fewer facilities met the standard for aerobic plate count than for the other two tests, and nearly three fourths of the facilities failed to meet the aerobic plate count for cutting boards. Critically, cross-contamination from these surfaces could result in contamination of food; thus, attention needs to be given to training and supervision to ensure proper hand washing and appropriate cleaning and sanitation procedures to reduce or eliminate cross-contamination.
Hartwell, Heather J; Edwards, John S A; Brown, Lorraine
Many aspects of eating out have been studied, yet emotions remain an under-researched area, despite having been shown to play a significant role in food consumption. The aim of this research is to critically evaluate the relationship between emotions and food consumption (macronutrient) in a realistic eating environment, a college cafeteria. Subjects (n = 408), diners using a cafeteria, completed an emotions questionnaire before and after freely choosing, paying for and consuming a hot main meal. The results demonstrated a greater feeling of contentment with a high fat, high energy meal, whereas with a low carbohydrate meal, participants felt unfulfilled. In addition, a high protein meal also leads to a feeling of contentment. These results are rather counter-intuitive to public health nutrition policy but indicate the importance of inclusion of a protein or high carbohydrate item in any dish design in a foodservice setting.
The patient-physician encounter is the pivotal starting point of any healthcare delivery, but it is subject to multiple process breakdowns and prevalent suboptimal performance. An overview of the techniques and components of a successful encounter valid for every setting and readily applicable is presented, stressing 7 rules: (1) ensuring optimal environment, tools, and teamwork; (2) viewing each encounter not only as a cognitive/biomedical challenge, but also as a personal one, and a learning opportunity; (3) adopting an attitude of curiosity, concentration, compassion, and commitment, and maintaining a systematic, orderly approach; (4) "simple is beautiful"-making the most of the basic clinical data and their many unique advantages; (5) minding "the silent dimension"-being attentive to the patient's identity and emotions; (6) following the "Holy Trinity" of gathering all information, consulting databases/colleagues, and tailoring gained knowledge to the individual patient; and (7) using the encounter as a "window of opportunity" to further the patient's health-not just the major problem, by addressing screening and prevention; promoting health literacy and shared decision-making; and establishing proper follow-up. Barriers to implementation identified can be overcome by continuous educational interventions. A high-quality encounter sets a virtuous cycle of patient-provider interaction and results in increasing satisfaction, adherence, and improved health outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.
Andersen, Lars Bo; Bøge, Ask Risom; Danholt, Peter
Privacy is a major concern when new technologies are introduced between public authorities and private citizens. What is meant by privacy, however, is often unclear and contested. Accordingly, this article utilises grounded theory to study privacy empirically in the research and design project...... Teledialogue aimed at introducing new ways for public case managers and placed children to communicate through IT. The resulting argument is that privacy can be understood as an encounter, that is, as something that arises between implicated actors and entails some degree of friction and negotiation....... An argument which is further qualified through the philosophy of Gilles Deleuze. The article opens with a review of privacy literature before continuing to present privacy as an encounter with five different foci: what technologies bring into the encounter; who is related to privacy by implication; what...
Andersen, Lars Bo; Bøge, Ask Risom; Danholt, Peter
Privacy is a major concern when new technologies are introduced between public authorities and private citizens. What is meant by privacy, however, is often unclear and contested. Accordingly, this article utilises grounded theory to study privacy empirically in the research and design project....... An argument which is further qualified through the philosophy of Gilles Deleuze. The article opens with a review of privacy literature before continuing to present privacy as an encounter with five different foci: what technologies bring into the encounter; who is related to privacy by implication; what...... Teledialogue aimed at introducing new ways for public case managers and placed children to communicate through IT. The resulting argument is that privacy can be understood as an encounter, that is, as something that arises between implicated actors and entails some degree of friction and negotiation...
Jacob, C J; Powell, D A
Foodservice professionals, politicians, and the media are often cited making claims as to which locations most often expose consumers to foodborne pathogens. Many times, it is implied that most foodborne illnesses originate from food consumed where dishes are prepared to order, such as restaurants or in private homes. The manner in which the question is posed and answered frequently reveals a speculative bias that either favors homemade or foodservice meals as the most common source of foodborne pathogens. Many answers have little or no scientific grounding, while others use data compiled by passive surveillance systems. Current surveillance systems focus on the place where food is consumed rather than the point where food is contaminated. Rather than focusing on the location of consumption-and blaming consumers and others-analysis of the steps leading to foodborne illness should center on the causes of contamination in a complex farm-to-fork food safety system.
Høybye, Mette Terp; Tjørnhøj-Thomsen, Tine
Based on extensive ethnographic material from in-depth interviews with Danish cancer patients after treatment, this study analyzes their stories to explore how interactions with the physician configures and situates a need for rehabilitation. We identify three themes in the illness stories: (1...... by this encounter. The significance of the social encounters in cancer treatment is elucidated through this analysis, and we demonstrate how the need for recognition of the complex effects of cancer on one's life is central to counter experiences of objectification and dehumanization....
Desai, Jyotika; Winter, Aaron; Young, Karen W H; Greenwood, Carol E
To compare energy intakes in seniors with cognitive impairment residing in long-term care and receiving meals by bulk (cafeteria style with waitress service) vs traditional tray delivery systems and determine subject characteristics that identify responsiveness to type of foodservice provided. DESIGN AND SUBJECTS/SETTING: Usual energy intakes were compared in subjects residing in cognitive impairment units in either the old (tray delivery, n=23) or new (bulk delivery, n=26) nursing home at Baycrest, a teaching facility associated with University of Toronto Medical School. Changes to foodservice and physical environment (from institutional to more home-like environment). Twenty-one consecutive day investigator-weighed energy and macronutrient intakes and behavioral function (London Psychogeriatric Rating Scale). Analysis of variance determined mean differences in intake and regression analyses identified predictors of sensitivity to type of food delivery systems. Higher 24-hour total (P<0.001) and dinner (P<0.001) energy intakes in subjects receiving bulk compared to tray delivery were predominantly associated with greater carbohydrate intakes (P<0.001). Higher energy, carbohydrate, and protein, but not fat intakes, with bulk delivery were more apparent in individuals with lower body mass indexes (BMIs) (food delivery by BMI interaction, all P values <0.05). High-risk, cognitively impaired individuals with low BMI benefited the most from the changed foodservice and physical environment, whereas individuals with higher BMIs did not show substantive changes in intake. Bulk foodservice and a home-like dining environment optimize energy intake in individuals at high risk for malnutrition, particularly those with low BMIs and cognitive impairment.
The objectives of the study were to investigate job burnout and leader-member exchange (LMX) levels as well as to evaluate buffering effects of LMX on burnout among dietitians and chefs at institutional foodservices. Hypotheses were proposed based on the Job Demands-Resources model and LMX theory. The study population consisted of dietitians and chefs who were in charge of managing unit operations in a nationwide contract management company. Positive/negative affectivity, workload, job burnou...
Preparation Kitchen Safety: Preventing Machine Injuries Basic Nutrition Food Poisoning - Preventatives MEAN 5.29 5.68 5.01 5.17 MM MÜ ■ttüiüüii...Presentation Creative Cooking Nutrition Baking Accident Prevention MSs CITING (%) 29 26 16 16 16 13 10 1 Percents are based on only the 31 MSs...foodservice training are listed below. Commercial Sources. National Educational Media, Inc., 21601 Devonshire Street, Chatsworth, VA 91311. Culinary
In this PhD thesis spatial production becomes a common matter among employees and architects. From an ideal that issues and questions develops in the engagement with a work context it is exemplified and explored how design grows out of encounters between people and things. In that relation the th...
Juul, Annegrete; Langstrup, Henriette
As already recognized, though little theorized within International Relations, the capacity of technology to ensure the achievement of preset policy goals is often grossly overrated. Drawing on Science and Technology Studies, this chapter proposes a lens to investigate global encounters, which ta...
Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
Leer, Jonatan; Kjær, Katrine Meldgaard
In this article, we examine the ways in which the encountering of 'other' food cultures is played out in the two travelogue cooking shows Gordon's Great Escape and Jamie's Italian Escape. We investigate how the two protagonist chefs Jamie Oliver and Gordon Ramsay imagine, meet and evaluate the ‘o...... approach to meeting the other (culinary culture), ultimately, their respective culinary adventures work to re-affirm a social hierarchy in their favor....
Lykke Hindhede, Anette
This article addresses the social power variations in the context of audiological rehabilitation. The empirically based study examines the everyday interaction between professional medicine and the patient when hearing aids are being provided. By the use of video recordings an analysis is conducted...... patients are allowed to bring to the audiological encounter. Bureaucratic time imperatives preclude patients' subjective experiences and standardised, normative accountabilities based on scientific knowledge work as an effective structuring principle to get the work done in the appropriate time....
Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed
The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.
Roberts, S; Marshall, A P; Gonzalez, R; Chaboyer, W
Active patient involvement in nutrition care may improve dietary intakes in hospital. Our team is developing an innovative programme allowing patients to self-assess and self-monitor their nutrition at the bedside. The present study aimed to assess usability and patient perceptions of an electronic foodservice system (EFS) for participating in nutrition care. This qualitative study was conducted in an Australian tertiary hospital. Participants were sampled purposively and included patients who were able to provide informed consent and communicate in English. Patient interviews were conducted at the bedside and consisted of: (i) usability testing of the EFS using 'Think Aloud' technique and (ii) questioning using a semi-structured interview guide to understand perceptions of the EFS. Interview data were analysed using inductive content analysis. Thirty-two patients were interviewed. Their perceptions of using the EFS to participate in nutrition care were expressed in five categories: (i) Familiarity with technology can affect confidence and ability but is not essential to use EFS; (ii) User interface design significantly impacts EFS usability; (iii) Identifying benefits to technology increases its acceptance; (iv) Technology enables participation, which occurs to varying extents; and (v) Degree of participation depends on perceived importance of nutrition. Patients found the EFS acceptable and acknowledged benefits to its use. Several factors appeared to influence usability, acceptability and willingness to engage with the system, such as user interface design and perceived ease of use, benefits and importance. The present study provides important insights into designing technology-based interventions for engaging inpatients in their nutrition care. © 2017 The British Dietetic Association Ltd.
Martinsen, Dorte Sindbjerg; Vasev, Nikolay Rumenov
This article examines the institutional output and preliminary outcome of the EU Patients' Rights Directive in two health care models: the Beveridge and Bismarck models in Denmark and Bulgaria, respectively. The study applies a most dissimilar system design to explain a similar transposition output...... through three explanatory variables, namely, institutional misfit, salience and administrative resources. We find that Denmark and Bulgaria have transposed the Directive in protectionist and minimalistic ways, thus far leading to a low outcome, i.e. low patient outflow. The encounter between the EU...
Koning, Juliette; Ooi, Can-Seng
from these encounters. Un-paralyzing reflexivity means to include the awkward, the emotional, and admit the non-rational aspects of our ethnographic experiences; such inclusive reflexivity is incredibly insightful. Research limitations/implications – Inclusive reflexivity not only allows room...... (Koning), and visiting an artist village in China (Ooi). Based on analysing their awkwardness, and in the context of a critical assessment of the reflexive turn in ethnography, the authors propose a more inclusive reflexivity. The paper ends with formulating several points supportive of reaching inclusive...
Christiansen, Lene Bull
). This paper proposes to study cultural encounters which are organised around ideals of cultural difference as a positive social and political force. The Danish People to People NGO Mellemfolkeligt Samvirke (MS) is build around ideals of equality, co-operation, mutuality and solidarity between people...... framework for an investigation into MS’ organisation of what I have termed ‘the idealized cultural encounter’, while also questioning the ways in which ‘culture’ is envisioned in contexts where ‘encounter’ is seen as a positive and desirable force....
Yates, S C; Shanklin, C W; Gorman, M A
The purpose of this research was to determine competencies of foodservice directors/managers as required by health care administrators and to ascertain the degree to which dietetic curriculums address those competencies. Validated questionnaires were mailed to a random sample of 376 health care administrators and 154 dietetic educators from various types of educational programs. Each questionnaire included 57 competencies representing the following areas: financial, technical, personnel management, nutrition services, production, and marketing. Health care administrators were asked to rate the degree of importance for each competency. Dietetic educators assessed the degree to which each competency was addressed in their curriculums. Of the 288 returned questionnaires, 243 contained usable data. Health care administrators' mean ratings were compared with dietetic educators' mean ratings. Significant differences were noted in 44 of the 57 competencies. Dietetic educators placed significantly greater emphasis on competencies related to nutrition services and significantly less on financial competencies than did health care administrators. Significant differences also were observed for selected competencies classified as technical and production. Results indicated that dietetic educators must continually evaluate curriculums and respond to the changing needs of the health care industry.
Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth
reactions. It is essential that the faculties prepare and guide the students before, during and after the professional care encounter to assist the development of educational strategies to prevent attrition and to the topic “The Established Relationship between the Nurse and Patient” curricula...... are challenged by their personal boundaries in the professional care encounter and they experience a great psychological impact Patient contact is an unavoidable and complex component in the nursing education. The students have not yet built up a professional filter and are exposed to a wealth of emotional......To prepare and guide the nursing students through their clinical periods, evidence on the students’ experiences of professional care encounters in a hospital unit, is required. A systematic review following The Joanna Briggs Institute guidelines. Five qualitative research articles were included...
, as sociologists, need to take everyday life seriously. This is the objective of this book. Encountering the Everyday: An Introduction to the Sociologies of the Unnoticed provides the first comprehensive and updated globally applicable introduction to everyday life sociology for many years. The contributors...... and the absurdists. Finally, a section deals with the most recent approaches such as the specifically Scandinavian everyday life perspectives, the sociology of emotions, social semiotics, cultural studies and postmodern interpretive interactionism. The chapters all accessibly introduce the reader to the ‘core......' of these traditions and perspectives and provide an entry-point for students and scholars alike into the world of the everyday. The book is edited by Michael Hviid Jacobsen, PhD, Associate Professor of Sociology and Director of Studies at Aalborg University, Denmark. He has previously published books on everyday life...
Chang, Hye-Ja; Kim, Jeong-Won; Ju, Se-Young; Go, Eun-Sun
In order to create a worker-friendly environment for institutional foodservice, facilities operating with a dry kitchen system have been recommended. This study was designed to compare the work safety and work environment of foodservice between wet and dry kitchen systems. Data were obtained using questionnaires with a target group of 303 staff at 57 foodservice operations. Dry kitchen facilities were constructed after 2006, which had a higher construction cost and more finishing floors with anti-slip tiles, and in which employees more wore non-slip footwear than wet kitchen (76.7%). The kitchen temperature and muscular pain were the most frequently reported employees' discomfort factors in the two systems, and, in the wet kitchen, "noise of kitchen" was also frequently reported as a discomfort. Dietitian and employees rated the less slippery and slip related incidents in dry kitchens than those of wet kitchen. Fryer area, ware-washing area, and plate waste table were the slippery areas and the causes were different between the functional areas. The risk for current leakage was rated significantly higher in wet kitchens by dietitians. In addition, the ware-washing area was found to be where employees felt the highest risk of electrical shock. Muscular pain (72.2%), arthritis (39.1%), hard-of-hearing (46.6%) and psychological stress (47.0%) were experienced by employees more than once a month, particularly in the wet kitchen. In conclusion, the dry kitchen system was found to be more efficient for food and work safety because of its superior design and well managed practices.
and two desserts . In designing the menu, consideration was given to the basic menu planning principles of color, shape, flavor, acceptability...cost using available raw ingredient price lists. The convenience foodservice system combined both convenience and selected conventional food costs...prepared by using ingredients in convenience form. For example, cole slaw could be prepared from precut cabbage, onions end other fresh vegetables
A practicum was conducted to examine and improve the performance of students enrolled in a college of culinary arts on the National Restaurant Association Foodservice (NRAF) sanitation certification examination. Because the pass rate among students retaking the examination was lower than that among students taking the examination for the first…
Smith, Leonard; Pezzullo, Caroline
The lack of visible career paths was universally recognized as a major factor leading to the extraordinarily high rate of turnover and absenteeism in the foodservice industry. The report evaluates the potential of a National Trade Association as a vehicle for improvements in this area and focuses on National Restaurant Association (NRA) efforts in…
treatment modality. Design: It is a retrospective study of all conﬁrmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically conﬁrmed ...
The objectives of the study were to investigate job burnout and leader-member exchange (LMX) levels as well as to evaluate buffering effects of LMX on burnout among dietitians and chefs at institutional foodservices. Hypotheses were proposed based on the Job Demands-Resources model and LMX theory. The study population consisted of dietitians and chefs who were in charge of managing unit operations in a nationwide contract management company. Positive/negative affectivity, workload, job burnout, and LMX scales that had been validated in previous research were adopted. A total of 552 questionnaires were distributed and 154 responses were returned. Results indicated that respondents' burnout levels were moderate and emotional exhaustion was greater than cynicism. In terms of LMX, the surveyed dietitians and chefs showed higher respect toward their supervisors than loyalty. When positive affectivity and negative affectivity were controlled, workload influenced emotional exhaustion and professional efficacy significantly. With affectivity and workload controlled, however, LMX did not influence any dimensions of burnout. The moderating effect of LMX on the relationship between workload and cynicism was significant. That is, the effect of workload on cynicism was weak if the dietitians and chefs perceived the relationship with their supervisor positively. Based on the findings and literature reviewed, how to mitigate job burnout among foodservice managers is discussed.
Holopainen, Gunilla; Nyström, Lisbet; Kasén, Anne
The concept 'encounter' occurs in caring literature as a synonym for dialogue and relation describing deeper levels of interaction between patient and nurse. In nursing and caring research, the concept 'caring encounter' is often used without further reflection on the meaning of the concept. Encounters are, however, continuously taking place in the world of caring, which calls for a clarification of the concept. This study is an analysis of the concept of caring encounter in nursing from the patients' and nurses' point of view. Rodgers' evolutionary view guided the concept analysis within the theoretical perspective of caritative caring. Peer-reviewed articles in English published between 1990 and 2014 were retrieved from the databases: CINAHL, PubMed, Web of Science, ScienceDirect (Elsevier), Springer Link, Primo Central (Ex Libris) and Academic Search Premier (EBSCO) using different combinations of encounter, caring and nursing as keywords. In all, 28 articles related to caring encounters were included in the analysis after applying inclusion and exclusion criteria. Ethical considerations: This study was conducted according to good scientific practice. Four antecedents to the caring encounter are found in the nurse's way of being: a reflective way of being; openness, sensitivity, empathy and ability to communicate; confidence, courage and professionalism; and showing respect and supporting dignity. The attributes are as follows: being there, uniqueness and mutuality. As a consequence, the caring encounter influences both patient and nurse. The caring encounter is an encounter between two equal persons where one is nurse and the other is patient. They encounter in mutuality, in true presence, and both have allowed themselves to be the person they are. The results clarify the conceptual differences between relationship and caring communion as the mutuality in the caring encounter differs from the dependence on the other pronounced in the relationship.
. Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise......- sick-leave and work-related injuries....
National Aeronautics and Space Administration — added ARCHIVE_STATUS, ,This data set contains the R_EDR data for the Galileo Orbiter PPR instrument for the period corresponding to the Venus encounter observations...
National Aeronautics and Space Administration — added ARCHIVE_STATUS, ,This data set contains the RDR data for the Galileo Orbiter PPR instrument for the period corresponding to the Venus encounter observations in...
This article is an expanded version of a book review which originally appeared in "Self & Society." In it the author criticizes the methodology and findings of Lieberman, Yalom, and Miles on their book about encounter groups. (Editor/RK)
Shawver, Lois; Pines, Ayala
This study examines value-attribution found in encounter groups. Group members tend to refer to themselves in neutralizing negative valuations. Group leaders were negative in describing group members. Published group transcripts are more positive than unpublished, private transcripts. (MFD)
Full Text Available As the archives from the second half of Grotowski’s life were made available, this text focuses on the Polish master’s conceptions of theatre where he describes theatre as the art of the encounter. This paper simultaneously places this proposition in the context of questions of a specific time period, and reveals how this encounter is the anathema that will revert viewpoints both about the art of acting and the creation of theatrical relations. These researches on theatre as the art of the encounter continue today through the Open Program, one of the two groups of the Workcenter of Jerzy Grotowski and Thomas Richards, and, notably, their creations around American poet Allen Ginsberg, an author whose poetry intends, in a similar way, to encounter the other and the world.
Ferenchick, Gary; Mohmand, Asad; Mireles, Jesus; Solomon, David
Patient encounter logs help assess a student's educational experience. The use of a grading incentive linked to the mandatory documentation of prespecified clinical encounters has been insufficiently studied. Given this, our objectives were to determine (a) if mandating student exposure to patients with 18 key training problems leads to the successful documentation of these encounters, (b) the degree of difficulty students and clerkship directors experienced in meeting these mandates, (c) the accuracy of mandated log entries, and (d) how often the log entries were questioned or rejected by preceptors. Ninety-two 3rd-year internal medicine students and 6 internal medicine clerkship directors at 9 geographically dispersed hospitals and 30 ambulatory sites participated in the study. Over a single academic year, we directly measured the completion rate of mandated logs, the degree of their accuracy as judged against faculty-generated logs of two required videotaped standardized patient encounters, and the percentage of logs that were not validated. We surveyed students and directors on the perceived degree of difficulty in meeting mandated requirements. Ninety-eight percent of students met our mandated requirements and 93.8% of students found it "easy" or "very easy" to meet this requirement. The amount of estimated time spent by clerkship directors helping students meet mandated requirements for the entire year was 4.5 hr. The accuracy of submitted logs was 77%; however, almost all inaccurate log entries were "validated" by preceptors. Mandating encounters is effective in assuring that students document encounters with patients who present with specific clinical problems. The accuracy of our students' mandated logs is similar to previously published data. However, even inaccurate logs were rarely questioned or rejected by preceptors.
Jennifer E. Gaddis
Full Text Available School foodservice is a form of reproductive labor, which is a term meant to encompass various kinds of work—mental, manual, and emotional—aimed at providing the historically and socially, as well as biologically, defined care necessary to maintain existing life and to reproduce the next generation. The increasing reliance on part-time work, convenience foods, and privatization that began in the early 1970s prevents many lunchroom workers’ from performing critical acts of reproductive labor. The unintended consequences of this transformation are now becoming clear in terms of the quality of food served in the nation’s lunchrooms, the nature of school foodservice labor, and the ecological consequences of the industrial food system. For a radical food politics, reversing the devaluing and deskilling of school foodservice provides a tremendous opportunity to engage both workers and students in pursuit of a just and sustainable food system. Much is at stake – over thirty million children participate in the National School Lunch Program each day. Thus the critical question becomes one of how such a radical revaluing and reskilling can be initiated. One possible avenue is through organized labor. In this article, I analyze early efforts to drive such a transformation, drawn from twelve months of participatory research with UNITE HERE! during their “Real Food, Real Jobs” campaigns in three U.S. cities.
Park, Eun A; Chae, In Sook; Jo, Mi Na
The purpose of this study was to analyze foodservice operation, dietary life education, and nutrition counseling tasks of nutrition teachers and dietitians in elementary, middle, and high schools in Jeju, Korea, and to provide effective ways to implement dietary life education and nutrition counseling in schools. This study surveyed 94 nutrition teachers and 46 dietitians working at elementary, middle, and high schools in Jeju during 7–14 May 2015. The importance and performance of 16 tasks of nutrition teachers and dietitians were measured using questionnaires. The data was analyzed by using the SPSS software and Importance–Performance Analysis (IPA). Importance was ranked in the order of foodservice operation (4.72), dietary life education (4.37), and nutrition counseling (4.24); and performance was ranked in the order of foodservice operation (4.48), dietary life education (3.70), and nutrition counseling (3.22). The importance–performance matrix showed that in Quadrant 4, the “Concentrate Here” item was “nutrition and dietary life education for students”, while in Quadrant 2, the “Possible Overkill” item was “cost control and office management”. These findings suggest that it is important to reduce unnecessary administrative and office management tasks in order for nutrition teachers and dietitians to implement effective nutrition education, dietary life education, and nutrition counseling programs. PMID:29065495
Park, Eun A; Chae, In Sook; Jo, Mi Na
The purpose of this study was to analyze foodservice operation, dietary life education, and nutrition counseling tasks of nutrition teachers and dietitians in elementary, middle, and high schools in Jeju, Korea, and to provide effective ways to implement dietary life education and nutrition counseling in schools. This study surveyed 94 nutrition teachers and 46 dietitians working at elementary, middle, and high schools in Jeju during 7-14 May 2015. The importance and performance of 16 tasks of nutrition teachers and dietitians were measured using questionnaires. The data was analyzed by using the SPSS software and Importance-Performance Analysis (IPA). Importance was ranked in the order of foodservice operation (4.72), dietary life education (4.37), and nutrition counseling (4.24); and performance was ranked in the order of foodservice operation (4.48), dietary life education (3.70), and nutrition counseling (3.22). The importance-performance matrix showed that in Quadrant 4, the "Concentrate Here" item was "nutrition and dietary life education for students", while in Quadrant 2, the "Possible Overkill" item was "cost control and office management". These findings suggest that it is important to reduce unnecessary administrative and office management tasks in order for nutrition teachers and dietitians to implement effective nutrition education, dietary life education, and nutrition counseling programs.
Sheng, Jian; Molaei, Mehdi
Encountering of microorganisms with rising oil droplets in aqueous environments is the first and one of the critical steps in the biodegradation of crude oil. Several factors such as droplet sizes, rising velocity, surfactant, and motility of bacteria are expected to affect the encounter rate. We establish well controlled microfluidic devices by applying layer-by-layer technique that allows us to produce horizontal micro droplets with different sizes. The encounter rates of passive particles, motile and non-motile bacteria with these droplets are measured by high speed microscopy. The effects of mobility and motility of these particles on encounter rates are assessed quantitatively. Meanwhile, we visualize reorientation of the particle due to flow filed around the oil droplet. Results show that the motile bacteria have higher probabilities to interact with an oil droplet compare to the passive particles. Ongoing analyses focus on the effect of shear rates, angular dispersion, curvatures of streamlines, and the swimming velocity of bacteria. The ratios of the encounter area to the entire droplet surface at various flow regimes will also been measured. GoMRI.
this by examining the materials and types of knowledge that participate in shaping local community work practices and encounters between local community workers and residents in marginalized housing areas. Through this analysis, I argue that social work research can benefit from orienting itself more concretely......Encountering social work through STS: Marginalization, materials and knowledge In this presentation, I attempt to produce an encounter between STS and social work. Concretely, I focus on the subset of social work called “local community work”, which in Denmark is used to intervene on marginalized...... housing areas. The Danish state and its municipalities diligently track and monitor the statistics of social housing areas. Using “parameters of marginalization” such as ethnicity, income, unemployment and education, topographical depictions of social issues in certain areas are constituted and used...
Stone, E. C.
In 1972, the Voyager Program was undertaken by NASA as a major step in the exploration of the outer solar system. Recently the objectives of this program have been extended to include an investigation of Uranus and possibly Neptune. In connection with the present investigation, a brief description of the Voyager spacecraft is presented and an overview of the scientific results from the Saturn encounters is provided. Two essentially identical Voyager spacecraft were launched in 1977 toward encounters with the Jovian and Saturnian planetary systems. The Voyager 1 trajectory at Saturn was chosen to provide a close encounter with Titan, a planet-sized satellite with an atmosphere, and to provide an optimum geometry for dual-frequency radio occultation studies of Saturn's rings. The Voyager 2 trajectory provided improved viewing of the rings.
To identify food-safety educational goals for dietetics and hospitality management students. Written questionnaires were used to identify educational goals and the most important food safety competencies for entry-level dietitians and foodservice managers. The sample included all directors of didactic programs in dietetics approved by the American Dietetic Association and baccalaureate-degree hospitality programs with membership in the Council on Hotel, Restaurant, and Institutional Education. Fifty-one percent of the directors responded. Descriptive statistics were calculated. chi 2 analysis and independent t tests were used to compare educators' responses for discrete and continuous variables, respectively. Exploratory factor analysis grouped statements about food safety competence. Internal consistency of factors was measured using Cronbach alpha. Thirty-four percent of dietetics programs and 70% of hospitality programs required or offered food safety certification. Dietetics educators reported multiple courses with food safety information, whereas hospitality educators identified 1 or 2 courses. In general, the educators rated food-safety competencies as very important or essential. Concepts related to Hazard Analysis and Critical Control Points (HAACP), irradiation, and pasteurization were rated less highly, compared with other items. Competencies related to reasons for outbreaks of foodborne illness were rated as most important. Food safety certification of dietitians and an increased emphasis on HAACP at the undergraduate level or during the practice component are suggested. Research is recommended to assess the level of food-safety competence expected by employers of entry-level dietitians and foodservice managers.
Antologien præsenterer det NOS-HS-finansierede forskningsnetværk "Encountering Foreignness" gennem eksempler på den forskning medlemmerne har produceret i forbindelse med arbejdet i netværket. Den meget forskelligartede samling af tekster viser, hvor bred netværkets spændvidde har været. Der...
[Interpersonal relationships: perception of the communication, treatment and adverse experiences encountered by users of medical units that belong to the Coordinating Commission of the National Institutes of Health and High Specialty Hospitals (CCINSHAE)].
Arroyo-Valerio, América Guadalupe Guadalupe; Cortés-Poza, David; Aguirre Hernández, Rebeca; Fuentes García, Ruth; Ramírez de la Roche, Omar Fernando; Hamui Sutton, Alicia
User's perception with regard to the attention they received in healthcare units is increasingly being taken into account by the health service providers in order to improve the quality of their service. Describe how the users perceive the health services provided by the CCINSHAE with regard to the communication with the physicians, the attention of the staff and the adverse personal and institutional experiences and to explore their relation with user's demographic characteristics, health condition, physical limitations to carry out daily activities and service area. A questionnaire was designed to collect information about the user and his/her opinion with regard to the healthcare units, the communication with the physicians, the attention of the staff and the adverse personal and institutional experiences. The data were analyzed with STATA using sample weights. A total of 2,176 individuals were interviewed after they had received attention and represent a population of 1,457,964 users, over 6 months, of the CCINSAHE. We then calculated four binary variables that reflect the perception of the users. These four variables were significantly associated with the type of health unit where the user received attention, schooling, limitations to carry out daily activities, facilities provided to the relatives, family income, the use of alternative medicine, and the area of attention. A fundamental aspect of the service provided by the healthcare institutions is the communication between the physicians and the users. We found that the perception of the users with regard to the communication with the physician, the attention of the staff, and the adverse personal and institutional experiences was associated with the type of healthcare unit. The federal reference hospitals produced the most unfavorable perception while the regional hospitals produced the most favorable impression. This study enables the decision-making personnel to determine what needs to be modified in
Alan E. Watson; Rich Cronn; Neal A. Christensen
Many managers face the challenge of monitoring rates of visitor encounters in wilderness. This study (1) provides estimates of encounter rates through use of several monitoring methods, (2) determines the relationship between the various measures of encounter rates, and (3) determines the relationship between various indirect predictors of encounter rates and actual...
Galal, Lise Paulsen
The concept of interfaith dialogue has been introduced and developed by scholars of different religions. The aim has been to find solutions from within religion to handle and optimise encounters with religious ‘Others’. Furthermore, interfaith dialogue has increasingly become a tool to solve...... problems of integration and geopolitical conflicts. Thus the focus has changed from religion as the solution to an ontologically given differentiation, to religion being the problem that must be transgressed in order to meet on equal terms. In this paper, I discuss the setup of interfaith dialogue meetings...... at the same time changing themselves into better – more tolerant – human beings....
Special relativity provides the foundations of our knowledge of space and time. Without it, our understanding of the world, and its place in the universe, would be unthinkable. This book gives a concise, elementary, yet exceptionally modern, introduction to special relativity. It is a gentle yet serious 'first encounter', in that it conveys a true understanding rather than purely reports the basic facts. Only very elementary mathematical knowledge is needed to master it (basichigh-school maths), yet it will leave the reader with a sound understanding of the subject. Special Relativity: A First
This study presents a compilation of 24 cases involving general aviation (GA) pilots weather encounters over the : continental U.S. The project team interviewed pilots who had experienced a weather encounter, and we : examined their backgrounds, f...
Bloom, Thomas A.
A survey was conducted of students in 77 of the 144 two-year foodservice management programs in the United States to assess their knowledge of and attitudes toward fast food restaurant management as compared to full service restaurant management. A total of 1,403 students from 44 programs responded. Results indicated that the food service…
G. Wright; J.J. Dekker
The initial encounter between a buyer and a seller has received much attention among practitioners. The first time a buyer interacts with a seller is thought to be highly influential. The premise is that buyers form an opinion during this first encounter, or even the first minutes of this encounter.
Other moderately occurring, disorders included dystocia & post partum complications 14(2.2%) each, mal-directed horn/hooves 12(1.9%), tick infestation 10(1.6%), coccidiosis 9(1.4%), fracture 8(1.3%), hernia, PPR, pregnancy toxemia & castration 7(1.1%) each. Poisoning, infectious coryza, arthritis, rumen impaction ...
It has been nearly 100 years since the Apollo moon landings, when Jack and Vladimir, two astronauts on a mission to Venus, discover a mysterious void related to indigenous life on the planet. Subsequently more voids are detected on Earth, Mars, Titan, and, quite ominously, inside a planetoid emerging from the Kuiper belt. Jack is sent to investigate the voids in the Solar System and intercept the planetoid - which, as becomes increasingly clear, is inhabited by alien life forms. Jack and his crew will have little time to understand their alien biochemistry, abilities, behavior patterns, resilience, and technology, but also how these life forms relate to the voids. Humankind's first encounter with these exotic life forms couldn't be more fateful, becoming a race against time to save life on Earth and to reveal the true nature of the voids, which seem to be intrinsically related to life and the universe itself. In this novel, the author combines many topics related to state-of-the-art research in the field of...
Geller, Aaron M.; Leigh, Nathan W. C.
Strong encounters between single stars and binaries play a pivotal role in the evolution of star clusters. Such encounters can also dramatically modify the orbital parameters of binaries, exchange partners in and out of binaries, and are a primary contributor to the rate of physical stellar collisions in star clusters. Often, these encounters are studied under the approximation that they happen quickly enough and within a small enough volume to be considered isolated from the rest of the cluster. In this paper, we study the validity of this assumption through the analysis of a large grid of single-binary and binary-binary scattering experiments. For each encounter we evaluate the encounter duration, and compare this with the expected time until another single or binary star will join the encounter. We find that for lower-mass clusters, similar to typical open clusters in our Galaxy, the percent of encounters that will be “interrupted” by an interloping star or binary may be 20%-40% (or higher) in the core, though for typical globular clusters we expect ≲1% of encounters to be interrupted. Thus, the assumption that strong encounters occur in relative isolation breaks down for certain clusters. Instead, many strong encounters develop into more complex “mini-clusters,” which must be accounted for in studying, for example, the internal dynamics of star clusters, and the physical stellar collision rate.
Geller, Aaron M. [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and Department of Physics and Astronomy, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208 (United States); Leigh, Nathan W. C., E-mail: firstname.lastname@example.org, E-mail: email@example.com [Department of Astrophysics, American Museum of Natural History, Central Park West and 79th Street, New York, NY 10024 (United States)
Strong encounters between single stars and binaries play a pivotal role in the evolution of star clusters. Such encounters can also dramatically modify the orbital parameters of binaries, exchange partners in and out of binaries, and are a primary contributor to the rate of physical stellar collisions in star clusters. Often, these encounters are studied under the approximation that they happen quickly enough and within a small enough volume to be considered isolated from the rest of the cluster. In this paper, we study the validity of this assumption through the analysis of a large grid of single–binary and binary–binary scattering experiments. For each encounter we evaluate the encounter duration, and compare this with the expected time until another single or binary star will join the encounter. We find that for lower-mass clusters, similar to typical open clusters in our Galaxy, the percent of encounters that will be “interrupted” by an interloping star or binary may be 20%–40% (or higher) in the core, though for typical globular clusters we expect ≲1% of encounters to be interrupted. Thus, the assumption that strong encounters occur in relative isolation breaks down for certain clusters. Instead, many strong encounters develop into more complex “mini-clusters,” which must be accounted for in studying, for example, the internal dynamics of star clusters, and the physical stellar collision rate.
Liang, Di; Li, Xiang; Zhang, Yi-Qing
Familiar strangers, pairs of individuals who encounter repeatedly but never know each other, have been discovered for four decades yet lack an effective method to identify. Here we propose a novel method called familiar stranger classifier (FSC) to identify familiar strangers from three empirical datasets, and classify human relationships into four types, i.e., familiar stranger (FS), in-role (IR), friend (F) and stranger (S). The analyses of the human encounter networks show that the average number of FS one may encounter is finite but larger than the Dunbar Number, and their encounters are structurally more stable and denser than those of S, indicating the encounters of FS are not limited by the social capacity, and more robust than the random scenario. Moreover, the temporal statistics of encounters between FS over the whole time span show strong periodicity, which are diverse from the bursts of encounters within one day, suggesting the significance of longitudinal patterns of human encounters. The proposed method to identify FS in this paper provides a valid framework to understand human encounter patterns and analyse complex human social behaviors.
Kelly Lameiro Rodrigues
Full Text Available The aims of this study were to investigate the hygienic practices in the food production of an institutional foodservice unit in Southern Brazil and to evaluate the effect of implementing good food handling practices and standard operational procedures using microbiological hygiene indicators. An initial survey of the general operating conditions classified the unit as regular in terms of compliance with State safety guidelines for food service establishments. An action plan that incorporated the correction of noncompliance issues and the training of food handlers in good food handling practices and standard operational procedures were then implemented. The results of the microbiological analysis of utensils, preparation surfaces, food handlers' hands, water, and ambient air were recorded before and after the implementation of the action plan. The results showed that the implementation of this type of practice leads to the production of safer foods.
Pioneer 10 space probe's encounter with the Jupiter is discussed in detail. Tables are presented which include data on the distances during the encounter, times of crossing satellite orbits, important events in the flight near Jupiter, and time of experiments. Educational study projects are also included.
Sørensen, Jannick Kirk
When a digital service encounter develops differently than anticipated, the client becomes a user. This transformation reveals the ambiguous nature of digital service encounter being neither well-functioning tools, nor having the same sensitivity to and tolerance for service failures as in human...... service encounters. Through the case-study of a service failure and subsequent co-creation of the service recovery, this chapter introduces and unfolds the concept of 'cognitively dominated service encounters'. This category is suggested to supplement and criticise Paul Dourish's (2001) concept...... of Embodied Interaction. With a micro analysis of the interaction in this service journey, we identify the need for a category of knowledge intensive service encounters that acknowledge both the complexity of the service provided, but also the constraints and possibilities in the digital design material....
Sundbo, Jon; Sundbo, Donna; Henten, Anders
This article examines the factors affecting the innovativeness of service encounters – either as drivers or as barriers. The assumption is that a considerable number of innovations in service industries are initiated in service encounters and that employees are the core factor in connecting...... customers with the innovating organization. Based on literature studies and pilot case studies, seven propositions are proposed and tested in a qualitative, hermeneutic way in field experiments in nine service organizations. Important new results are that encounter-based innovation requires mutual empathy...
Connell, Linda J.; Taube, Elisa Ann; Drew, Charles Robert; Barclay, Tommy Earl
ASRS is conducting a structured callback research project of wake vortex incidents reported to the ASRS at all US airports, as well as wake encounters in the enroute environment. This study has three objectives: (1) Utilize the established ASRS supplemental data collection methodology and provide ongoing analysis of wake vortex encounter reports; (2) Document event dynamics and contributing factors underlying wake vortex encounter events; and (3) Support ongoing FAA efforts to address pre-emptive wake vortex risk reduction by utilizing ASRS reporting contributions.
Stone, E. C.; Miner, E. D.
An overview is presented of the encounter of Voyager 2 with the Saturnian system. Following an indication of the spacecraft trajectory through the Saturn system on its way to a 1986 encounter with Uranus, and the design and operation of the Voyager 2 scientific instruments, attention is given to the major scientific results of the encounters. These results include observations of similarities between the atmospheres of Saturn and Jupiter, studies of gaps in the rings and the eccentric ringlets within the gaps, imaging of the ring systems and satellites, particularly Phoebe, Iapetus, Hyperion, Tethys, Enceladus and the atmosphere of Titan, and studies of magnetospheric structures and dynamics responsible for Saturn radio emission.
Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth
OBJECTIVES: To identify, appraise and synthesize the best available evidence exploring nursing students' experiences of professional patient care encounters in a hospital unit. DESIGN: The Joanna Briggs Institute (JBI) guidelines were followed and a meta-synthesis was conducted. DATA SOURCES......; and clinical learning environment. CONCLUSIONS: We meta-synthesized that: Nursing students experienced personal inadequacy, vulnerability and a transformation during their patient care encounter....
Author severely criticized a book on encounter groups by Lieberman, Yalom, and Miles (1973) and stated that it was a methodological morass, theroetically obsolescent, and almost totally unjustified in its conclusions. (Author/RK)
peer) x xka (church), atx (suggestion). For a comparative study and better analysis, let us put the consonant sounds in a table/ chart. 75. 76. Ifeanyi S. Odinye. The Phonological Problems Encountered by Igbo Students in Chinese ...
Full Text Available [Purpose/significance] Under the “Internet +” ecology, information encountering is an important and efficient way to solve the problem of information acquisition. Therefore, the learning (encountered-information-based learning or EI-learning after information encountering is more meaningful. [Method/process] On the basis of literature review of information encountering theories and its models, this paper analyzed EI-learning from the perspective of Unicom and New-constructivism to build the EI-learning model and provided related countermeasures. [Result/conclusion] The EI-learning model includes six elements: information encountering, encountered information management, learning strategy, learning process, learning outcomes and learning to share. And this paper puts forward related countermeasures to promote the EI-learning, including: improving information literacy education, perfecting technology ecosystem, designing information community.
Full Text Available Drawing from my experience as an anthropologist working at the “Consulta do Migrante” at Hospital Miguel Bombarda in Lisbon, this text proposes a short reflection on the necessary dialogue between different fields of knowledge and different forms of relation to the Other, in a clinical setting. Problematizing the encounter with difference in an institutionalized service such as a hospital, the aim is to show the richness of the complex reality implicit in such an encounter between migrants and established health services.
Full Text Available Cutting-edge mobile devices like smartphones and tablets are equipped with various infrastructureless wireless interfaces, such as WiFi Direct and Bluetooth. Such technologies allow for novel mobile applications that take advantage of casual encounters between co-located users. However, the need to mimic the behavior of real-world encounter networks makes testing and debugging of such applications hard tasks. We present Termite, an emulation testbed for encounter networks. Our system allows developers to run their applications on a virtual encounter network emulated by software. Developers can model arbitrary encounter networks and specify user interactions on the emulated virtual devices. To facilitate testing and debugging, developers can place breakpoints, inspect the runtime state of virtual nodes, and run experiments in a stepwise fashion. Termite defines its own Petri Net variant to model the dynamically changing topology and synthesize user interactions with virtual devices. The system is designed to efficiently multiplex an underlying emulation hosting infrastructure across multiple developers, and to support heterogeneous mobile platforms. Our current system implementation supports virtual Android devices communicating over WiFi Direct networks and runs on top of a local cloud infrastructure. We evaluated our system using emulator network traces, and found that Termite is expressive and performs well.
’s collaboration and how the institutional demands influence children’s collaborative encounters. The study is based on video recordings of paedagogical activities (workshops and circle times) in two Danish pre-schools over a period of 11 months. Although institutional demands challenge children’s initiatives......, it is found that children build friendships, assist, inspire, and imitate one another in their collaborative encounters in paedagogical activities. In order to better support children’s learning and engaged participation in paedagogical activities, an increased attention to the institutional demands...
Stone, E. C.
The instruments and science investigations of the Voyager 2 payload are listed in tables and illustrated with a drawing, and a general overview of the encounter with Uranus in January 1986 is given. The spacecraft approached to within 107,100 km of the center of Uranus, and to within 29,000 km of the Uranian satellite Miranda before continuing on for an encounter with Neptune in 1989; the trajectory also permitted radio occultation studies of the Uranian rings and radio and UV occultation studies of the planet's atmosphere. Diagrams of the trajectory are provided.
Stone, E. C.
The instruments and science investigations of the Voyager 2 payload are listed in tables and illustrated with a drawing, and a general overview of the encounter with Uranus in January 1986 is given. The spacecraft approached to within 107,100 km of the center of Uranus, and to within 29,000 km of the Uranian satellite Miranda before continuing on for an encounter with Neptune in 1989; the trajectory also permitted radio occultation studies of the Uranian rings and radio and UV occultation studies of the planet's atmosphere. Diagrams of the trajectory are provided.
Mattsson, Jan; Söderlund, Magnus
) the memorability of the service encounter and (b) the extent to which what had happened had been subject to rehearsal with the purpose of telling others about it. These findings should be seen in relation to the literature’s view that customer satisfaction, not thinking, is a dominant predictor of word......-of-mouth. Our results, however, indicate that satisfaction’s contribution to the variation in talking about the encounter was modest (and customer satisfaction played only a minor role in explaining why an encounter is thought about).......This study examines the impact of thinking about a service encounter, after it has been completed, on telling others about it (i.e., word-of-mouth). The main finding was that encounter-related thinking boosted word-of-mouth. We also found that the think-talk association was mediated by (a...
Conclusion: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.
Kinch, Sofie; Grönvall, Erik; Petersen, Marianne Graves
; a concert hall, an airport and a shopping mall. We gathered insights from more than 120 people, as they unexpectedly encountered the shape changing capabilities of the bench. By taking the user tests out of the lab and into the wild, we explored the influence of context on the users experience of a shape...
In this paper, I enter a crack to think otherwise about the concept "gossip". Drawing on previous scholarship engaging with Deleuzian concepts to inform research methodologies, this paper builds on this body of work. Following Deleuze and Guattari, the paper undertakes a mapping of gossip, subsequent to an encounter with a crack.…
In this article, the author John Volk, professor of Worldview Studies at Renaissance College, University of New Brunswick, Fredericton, New Brunswick, Canada, looks forward toward the November 2017 Religious Education Association Conference, which is entitled "Learning in Encounter: Crossroads, Connections, Collaborations", and says that…
This article reports a study on an encounter between preschoolers and contemporary photography. The article has two aims: first, it elucidates preschoolers' meaning-making when viewing photographs, and second, it investigates the possible benefits of using contemporary photography as a forum for prompting children's aesthetic agency in early…
Every day we encounter many threats to survival: a car speeding on a small street or an angry neighbor carrying an axe. Mostly, people go through their days not worrying that their chance of survival might be small. They avoid many dangers without even thinking about them (e.g., looking at both
Bell, David Raymond
This article discusses how museum settings can provide opportunities for sensory and aesthetic encounters and learning. It draws on research into museum education programmes that included examinations of curatorial construction and display, observations of teaching and open-ended interviews with museum educators. The examples selected here focus…
Andersson, Karin; Öhman, Johan
The overall aim of this article is to develop in-depth knowledge about the connection between outdoor experiences and moral attitudes towards nature. The study focuses on processes in which moral relations are at stake in encounters between students and nature. The purpose is to identify such events, describe their specific circumstances and…
Ali, Sirwan Kamil
Background and objective; There is growing recognition that violence against women has a large public health impact, in addition to being a gross violation of women's human rights. The study's aims were: To show the types of domestic abuse encountered by Kurdish women, and study the relationship between them. Methods; The study conducted in the…
Boundary transgressions tend to be conceptualized on a continuum ranging from boundary crossings to boundary violations. Boundary crossings (e.g. accepting an inexpensive holiday gift from a client, unintentionally encountering a client in public, or attending a client's special event) are described in the literature as ...
Simonsen, Kirsten; Koefoed, Lasse Martin
Starting from phenomenology's notion of orientation towards and involvement with the other and the surrounding environment the paper want to pursue a development from the meeting and opening up to the universalized other of phenomenology towards a focus on encounters with particular others...
Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth
in the review. Data were extracted and the findings were categorized and themed on the basis of similarity of meaning and aggregated to produce a comprehensive set of synthesized findings. The review process resulted in 55 findings and 14 categories. The categories generated six themes: Psychological reactions...... to keep the patients happy as they try to avoid conflicts. The imagination and thoughts of what might happen in the encounter are based on the nursing students’ personal life experiences. They uses their close relatives as keys to the express empathy in the establishment of the nurse-patient relation...... are challenged by their personal boundaries in the professional care encounter and they experience a great psychological impact Patient contact is an unavoidable and complex component in the nursing education. The students have not yet built up a professional filter and are exposed to a wealth of emotional...
Yildirim, Dilek; Yildirim, Aytolan; Timucin, Arzu
The term 'mobbing' is defined as antagonistic behaviors with unethical communication directed systematically at one individual by one or more individuals in the workplace. This cross-sectional and descriptive study was conducted for the purpose of determining the mobbing behaviors encountered by nursing school teaching staff in Turkey, its effect on them, and their responses to them. A large percentage (91%) of the nursing school employees who participated in this study reported that they had encountered mobbing behaviors in the institution where they work and 17% that they had been directly exposed to mobbing in the workplace. The academic staff who had been exposed to mobbing behaviors experienced various physiological, emotional and social reactions. They frequently 'worked harder and [were] more organized and worked very carefully to avoid criticism' to escape from mobbing. In addition, 9% of the participants stated that they 'thought about suicide occasionally'.
This study asks whether users’ encounter with normative discourses of lifestyle, consumption, and health on social media such as Facebook gives rise to agency. The theoretical framework draws on reception analysis, for its implied, but central interest in agency that lies at the intersection...... an explicit focus on the socio-cultural practices of ordinary audiences in their encounters with media discourses. The study investigates user agency on seven Facebook groups and pages with the help of a three-pronged perspective based on the notion of the media–audience relationship as (1) power structure......, (2) nexus, and (3) reception. The analysis reveals that the structure at play on these Facebook groups and pages does not encourage user agency. However, user agency manifests itself through user interactions and expressive sense-making processes associated with reception. The benefits...
In a globalized business environment, interaction across linguistic boundaries is becoming a normal part of everyday life. In these encounters language differences may affect the formation of social identities among organization members. While studies based on Social Identity Theory perceive...... on the encounter between expatriates and local employees of a Danish subsidiary in England. The findings show that identity making may be actualized by competition for resources and recognition. This can be done by investing certain objects such as the symbolic application of language with certain identifications...... the link between identity and language to be linear, this article takes a different approach. By drawing on anthropological theories on ethnic identity it is argued that the relation between language and social identity is negotiated in interaction. In the empirical analysis the article focuses...
Visser, Andre; Kiørboe, Thomas
distances to their prey, but short compared to the reaction distances of their predators. We show motility data for planktonic organisms ranging from bacteria to copepods that support this prediction. We also present simple ballistic and diffusive motility models for estimating encounter rates, which lead......Many planktonic organisms have motility patterns with correlation run lengths (distances traversed before direction changes) of the same order as their reaction distances regarding prey, mates and predators (distances at which these organisms are remotely detected). At these scales, the relative...... measure of run length to reaction distance determines whether the underlying encounter is ballistic or diffusive. Since ballistic interactions are intrinsically more efficient than diffusive, we predict that organisms will display motility with long correlation run lengths compared to their reaction...
Ottrey, Ella; Porter, Judi
Most patients in developed countries solely depend on the hospital menu to order their food. The provision of menu choices to patients differs between facilities. The purpose of this paper is to determine which strategies that provide menu choices to patients are effective in improving clinical and non-clinical outcomes in hospital. Five databases were searched to identify relevant publications. Prospective research published in English with the menu as the primary intervention was included. Study eligibility was determined and risk of bias assessed. Outcome data were combined narratively due to absence of homogeneous study design and outcomes. Of the 2,201 records screened, six studies met inclusion criteria. Standardised menu formatting and the spoken menu system were found to improve meal tray accuracy. The spoken menu and computerised interactive menu selector system enhanced aspects of patient satisfaction without cost increases. Descriptive menus may increase food consumption. Branding food items was not well supported by patients. One study rated positively for study quality with the remaining five studies receiving neutral quality ratings. The small number of studies conducted on each intervention and the quality of the evidence made it difficult to establish a solid evidence base around providing menu choices to patients. Further research is needed on menu ordering systems, including spoken and visual menus, to determine their impact on outcomes in hospital. This review is first to examine the effectiveness of menu interventions in hospital. Hospital foodservice departments should consider these findings when reviewing local systems.
Sørensen, Jannick Kirk; Henten, Anders
Innovations in services often emanate from service encounters (i.e. the touch points between the service producers and the customers). Two different types of service encounters are dealt with: face-to-face and ICT-based service encounters. The aim of the chapter is to examine the specific...... conditions for innovations from ICT-based service encounters. The service encounter research tradition is mostly concerned with customer satisfaction. The perspective of the present chapter is on innovations in the service encounter. The specific contribution of the chapter is to establish a conceptual...... foundation for innovations in ICT-based service encounters....
Rosenfeld, Lindsay E; Cohen, Juliana Fw; Gorski, Mary T; Lessing, Andrés J; Smith, Lauren; Rimm, Eric B; Hoffman, Jessica A
In autumn 2012, Massachusetts schools implemented comprehensive competitive food and beverage standards similar to the US Department of Agriculture's Smart Snacks in School standards. We explored major themes raised by food-service directors (FSD) regarding their school-district-wide implementation of the standards. For this qualitative study, part of a larger mixed-methods study, compliance was measured via direct observation of foods and beverages during school site visits in spring 2013 and 2014, calculated to ascertain the percentage of compliant products available to students. Semi-structured interviews with school FSD conducted in each year were analysed for major implementation themes; those raised by more than two-thirds of participating school districts were explored in relationship to compliance. Massachusetts school districts (2013: n 26; 2014: n 21). Data collected from FSD. Seven major themes were raised by more than two-thirds of participating school districts (range 69-100 %): taking measures for successful transition; communicating with vendors/manufacturers; using tools to identify compliant foods and beverages; receiving support from leadership; grappling with issues not covered by the law; anticipating changes in sales of competitive foods and beverages; and anticipating changes in sales of school meals. Each theme was mentioned by the majority of more-compliant school districts (65-81 %), with themes being raised more frequently after the second year of implementation (range increase 4-14 %). FSD in more-compliant districts were more likely to talk about themes than those in less-compliant districts. Identified themes suggest best-practice recommendations likely useful for school districts implementing the final Smart Snacks in School standards, effective July 2016.
Aylett, Tasha; Chipperfield, Martyn; Diego Carrillo Sánchez, Juan; Feng, Wuhu; Forster, Piers; Plane, John
Although a close encounter with a comet is extremely unlikely, a significant perturbation to the flux of Earth-bound dust from a comet's close passage could have huge implications for both the chemistry of the atmosphere and climate. For example, following the close passage of Comet Halley to Earth in A.D. 536, dark skies, reduced day lengths and a protracted global cooling were reported , for which an extraterrestrial disturbance is likely to be at least partly responsible. Indeed, the recent encounter of Comet Siding Spring with Mars provided evidence that the risks posed by such an event are significant . We have run sensitivity simulations using the Whole Atmosphere Community Climate Model (WACCM) with an elevated Meteoric Input Function (MIF) to investigate such an encounter - specifically, Comet Halley in A.D. 536. The simple analytical model developed by Moorhead et al.  has been incorporated into an atmospheric chemical ablation model to provide the MIF of several meteoric species (Na, Fe, Si, Mg and S) in the mesosphere and lower thermosphere (70-120 km) for input into WACCM. Key effects of this additional input on the chemistry of the upper atmosphere and the metal layers have been explored in the simulations and effects on mesospheric and stratospheric ozone chemistry have been assessed. In addition to any effects on atmospheric chemistry, WACCM will also be used to provide insight into the impacts of a high dust flux on the Earth's climate. References  Stothers, R. B. (1984), Mystery Cloud of Ad-536, Nature, 307(5949), 344-345.  Schneider, N. M., et al. (2015), MAVEN IUVS observations of the aftermath of the Comet Siding Spring meteor shower on Mars, Geophys Res Lett, 42(12), 4755-4761.  Moorhead, A. V., P. A. Wiegert, and W. J. Cooke (2014), The meteoroid fluence at Mars due to Comet C/2013 A1 (Siding Spring), Icarus, 231, 13-21.
The author approaches the works of Karl W. Deutsch from the position of a historian and presents three aspects of his own encounters with Deutsch’s writings. First, he describes how he applied some of the methodological principles in Deutsch’s concept of nation-building to his own research work. Second, he presents his opinion on the place Deutsch occupies in the evolution of ‘theories of nationalism’. Third, he reflects on how Deutsch’s The Nerves of Government can serve as a source of inspi...
This article investigates English conversation meetings at a grassroots integration initiative which targets improving the life situation of asylum seekers and refugees in Denmark. Contrary to similar initiatives which have been studied from an integration policy evaluation perspective, this study...... the intentional diversity fundamental to organised cultural encounters, seeing as the volunteers seek co-membership as a result of a particular oriented to difference in membership belongings among the participants. Since these English conversation meetings are transient by nature, a focus on managing...
Greenberg, R.; Belton, M.; Dejong, E.; Ingersoll, A.; Klaasen, K.; Geissler, P.; Moersch, J.; Thompson, W. R.
The recent flyby of the Galileo spacecraft en route to Jupiter contributes a unique perspective to our view of our home planet. Imaging activities conducted during the second Earth encounter provide an important opportunity to assess new methods and approaches on familiar territory. These include unique multispectral observations, low light-level imaging (searches for aurorae, lightning and artificial lights on the nightside) and experiments with multiple exposure times to extend the effective radiometric resolution and dynamic range of the camera system. Galileo imaging data has the potential to make important contributions to terrestrial remote sensing. This is because the particular set of filters included in the Solid State Imaging system are not presently incorporated in any currently operating Earth-orbiting sensor system. The visible/near-infrared bandpasses of the SSI filters are well suited to remote sensing of geological, glaciological, botanical, and meteorological phenomena. Data from this and the previous Earth encounter may provide an extremely valuable reference point in time for comparison with similar data expected from EOS or other systems in the future, contributing directly to our knowledge of global change. The highest resolution imaging (0.2 km/pixel) during the December, 1992 encounter occurred over the central Andes; a five filter mosaic of visible and near infrared bands displays the remarkable spectral heterogeneity of this geologically diverse region. As Galileo departed the Earth, cooperative imaging with the Near Infrared Mapping Spectrometer (NIMS) instrument targeted Antarctica, Australia, and Indonesia at 1.0 to 2.5 km/pixel resolutions in the early morning local times near the terminator. The Antarctic data are of particular interest, potentially allowing ice grain size mapping using the 889 and 968 nm filters and providing an important means of calibrating the technique for application to the Galilean satellites. As the spacecraft
Miller, L. J.; Savary, K. E.
Voyager 2 will make the first close observations of the planet Neptune, during the period from June 1 to October 1,1989. A number of flight engineering activities are being conducted in preparation for the encounter. This paper discusses the most significant of these activities: new image motion compensation techniques, attitude control system changes, new exposure capabilities, new data handling capabilities, radiation protection measures, and new navigation methods. In addition, the process of performing late sequence updates is discussed. An overview of the Neptune mission is also presented.
To "envision" animals is to visualize, to experience, to figure, to image, kinds of species, discourses, representations, institutions, histories, epistemologies; and, to "imagine possible" a set of material and ethical relationships between species. This dissertation explores the "envisioning of animals" that takes place through/across/between the interfaces of seawater/visuality/experience/biology/technology/phyla---as illustrated in the documentary works of Jean Painleve (scientist and filmmaker), Genevieve Hamon (filmmaker and set-designer), Leni Riefenstahl (filmmaker and photographer), and David Powell (scientist and aquarist). In each case, aesthetic conceptions of beauty and/or ambiguity coupled with biological epistemology and phenomenology of the organisms themselves compete over "what gets to count as culture and nature," and in doing so, construct a host of hybridized and enmeshed "encounters." In the process the following questions are raised: What is the role of the ocean---it's ecosystems and semiotics---in the production of "envisioning"? How are animals used---and in turn shape and reshape the users---to construct tropes of encounter? What theories can be used to understand the phenomenological, semiotic, material, and rhetorical use/miss-use of animals in the articulation of history, economy, biology, narrativity, and representation? How does this motley crew of documentarians answer differently "the animal question," and challenge and/or reinforce anthropocentrism? Divided into two parts, the dissertation first develops a set of methodological questions derived from critical appraisal of "envisioning," encountering, and embodying through science studies, as well as an account of the use and misuse of animals as only "stand ins" for human intentionality; secondly, the dissertation analyses the work of the documentarians in question. Jean Painleve and Genevieve Hamon are shown to critique traditions of representation in nature/science films
Rendtorff, Jacob Dahl; Mattsson, Jan
/implications – The important implication for managerial research of this study would be for banks to focus on customer competency with an ethical concern instead of only being concerned with technical solutions for effective internet operations. Practical implications – Since more and more businesses are digitally based......Purpose – The purpose of this paper is to discuss some ethical issues in the internet encounter between customer and bank. Empirical data related to the difficulties that customers have when they deal with the bank through internet technology and electronic banking. The authors discuss...... the difficulties that customers expressed from an ethical standpoint. Design/methodology/approach – The key problem of the paper is “how does research handle the user's lack of competence in a web-based commercial environment?” The authors illustrate this ethical dilemma with data from a Danish Bank collected...
Liu, Z.; Burcharth, H. F.
wave height corresponding to a certain exceedence probability within a structure lifetime (encounter probability), based on the statistical analysis of long-term extreme significant wave height. Then the design individual wave height is calculated as the expected maximum individual wave height...... associated with the design significant wave height, with the assumption that the individual wave heights follow the Rayleigh distribution. However, the exceedence probability of such a design individual wave height within the structure lifetime is unknown. The paper presents a method for the determination...... of the design individual wave height corresponding to an exceedence probability within the structure lifetime, given the long-term extreme significant wave height. The method can also be applied for estimation of the number of relatively large waves for fatigue analysis of constructions....
Sharon Moloney PhD
Full Text Available Focus groups are a valuable method for exploring the construction and negotiation of meanings. In her doctoral research the author explored how Australian women's experiences of menstruation, birth, and spirituality are invested with meaning and how that meaning influences and shapes those experiences. The focus group has been described as a potentially liminal space, which enables the discussion of taboo subjects by breaking the ice and giving people permission to comment. In addition, she discovered that the groups could be occasions of empowerment and transformation for both participants and researcher. In a way that far exceeded her expectations, the group format was ideally suited to feminist research and the organic inquiry methodology she used. Some groups became deeply spiritual encounters that were nourishing and transformative for all. This article explores how focus groups can be vehicles of spiritual transformation, examining one group in particular to highlight the points raised.
Holliday, Ruth; Bell, David; Cheung, Olive; Jones, Meredith; Probyn, Elspeth
This paper reports findings from a large-scale, multi-disciplinary, mixed methods project which explores empirically and theoretically the rapidly growing but poorly understood (and barely regulated) phenomenon of cosmetic surgery tourism (CST). We explore CST by drawing on theories of flows, networks and assemblages, aiming to produce a fuller and more nuanced account of - and accounting for - CST. This enables us to conceptualise CST as an interplay of places, people, things, ideas and practices. Through specific instances of assembling cosmetic surgery that we encountered in the field, and that we illustrate with material from interviews with patients, facilitators and surgeons, our analysis advances understandings and theorisations of medical mobilities, globalisation and assemblage thinking. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Bødker, Susanne; Bannon, Liam
This paper is written by two people who come form rather different backgrounds, yet who, at the same time, share similar concerns about the human-computer interaction (HCI) area. One of us has a background in computing and cognitive science, coupled with a long-standing interest in helping users...... in their interactions with technology. He became uncomfortable with the gap between current cognitive theories and their utility in designing better interfaces to computer systems. The other person has a background in software engineering and computer systems design. In her search for a deeper understanding of issues...... did studies in Scandinavia, one primarily in North America. As both of us are concerned with making more useful and usable computer applications we decided to look further for frameworks to help us. In this paper we shall try to expose some of the problems that we encountered in our joint effort...
Sasson, Theodore; Mittelberg, David; Hecht, Shahar; Saxe, Leonard
More than 300,000 diaspora Jewish young adults and tens of thousands of their Israeli peers have participated in structured, cross-cultural encounters--"mifgashim"--in the context of an experiential education program known as Taglit-Birthright Israel. Drawing on field observations, interviews, and surveys, the formal and informal…
Riascos, A. P.; Mateos, José L.
There is a burst of work on human mobility and encounter networks. However, the connection between these two important fields just begun recently. It is clear that both are closely related: Mobility generates encounters, and these encounters might give rise to contagion phenomena or even friendship. We model a set of random walkers that visit locations in space following a strategy akin to Lévy flights. We measure the encounters in space and time and establish a link between walkers after the...
This thesis investigates customer-to-customer roles and impacts in the context of service encounters. This topic is studied from two angles: customer interactions during group service encounters and customer perceptions post service encounters. The first angle is a focus on group service encounters that addresses the lack of research on customer-to-customer interactions that occur in customer-to-customer interaction-intensive contexts. These are contexts where the interactions between custome...
Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...
The pupose of the paper is to develop a framework for analyzing the dynamics of innovations emanating from the ICT-based service encounters. Many innovations are based on the direct encounter between employees and customers, and the paper aims to extend the analysis of such encounters to ICT...
U.S. Department of Health & Human Services — Unplanned Hospital Visits â provider data. This data set includes provider data for the hospital return days (or excess days in acute care) measures, the unplanned...
Pesut, Barbara; Reimer-Kirkham, Sheryl
Despite increasingly diverse, globalized societies, little attention has been paid to the influence of religious and spiritual diversity on clinical encounters within healthcare. The purpose of the study was to analyze the negotiation of religious and spiritual plurality in clinical encounters, and the social, gendered, cultural, historical, economic and political contexts that shape that negotiation. Qualitative: critical ethnography. The study was conducted in Western Canada between 2006 and 2009. Data collection occurred on palliative, hospice, medical and renal in-patient units at two tertiary level hospitals and seven community hospitals. Participants were recruited through purposive sampling and snowball technique. Twenty healthcare professionals, seventeen spiritual care providers, sixteen patients and families and twelve administrators, representing diverse ethnicities and religious affiliations, took part in the study. Data collection included 65 in-depth interviews and over 150h of participant observation. Clinical encounters between care providers and recipients were shaped by how individual identities in relation to religion and spirituality were constructed. Importantly, these identities did not occur in isolation from other lines of social classification such as gender, race, and class. Negotiating difference was a process of seeing spirituality as a point of connection, eliciting the meaning systems of patients and creating safe spaces for the expression of that meaning. The complexity of religious and spiritual identity construction and negotiation raises important questions about language and about professional competence and boundaries in clinical encounters where religion and spirituality are relevant concerns. Copyright 2009 Elsevier Ltd. All rights reserved.
Pendergrast, Robert A.
Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations. PMID:28300761
Robert A. Pendergrast
Full Text Available Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations.
Sundaramurthy, Sharada; Suresh, H B; Anirudh, A V; Prakash Rozario, Anthony
Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and management a challenge to the treating surgeon. Presentation may be misleading and diagnosis often missed. An imaging study forms an indispensable aid in the diagnosis and surgery is the only treatment option. A 42 year old male presented with history of pain in lower back of 4 years duration and was being treated symptomatically over 4 years with analgesics and physiotherapy. He had noticed a swelling over the left side of his mid-back and consequently on examination was found to have a primary acquired lumbar hernia arising from the deep superior lumbar triangle of Grynfelt. Diagnosis was confirmed by Computed Tomographic imaging. A lumbar hernia may be primary or secondary with only about 300 cases of primary lumbar hernia reported in literature. Lumbar hernias manifest through two possible defects in the posterior abdominal wall, the superior being more common. Management remains surgical with various techniques emerging over the years. The patient at our center underwent an open sublay mesh repair with excellent outcome. A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach. Copyright © 2016. Published by Elsevier Ltd.
CERN is building a new control centre for the operation of its entire accelerator complex and technical infrastructure. The prototype console for the new centre has just been installed and tested. Close encounters of the prototype kind CERN is building a new control centre for the operation of its entire accelerator complex and technical infrastructure. The prototype console for the new centre has just been installed and tested. The prototype of the control consoles that will be at the heart of the future CERN Control Centre (CCC) has just been installed in the Roy Billinge Room in Building 354. Until now, there have been four separate control rooms for the CERN accelerators and technical infrastructure. The CCC, which will be located on the Prévessin site, will bring them all together in a single room. The Centre will consist of 40 consoles for four different areas (LHC, SPS, PS complex and technical infrastructure). The prototype was tested by the technicians for a month. Following installation and con...
Mike Lamont for the LHC Team
On 29 May, yet another record was set as 1092 bunches per beam were injected into the LHC, hitting a peak luminosity of 1.26x1033 cm-2 s-1. While running at 3.5 TeV each beam now packs a total energy of over 70 MJ – equivalent to a TGV travelling at a 70 kph. Operators in the LHC Control Centre happily show off their display screens after succesfully injecting 1092 bunches injected into the machine for the first time. As the total beam intensity has been pushed up, the LHC has encountered a number of related problems, such as the so-called UFOs (Unidentified Falling Objects). These are thought to be dust particles falling through the beam, causing localized beam loss. The losses can push nearby beam loss monitors over the threshold and dump the beam. This is more of an annoyance than a danger for the LHC, but UFOs do reduce the operational efficiency of the machine. Despite this, the luminosity delivered to the experiments has steadily increased. On three occasions there ha...
Full Text Available Osteoarthritis (OA is a major health burden of our time. Age is the most prominent risk factor for the development and progression of OA. The mechanistic influence of aging on OA has different facets. On a molecular level, matrix proteins such as collagen or proteoglycans are modified, which alters cartilage function. Collagen cross-linking within the bone results in impaired plasticity and increased stiffness. Synovial or fat tissue, menisci but also ligaments and muscles play an important role in the pathogenesis of OA. In the elderly, sarcopenia or other causes of muscle atrophy are frequently encountered, leading to a decreased stability of the joint. Inflammation in form of cellular infiltration of synovial tissue or subchondral bone and expression of inflammatory cytokines is more and more recognized as trigger of OA. It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms. Therefore physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass. A reduced stem cell capacity in the elderly is likely associated with a decrease of repair mechanisms of the musculoskeletal system. New treatment strategies, for example with mesenchymal stem cells (MSC are investigated, despite clear evidence for their efficacy is lacking.
Kahn, J A; Piggins, J; Blewett, D R; Hassan, L; Raila, W; Link, D; Oliver, D E; Barnett, G O
Casebook is a clinically oriented database, written in MUMPS, and designed for recording the clinical encounters of medical students at Harvard Medical School. Its main goals are to 1) increase student use of computer technology, 2) help faculty evaluate the diversity of clinical experiences on their service, 3) provide data to the faculty on the "typical" experience of medical students on their service to aid in the evaluation of the curriculum and, 4) provide report-generation capabilities for the students to improve dialog with their preceptors. Students are able to enter information on "Problems" and "Procedures" selecting from a pop-up menu of medical terms or by entering free text. Casebook is currently in use in the Medicine, OB/GYN, Pediatric and Ambulatory rotations. At sites where the faculty take an active interest in the use of Casebook students perceive it to be valuable and subsequently use it more frequently. It is currently being expanded for use by medical students in their second, third, and fourth years of school.
Carrier, J M
Preliminary data are presented on 53 urban Mexican males interviewed during 1970-1971 in a study of homosexual encounters in a large Mexican city. These data are compared with data from recent studies in the United States and England of male homosexual behavior. Although preliminary and limited, the Mexican data indicate that cultural factors are important determinants of life styles and sex practices of homosexual males. Forty-eight of the 53 (90%) preferred and usually practiced anal intercourse, four preferred oral contacts, and one preferred mutual masturbation. Interviewees were also grouped according to major type of sex activity during the first sustained year of homosexual activity after puberty. One intragroup comparison indicates significant differences between anal active and anal passive interviewees. For example, as children anal passive subjects had significantly more homosexual contacts with adults; they also considered themselves more effeminate and as children were more involved with female sex-typed activities. Comparison of data from the English and United States studies with the present data suggests that preference for a particular sexual technique is not as developed in the former two countries; when there is a preference, it is not usually for anal intercourse.
Robert F. Barsky
Full Text Available The hypothesis that guides this work is that although it may be valuable to lobby for competent translators to help vulnerable foreigners in cross-cultural settings, such as the Canadian Convention refugee determination hearings or criminal trials, it is nevertheless too late to make much of a difference at that point, because most of the incriminating damage is done in the initial encounter between claimant/defendant and authority. Approaching a discussion about the relative merits of translation versus interpretation from this perspective, that emphasizes the time at which the conversation occurs, would suggest that linguistic accuracy is much more important in formal hearings, while interpretation is crucial during the initial encounter, because it is during this period of negotiation that a sensitive and qualified interpreter can keep a claimant from incriminating herself or mis-communicating the situation to authority.
Cruz-Adalia, Aranzazu; Veiga, Esteban
During infections, the first reaction of the host against microbial pathogens is carried out by innate immune cells, which recognize conserved structures on pathogens, called pathogen-associated molecular patterns. Afterward, some of these innate cells can phagocytose and destroy the pathogens, secreting cytokines that would modulate the immune response to the challenge. This rapid response is normally followed by the adaptive immunity, more specific and essential for a complete pathogen clearance in many cases. Some innate immune cells, usually named antigen-presenting cells, such as macrophages or dendritic cells, are able to process internalized invaders and present their antigens to lymphocytes, triggering the adaptive immune response. Nevertheless, the traditional boundary of separated roles between innate and adaptive immunity has been blurred by several studies, showing that very specialized populations of lymphocytes (cells of the adaptive immunity) behave similarly to cells of the innate immunity. These “innate-like” lymphocytes include γδ T cells, invariant NKT cells, B-1 cells, mucosal-associated invariant T cells, marginal zone B cells, and innate response activator cells, and together with the newly described innate lymphoid cells are able to rapidly respond to bacterial infections. Strikingly, our recent data suggest that conventional CD4+ T cells, the paradigm of cells of the adaptive immunity, also present innate-like behavior, capturing bacteria in a process called transinfection. Transinfected CD4+ T cells digest internalized bacteria like professional phagocytes and secrete large amounts of proinflammatory cytokines, protecting for further bacterial challenges. In the present review, we will focus on the data showing such innate-like behavior of lymphocytes following bacteria encounter. PMID:27774092
Full Text Available Biomphalaria glabrata snails play an integral role in the transmission of Schistosoma mansoni, the causative agent for human schistosomiasis in the Western hemisphere. For the past two decades, tremendous advances have been made in research aimed at elucidating the molecular basis of the snail/parasite interaction. The growing concern that there is no vaccine to prevent schistosomiasis and only one effective drug in existence provides the impetus to develop new control strategies based on eliminating schistosomes at the snail-stage of the life cycle. To elucidate why a given snail is not always compatible to each and every schistosome it encounters, B. glabrata that are either resistant or susceptible to a given strain of S. mansoni have been employed to track molecular mechanisms governing the snail/schistosome relationship. With such snails, genetic markers for resistance and susceptibility were identified. Additionally, differential gene expression studies have led to the identification of genes that underlie these phenotypes. Lately, the role of schistosomes in mediating non-random relocation of gene loci has been identified for the first time, making B. glabrata a model organism where chromatin regulation by changes in nuclear architechture, known as spatial epigenetics, orchestrated by a major human parasite can now be investigated. This review will highlight the progress that has been made in using molecular approaches to describe snail/schistosome compatibility issues. Uncovering the signaling networks triggered by schistosomes that provide the impulse to turn genes on and off in the snail host, thereby controlling the outcome of infection, could also yield new insights into anti-parasite mechanism(s that operate in the human host as well.
Full Text Available The main risk factor for suicide is the attempt to do. It boosts the risk of further attempts and heightens the risk of subsequent suicide considerably. We know the rate of suicide attempters willing to attend even an aftercare appointment to be low. It is also known that if attempters do seek help, from the first encounter on the quality of the therapeutic alliance plays an important role in the formation of the patient's decision to continue the therapeutic relationship. Clinically, this implies the urgency to offer these patients a helping and trustful relationship from the beginning, since we might only get this one chance to reach and engage them in a helping relationship. But what are good encounters with such patients? How are positively experienced encounters characterized and how to pursue such questions on the basis of empirical material? The aim of this investigation into clinicians’ ways of interacting with these patients is to elicit characteristics of interaction from positively and negatively experienced encounters. Conversation and interaction analysis provide valuable access to these questions, because they allow a detailed investigation into the turn-by-turn unfolding of interaction. They demonstrate how the interactants mutually present themselves and how communicative moves are productive or not. Results of such an investigation into four such first-encounters are presented. Out of a pool of 40 videotaped first-encounters, held at the Bern University Hospital, two of the best and two of the worst encounters in patients’ rating were selected, transcribed, and analyzed. It was found that the interviewers of the positively experienced encounters were attentively and empathically present throughout the entire conversation. While giving patients ample opportunity to autonomously develop the story of their suicide-attempt, clinicians where nevertheless structuring and focusing the conversation and assisting the development of
Kim, Howard S; McCarthy, Danielle M; Mark Courtney, D; Lank, Patrick M; Lambert, Bruce L
Benzodiazepine-opioid combination therapy is potentially harmful due to the risk of synergistic respiratory depression, and the rate of death due to benzodiazepine-opioid overdose is increasing. Little is known about the prevalence and characteristics of benzodiazepine-opioid co-prescribing from the ED setting. Secondary analysis of data from the National Hospital Ambulatory Medical Care Survey, using sample weights to generate population estimates. The primary objective was to describe the annual prevalence of benzodiazepine-opioid co-prescribing from 2006 to 2012, using 95% confidence intervals (95% CI) to compare adjacent years. The secondary objective was to compare characteristics of ED encounters receiving a benzodiazepine-opioid co-prescription versus those receiving an opioid prescription alone, using a multivariable logistic regression. The prevalence of benzodiazepine-opioid co-prescribing did not significantly change from 2006 to 2012. During this period, 2.7% (95% CI: 2.5-2.8%) of ED encounters prescribed an opioid were also prescribed a benzodiazepine. Relative to encounters receiving an opioid prescription alone, encounters receiving a co-prescription were more likely to represent a follow-up rather than initial visit (Odds Ratio [OR] 1.52), receive more medications (OR 1.41) and fewer procedures (OR 0.48) while in the ED, and more likely to have a diagnosis related to mental disorder (OR 20.60) or musculoskeletal problem (OR 3.71). From 2006 to 2012, almost 3% of all ED encounters receiving an opioid prescription also received a benzodiazepine co-prescription. The odds of benzodiazepine-opioid co-prescribing were significantly higher in ED encounters representing a follow-up visit and in diagnoses relating to a mental disorder or musculoskeletal problem. Copyright © 2016 Elsevier Inc. All rights reserved.
Note that no existing model covers encoun- ters between two IFR aircraft in oceanic airspace. The reason for this is that one cannot observe encounters...encounters between instrument flight rules ( IFR ) and non- IFR traffic beyond 12NM. 2 TABLE 1 Encounter model categories. Aircraft of Interest Intruder...Aircraft Location Flight Rule IFR VFR Noncooperative Noncooperative Conventional Unconventional CONUS IFR C C U X VFR C U U X Offshore IFR C C U X VFR C U
The critical incident technique (CIT) was used to explore faculty experiences with uncivil nursing students. Twenty-one nursing faculty with various years of experience in teaching were interviewed to ascertain what they considered critical incidents of uncivil encounters with nursing students and what effect those encounters had on them. Thirty-six encounters were described by the faculty. Of the 36 encounters, 33 occurred with individual students and 3 occurred with groups of students. Twenty-three encounters occurred in the context of poor student performance requiring constructive criticism or resulting in course failure. A battlefield metaphor is used to describe the incidents, their antecedents, and their consequences. The encounters were precipitated by a period of escalating tensions and effort by the faculty to diffuse the situation. The faculty were surprised and caught off guard by the encounters, which ranged in severity from mild to highly aggressive. The faculty often perceived significant threats to well-being of self, loved ones, job security, and/or possessions. The aftermath of the encounters included physical and emotional tolls on faculty, decreased self-esteem and loss of confidence in teaching ability, significant time expenditures, and negative consequences to the educational process. Three of the faculty left teaching in part due to encounters with students.
Kochenderfer, M. J; Kuchar, J. K; Espindle, L. P; Gertz, J. L
... procedures and collision avoidance systems. Of particular relevance to Unmanned Aircraft Systems is the potential for encountering general aviation aircraft that are flying under Visual Flight Rules (VFR...
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Multispectral Visible Imaging Camera instrument during the Jupiter encounter mission phase.
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Long Range Reconnaissance Imager instrument during the Jupiter encounter mission phase.
Mikkelsen, Bent Egberg; Beck, Anne Marie; Lassen, Anne Dahl
and nursing home residents has resulted in measurable progress. Design: A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n = 96) and nursing homes (n = 898) in 1995 and 2002/3 (n = 90) and (n = 682), respectively. The study used compliance with selected issues......Background: Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. Aim: The purpose of this study was to investigate whether the increased focus on nutritional problems in patients...... in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food...
Heritage, John; Lindstrom, Anna
Examines moments in the course of informal medical encounters between English health visitors and mothers in which motherhood and medicine collide. Within the conversations, motherhood, medicine, and morality are yoked to the interaction order that is inflected and influenced by the medical context of the encounters. The paper discusses motherhood…
This book is about power in welfare encounters. Present-day citizens are no longer the passive clients of the bureaucracy and welfare workers are no longer automatically the powerful party of the encounter. Instead, citizens are expected to engage in active, responsible and coproducing relationsh...
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
Nowatzki, Nadine R; Kalischuk, Ruth Grant
Historical accounts and previous research have shown that bereaved individuals often report seeing, hearing, or feeling the presence of the deceased. We examined such encounters in the context of the grieving, mourning, and healing processes. Semi-structured, in-depth interviews were conducted with 23 individuals who reported a post-death encounter following the death of a loved one. Phenomenological analysis showed that participants went through an interpretive process in which they attempted to make sense of their experiences. The encounters profoundly affected the participants' beliefs in an afterlife and attitudes toward life and death, and had a significant impact on their grief. Finally, post-death encounters had a healing effect on the participants by contributing to a sense of connectedness with the deceased. We conclude that health care professionals and counselors should be educated about post-death encounters so that the bereaved can share their experiences in a supportive and understanding atmosphere.
Valsecchi, G. B.; Alessi, E. M.; Rossi, A.
Close planetary encounters play an important role in the evolution of the orbits of small Solar system bodies and are usually studied with the help of numerical integrations. Here we study close encounters in the framework of an analytic theory, focusing on the so-called b-plane, which is the plane centred on the planet and perpendicular to the planetocentric velocity at infinity of the small body. As shown in previous papers, it is possible to identify the initial conditions on the b-plane that lead to post-encounter orbits of given semimajor axis. In this paper we exploit analytical relationships between b-plane coordinates and pre-encounter orbital elements and compute the probability of transition to these post-encounter states, and numerically check the validity of the analytic approach.
Jílková, Lucie; Hamers, Adrian S.; Hammer, Michael; Portegies Zwart, Simon
We study mass transfers between debris discs during stellar encounters. We carried out numerical simulations of close flybys of two stars, one of which has a disc of planetesimals represented by test particles. We explored the parameter space of the encounters, varying the mass ratio of the two stars, their pericentre and eccentricity of the encounter, and its geometry. We find that particles are transferred to the other star from a restricted radial range in the disc and the limiting radii of this transfer region depend on the parameters of the encounter. We derive an approximate analytic description of the inner radius of the region. The efficiency of the mass transfer generally decreases with increasing encounter pericentre and increasing mass of the star initially possessing the disc. Depending on the parameters of the encounter, the transfer particles have a specific distribution in the space of orbital elements (semimajor axis, eccentricity, inclination, and argument of pericentre) around their new host star. The population of the transferred particles can be used to constrain the encounter through which it was delivered. We expect that many stars experienced transfer among their debris discs and planetary systems in their birth environment. This mechanism presents a formation channel for objects on wide orbits of arbitrary inclinations, typically having high eccentricity but possibly also close to circular (eccentricities of about 0.1). Depending on the geometry, such orbital elements can be distinct from those of the objects formed around the star.
Aue, Tatjana; Hoeppli, Marie-Eve; Piguet, Camille; Hofstetter, Christoph; Rieger, Sebastian W; Vuilleumier, Patrik
Spider-phobic individuals are characterized by exaggerated expectancies to be faced with spiders (so-called encounter expectancy bias). Whereas phobic responses have been linked to brain systems mediating fear, little is known about how the recruitment of these systems relates to exaggerated expectancies of threat. We used fMRI to examine spider-phobic and control participants while they imagined visiting different locations in a forest after having received background information about the likelihood of encountering different animals (spiders, snakes, and birds) at these locations. Critically, imagined encounter expectancies modulated brain responses differently in phobics as compared with controls. Phobics displayed stronger negative modulation of activity in the lateral prefrontal cortex, precuneus, and visual cortex by encounter expectancies for spiders, relative to snakes or birds (within-participants analysis); these effects were not seen in controls. Between-participants correlation analyses within the phobic group further corroborated the hypothesis that these phobia-specific modulations may underlie irrationality in encounter expectancies (deviations of encounter expectancies from objective background information) in spider phobia; the greater the negative modulation a phobic participant displayed in the lateral prefrontal cortex, precuneus, and visual cortex, the stronger was her bias in encounter expectancies for spiders. Interestingly, irrationality in expectancies reflected in frontal areas relied on right rather than left hemispheric deactivations. Our data accord with the idea that expectancy biases in spider phobia may reflect deficiencies in cognitive control and contextual integration that are mediated by right frontal and parietal areas.
Andrew M Hein
Full Text Available Most motile organisms use sensory cues when searching for resources, mates, or prey. The searcher measures sensory data and adjusts its search behavior based on those data. Yet, classical models of species encounter rates assume that searchers move independently of their targets. This assumption leads to the familiar mass action-like encounter rate kinetics typically used in modeling species interactions. Here we show that this common approach can mischaracterize encounter rate kinetics if searchers use sensory information to search actively for targets. We use the example of predator-prey interactions to illustrate that predators capable of long-distance directional sensing can encounter prey at a rate proportional to prey density to the [Formula: see text] power (where [Formula: see text] is the dimension of the environment when prey density is low. Similar anomalous encounter rate functions emerge even when predators pursue prey using only noisy, directionless signals. Thus, in both the high-information extreme of long-distance directional sensing, and the low-information extreme of noisy non-directional sensing, encounter rate kinetics differ qualitatively from those derived by classic theory of species interactions. Using a standard model of predator-prey population dynamics, we show that the new encounter rate kinetics derived here can change the outcome of species interactions. Our results demonstrate how the use of sensory information can alter the rates and outcomes of physical interactions in biological systems.
This text introduces a research project in motion. The area is maternity, subjectivity and art encounters. The text gives a sense of this research, presenting both the process of thinking within and about the work, showing it to be a living inquiry. The research itself is located in my disrupted maternal-self and an encounter with the oeuvre of Louise Bourgeois; an encounter that had a transformative impact on me by creating a space to contemplate my experiences and beyond to explore maternit...
Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F
According to ecological models, the physical environment plays a major role in determining individual health behaviors. As such, researchers have started targeting the consumer nutrition environment of large-scale foodservice operations when implementing obesity-prevention programs. In 2010, the American Hospital Association released a call-to-action encouraging health care facilities to join in this movement and improve their facilities' consumer nutrition environments. The Hospital Nutrition Environment Scan (HNES) for Cafeterias, Vending Machines, and Gift Shops was developed in 2011, and the present study evaluated the inter-rater reliability of this instrument. Two trained raters visited 39 hospitals in southern California and completed the HNES. Percent agreement, kappa statistics, and intraclass correlation coefficients were calculated. Percent agreement between raters ranged from 74.4% to 100% and kappa statistics ranged from 0.458 to 1.0. The intraclass correlation coefficient for the overall nutrition composite scores was 0.961. Given these results, the HNES demonstrated acceptable reliability metrics and can now be disseminated to assess the current state of hospital consumer nutrition environments. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Full Text Available This article examines the interaction between Finnish employment officials and their immigrant clients in service encounter conversations. It employs the concepts of metacommunicative talk, silence, agency and asymmetric interaction situation. Such service encounters between native speakers of Finnish and immigrants going through the integration process and speaking Finnish as their second language constitute situations of institutional interaction, characterised by asymmetry. Asymmetry during the service encounter arises from the roles and power relations between the official and client, a familiarity with the routines associated with service encounters, and the use of Finnish as the language of conversation during the encounter. This article examines two authentic service encounters, recorded in a Finnish employment office. The encounters are analysed using discourse analysis, combining micro-level analysis of language use and macro-level analysis of the situation. Interviews with the employment officials and background information collected from the officials and clients via questionnaires are used in support of the qualita-tive analysis. Officials use different methods of interaction with their clients. In addition, the individual characteristics of officials and clients and their cultural differences in-fluence the construction of interaction during a service encounter. Finnish officials can sometimes handle service encounters with very little talk - sometimes with hardly any talk at all. However, metacommunicative talk can serve as a vehicle for reinforcing the client's agency and supporting the immigrant in learning the language and customs, as well as in establishing a foothold in the new community, and thereby promoting the integration process as a whole.
National Aeronautics and Space Administration — This data set contains Raw data taken by the New Horizons Pluto Energetic Particle Spectrometer Science Investigation instrument during the Jupiter encounter mission...
Lo, Ming‐cheng M; Stacey, Clare L
.... This paper develops a more careful conceptual model for understanding the role of culture in the clinical encounter, paying particular attention to the relationship between culture, contexts and social structures...
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Long Range Reconnaissance Imager instrument during the Pluto encounter mission phase. This is...
National Aeronautics and Space Administration — This data set contains Raw data taken by the New Horizons Long Range Reconnaissance Imager instrument during the Pluto encounter mission phase. This is VERSION 1.0...
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Alice Ultraviolet Imaging Spectrograph instrument during the Pluto encounter mission phase. This is...
Stone, E C; Miner, E D
An overview of the Voyager 2 encounter with Uranus is presented, inclding a brief discussion of the trajectory and the planned observations as well as the highlights of the results described in the 11 companion papers.
U.S. Department of Health & Human Services — Assessing the Usability of MAX 2008 Encounter Data for Comprehensive Managed Care As growing numbers of Medicaid enrollees receive comprehensive health benefits...
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Linear Etalon Imaging Spectral Array instrument during the Jupiter encounter mission phase.
National Aeronautics and Space Administration — This data set contains Raw data taken by the New Horizons Long Range Reconnaissance Imager instrument during the Jupiter encounter mission phase. This is VERSION 2.0...
National Aeronautics and Space Administration — This data set contains Calibrated data taken by the New Horizons Linear Etalon Imaging Spectral Array instrument during the Jupiter encounter mission phase.
U.S. Department of Health & Human Services — Availability and Usability of Behavioral Health Organization Encounter Data in MAX 2009, published in Volume 4, Issue 2 of Medicare and Medicaid Research Review,...
Deienno, Rogerio; Nesvorný, David [Southwest Research Institute, Boulder, CO (United States); Vokrouhlický, David [Institute of Astronomy, Charles University, Prague (Czech Republic); Yokoyama, Tadashi, E-mail: firstname.lastname@example.org [Universidade Estadual Paulista, Rio Claro, SP (Brazil)
The Nice model of the dynamical instability and migration of the giant planets can explain many properties of the present solar system, and can be used to constrain its early architecture. In the jumping-Jupiter version of the Nice model, required from the terrestrial planet constraint and dynamical structure of the asteroid belt, Jupiter has encounters with an ice giant. Here, we study the survival of the Galilean satellites in the jumping-Jupiter model. This is an important concern because the ice-giant encounters, if deep enough, could dynamically perturb the orbits of the Galilean satellites and lead to implausible results. We performed numerical integrations where we tracked the effect of planetary encounters on the Galilean moons. We considered three instability cases from Nesvorný and Morbidelli that differed in the number and distribution of encounters. We found that in one case, where the number of close encounters was relatively small, the Galilean satellite orbits were not significantly affected. In the other two, the orbital eccentricities of all moons were excited by encounters, Callisto's semimajor axis changed, and, in a large fraction of trials, the Laplace resonance of the inner three moons was disrupted. The subsequent evolution by tides damps eccentricities and can recapture the moons in the Laplace resonance. A more important constraint is represented by the orbital inclinations of the moons, which can be excited during the encounters and not appreciably damped by tides. We find that one instability case taken from Nesvorný and Morbidelli clearly does not meet this constraint. This shows how the regular satellites of Jupiter can be used to set limits on the properties of encounters in the jumping-Jupiter model, and help us to better understand how the early solar system evolved.
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
Tavallali, Azar Gashasb; Jirwe, Maria; Kabir, Zarina Nahar
Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters. © 2016 Nordic College of Caring Science.
Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner
The communicative encounter has been described as a fundamental element in caring for the patients, and further, in this encounter, the nonverbal body language and the tone of speech are agued to play a crucial role. This study explores how seriously ill hospitalised patients experience and assign meaning to the health professionals' communication with special attention to the nonverbal body language and tone of speech. The study is part of a larger study exploring how seriously ill patients experience and assign meaning to the sensory impressions in the physical hospital environment as well as to the health professionals' communication. The study is based on qualitative interviews supplemented by observations and applies Paul Ricoeur's phenomenological-hermeneutic theory of interpretation in processing the collected data. We included twelve patients with potentially life-threatening illnesses such as cancer, severe lung, liver and heart disease. Through analysis and interpretation of the interviews, we identified two themes in the text: (i) Being confirmed, (ii) Being ignored and an inconvenience. The patients experienced that the health professionals' nonverbal communication was imperative for their experience of being confirmed or in contrast, their experience of being ignored and an inconvenience. The health professionals' nonverbal communication proved essential for the seriously ill patients' experience of well-being in the form of positive thoughts and emotions. Consequently, this sensory dimension of the communicative encounter represents a significant ethical element in caring for the patients. © 2016 Nordic College of Caring Science.
Not long after the word hospitality emerged as a collective noun to describe the commercial provision of services associated with accommodation, drinking and eating, some academics began to investigate the meanings of hospitality and hospitableness. Whilst most academic programme provision related to developing ...
Amalia L. Cabezas
Full Text Available Drawing on research in Cuba and the Dominican Republic this paper explores the uses of intimacy in both the corporate sector and in romantic relationships. I use research with hotel workers and with people involved in sexual-affective exchanges connected to tourism to link intimacy to the political economic structures of transnational tourism. These are new spaces of analysis that present practices of transnational corporategenerated intimacy that combine love – or the exploitation of worker’s emotions − and labour. The central aim is to intertwine the intimate with the global, from the formal customer service policies of transnational hotels with the informal, on-the-ground, intimate encounters between tourists and hospitality workers. The commercialization of intimacy, including sexual-affective relations in the delivery of hospitality services, is linked to political and economic processes that are part of transnational tourism practices. This paper challenges the notion that sex tourism and sex work are individualistic practices that exist outside of the spaces of corporate global profit. It further posits that relationships where money is exchanged are not necessarily devoid of care and intimacy.Resumen: Encuentros íntimos: economías afectivas en Cuba y República Dominicana A partir de investigaciones en Cuba y la República Dominicana, este trabajo explora los usos de la intimidad, tanto en el sector empresarial como en las relaciones románticas. Se hicieron investigaciones entre trabajadores de hostelería y personas involucradas en el intercambio afectivosexual relacionado con el turismo con el fin de vincular la intimidad de las estructuras políticoeconómicas del turismo transnacional. Estos son nuevos espacios de análisis que las prácticas de las empresas transnacionales generan por el uso de la intimidad que combinan el amor – o la explotación de las emociones del trabajador – y la mano de obra. El objetivo central
Cavallario, Julie M; Van Lunen, Bonnie L; Hoch, Johanna M; Hoch, Matthew; Manspeaker, Sarah A; Pribesh, Shana L
Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters. Cross-sectional study. Professional athletic training program, National Collegiate Athletic Association Division I institution. We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track Pes, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant's role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented ( yes/ no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site
A P Riascos
Full Text Available There is a burst of work on human mobility and encounter networks. However, the connection between these two important fields just begun recently. It is clear that both are closely related: Mobility generates encounters, and these encounters might give rise to contagion phenomena or even friendship. We model a set of random walkers that visit locations in space following a strategy akin to Lévy flights. We measure the encounters in space and time and establish a link between walkers after they coincide several times. This generates a temporal network that is characterized by global quantities. We compare this dynamics with real data for two cities: New York City and Tokyo. We use data from the location-based social network Foursquare and obtain the emergent temporal encounter network, for these two cities, that we compare with our model. We found long-range (Lévy-like distributions for traveled distances and time intervals that characterize the emergent social network due to human mobility. Studying this connection is important for several fields like epidemics, social influence, voting, contagion models, behavioral adoption and diffusion of ideas.
Winter, A. J.; Clarke, C. J.; Rosotti, G.; Booth, R. A.
The majority of stars form in a clustered environment. This has an impact on the evolution of surrounding protoplanetary discs (PPDs) due to either photoevaporation or tidal truncation. Consequently, the development of planets depends on formation environment. Here we present the first thorough investigation of tidally induced angular momentum loss in PPDs in the distant regime, partly motivated by claims in the literature for the importance of distant encounters in disc evolution. We employ both theoretical predictions and dynamical/hydrodynamical simulations in 2D and 3D. Our theoretical analysis is based on that of Ostriker (1994) and leads us to conclude that in the limit that the closest approach distance xmin ≫ r, the radius of a particle ring, the fractional change in angular momentum scales as (xmin/r)-5. This asymptotic limit ensures that the cumulative effect of distant encounters is minor in terms of its influence on disc evolution. The angular momentum transfer is dominated by the m = 2 Lindblad resonance for closer encounters and by the m = 1, ω = 0 Lindblad resonance at large xmin/r. We contextualise these results by comparing expected angular momentum loss for the outer edge of a PPD due to distant and close encounters. Contrary to the suggestions of previous works we do not find that distant encounters contribute significantly to angular momentum loss in PPDs. We define an upper limit for closest approach distance where interactions are significant as a function of arbitrary host to perturber mass ratio M2/M1.
Geffen, Eli; Kam, Michael; Hefner, Reuven; Hersteinsson, Pall; Angerbjorn, Anders; Dalen, Love; Fuglei, Eva; Noren, Karin; Adams, Jennifer R.; Vicetich, John; Meier, Thomas J.; Mech, L.D.; VonHoldt, Bridgett M.; Stahler, Daniel R.; Wayne, Robert K.
Mating with close kin can lead to inbreeding depression through the expression of recessive deleterious alleles and loss of heterozygosity. Mate selection may be affected by kin encounter rate, and inbreeding avoidance may not be uniform but associated with age and social system. Specifically, selection for kin recognition and inbreeding avoidance may be more developed in species that live in family groups or breed cooperatively. To test this hypothesis, we compared kin encounter rate and the proportion of related breeding pairs in noninbred and highly inbred canid populations. The chance of randomly encountering a full sib ranged between 1–8% and 20–22% in noninbred and inbred canid populations, respectively. We show that regardless of encounter rate, outside natal groups mates were selected independent of relatedness. Within natal groups, there was a significant avoidance of mating with a relative. Lack of discrimination against mating with close relatives outside packs suggests that the rate of inbreeding in canids is related to the proximity of close relatives, which could explain the high degree of inbreeding depression observed in some populations. The idea that kin encounter rate and social organization can explain the lack of inbreeding avoidance in some species is intriguing and may have implications for the management of populations at risk.
Riascos, A P; Mateos, José L
There is a burst of work on human mobility and encounter networks. However, the connection between these two important fields just begun recently. It is clear that both are closely related: Mobility generates encounters, and these encounters might give rise to contagion phenomena or even friendship. We model a set of random walkers that visit locations in space following a strategy akin to Lévy flights. We measure the encounters in space and time and establish a link between walkers after they coincide several times. This generates a temporal network that is characterized by global quantities. We compare this dynamics with real data for two cities: New York City and Tokyo. We use data from the location-based social network Foursquare and obtain the emergent temporal encounter network, for these two cities, that we compare with our model. We found long-range (Lévy-like) distributions for traveled distances and time intervals that characterize the emergent social network due to human mobility. Studying this connection is important for several fields like epidemics, social influence, voting, contagion models, behavioral adoption and diffusion of ideas.
with often competing interests and positions - the practice of public hearings can be approached as a form of organized cultural encounter, whose “implied purposes” are to deal with more or less substantial cultural differences and to provide a wider cultural understanding of each different position. Through......Within the context of resource extraction, cultural encounters have been historically performed in the way of more or less antagonistic social interactions, ranging from outright domination to more empowerment-oriented relations. Throughout the last decades, the building of pipelines in particular...... has linked together countries, cultures, identities, ultimately challenging, reorganizing and renegotiating them. Starting from these premises, the following paper intends to show how Canadian Mackenzie Valley represents a unique contact zone for the development of cultural encounters, where different...
Titelman, Josefin; Kiørboe, Thomas
Velocity differences drive all encounter processes. Therefore, knowledge of both prey and predator motility are essential in order to understand feeding behavior and predict food acquisition rates. Here, we describe and quantify the motility behavior of young and old naupliar stages of 6 copepods...... with a smoother glide of varying continuity. We apply observed time budgets and behavior-specific speeds in simple models to examine mechanisms of food encounter. The motility of all nauplii may account for clearance rates reported in the literature, but through different mechanisms. Smoothly swimming nauphi...... encounter food by scavenging, which also allows for some food capture inefficiency. Jump-sink types rely on motile food. We demonstrate how diffusivity of motile prey may account for observed clearance rates for jump-sink types, which seem to employ 2 strategies. Infrequent jumping as observed in many...
Stone, E. C.
In 1972, the Voyager Program was undertaken by NASA as a major step in the exploration of the outer solar system. Recently the objectives of this program have been extended to include an investigation of Uranus and possibly Neptune. In connection with the present investigation, a brief description of the Voyager spacecraft is presented and an overview of the scientific results from the Saturn encounters is provided. Two essentially identical Voyager spacecraft were launched in 1977 toward encounters with the Jovian and Saturnian planetary systems. The Voyager 1 trajectory at Saturn was chosen to provide a close encounter with Titan, a planet-sized satellite with an atmosphere, and to provide an optimum geometry for dual-frequency radio occultation studies of Saturn's rings. The Voyager 2 trajectory provided improved viewing of the rings.
Collet, Julien; Patrick, Samantha C; Weimerskirch, Henri
Animals are attracted to human food subsidies worldwide. The behavioral response of individuals to these resources is rarely described in detail, beyond chances of encounters. Seabirds for instance scavenge in large numbers at fishing boats, triggering crucial conservation issues, but how the response to boats varies across encounters is poorly known. Here we examine the behavioral response of wandering albatrosses (Diomedea exulans), equipped with GPS tags, to longline fishing boats operating near their colony for which we had access to vessel monitoring system data. We distinguish between encounters (flying within 30 km of a boat) and attendance behavior (sitting on the sea within 3 km of a boat), and examine factors affecting each. In particular, we test hypotheses that the response to encountered boats should vary with sex and age in this long-lived dimorphic species. Among the 60% trips that encountered boats at least once, 80% of them contained attendance (but attendance followed only 60% of each single encounter). Birds were more attracted and remained attending longer when boats were hauling lines, despite the measures enforced by this fleet to limit food availability during operations. Sex and age of birds had low influence on the response to boats, except the year when fewer boats came fishing in the area, and younger birds were attending further from boats compared to older birds. Net mass gain of birds was similar across sex and not affected by time spent attending boats. Our results indicate albatrosses extensively attend this fishery, with no clear advantages, questioning impacts on foraging time budgets. Factors responsible for sex foraging segregation at larger scale seem not to operate at this fleet near the colony and are not consistent with predictions of optimal foraging theory on potential individual dominance asymmetries. This approach complements studies of large-scale overlap of animals with human subsidies.
Shahgholi, Leili; De Jesus, Sol; Wu, Samuel S; Pei, Qinglin; Hassan, Anhar; Armstrong, Melissa J; Martinez-Ramirez, Daniel; Schmidt, Peter; Okun, Michael S
Patients with Parkinson disease (PD) are at high risk of hospital encounters with increasing morbidity and mortality. This study aimed to determine the rate of hospital encounters in a cohort followed over 5 years and to identify associated factors. We queried the data from the International Multicenter National Parkinson Foundation Quality Improvement study. Multivariate logistic regression with backward selection was performed to identify factors associated with hospital encounter prior to baseline visit. Kaplan-Meier estimates were obtained and Cox regression performed on time to hospital encounter after the baseline visit. Of the 7,507 PD patients (mean age 66.5±9.9 years and disease duration 8.9±6.4 years at baseline visit), 1919 (25.6%) had a history of a hospital encounter prior to their baseline visit. Significant factors associated with a history of a hospital encounter prior to baseline included race (white race: OR 0.49), utilization of physical therapy (OR 1.47), history of deep brain stimulation (OR 1.87), number of comorbidities (OR 1.30), caregiver strain (OR 1.17 per standard deviation), and the standardized Timed Up and Go Test (OR 1.21). Patients with a history of hospitalization prior to the baseline were more likely to have a re-hospitalization (HR1.67, P<0.0001) compared to those without a prior hospitalization. In addition, the time to hospital encounter from baseline was significantly associated with age and number of medications. In patients with a history of hospitalization prior to the baseline visit, time to a second hospital encounter was significantly associated with caregiver strain and number of comorbidities. Hospitalization and re-hospitalization were common in this cohort of people with PD. Our results suggest addressing caregiver burden, simplifying medications, and emphasizing primary and multidisciplinary care for comorbidities are potential avenues to explore for reducing hospitalization rates.
Full Text Available Patients with Parkinson disease (PD are at high risk of hospital encounters with increasing morbidity and mortality. This study aimed to determine the rate of hospital encounters in a cohort followed over 5 years and to identify associated factors.We queried the data from the International Multicenter National Parkinson Foundation Quality Improvement study. Multivariate logistic regression with backward selection was performed to identify factors associated with hospital encounter prior to baseline visit. Kaplan-Meier estimates were obtained and Cox regression performed on time to hospital encounter after the baseline visit.Of the 7,507 PD patients (mean age 66.5±9.9 years and disease duration 8.9±6.4 years at baseline visit, 1919 (25.6% had a history of a hospital encounter prior to their baseline visit. Significant factors associated with a history of a hospital encounter prior to baseline included race (white race: OR 0.49, utilization of physical therapy (OR 1.47, history of deep brain stimulation (OR 1.87, number of comorbidities (OR 1.30, caregiver strain (OR 1.17 per standard deviation, and the standardized Timed Up and Go Test (OR 1.21. Patients with a history of hospitalization prior to the baseline were more likely to have a re-hospitalization (HR1.67, P<0.0001 compared to those without a prior hospitalization. In addition, the time to hospital encounter from baseline was significantly associated with age and number of medications. In patients with a history of hospitalization prior to the baseline visit, time to a second hospital encounter was significantly associated with caregiver strain and number of comorbidities.Hospitalization and re-hospitalization were common in this cohort of people with PD. Our results suggest addressing caregiver burden, simplifying medications, and emphasizing primary and multidisciplinary care for comorbidities are potential avenues to explore for reducing hospitalization rates.
The aim of the study was to describe a paper-based, template-driven and an electronic medical record used for capturing emergency care clinical information and to compare the accuracy of these documentation systems for coding patient encounters using the American Medical Association Current Procedural Terminology-2004 (AMA CPT-2004) evaluation and management codes intended for provider reimbursement. A retrospective, cross-sectional study of 4-consecutive-day samples of ED patient encounter records from 2 similar community hospitals was done. For clinical documentation, hospital A uses an electronic medical record, whereas hospital B uses a paper-based template-driven record. Using a simple analytic model, expert coders A and B, respectively, coded the records from hospitals A and B for completeness. First, power analysis determined the acceptability of the patient record sample sizes (1 - beta = .90 at 1% significance level), and the frequency of AMA CPT-2004 primary evaluation and management codes 99281 through 99285 was calculated. Second, the completeness discrepancy rates for hospitals A and B were compared to determine the accuracy of both the paper-based, template-driven record and the electronic medical record in documenting and representing the clinical encounter. Third, interrater reliability between expert coders A and B was calculated to assess the level of agreement between each expert coder in determining the completeness discrepancy rates between hospitals A and B. Finally, the frequency of primary evaluation and management codes was analyzed to determine if there was a statistically significant difference between the paper-based, template-driven record and the electronic medical record representation of the clinical information, and if that difference could be attributable to the differing clinical documentation systems used in hospitals A and B. First, descriptive display demonstrated a difference in the frequency of the primary evaluation and
Recent marketing and management literature has introduced the concept of co-creation of value. Current value modeling approaches such as e3-value focus on the exchange of value rather than co-creation. In this paper, an extension to e3-value is proposed in the form of a “value encounter”. Value encounters are defined as interaction spaces where a group of actors meet and derive value by each one bringing in some of its own resources. They can be analyzed from multiple strategic perspectives, including knowledge management, social network management and operational management. Value encounter modeling can be instrumental in the context of service analysis and design.
Backes, Heiko; Neubauer, Fritz M; Dougherty, Michele K; Achilleos, Nicholas; André, Nicolas; Arridge, Christopher S; Bertucci, Cesar; Jones, Geraint H; Khurana, Krishan K; Russell, Christopher T; Wennmacher, Alexandre
The magnetic field signature obtained by Cassini during its first close encounter with Titan on 26 October 2004 is presented and explained in terms of an advanced model. Titan was inside the saturnian magnetosphere. A magnetic field minimum before closest approach marked Cassini's entry into the magnetic ionopause layer. Cassini then left the northern and entered the southern magnetic tail lobe. The magnetic field before and after the encounter was approximately constant for approximately 20 Titan radii, but the field orientation changed exactly at the location of Titan's orbit. No evidence of an internal magnetic field at Titan was detected.
Smith, R P
We have all faced the problem of whether or not to venture into that gastronomic wasteland known as the hospital cafeteria. Hospital cafeterias have developed a reputation, deserved or otherwise, as less than ideal places to eat. Many people overlook the fact that this is a direct result of trying to provide patient meals that are salt-free, sugar-free, fiber-free, and taste-free. (Some faint traces of color may, occasionally, be found.) How then does one go about choosing whether to venture in, and how does one survive the encounter once there? The following guide has been assembled to help the reader through this difficult process.
Mayes, Robyn; McAreavey, Ruth
This paper explores migrant women's encounters with formal and informal education in what can be termed new immigration rural destinations. We ask to what extent educational opportunities are realized in these new destinations. We show that education aspirations may be jeopardized because of the desire to achieve economic goals and thus require…
Deveci Topal, Arzu; Kolburan Gecer, Aynur
The development of web 2.0 technology has resulted in an increase in internet sharing. The scope of this study is social networking, which is one of the web 2.0 tools most heavily used by internet users. In this paper, the unethical behaviours that preservice teachers encounter on social networks and the ways to deal with these problems are…
Sagan, Adam; Kowalska-Musiał, Magdalena
Dyadic interactions are an important aspects in service encounters. They may be observed in B2B distribution channels, professional services, buying centers, family decision making or WOM communications. The networks consist of dyadic bonds that form dense but weak ties among the actors.
The aim of this dissertation study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters and to understand work system factors influencing information sharing. Ultimately, this will promote better design of EHR technologies and effective training…
Dulmen, A.M. van; Bensing, J.
The efficacy of a medical treatment partly depends on the interpersonal context in which an intervention takes place. By identifying what factors in the medical encounter engender effect beyond that of the therapeutic intervention, treatment outcome is likely to increase. This study gives an
Chahal, Hardeep; Devi, Pinkey
Purpose: This paper seeks to explore satisfactory and dissatisfactory service encounters in higher education. Design/methodology/approach: The data are collected through the well established critical incident technique (CIT) method. All the satisfied and dissatisfied critical incidents are then grouped on the basis of Bitner et al.'s…
Heralding the 200th anniversary of Darwin's birth, Randolph Nesse affirms, in the December 2008 issue of The Lancet, his vision that the basic science curricula of medical school include evolutionary biology. Nesse suggests that evolutionary biology would unite the basic science principles of the preclinical years and serve as an explanatory tool in the doctor-patient encounter.This article visits this same question, but from a different vantage. Here, the author argues that the primacy of the basic sciences in medical education sanctions medical practice based on reasoning from scientific principles. Such an approach is outdated and dangerous in the era of top-down, evidence-based medicine (EBM). The author offers a new approach to the preclinical years: encounter-based medical education, which elevates the doctor-patient encounter as the prime subject of study in medical education. The author describes the historical roots of the shift to EBM and highlights the inadequacy of problem-based learning to resolve its challenges. The article details the advantages of an encounter-based approach to medical education.
This may be because of the difference in the phonology of Chinese language and other alphabetic languages. Chinese language is a logographic and tonal language which makes it hard to speak and write. This paper examines the phonological problems Nigerian students speaking Igbo language encounter in learning ...
The paper examined the effects of concentrated language encounter method in developing letter Knowledge words skill among primary school pupils in cross river state. The purpose of the study was to find out the effect of Primary One pupils' reading level, English letter Knowledge words involving small and capital letters ...
The paper examined the effect of concentrated language encounter method in developing sight word recognition skill in primary school pupils in cross river state. The purpose of the study was to find out the effect of Primary One pupils' reading level, English sight word recognition skill. It also examine the extent to which the ...
review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population. S Afr J Rad ...
In this article, I explore the claim that one-to-one encounters between community music facilitators and music participants can be described as friendships. By exploring the relational structure through the call and the welcome, I make some general comments on friendship before finally tackling the question lying at the heart of this article: How…
Dec 2, 2017 ... Processing of gold from refractory ores containing carbonaceous materials (CM) poses challenges due to the ability of the. CM to preg-rob dissolved gold. Depending on the type and maturity of CM encountered, preg-robbing of aurocyanide ion can lead to reduction in gold recovery ranging from a few ...
Processing of gold from refractory ores containing carbonaceous materials (CM) poses challenges due to the ability of the CM to preg-rob dissolved gold. Depending on the type and maturity of CM encountered, preg-robbing of aurocyanide ion can lead to reduction in gold recovery ranging from a few percentages to more ...
In six donkeys examined at postmortem, several species of internal parasites were encountered. Dictyocaulus arnfieldi, Gastrophilus intestinalis, Strongylus vulgaris, S. edentatus were each isolated from 100% of the donkeys. Cylicocylus radiatus and Strongylus equines were isolated from 83% and 67% of the examined ...
Kathuri-Ogola, Lucy; VanLeeuwen, Charlene; Kabaria-Muriithi, Joan; Weeks, Lori E.; Kieru, Jane; Ndayala, Phoebe
There is little published research that examines the supervision experience of field attachment supervisors in Kenya. In this study, we identify the challenges encountered by field supervisors during student field attachments with community organizations. Fifteen organizations that had hosted third year students from the Department of Community…
Ray, Trina L.; Knight, Russel L.; Mohr, Dave
In an effort to demonstrate the efficacy of automated planning and scheduling techniques for large missions, we have adapted ASPEN (Activity Scheduling and Planning Environment)  and CLASP (Compressed Large-scale Activity Scheduling and Planning)  to the domain of scheduling high-level science goals into conflict-free operations plans for Titan encounters by the Cassini spacecraft.
'Shakespeare in the bush' and encountering the other in the hermeneutical dialectic of belonging and distanciation 'Shakespeare in the Bush' is an account of an anthropologist's hermeneutical experience among the Tiv people of Nigeria that serves as an illustration o f a hermeneutical circle which results in transforming ...
The article tells the life history of a young female student, Chrester, as she enjoyed her life while encountering gender contradictions throughout her student life during 1970s, 1980s, 1990s and 2000s at the University of Dar es Salaam. The narration covers the age of naiveté as well as her mature age as a senior student.
The paper examined the effects of concentrated language encounter method in developing comprehension skills in primary School Pupils in Cross River State. The purpose of the study was to find out the effects of primary one pupils' reading level, English comprehension skill. It also examined the extent to which the CLE ...
Objective: This study aimed to discover the emotional reactions, attitudes and beliefs of undergraduate medical students of University of Jos medical school to 1st time encounter with human cadaver. Materials and Methods: A structured pretested and validated questionnaire was administered to 450 students of 200 to 500 ...
Sørensen, Flemming; Jensen, Jens Friis
encounters’ by integrating them into the tourism experience to which they are related, this will create added experiential value for tourists and increase the creation of knowledge about users. This is illustrated in an innovation field experiment in a retro design boutique hotel in which service encounters...
O’Grady, Alice; Kill, Rebekka
This article outlines the activities of the research network "Festival Performance as a State of Encounter", which was funded by the Arts and Humanities Research Council as part of the Beyond Text strategic programme. The network was formulated in 2008, and a range of different events were organized over the course of two years to…
the infinitude of encounters through which we make the world and are made by it in turn. Drawing on material from two recent research projects carried out in Copenhagen, I analyse experiences and feelings generated in cross-cultural meetings in the city. The analysis is informed by theories of embodied...
This article focuses on the nature of power dynamics that faculty and staff grassroots leaders encounter as they attempt to create change. I identified five distinctive types of power dynamics--"oppression," "silencing," "controlling," "inertia," and "micro-aggressions" from the most overt to more subtle and covert forms. Staff experience multiple…
Mechanisms used to face difficulties encountered following surgical treatment for breast. CHI'ICGI". José Maria Pereira de Godoy', Silvia Helena da Silvaz, Maria de Fatima Guerreiro Godoy3. FAMERP, Sao Jose do Rio Preto, Brazil. Qualitative studies report factors that may affect the quality of life (QOL) of patients after ...
Jones, E H; Hinckley, A F; Hook, S A; Meek, J I; Backenson, B; Kugeler, K J; Feldman, K A
We examined whether pet ownership increased the risk for tick encounters and tickborne disease among residents of three Lyme disease-endemic states as a nested cohort within a randomized controlled trial. Information about pet ownership, use of tick control for pets, property characteristics, tick encounters and human tickborne disease were captured through surveys, and associations were assessed using univariate and multivariable analyses. Pet-owning households had 1.83 times the risk (95% CI = 1.53, 2.20) of finding ticks crawling on and 1.49 times the risk (95% CI = 1.20, 1.84) of finding ticks attached to household members compared to households without pets. This large evaluation of pet ownership, human tick encounters and tickborne diseases shows that pet owners, whether of cats or dogs, are at increased risk of encountering ticks and suggests that pet owners are at an increased risk of developing tickborne disease. Pet owners should be made aware of this risk and be reminded to conduct daily tick checks of all household members, including the pets, and to consult their veterinarian regarding effective tick control products. © 2017 Blackwell Verlag GmbH.
This paper tells the story of an encounter between two early years teachers and two Forest School workers, the growing tensions in their relationships and how these tensions were resolved. When analysed through a Foucauldian (poststructuralist) lens, the story can be read as a battle between dominant discourses--a battle exacerbated by the outdoor…
Yalçin, Sinan; Altun Yalçin, Sema
This present research, aimed to determine the occasions, which the academicians encountered during the academic research process and how these affect the research process, was prepared as a case study pattern among the qualitative research methods. 34 academicians, who were working in a university in Turkey, participated in the research. The data…
A qualitative, explorative, descriptive and contextual research approach was followed to study the problems experienced by teenage mothers in the southern Hho-Hho region of Swaziland. The findings of transcribed in-depth individual interviews indicated that the major problem encountered by the participants was the lack ...
This study is a descriptive survey designed to investigate challenges teachers encounter in teaching English reading in the uThungulu District schools in the province of KwaZulu Natal. This study comprised 44 teachers who were purposely sampled on grounds of availability. Views were sampled through the use of a ...
The central claim that understanding quantum mechanics requires a conscious observer, which is made made by B. Rosenblum and F. Kuttner in their book "Quantum Enigma: Physics encounters consciousnes", is shown to be based on various misunderstandings and distortions of the foundations of quantum mechanics.
Christou, A. A.; Vaubaillon, J.
We have simulated numerically the existence of meteoroid streams that encounter the orbits of Mars and Venus, potentially producing meteor showers at those planets. We find that 17 known comets can produce such showers, the intensity of which can be determined through observations. Six of these streams contain dense dust trails capable of producing meteor outbursts.
Difficulties encountered by black women entrepreneurs in accessing training from the small enterprise development agency in South Africa. ... and apartheid, imposed oppression and exploitation on women especially black African women, meant that they could not own property in their own rights or enter into a contract.
This paper examines my effort to document the experiences of a Bhutanese refugee community in a mid-western city of the United States. In particular, the essay looks at housing experiences the community encountered and my efforts to translate the events through photographs. The essay also explores how oppression operates in relation to refugee…
According to recent inquiries carried out in French hospitals, the characteristics and performances of air conditioning equipments greatly varies from one hospital to the other. A reflexion has been initiated in some hospitals concerning the indoor air quality, and in parallel with the fight against nosocomial diseases. This paper presents the problems encountered for the improvement and maintenance of air-conditioning systems in hospitals (thermal comfort, air quality, budget). (J.S.)
Chris A Rees
Full Text Available Human immunodeficiency virus (HIV contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting.This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi. We compared clinical indicators documented from the final outpatient encounter for patients who died in the outpatient setting versus those who were alive after their penultimate clinical encounter.Of the 8,546 patients who were attended to over a 10-year period at the Baylor Center of Excellence, 851 had died (10%. Of children who died, 392 (46% were directly admitted to the hospital after their last clinical encounter and died as inpatients. Of the remaining 459 who died as outpatients after their last visit, 53.5% had a World Health Organization (WHO stage IV condition at their last visit, and 25% had a WHO stage III condition. Multivariate regression analysis demonstrated that poor nutritional status, female gender, shorter time as a patient, more clinical encounters in the prior month, if last visit was an unscheduled sick visit, and if the patient had lost weight since their prior visit independently predicted increased mortality in the outpatient setting after the final clinical encounter.Clinical indicators may assist in identifying children with HIV who have increased risk of mortality in the outpatient setting. Recognizing these indicators may aid in identifying HIV-infected children who require a higher level of care or closer follow-up.
Kelley Maureen C
Full Text Available Abstract Background In the United States, an estimated 70 stillbirths occur each day, on average 25,000 each year. Research into the prevalence and causes of stillbirth is ongoing, but meanwhile, many parents suffer this devastating loss, largely in silence, due to persistent stigma and taboo; and many health providers report feeling ill equipped to support grieving parents. Interventions to address bereavement after neonatal death are increasingly common in U.S. hospitals, and there is growing data on the nature of parent bereavement after a stillbirth. However, further research is needed to evaluate supportive interventions and to investigate the parent-clinician encounter during hospitalization following a stillbirth. Qualitative inquiry offers opportunities to better understand the lived experience of parents against the backdrop of clinicians’ beliefs, intentions, and well-meaning efforts to support grieving parents. Methods We present a secondary qualitative analysis of transcript data from 3 semi-structured focus groups conducted with parents who had experienced a stillbirth and delivered in a hospital, and 2 focus groups with obstetrician-gynecologists. Participants were drawn from the greater Seattle region in Washington State. We examine parents’ and physicians’ experiences and beliefs surrounding stillbirth during the clinical encounter using iterative discourse analysis. Results Women reported that the cheery, bustling environment of the labor and delivery setting was a painful place for parents who had had a stillbirth, and that the well-meaning attempts of physicians to offer comfort often had the opposite effect. Parents also reported that their grief is deeply felt but not socially recognized. While physicians recognized patients’ grief, they did not grasp its depth or duration. Physicians viewed stillbirth as an unexpected clinical tragedy, though several considered stillbirth less traumatic than the death of a neonate
Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
Lo, Ming-Cheng M; Stacey, Clare L
In response to widely documented racial and ethnic disparities in health, clinicians and public health advocates have taken great strides to implement 'culturally competent' care. While laudable, this important policy and intellectual endeavour has suffered from a lack of conceptual clarity and rigour. This paper develops a more careful conceptual model for understanding the role of culture in the clinical encounter, paying particular attention to the relationship between culture, contexts and social structures. Linking Bourdieu's (1977) notion of 'habitus' and William Sewell's (1992) axioms of multiple and intersecting structures, we theorise patient culture in terms of 'hybrid habitus'. This conceptualisation of patient culture highlights three analytical dimensions: the multiplicity of schemas and resources available to patients, their specific patterns of integration and application in specific contexts, and the constitutive role of clinical encounters. The paper concludes with a discussion of directions for future research as well as reforms of cultural competency training courses.
Fletcher, David; Hanton, Sheldon; Wagstaff, Christopher R D
We investigated athletes' responses to organisational stressors. Ten sport performers (five males and five females) were interviewed with regard to the organisational-related demands they had encountered and their responses to these stressors. The main emotional responses that were revealed were anger, anxiety, disappointment, distress, happiness, hope, relief, reproach and resentment. The main attitudinal responses were beliefs, motivation and satisfaction. The main behavioural responses were categorised as verbal and physical. The data indicate that performers generally respond to organisational stressors with a wide range of emotions, attitudes and behaviours. The findings are discussed in relation to the extant literature and in terms of their implications for applied practice and future research. Consultants should employ reactive strategies alongside proactive approaches to ensure that performers are psychologically prepared to manage and cope with any demands that are not eliminated. Future research should focus on performers' cognitive appraisals of the organisational stressors they encounter.
Full Text Available The purpose of this study is to provide criteria for selecting operations managers at the ‘service encounter’ for mobile telecommunication companies, and develop a system for this multi-criteria decision-making scheme based on the Analytical Hierarchy Process (AHP. There are three main criteria for evaluating the capability of service-encounter operation managers: (1 the ability to design service process; (2 the ability to operate service process; (3 the ability to conduct improvement. The AHP operation manager selection tool was developed based on the complex problems at the service encounter. It was created as a decision support system which was used to recruit and evaluate operations managers’ capability for the purpose of career advancement.
Taylor, T. H.; Jacobson, R. A.; Synnott, S. P.; Lewis, G. D.; Riedel, J. E.
The Voyager II flyby of Uranus in January 1986 was the most distant planetary encounter ever attempted, and presented unique challenges to the process of orbit determination. Long light-times and spacecraft receiver difficulties hampered the collection of two-way radiometric data and helped bring about the maturation of a Very Long Baseline Interferometry navigational data type during the long cruise from Saturn. Planet and satellite ephemeris uncertainties necessitated the use of the onboard spacecraft optical system for Uranus-relative navigation. During the close approach phase, these optical data were combined with radiometric data to drive the Uranus system-relative uncertainties down to the level of a few tens of kilometers. This paper contains qualitative and quantitative results and conclusions based on orbit determination experience during Uranus cruise and encounter. Topics include an overview of the navigation-related mission events and requirements, and a review of the salient orbit determination results.
Popular culture (movies, SF literature) and witness accounts of close encounters with extraterrestrials provide a rather bizarre image of Aliens behavior on Earth. It is far from stereotypes of human space exploration. The reported Aliens are not missions of diplomats, scientists nor even invasion fleets; typical encounters are with lone ETs (or small groups), and involve curious behavior: abductions and experiments (often of sexual nature), cattle mutilations, localized killing and mixing in human society using various methods. Standard scientific explanations of these social memes point to influence of cultural artifacts (movies, literature) on social imagination, projection of our fears and observations of human society, and, in severe cases, psychic disorder of the involved individuals. In this work we propose an alternate explanation, claiming that the memes might be the result of observations of actual behavior of true Aliens, who, visiting Earth behave in a way that is then reproduced by such memes. Th...
Choosing a language in international office service encounters – from multilingual miscellany to medium-of-interaction in a matter of seconds Spencer Hazel Roskilde University, Denmark In higher education settings characterized by increasing transnational student and staff mobility, members...... study of interactional competence (Hall, Hellerman & Pekarek Doehler, 2011) in the multilingual setting of an internationalizing university. As such, the project investigates the range of competencies that come into play in participants’ co-construction of situated social practices. Included...... in these is “the flexibility to navigate in dynamic language scenarios, and to be able to make the most of what the latent linguistic diversity of internationalized universities has to offer” (Hazel & Mortensen, in press). The data consist of 90 video-recorded service encounters. These are subjected...
Amanish Singh Shinh
Full Text Available Introduction: Orthodontics and Dentofacial Orthopedics requires profound and disciplined training over a considerable period. Given the rigorous nature of the program, it is but logical to assume that the students can encounter some difficulties during the course. The aim of the present study was to gather detailed first-hand information from the postgraduate students of all the practical challenges they encounter in academic programme of orthodontics in India. Materials and Methods: Utilizing a descriptive, cross-sectional survey, conducted through a web-based self-administered questionnaire, the sample population consisted of 799 orthodontic postgraduate students in India and 39 questions were put forward to them. Conclusion: Results showed that even while keeping the basics intact, every course should aim at inputs to help make the academic climate productive, less stressful and student-centric. Change in teaching technology, methodology and structure is needed in training our postgraduate students, to promote a more congenial academic climate.
Kaufman, Michele; Elmegreen, Bruce G.; Thomasson, Magnus; Elmegreen, Debra M.
Gerola et al. (1983) propose that isolated dwarf galaxies can form during galaxy interactions. As evidence of this process, Mirabel et al. (1991) find 10(exp 9) solar mass clouds and star formation complexes at the outer ends of the tidal arms in the Antennae and Superantennae galaxies. We describe observations of HI clouds with mass greater than 10(exp 8) solar mass in the interacting galaxy pair IC 2163/NGC 2207. This pair is important because we believe it represents an early stage in the formation of giant clouds during an encounter. We use a gravitational instability model to explain why the observed clouds are so massive and discuss a two-dimensional N-body simulation of an encounter that produces giant clouds.
Andaleeb, Syed Saad; Kara, Ali
The objective of this study was to examine a complex service environment-hospitals-to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively. In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage. Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs). Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs. Primary actors-ie, doctors-need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, "putting the customer first." Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as "patient advocates." Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.
Høye, Sevald; Severinsson, Elisabeth
The aim of this study was to explore nurses' perceptions of their encounters with multicultural families in intensive care units in Norwegian hospitals. Immigrants from non-Western countries make up 6.1% of the population in Norway. When a person suffers an acute and critical illness the person's family may experience crises. Nurses' previous experiences of caring for culturally diverse patients and families is challenging due to linguistic differences, and contextual factors. Family members should be near their critically ill spouse to reduce the impact from a frightening environment. The study had a descriptive exploratory qualitative design with a retrospective focus. Three multistage focus groups consisting of 16 nurses were set up in intensive care units. The data were analysed by interpretive content analysis. The theme 'Cultural diversity and workplace stressors' emerged. This theme was characterised by four categories: 'impact on work patterns'; 'communication challenges'; 'responses to crises' and 'professional status and gender issues'. In conclusion, nurses' perception of their encounters with multicultural families in intensive care units seem to be ambiguous with challenges in interaction, and the nurses' stressors emanating from linguistic, cultural and ethnic differentness. To diminish cultural diversity the nurses strive for increased knowledge of different cultures and religions.
Block, Lauren; Hutzler, Lindsey; Habicht, Robert; Wu, Albert W; Desai, Sanjay V; Novello Silva, Kathryn; Niessen, Timothy; Oliver, Nora; Feldman, Leonard
Etiquette-based communication may improve the inpatient experience but is not universally practiced. We sought to determine the extent to which internal medicine interns practice behaviors that characterize etiquette-based medicine. Trained observers evaluated the use of 5 key communication strategies by internal medicine interns during inpatient clinical encounters: introducing one's self, explaining one's role in the patient's care, touching the patient, asking open-ended questions, and sitting down with the patient. Participants at 1 site then completed a survey estimating how frequently they performed each of the observed behaviors. A convenience sample of 29 interns was observed on a total of 732 patient encounters. Overall, interns introduced themselves 40% of the time and explained their role 37% of the time. Interns touched patients on 65% of visits, asked open-ended questions on 75% of visits, and sat down with patients during 9% of visits. Interns at 1 site estimated introducing themselves and their role and sitting with patients significantly more frequently than was observed (80% vs 40%, P etiquette-based medicine. © 2013 Society of Hospital Medicine.
van Veelen, M A; Nederlof, E A L; Goossens, R H M; Schot, C J; Jakimowicz, J J
The aim of this study is to gain insight into the problems encountered by the medical team related to products used for minimally invasive surgery. An inventory was made of the problems encountered during 12 endoscopic operations performed in one city hospital (Eindhoven, the Netherlands). After the observation, a questionnaire was distributed to all medical staff involved. All categories of personnel had physical, perceptional, and cognitive problems, especially surgeons, residents, and the sterile operation nurse. The main causes were the positioning of apparatus and staff, work clothing, and the limited reach of apparatus and/or instruments. Of the questionnaires, 80% were returned: 50% of the medical staff experienced perceptional problems and 63% had physical discomfort during the surgical procedure. The diversity of problems observed and/or reported by the staff during minimally invasive surgery decrease the comfort, efficiency, and safety of the operating-room work environment. Therefore, a new design approach is needed for MIS products in order to address the problems that occur with the current equipment.
The article examines the theme of paganism as the leading religion in Ukraine before the advent of Christianity with the goal of describing the period of the encounter between paganism and Christianity and evaluating the reasons for the present growth of interest in paganism. The article shows that the traditions of Ukrainian paganism were connected with ancient Asiatic religions brought to the area by means of trade routes from India and China to the Roman Empire that crossed the present ter...
Vitaliy Valentynovych Proshak
The article examines the theme of paganism as the leading religion in Ukraine before the advent of Christianity with the goal of describing the period of the encounter between paganism and Christianity and evaluating the reasons for the present growth of interest in paganism. The article shows that the traditions of Ukrainian paganism were connected with ancient Asiatic religions brought to the area by means of trade routes from India and China to the Roman Empire that crossed the present ter...
Koehn Peter H
Abstract Unprecedented migration, a core dimension of contemporary globalization, challenges population health. In a world of increasing human mobility, many health outcomes are shaped by transnational interactions among care providers and care recipients who meet in settings where nationality/ethnic match is not an option. This review article explores the value of transnational competence (TC) education as preparation for ethnically and socially discordant clinical encounters. The relevance ...
Looi, Lai-Meng; Wong, Li Xuan; Koh, Cing Chai
In June 2015, invitations were sent by email to 151 APAME journals to participate in an online survey with an objective of gaining insight into the common publication misconduct encountered by APAME editors. The survey, conducted through SurveyMonkey over a 20-day-period, comprised 10 questions with expansions to allow anecdotes limited to 400 characters, estimated to take less than 10 minutes to complete. Only one invitation was issued per journal, targeting (in order of priority) editors, editorial board members and editorial staff, and limited by email availability. 54 (36%) journals responded. 98% of respondents held Editor or Editorial Board positions. All respondent journals have editorial policies on publication ethics and 96% provide instructions related to ethics. 45% use anti-plagiarism software to screen manuscripts, the most popular being iThenticate, CrossCheck and Turnitin. Up to 50% of journals had encountered studies without IRB approval. Author misconduct encountered were (in rank order): plagiarism (75%), duplicate publication (58%), unjustified authorship (39%), authorship disputes (33%), data falsification (29%), data/image manipulation (27%), conflict of interest (25%), copyright violation (17%) and breach of confidentiality (10%). Reviewer misconduct encountered were: conflict of interest (19%), plagiarism (17%), obstructive behavior (17%), abusive language (13%) and breach of confidentiality (13%). Notwithstanding the limitations of the survey and the response rate, a few insights have been gained: (1) the need for strengthening the ethical culture of researchers/authors and reviewers, (2) anti-plagiarism software can improve plagiarism detection by about 15%, and (3) the need for technical support to detect plagiarism, duplicate publication and image manipulation.
Full Text Available As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP encounters strengthen third-year medical students’ communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students’ self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n = 215; response rate, 96% analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students’ perception of their confidence and abilities regarding their performance (P < 0.05; Bonferroni correction, P < 0.006. There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents.
Owen, Jesse; Fincham, Frank D
Hooking up, or a sexual encounter ranging from kissing to intercourse that occurs on one occasion and where the partners do not necessarily expect future physical encounters or a committed relationship, has become commonplace among college students. This study (N = 500) examined gender differences in emotional reactions after hooking up and explored the relationship between specific processes in the hooking up encounter and reactions to hooking up. Compared to women, men reported more positive and fewer negative emotional reactions; however, both men and women reported that the experience was largely more positive than negative. Coital hook ups were associated with fewer negative emotional responses for men as compared to women who engaged in coital and non-coital hook ups and to men who engaged in non-coital hook ups. For those who engaged in coital hook ups, women reported that condom use was associated with fewer positive and more negative emotional reactions whereas condom use was related to fewer negative emotion reactions for men. Negative emotional reactions were also related to reports of depressive symptoms and feelings of loneliness; however, feelings of loneliness were not related to negative emotional reactions after accounting for young adults' positive emotional reactions. Positive emotional reactions were related to hope for and discussion of a committed relationship. Implications for relationship education and future research are outlined.
Fernández, R; Menéndez, M; Fernández, M J; Pérez, M; Novo, M Á; Álvarez, J A
The main objective of the study is to analyze the perception of difficult encounters experienced by the various professional groups involved in patient care. The methodology used is qualitative, using focus groups. Four groups were formed: doctors, nurses, primary care receptionists, and experts in communication skills. The location was primary care, in Ourense area. Sampling was purposive. Patients were recruited by a member of the same professional group. Each session was recorded on audio and video. Information was categorized by reference to the bibliography and information resulting from conversations. The following categories were established: the concept of a difficult patient/difficult encounter, reasons for difficulty, consequences for the professional and patient, individual strategies of management, and strategies that institutions should take. The concept of difficulty varies among the different groups. All are capable of recognizing the professional responsibility, but this aspect does not arise spontaneously, except in the group of experts. In relation to difficult encounter management, most express strategies based on common sense and experience. The expert group uses more sophisticated techniques. There are differences in the quality of discourse and positioning relative to the user from the group of experts and other groups. Training in communication techniques is recommended to encourage a change in attitudes towards a patient-centered code, but the content of training should be developed based on knowledge of the group to which they are addressed. Copyright © 2014. Publicado por Elsevier España, S.L.U.
Son, Kwangmin; Guasto, Jeffrey S.; Cubillos-Ruiz, Andres; Chisholm, Sallie W.; Sullivan, Matthew B.; Stocker, Roman
Viruses are non-motile infectious agents that rely on Brownian motion to encounter and subsequently adsorb to their hosts. Paradoxically, the viral adsorption rate is often reported to be larger than the theoretical limit imposed by the virus-host encounter rate, highlighting a major gap in the experimental quantification of virus-host interactions. Here we present the first direct quantification of the viral adsorption rate, obtained using live imaging of individual host cells and viruses for thousands of encounter events. The host-virus pair consisted of Prochlorococcus MED4, a 800 nm small non-motile bacterium that dominates photosynthesis in the oceans, and its virus PHM-2, a myovirus that has a 80 nm icosahedral capsid and a 200 nm long rigid tail. We simultaneously imaged hosts and viruses moving by Brownian motion using two-channel epifluorescent microscopy in a microfluidic device. This detailed quantification of viral transport yielded a 20-fold smaller adsorption efficiency than previously reported, indicating the need for a major revision in infection models for marine and likely other ecosystems.
This article examines the phenomenology of body shame in the context of the clinical encounter, using the television program 'Embarrassing Bodies' as illustrative. I will expand on the insights of Aaron Lazare's 1987 article 'Shame and Humiliation in the Medical Encounter' where it is argued that patients often see their diseases and ailments as defects, inadequacies or personal shortcomings and that visits to doctors and medical professionals involve potentially humiliating physical and psychological exposure. I will start by outlining a phenomenology of shame in order to understand more clearly the effect shame about the body can have in terms of one's personal experience and, furthermore, one's interpersonal dynamics. I will then examine shame in the clinical encounter, linking body shame to the cultural stigma attached to illness, dysfunction and bodily frailty. I will furthermore explore how shame can be exacerbated or even incited by physicians through judgment and as a result of the power imbalance inherent to the physician-patient dynamic, compounded by the contemporary tendency to moralise about 'lifestyle' illnesses. Lastly, I will provide some reflections for how health care workers might approach patient shame in clinical practice.
Seuront, Laurent; Stanley, H Eugene
For millimeter-scale aquatic crustaceans such as copepods, ensuring reproductive success is a challenge as potential mates are often separated by hundreds of body lengths in a 3D environment. At the evolutionary scale, this led to the development of remote sensing abilities and behavioral strategies to locate, to track, and to capture a mate. Chemoreception plays a crucial role in increasing mate encounter rates through pheromone clouds and pheromone trails that can be followed over many body lengths. Empirical evidence of trail following behavior is, however, limited to laboratory experiments conducted in still water. An important open question concerns what happens in the turbulent waters of the surface ocean. We propose that copepods experience, and hence react to, a bulk-phase water pheromone concentration. Here we investigate the mating behavior of two key copepod species, Temora longicornis and Eurytemora affinis, to assess the role of background pheromone concentration and the relative roles played by males and females in mating encounters. We find that both males and females react to background pheromone concentration and exhibit both innate and acquired components in their mating strategies. The emerging swimming behaviors have stochastic properties that depend on pheromone concentration, sex, and species, are related to the level of reproductive experience of the individual tested, and significantly diverge from both the Lévy and Brownian models identified in predators searching for low- and high-density prey. Our results are consistent with an adaptation to increase mate encounter rates and hence to optimize reproductive fitness and success.
Objectives: To review the spectrum of thyroid pathology diagnoses likely to be encountered by surgeons working in East African hospitals. Design: A retrospective review of all thyroidectomies performed over a three year period. Setting: A rural church based hospital in Kenya. Subjects: Two hundred and twenty two patients ...
years and below, who presented at the University of Port Harcourt Teaching' Hospital during a. 12-year period. ... However, the role of malignancies as a cause of death- .University of Port-Harcourt Teaching Hospital,. 'Port-Harcourt . " Department of Anatomical Pathology _ ' '. '''Lecturer ' ' - .... decreasing numerical order.
In the School of Science of the Universidad de Los Andes (ULA), in Mérida, Venezuela, a very successful event focused on high school students and primary school students, was founded in 2000. The name of this event is "Encounters with Physics, Chemistry, Mathematics, and Biology" (hereinafter "Encounters with Science"), and it integrates these disciplines as well as Astronomy. Its main purpose is that young minds can become familiar with the methods of science inquiry and reasoning, and can understand the concepts and processes of the sciences through thoroughly prepared experiences. This flourishing program is continuing to grow and to become strong. As a matter of fact, in its sixth edition (2005), the number of high and elementary school students coming from all over the country, has reached the outstanding number of nine thousand. Among all the experiences that the students could be engaged in were many involving Astronomy. These experiences were prepared by professors, together with graduate and undergraduate students, who are pursuing their degrees in all branches of science including astronomy. Although there is this incredible team of faculties and graduate and undergraduate students working together; the target is the students of the high and elementary schools. We certainly focus on the engaging and encouraging of students to experience scientific work first hand. Additionally, our professors have prepared an excellent didactic material that can, together with the hour/class teaching, prepare high school and elementary school students for a better understanding of science; particularly, helping in this way for a better education in Astronomy. The main event of the Encounters lasts five days in the School of Science of ULA, but subsidiary events are spread all over the year and around the country. As a successful program, it can be interesting to see if other countries can adopt this method to recruit or to trigger the interest of students to pursue their
Roberts, Lisa C; Whittle, Christopher T; Cleland, Jennifer; Wald, Mike
Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician. The purpose of this study was to measure verbal communication between physical therapists and patients with back pain during their initial consultation and trial management of the data using a novel, Web-based application. A cross-sectional study was conducted. Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio recorded, and categorized using the Medical Communications Behavior System. Data were managed using Synote, a freely available application enabling synchronization of audio recordings with transcripts and coded notes. In this sample, physical therapists spoke for 49.5% of the encounter and patients for 33.1%. Providers and patients spent little time overtly discussing emotions (1.4% and 0.9%, respectively). More-experienced clinicians used more "history/background probes," more "advice/suggestion," and less "restatement" than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients (7.6% compared with 2.6%). Although studies measuring actual behavior are considered to be the gold standard, audio recordings do not enable nonverbal behaviors to be recorded. This study investigated a method for measuring the verbal content of clinical encounters in a physical therapy outpatient setting. The study has directly contributed to developing a research-friendly version of the application (i.e., Synote Researcher). Given the pivotal role of communication in ensuring a positive experience and outcome for both patient and provider, investing time in further developing communication skills should be an on-going priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in sex and provider
Koefoed, Lasse Martin
of Copenhagen. Multicultural festivals are seen as places for on-going identity negotiations, where individuals and groups define meaningful concepts of identity along with notions of exclusion. In the paper, we adopt a performative approach abandoning the distinction between bodies and space and embracing......This article is part of a project on Paradoxical Spaces: Encountering the Other in public space which explores how cultural difference is experienced, practiced and negotiated in public space. Specifically, it explores the ‘multicultural’ festival Kulturhavn taking place yearly along the harbour...
especially in psychological studies. Determining to which extent alignment of verbal and non-verbal behaviors takes place in conversations in which a large amount of information is exchanged, is important a) for understanding how humans communicate and b) providing empirical based models for designing...... and whether it increases when the participants get more acquainted as suggested, at least for speech, in the literature. Alignment of verbal and non verbal behaviors is investigated by extracting overlapping spoken contributions and facial expressions in the first encounters and comparing their occurrences...
Nishimura, T.; Matsuo, H.; Takano, T.; Kawaguchi, J.
The techniques used by ISAS in the guidance of the Sakigake and Suisei probes, which encountered Comet Halley in March 1986, are reviewed. Consideration is given to the guidance of the last rocket stage in the direct ascent phase, midcourse maneuvers, tracking systems and communication links, the tracking strategy, trajectory-generation and orbit-determination software, and orbit-determination accuracy. Diagrams, drawings, graphs, photographs, and tables of numerical data are provided, and the ISAS positions of both probes during the first 10 days after launch are shown to be within 100 km in distance and 1 m/sec in velocity of NASA coordinate estimates.
Ouvrage collectif coordonné par Bob White, professeur au département d’anthropologie de l’Université de Montréal, Music and Globalization. Critical Encounters est le fruit d’un travail mené par le laboratoire de recherche virtuel Critical World (www.criticalworld.net), qui se base sur la recherche ethnographique afin d’explorer les relations entre la culture populaire et les phénomènes de globalisation. Le lancement de Critical World, en 2004, fut marqué par des journées d’étude international...
slightly after, but also that there are delays in both directions in the range of -/+ 1s. Various factors that may influence delay duration are investigated. Correlations are found between delay length and the duration of the speech sequences associated with the head movements. Effects due to the different......This paper presents an analysis of the temporal alignment be- tween head movements and associated speech segments in the NOMCO corpus of first encounter dialogues . Our results show that head movements tend to start slightly before the onset of the corresponding speech sequence and to end...... head movement types are also discussed....
Mendenhall, Michael R.; Lesieutre, Daniel J; Kelly, Michael J.
The trailing vortex induced aerodynamic loads on a Falcon 20G business jet flying in the wake of a DC-8 are predicted to provide a preflight estimate of safe trail distances during flight test measurements in the wake. Static and dynamic loads on the airframe flying in the near wake are shown at a matrix of locations, and the dynamic motion of the Falcon 20G during traverses of the DC-8 primary trailing vortex is simulated. Safe trailing distances for the test flights are determined, and optimum vortex traverse schemes are identified to moderate the motion of the trailing aircraft during close encounters with the vortex wake.
Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.
On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.
Walter Thirring is the last offspring of an Austrian family of scientists. In this moving narrative, he describes how he survived the Nazi occupation and became instrumental in reconstructing European science. Thirring is one of the last living physicists who worked on the greatest discoveries and with the greatest scientists of the 20th century. He recollects encounters with the old masters like Einstein, Schrodinger, Heisenberg, Pauli and others as well as his collaborations with the present stars like Murray Gell-Mann and Elliott Lieb. The book presents the challenges faced when one of the
Full Text Available Fieldwork, an anthropologist's vocation, is full of tensions and dilemmas. However, the experiences of any or all tensions, troubles and even failures are a 'source of ethnographic knowledge in themselves'. During the fieldwork for my PhD research, I encountered several such incidents, which have made my work more interesting and my experience richer. This article describes the situation of doing fieldwork in the conflict period, when the 'peace process' was not yet come to the conclusion.DOI: http://dx.doi.org/10.3126/dsaj.v8i0.10723Dhaulagiri Journal of Sociology and Anthropology Vol. 8, 2014; 87-98
Full Text Available The problem of assessing the risk for a vessel to encounter a killer wave in the Black Sea is considered. Analysis of in situ wave data obtained from the platform of Marine Hydrophysical Institute in the autumn of 2009 shows that occurrence frequency of abnormally high waves (freak, rogue, or killer waves varies considerably on the time scale of several hours. It is shown that the formation of such waves is associated with nonlinear processes in the wave field, presumably, with the development of modulational instability. Ninety percent of the total number of killer waves was observed in the swell wave system, and 70% of them propagated approximately in wind direction. We propose a scenario of the killer waves formation in the Black Sea. The scenario was confirmed by numerical reconstruction of the wind and wave fields in the Black Sea for the history of storms on Oct. 14, 2009 in Katsiveli and on Feb. 01, 2003 in Gelendzhik, using the MM5 mesoscale atmospheric model and the WAM-C4 wave model. A practical approach to assessing the risk for a vessel to encounter a killer wave in the Black Sea is presented.
Objectives. Negative social interactions are the most frequently reported daily stressors and most detrimental for well-being, yet we know little about older adults’ efforts to regulate their emotional reactions to such encounters. This study examined age differences in emotional reactions to social encounters and the implications of these reactions for daily well-being. Methods. Middle-aged, young-old, and oldest-old adults (59% women; aged 40–95, N = 110) completed daily interviews for 14 days. Each day, participants reported whether they had social interactions that made them feel irritated, hurt, or annoyed (experienced emotional reaction) and social interactions in which they could have felt irritated, hurt, or annoyed but avoided feeling that way (minimized emotional reaction). Results. Findings revealed no age differences in the types of emotional reactions reported (experienced or minimized). Associations between emotional reactions and daily well-being varied by age group. Oldest-old individuals’ well-being was less negatively affected by minimized emotional reactions, but more negatively affected by experienced emotional reactions compared with younger individuals’ well-being. Discussion. Findings support the strength and vulnerability integration model that suggests that when older individuals use avoidant strategies, they show better emotion regulation than younger individuals. PMID:23697389
Spidsberg, Bente Dahl
This paper is a report of a study to describe the maternity care experiences narrated by a sample of lesbian couples. Pregnant and labouring women are dependent on the professional skill and caring ability of the healthcare provider. Studies show that lesbian women who reveal their sexual identity are exposed to homophobic prejudice and discrimination in midwifery care. A phenomenological hermeneutical study inspired by the French philosopher Paul Ricoeur was conducted. Six lesbian couples were recruited in Norway by a snowball method, reporting a total of eight children conceived by donor insemination. Joint interviews were performed in January 2006, and the participants were encouraged to share narratives about important events in their maternity care experiences. The fundamental life conditions of vulnerability, responsibility and caring permeated the narratives, and were related with the couples' decisions to be open about their sexual identity. Being exposed, they experienced under- and over-focusing on sexuality. They felt responsible for having the right attitude in interactions, which meant being open, but not over-assertive. They described genuinely caring situations as well as being content with less genuine care, and demonstrated that in addition to receiving care, they provided care in the encounters. Lesbian women are a vulnerable group when encountering maternity care. They took responsibility in caring situations because of healthcare providers' uncertainty and anxiety. Existential needs, such as being seen, being cared for and communicated with, should be considered equally important for lesbian women and heterosexual women in labour.
Arnold, Rachel; Wagstaff, Christopher R D; Steadman, Lauren; Pratt, Yasmin
Organisational stressors have been found to be prevalent and problematic for sport performers, with research identifying demographic differences in the stressors encountered. Nevertheless, extant sport psychology research on the topic of stress has generally focused on able-bodied athletes; whilst that which has been conducted on performers with a disability has typically recruited relatively small samples to explore a narrow selection of organisational stressors, or examined other components of the stress process. The purpose of the present study was to explore the various organisational stressors that athletes with a disability encounter. The sample comprised 18 elite athletes with a disability (10 male, 8 female) who had a classified disability and experience of competing at a major championships in their sport (e.g., Paralympic Games, World Championships). Participants took part in a semi-structured interview which was analysed by drawing from grounded theory procedures. A total of 316 organisational stressors were identified, which were abstracted into 31 concepts and four, previously conceptualised, exploratory schemes: leadership and personnel issues, cultural and team issues, logistical and environmental issues, and performance and personal issues. This study not only provides the first illustration of the prevalence of organisational stressors for athletes with a disability, but also significantly points to salient similarities and distinct differences between the stress experiences of performers with and without a disability.
García-Bellido, Juan; Nesseris, Savvas
We propose that Gravitational Wave (GW) bursts with millisecond durations can be explained by the GW emission from the hyperbolic encounters of Primordial Black Holes in dense clusters. These bursts are single events, with the bulk of the released energy happening during the closest approach, and emitted in frequencies within the AdvLIGO sensitivity range. We provide expressions for the shape of the GW emission in terms of the peak frequency and amplitude, and estimate the rates of these events for a variety of mass and velocity configurations. We study the regions of parameter space that will allow detection by both AdvLIGO and, in the future, LISA. We find for realistic configurations, with total mass M ∼ 60M⊙, relative velocities v ∼ 0 . 01 c, and impact parameters b ∼ 10-3 AU, for AdvLIGO an expected event rate is O(10) events/yr/Gpc3 with millisecond durations. For LISA, the typical duration is in the range of minutes to hours and the event-rate is O(103) events/yr/Gpc3 for both 103M⊙ IMBH and 106M⊙ SMBH encounters. We also study the distribution functions of eccentricities, peak frequencies and characteristic timescales that can be expected for a population of scattering PBH with a log-normal distribution in masses, different relative velocities and a flat prior on the impact parameter.
Hills, J.G.; Goda, M.P.; Solem, J.C.
This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at Los Alamos National Laboratory (LANL). The authors find by numerical simulations that the elongated-potato shape that is characteristic of Earth-crossing asteroids (ECAs) is likely the result of previous close tidal encounters with Earth. Some meteoroids graze the atmosphere of Earth before returning to space (at reduced speed). They used a spherical atmospheric model to study such grazers to find the condition under which they are captured into gravitationally bound orbits around Earth. They find that for about every thousand iron asteroids that hit the Earth, one is captured into a gravitational-bound orbit. Some fraction of these captured objects will have their orbits stabilized for many revolutions by tidal encounters with the Moon and the sun. They have also studied how the damage produced by such grazing and near-grazing asteroids differs from that produced by asteroids that hit Earth more directly.
Griswold, Kim; Zayas, Luis E; Kernan, Joan B; Wagner, Christine M
This paper presents findings from a qualitative investigation of cultural awareness that medical students developed in the context of providing medical care to refugees. Our evaluation question was: What kinds of cultural awareness and communication lessons do medical students derive from clinical encounters with refugee patients? Thirty-eight semi-structured interviews were conducted to debrief a sample of 27 medical students. A multidisciplinary research team analyzed the debriefing texts following an interpretive "immersion-crystallization" approach. Three domains in cultural awareness training encompassed 13 key lessons or themes. Students reported enhanced awareness about the use of interpretation services and cross-cultural communication. A second set of lessons reflected awareness of the refugees' cultural background, and a third learning component involved experiences of cultural humility. The refugee plight prompted reflection on the students' own culture, and validated the rationale for empathetic care and patient empowerment. As medical school curricula incorporate more cultural diversity training, a patient-based learning approach with selected 'hands-on' experiences will create opportunities for students to increase their cultural sensitivity and competency. This program's experiential model indicates that after refugee medical encounters, these beginning medical students reported greater awareness of communication issues, and sensitivity toward religious values, family patterns, gender roles and ethnomedical treatments. It will be important to test these kinds of preceptor/apprenticeship models of cultural sensitivity training at later stages of medical training; in order to assess long-term effects.
Lie, D A; Bereknyei, S; Vega, C P
Describe longitudinal skill development of medical students for the interpreted encounter. Two successive classes of students (n=92 and 100) participated in standardized clinical stations testing general communication skills and skills for working with interpreters at the end of their second year and after completing clinical clerkships during their third year. Performance was rated by standardized patients, interpreters and students using validated scales. Analysis of individual matched paired data was performed for each scale item using the Wilcoxon signed-rank test. Pairwise correlation was used to compare global scores of the standardized patient and standardized interpreter with student self-ratings. Over one year students' (n=124-168) performance worsened in behaviors for 'managing the encounter' (per interpreters' ratings) or remained unchanged (per patients' ratings). By patients' ratings, performance scores in general communication remained high. Students rated themselves as significantly improved in five of eight skills for working with interpreters despite a lack of external evidence of improvement from patient or interpreter. Students showed a trend toward underestimating their own global skills at baseline and overestimating them in comparison with the interpreters' global ratings. Students' general communication skills remained excellent over one year of training but some skills for working with interpreters worsened. Over time students showed a pattern of overrating their own skills compared with trained observers. Faculty who teach students should focus on specific behaviors that are most likely to decay without reinforcement and practice.
Koehn Peter H
Full Text Available Abstract Unprecedented migration, a core dimension of contemporary globalization, challenges population health. In a world of increasing human mobility, many health outcomes are shaped by transnational interactions among care providers and care recipients who meet in settings where nationality/ethnic match is not an option. This review article explores the value of transnational competence (TC education as preparation for ethnically and socially discordant clinical encounters. The relevance of TC's five core skill domains (analytic, emotional, creative, communicative, and functional for migration health and the medical-school curriculum is elaborated. A pedagogical approach that prepares for the transnational health-care consultation is presented, with a focus on clinical-clerkship learning experiences. Educational preparation for contemporary medical encounters needs to include a comprehensive set of patient-focused interpersonal skills, be adaptable to a wide variety of service users and global practice sites, and possess utility in addressing both the quality of patient care and socio-political constraints on migration health.
U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...
Full Text Available Doctors and clients sometimes experience interactiveclashes during hospital meetings in South-western Nigerianhospitals because of their divergent culture-constrainedorientation to politeness cues. The goal of this paper is tounpack the discursive elements that characterize interactiveconfluence and divergence in selected consultativeencounters in the hospitals. The findings indicate thatinstitutional and cultural (disalignments occur in respect ofadjacency and non-adjacency pair greetings. In bothgreeting types, face support, threat and stasis are conjointlyco-constituted by doctors and Yoruba clients within theaffordances of the cultural, institutional and situationalcontext of the Southwestern Nigerian hospital setting.Adjacency pair greetings attract mutual interpretingsbetween the parties; interactive disalignments aredifferentially pragmatically accommodated by doctors andclients. In non-adjacency pair greeting, doctors’ threats areco-constituted as appropriate by both parties, theinstitutional power of doctor and shared Western culturalorientation playing significant roles.
Doerr, Otto; Velásquez, Oscar
It is well known how often psychiatric patients report religious experiences. These are especially frequent in schizophrenic and epileptic patients as the subject of their delusions. The question we pose is: are there differences between this kind of religious experiences and those we find in religious texts or in the mythological tradition? An overview on famous mythological narratives, such as The Aeneid, allows us to establish that the divinities become recognizable to the human being at the moment of their departure. Thus, Aeneas does not recognise his mother, Venus, when she appears to him in the middle of the forest at the coast of Africa. A dialogue between the two takes place, and only at the end of the encounter, when she is going away and already with her back to Aeneas, she shows her son the signs of her divinity: the rose-flush emanating from her neck, her hair perfume and the majesty of her gait. Something analogous can be observed in the encounter of Moses with Yahweh on Mount Sinai. Moses asks God: "Show me your glory, I beg you". And God replies, among other things: "you shall see the back of me, but my face is not to be seen". In the same sense, the Emmaus disciples do not recognise Jesus till the moment of his disappearance ("but he had vanished from their sight"), and Saul of Tars falls off his horse just in the moment when he feels the divine presence. In short, the direct encounter with the divinity seems not to occur in the realm of myth or in religious tradition. The realm of madness is exactly the opposite. Our research on religious experiences in schizophrenic and epileptic patients leads us to conclude that God appears to them face to face, and the patient describes God the father, Jesus or the Virgin Mary in intimate detail, always in an everyday setting. So, the divinity is seen in the garden, or in the bedroom, or maybe above the wardrobe, without any of its majesty. The nearness to God also tends to be so extreme that even an
To determine the pattern of drug prescription by consultants in a private hospital in Dubai, United Arab Emirates, 1190 prescriptions were collected from the hospital\\'s pharmacy over 30 days. In total, 2659 drugs were prescribed. The mean number of drugs per encounter was 2.2. Only 4.4% of all drugs prescribed were ...
Full Text Available Introduction: Rural populations have many barriers to quality health care including lack of access to primary care and specialty care and a greater likelihood to be underinsured or uninsured. They are also less likely to use preventive screening, or to participate in self-care and engage in their health when compared to urban residents. The purpose of this paper was to describe patients’ healthcare experiences in a rural western state focusing on their healthcare expectations and engagement. Methods: This qualitative study was conducted using a focus group protocol to elicit rural patients’ healthcare experiences. A purposeful sample of English speaking adult residents from a single county who were willing to discuss their healthcare experiences was included. Patients and community members (21 years and older were recruited through a local hospital as well as via flyers posted throughout the community. Each audio-recorded group took about two hours. A total of 15 focus groups were conducted to obtain sufficient text for theoretical saturation and thematic analysis. Each group had a range of 3-8 participants. A $25 visa gift card and lunch were provided for each participant as an incentive. Results: ‘Encounters with Healthcare Professionals’ and ‘Engagement in Health’ were the two dominant dimensions with two themes each. Themes centered around what characterized the best or worst encounters. Trust and Communication - both were based on time spent with the provider and establishment of rapport with the providers. The best encounters were those with health care providers or pharmacists who had sufficient time, adequately explained a diagnosis and new medications did not dismiss patient concerns, and treated individuals with respect. Typical responses describing the worst encounters included examples of misdiagnosis, dismissing patient’s symptoms, healthcare professionals whose attention was not focused on the patient, pushing too
Shklovski, Irina; de Souza e Silva, Adriana Araujo
Computing research has long been interested in location-aware mobile games, such as hybrid reality games, location-based games and urban games. With an increas- ingly pervasive IT infrastructure and comparatively affordable mobile devices, such games are becoming part of everyday play around...... the world. A study of an urban night-game called Encounter widely played in the Former Soviet Union and the Russian-speaking Diaspora is presented. The ways in which IT enables a complex interaction between the local experience of play in the urban environment and the geographically distributed nature......-based communication in daily experience. The most important outcome of these games then was not the direct individual engagement with the urban environment through technology or the collaboration with strangers in the course of play (although these were the necessary prerequisites), but the social relationships that...
Stroud, Phillip David [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Cuellar-Hengartner, Leticia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Kubicek, Deborah Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Cleland, Timothy James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
Los Alamos National Laboratory (LANL) is utilizing the Probability Effectiveness Methodology (PEM) tools, particularly the Pathway Analysis, Threat Response and Interdiction Options Tool (PATRIOT) to support the DNDO Architecture and Planning Directorate’s (APD) development of a multi-region terrorist risk assessment tool. The effort is divided into three stages. The first stage is an exploration of what can be done with PATRIOT essentially as is, to characterize encounter rate during transit across a single selected region. The second stage is to develop, condition, and implement required modifications to the data and conduct analysis to generate a well-founded assessment of the transit reliability across that selected region, and to identify any issues in the process. The final stage is to extend the work to a full multi-region global model. This document provides the results of the first stage, namely preliminary explorations with PATRIOT to assess the transit reliability across the region of southern Africa.
Full Text Available This paper examines my effort to document the experiences of a Bhutanese refugee community in a mid-western city of the United States. In particular, the essay looks at housing experiences the community encountered and my efforts to translate the events through photographs. The essay also explores how oppression operates in relation to refugee experiences. Recognizing that knowledge of recent refugees of color has been absent and perhaps may not be addressed in school curriculum in the near future, this photo essay project was created to serve as a curriculum about marginalized communities who are invisible in the curriculum. By using photographs, I explore three concepts that may help us examine the relationship between space and politics: (1 ideal spaces (2 violated spaces (3 damaged spaces. Lastly, by examining refugee experiences, the paper examines pedagogical approaches utilizing photographs to document oppression.
Remember the excitement three years ago before the gas cloud G2s encounter with the supermassive black hole at the center of our galaxy, Sgr A*? Did you notice that not much was said about it after the fact? Thats because not much happened and a new study suggests that this isnt surprising.An Anticipated ApproachG2,an object initially thought to be a gas cloud, was expected to make its closest approach to the 4.6-million-solar-mass Sgr A* in 2014. At the pericenter of its orbit, G2 was predicted to pass as close as 36 light-hours from the black hole.Log-scale column density plots from one of the authors simulations, showing the cloud at a time relative to periapsis (t=0) of 5, 1, 0, 1, 5, and 10 yr (left to right, top to bottom). [Morsony et al. 2017]This close brush with such a massive black hole was predicted to tear G2 apart, causing much of its material to accrete onto Sgr A*. It was thought that this process would temporarily increase the accretion rate onto the black hole relative to its normal background accretion rate, causing Sgr A*s luminosity to increase for a time.Instead, Sgr A* showed a distinct lack of fireworks, with very minimal change to its brightness after G2s closest approach. This cosmic fizzle has raised questions about the nature of G2: was it really a gas cloud? What else might it have been instead? Now, a team of scientists led by Brian Morsony (University of Maryland and University of Wisconsin-Madison) have run a series of simulations of the encounter to try to address these questions.No FireworksMorsony and collaborators ran three-dimensional hydrodynamics simulations using the FLASH code. They used a range of different simulation parameters, like cloud structure, background structure, background density, grid resolution, and accretion radius, in order to better understand how these factors might have affected the accretion rate and corresponding luminosity of Sgr A*.Accretion rate vs. time for two of the simulations, one with a wind
, all had fasted during Ramadan despite being diagnosed with type 2 diabetes. While fasting, they adapted their use of medicines in different ways, e.g. changing the time of intake or skipping morning medicines. Fasting during Ramadan meant a feeling of improvement in well-being for all interviewees......Background: The Danish healthcare sector, including community pharmacies, faces a modern challenge: a new and growing population group consisting of ethnic minorities with chronic conditions, associated with the prevalence of multiple conditions, poly-pharmacy and adherence issues. Aim: The aim...... of the study was to explore the challenges of encounters with medicines among ethnic minorities with chronic conditions in Denmark, exemplified by policy, professional and patient perspectives. Implications for community pharmacies was a particular focus. Methods: The study drew on different methods, types...
Bach, R. E., Jr.; Parks, E. K.
Recent studies of clear-air turbulence (CAT) encounters involving wide-body airliners have been based upon flight-path wind estimates made by analyzing digital flight-data-recorder (DFDR) records and radar records. Such estimates require a time history of the aircraft angle of attack, a record that is not usually included in the DFDR measurement set. This paper describes a method for reconstructing angle of attack that utilizes available flight record and aircraft-specific information associated with an aerodynamic model of the lift coefficient. Results from two wide-body incidents in which vane measurements of angle of attack were recorded show good agreement between measured and calculated time histories. This research has been performed in cooperation with the National Transportation Safety Board to provide a better understanding of the CAT phenomenon.
Full Text Available Intermediate filaments (IF are essential to maintain cellular and nuclear integrity and shape, to manage organelle distribution and motility, to control the trafficking and pH of intracellular vesicles, to prevent stress-induced cell death, and to support the correct distribution of specific proteins. Because of this, IF are likely to be targeted by a variety of pathogens, and may act in favor or against infection progress. As many IF functions remain to be identified, however, little is currently known about these interactions. Herpesviruses can infect a wide variety of cell types, and are thus bound to encounter the different types of IF expressed in each tissue. The analysis of these interrelationships can yield precious insights into how IF proteins work, and into how viruses have evolved to exploit these functions. These interactions, either known or potential, will be the focus of this review.
Borchorst, Nikolaj Gandrup; McPhail, Brenda; Smith, Karen Louise
administrative processes and the quality and swiftness of the service they receive. As we bring to light in this paper, this “fitting in” with rigid bureaucratic procedures and IT systems interestingly requires a substantial collaborative effort between the receiver(s) of the service and a complex constellation...... of surrounding stakeholders and intermediaries. This collaboration and the performing of multiple identities raises challenges for the design of e-government systems aimed at supporting physical and digital citizen service provision, as well as issues regarding privacy, citizenship, and public service quality......This paper explores in situ citizen service encounters in government offices. Drawing upon ethnographically informed fieldwork in Canada and Denmark, we discuss the challenges to supporting citizens in constructing and performing identities in public service settings. Our data suggests...
Chisholm, Robin; Finnell, John T
This study explored the Internet log files from emergency department workstations to determine search patterns, compared them to discharge diagnoses, and the emergency medicine curriculum as a way to quantify physician search behaviors. The log files from the computers from January 2006 to March 2010 were mapped to the EM curriculum and compared to discharge diagnoses to explore search terms and website usage by physicians and students. Physicians in the ED averaged 1.35 searches per patient encounter using Google.com and UpToDate.com 83.9% of the time. The most common searches were for drug information (23.1%) by all provider types. The majority of the websites utilized were in the third tier evidence level for evidence-based medicine (EBM). We have shown a need for a readily accessible drug knowledge base within the EMR for decision support as well as easier access to first and second tier EBM evidence.
Funke, G; Carlotti, A
Forty-three strains belonging to the genus Brevibacterium which were encountered in clinical materials over 2 decades were compared with reference strains, including the type strains, of B. casei, B. epidermidis, B. mcbrellneri, B. iodinum, and B. linens. By means of carbohydrate assimilation tests (CATs) the 43 clinical isolates could be assigned to the species B. casei (n = 41) and B. epidermidis (n = 2). DNA-DNA hybridizations were performed for 20 clinical isolates and confirmed the species identification of the isolates. Cellular fatty acid profiles of all strains were determined and found to have less discriminative power than CATs. This is the first report indicating that most clinical Brevibacterium isolates are B. casei and that CATs provide an easy-to-perform method for species determination within the genus, thus avoiding nucleic acid techniques. PMID:7929766
Aura CODREANU; Alina DEBU
Full Text Available The major aim of this article is to analyze the relationship between indirectness and politeness in requests. The research project supporting the findings of the paper was undertaken in order to find out to what extent politeness and indirectness are viewed as overlapping or mutually excluding categories by Romanians compared to other nationalities, such as the British and the Hebrew. Another inherent goal of the paper is to provide an example of the socio linguistics instruments that can be employed in the investigation of the differences and similarities likely to emerge in intercultural encounters. Thus, we believe that only through similar research undertaken in the fields contributing to the emerging field of interculturality one can actually trespass the theoretical assumptions and move on to the identification of the right tools and means through which intercultural discourse to be approached at a pragmatic level and thus better understood and taught in educational establishments.
Guerra, M; Indelicato, P; Santos, J P
Theoretical expressions for ionization cross sections by electron impact based on the binary encounter Bethe (BEB) model, valid from ionization threshold up to relativistic energies, are proposed. The new modified BEB (MBEB) and its relativistic counterpart (MRBEB) expressions are simpler than the BEB (nonrelativistic and relativistic) expressions because they require only one atomic parameter, namely the binding energy of the electrons to be ionized, and use only one scaling term for the ionization of all sub-shells. The new models are used to calculate the K-, L- and M-shell ionization cross sections by electron impact for several atoms with Z from 6 to 83. Comparisons with all, to the best of our knowledge, available experimental data show that this model is as good or better than other models, with less complexity.
There is growing recognition and evidence that health care professionals regularly encounter-though they may not identify-victims of human trafficking in a variety of health care settings. Identifying and responding appropriately to trafficking victims or survivors requires not only training in trauma-informed care but also consideration of the legal and ethical issues that arise when serving this vulnerable population. This essay examines three areas of law that are relevant to this case scenario: criminal law, with a focus on conspiracy; service provider regulations, with a focus on mandatory reporting laws; and human rights law. In addition to imposing a legal mandate, the law can inform ethical considerations about how health care professionals should respond to human trafficking. © 2017 American Medical Association. All Rights Reserved.
Bae, Yeong-Bok; Lee, Hyung Mok; Kang, Gungwon; Hansen, Jakob
The gravitational radiation driven capture (GR capture) between unequal mass black holes without spins has been investigated with numerical relativistic simulations. We adopt the parabolic approximation which assumes that the gravitational wave radiation from a weakly hyperbolic orbit is the same as that from the parabolic orbit having the same pericenter distance. Using the radiated energies from the parabolic orbit simulations, we have obtained the critical impact parameter (bcrit ) for the GR capture for weakly hyperbolic orbit as a function of initial energy. The most energetic encounters occur around the boundary between the direct merging and the fly-by orbits, and can emit several percent of total initial energy at the peak. When the total mass is fixed, energy and angular momentum radiated in the case of unequal mass black holes are smaller than those of equal mass black holes having the same initial orbital angular momentum for the fly-by orbits. We have compared our results with two different post-Newtonian (PN) approximations, the exact parabolic orbit (EPO) and PN corrected orbit (PNCO). We find that the agreement between the EPO and the numerical relativity breaks down for very close encounters (e.g., bcrit≲100 M ), and it becomes worse for higher mass ratios. For instance, the critical impact parameters can differ by more than 50% from those obtained in EPO if the relative velocity at infinity v∞ is larger than 0.1 for the mass ratio of m1/m2=16 . The PNCO gives more consistent results than EPO, but it also underestimates the critical impact parameter for the GR capture at bcrit≲40 M .
Amato, Davide; Baù, Giulio; Bombardelli, Claudio
We present an efficient strategy for the numerical propagation of small Solar system objects undergoing close encounters with massive bodies. The trajectory is split into several phases, each of them being the solution of a perturbed two-body problem. Formulations regularized with respect to different primaries are employed in two subsequent phases. In particular, we consider the Kustaanheimo-Stiefel regularization and a novel set of non-singular orbital elements pertaining to the Dromo family. In order to test the proposed strategy, we perform ensemble propagations in the Earth-Sun Circular Restricted 3-Body Problem (CR3BP) using a variable step size and order multistep integrator and an improved version of Everhart's radau solver of 15th order. By combining the trajectory splitting with regularized equations of motion in short-term propagations (1 year), we gain up to six orders of magnitude in accuracy with respect to the classical Cowell's method for the same computational cost. Moreover, in the propagation of asteroid (99942) Apophis through its 2029 Earth encounter, the position error stays within 100 metres after 100 years. In general, as to improve the performance of regularized formulations, the trajectory must be split between 1.2 and 3 Hill radii from the Earth. We also devise a robust iterative algorithm to stop the integration of regularized equations of motion at a prescribed physical time. The results rigorously hold in the CR3BP, and similar considerations may apply when considering more complex models. The methods and algorithms are implemented in the naples fortran 2003 code, which is available online as a GitHub repository.
Tully, Stephen; Cojocaru, Monica-Gabriela; Bauch, Chris T
Population transmission models have been helpful in studying the spread of HIV. They assess changes made at the population level for different intervention strategies. To further understand how individual changes affect the population as a whole, game-theoretical models are used to quantify the decision-making process. Investigating multiplayer nonlinear games that model HIV transmission represents a unique approach in epidemiological research. We present here 2-player and multiplayer noncooperative games where players are defined by HIV status and age and may engage in casual (sexual) encounters. The games are modelled as generalized Nash games with shared constraints, which is completely novel in the context of our applied problem. Each player's HIV status is known to potential partners, and players have personal preferences ranked via utility values of unprotected and protected sex outcomes. We model a player's strategy as their probability of being engaged in a casual unprotected sex encounter (USE), which may lead to HIV transmission; however, we do not incorporate a transmission model here. We study the sensitivity of Nash strategies with respect to varying preference rankings, and the impact of a prophylactic vaccine introduced in players of youngest age groups. We also study the effect of these changes on the overall increase in infection level, as well as the effects that a potential prophylactic treatment may have on age-stratified groups of players. We conclude that the biggest impacts on increasing the infection levels in the overall population are given by the variation in the utilities assigned to individuals for unprotected sex with others of opposite HIV status, while the introduction of a prophylactic vaccine in youngest age group (15-20 yr olds) slows down the increase in HIV infection.
Objective: The objective of the study was to assess the problems experienced by immediate families in caring for children affected with Sickle Cell Disease (SCD) seen at University Teaching Hospital (UTH) Lusaka, Zambia. Design: The study was a cross sectional descriptive study conducted at the SCD outpatient clinic ...
Most of the patients started rehabilitation care after discharge from the hospital, and 36.8 % of them were admitted after the C.V.A. 3 months. Initial functional assessment failed to assess neuropsychological impairments except aphasia. The rehabilitation care consisted only of physical therapy, but neither occupational nor ...
By drawing on a theoretical framing based on the geography of encounters, this article examines how students give meaning to racialised encounters on campus. These encounters are mediated by long established notions of difference based on power inequalities where race remains a powerful source of difference. However, race is not simply enacted but…
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health care claims or equivalent encounter... ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claims or Equivalent Encounter Information § 162.1101 Health care claims or equivalent encounter information...
Aydar, Erkan; Aladaǧ, Çaǧdaş Hakan; Menteş, Turhan
The jet era or age began at 1930 and 40's in aviation sector, with the production of first jet engine for the aircrafts. Since 1950's, the commercial aviation with regular flights were established. Civil aviation and air-transport drastically increased due to intensive demand, and declared at least 10 fold since 1970 by IATA report. Parallelly to technological and economical developpement, the commercial jets became more comfortable, secure and rapid, bringing the world smaller, the countries closer. On the other hand, according to Global Volcanism Program Catalogues of Smithsonian Institute, about 1,500 volcanoes have erupted in the Holocene, 550 of them have had historical eruptions and considered as active. Besides an average of 55-60 volcanoes erupt each year, and about 8-10 of these eruptions produce ash clouds that reach aircraft flight altitudes (Salinas and Watt, 2004). Volcanic ash can be expected to be in air routes at altitudes greater than 9 km (30,000 ft) for roughly 20 days per year worldwide (Miller &Casadeval, 2000). A precious compilation of incidents due to encounters of aircrafts with volcanic ash clouds covering the years between 1953 and 2009 was used in this work (Guffanti et al., 2010-USGS Report) with an additional information on Eyfjallajökull-2010 eruption. According to this compilation,129 incidents happened within the concerned time interval. The damages, in general, fall in second and third class of Severity index, indicating the damages are limited on airframe of the planes, or some abrasions in jet engine, windblast etc.. We focused on fourth class of severity index involving the damages on jet engine of aircraft (engine fail) due to ingestion of volcanic ash and investigate eruption style and caused damage relationships. During the eruptive sequences of Mts Saint Helen (USA), Galunggung (Indonesia, 2 incidents), Redoubt (USA), Pinatubo (Philipinnes), Unzen (Japan), Manam (Papua New Guinea), Soufriere Hills (Lesser Antilles), Chaiten
College of the Canyons, Valencia, CA.
A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…
Phipps, Alison; Barnett, Ronald
Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…
Hartama, D.; Mawengkang, Herman; Zarlis, M.; Sembiring, R. W.
This study proposes a framework for the utilization of IT resources in the face of natural disasters with the concept of Smart City in urban areas, which often face the earthquake, particularly in the city of North Sumatra and Aceh. Smart City is a city that integrates social development, capital, civic participation, and transportation with the use of information technology to support the preservation of natural resources and improved quality of life. Changes in the climate and environment have an impact on the occurrence of natural disasters, which tend to increase in recent decades, thus providing socio-economic impacts for the community. This study suggests a new approach that combines the Geographic Information System (GIS) and Mobile IT-based Android in the form of Geospatial information to encounter disaster. Resources and IT Infrastructure in implementing the Smart Mobility with Mobile service can make urban areas as a Smart City. This study describes the urban growth using the Smart City concept and considers how a GIS and Mobile Systems can increase Disaster Management, which consists of Preparedness, mitigation, response, and recovery for recovery from natural disasters.
Nonaka, Saori; Ando, Yuki; Kanetani, Takuto; Hoshi, Chiharu; Nakai, Yuji; Nainu, Firzan; Nagaosa, Kaz; Shiratsuchi, Akiko; Nakanishi, Yoshinobu
The phagocytic elimination of cells undergoing apoptosis is an evolutionarily conserved innate immune mechanism for eliminating unnecessary cells. Previous studies showed an increase in the level of engulfment receptors in phagocytes after the phagocytosis of apoptotic cells, which leads to the enhancement of their phagocytic activity. However, precise mechanisms underlying this phenomenon require further clarification. We found that the pre-incubation of a Drosophila phagocyte cell line with the fragments of apoptotic cells enhanced the subsequent phagocytosis of apoptotic cells, accompanied by an augmented expression of the engulfment receptors Draper and integrin αPS3. The DNA-binding activity of the transcription repressor Tailless was transiently raised in those phagocytes, depending on two partially overlapping signal-transduction pathways for the induction of phagocytosis as well as the occurrence of engulfment. The RNAi knockdown of tailless in phagocytes abrogated the enhancement of both phagocytosis and engulfment receptor expression. Furthermore, the hemocyte-specific RNAi of tailless reduced apoptotic cell clearance in Drosophila embryos. Taken together, we propose the following mechanism for the activation of Drosophila phagocytes after an encounter with apoptotic cells: two partially overlapping signal-transduction pathways for phagocytosis are initiated; transcription repressor Tailless is activated; expression of engulfment receptors is stimulated; and phagocytic activity is enhanced. This phenomenon most likely ensures the phagocytic elimination of apoptotic cells by stimulated phagocytes and is thus considered as a mechanism to prime phagocytes in innate immunity. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.
Chisholm, Robin; Finnell, John T.
Objective: This study explored the Internet log files from emergency department workstations to determine search patterns, compared them to discharge diagnoses, and the emergency medicine curriculum as a way to quantify physician search behaviors. Methods: The log files from the computers from January 2006 to March 2010 were mapped to the EM curriculum and compared to discharge diagnoses to explore search terms and website usage by physicians and students. Results: Physicians in the ED averaged 1.35 searches per patient encounter using Google.com and UpToDate.com 83.9% of the time. The most common searches were for drug information (23.1%) by all provider types. The majority of the websites utilized were in the third tier evidence level for evidence-based medicine (EBM). Conclusion: We have shown a need for a readily accessible drug knowledge base within the EMR for decision support as well as easier access to first and second tier EBM evidence. PMID:23304394
Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care is to facil......Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care...... of nursing. In this dissertation, focused ethnography is used to explore the interactions between patients and nurse anesthetists before general anesthesia. Moreover, it will explore the professional identity of nurse anesthetists, in relation to the situation of preparing patients for general anesthesia....... A micro-substantive theory is developed regarding the opportunities for creating meaningful encounters between patients and nurse anesthetists. The theory is based on three dominant motivations for interaction in anesthesia nursing. The context of care is not committed and responsive to the core elements...
We propose that Gravitational Wave (GW) bursts with millisecond durations can be explained by the GW emission from the hyperbolic encounters of Primordial Black Holes in dense clusters. These bursts are single events, with the bulk of the released energy happening during the closest approach, and emitted in frequencies within the AdvLIGO sensitivity range. We provide expressions for the shape of the GW emission in terms of the peak frequency and amplitude, and estimate the rates of these events for a variety of mass and velocity configurations. We study the regions of parameter space that will allow detection by both AdvLIGO and, in the future, LISA. We find for realistic configurations, with total mass M∼60 M⊙, relative velocities v∼0.01c, and impact parameters b∼10−3 AU, for AdvLIGO an expected event rate is O(10) events/yr/Gpc^3 with millisecond durations. For LISA, the typical duration is in the range of minutes to hours and the event-rate is O(10^3) events/yr/Gpc^3 for both 10^3 M⊙ IMBH and 1...
Allan, John; Edirisinghe, Rohini; Anderson, Jasen; Jemmott, Rodney; Nandini, A V; Gattas, Michael
An increased embryo aneuploidy rate is associated with advancing maternal age. Preimplantation genetic diagnosis (PGD) using fluorescence in situ hybridisation (FISH) coupled with in vitro fertilisation (IVF)/embryo biopsy provides a powerful tool to improve the take home baby rates for this poor prognostic group. To report the preliminary findings of a PGD study for aneuploidy screening and to discuss the dilemmas encountered. Preimplantation genetic diagnosis was offered in egg pick up-PGD and frozen embryo transfer-PGD cycles. Embryo biopsy was carried out on day 3 and FISH was used to detect chromosomal abnormalities. The outcome of 75 patients, 100 treatment cycles; 62 egg pick up-PGD and 38 frozen embryo transfer-PGD are presented. The embryo biopsy rate, blastomere survival, presence of nuclei and successful FISH rates for egg pick-up and frozen embryo transfer cycles were similar giving a chromosomal abnormality rate of 57.5 and 51.2% for the respective treatment group. The positive pregnancy, clinical pregnancy and implantation rates were, for egg pick up-PGD 22.7, 13.6 and 21.1% and for frozen embryo transfer-PGD 13.8, 10.3 and 10.0%, respectively. Preimplantation genetic diagnosis coupled with IVF treatment seems to give satisfactory pregnancy rates. The high embryo aneuploidy rates, chromosomal mosaicism and other issues have presented significant ethical and management dilemmas for our physicians and patients alike. These issues highlight the importance of skillful pretreatment counselling for patients considering PGD.
Vogel, H.; Steinkamp, U.
The following problems are analysed referring to the literature and to practical experience of the authors: - Types of complications encountered in contrast roentgenography or in endoscopy of the colon, and their frequency. - Risk factors and secondary injuries. Intestinal perforation is the most frequent complication experienced as a consequence of contrast barium enema. The main risk factors are to be seen in the use of balloon-tipped catheters, or of intestinal tubes with hard tips, in a rise of hydrostatic pressure above 80 cm water column, and in an excessively strong air insufflation. Frequency of complications for contrast barium enema is stated to be 0.002 p.c. (Welin and Welin, 1980) or 0.08 p.c. (Clark et al. 1961). The frequency of perforations in rectoscopy is shown to be in the same order of magnitude. For diagnostic colonoscopy, the frequency of complications is about one per mil. Existing diseases such as carcinoma, diverticulosis, diverticulitis, colitis ulcerosa, or morbus Crohn are factors enhancing the risk. Also, patients of advanced age are running a higher risk due to decreasing intestine wall elasticity with age. Previous biopsy or excision forbids contrast barium enema for the next two weeks. Injuries and sequelae to be expected after perforation are abscesses, phlegmon, peritonitis including formation of adhesion and bands, retroperitoneal fibrosis with formation of hydronephrosis, and anus praeter, the latter being temporary or permanent. An extensive literature survey covering 200 publications has been prepared and is available from the authors upon request.
Wishing to highlight the asymmetric dimension that characterizes ethics as 'responsibility toward the other' in Levinas's philosophy, the author presents as an introduction three related concepts of Levinas's thinking: the caress, the face, the saying. Following some poetic narrative reflections offered as 'interlude' moments, the author seeks to bring together her concept of 'matricial space' inspired by Levinas's conception of ethics and the Laplanchian concept of 'primal seduction', both based on asymmetry. She suggests adding to Laplanche's proposition of two kinds of transference (filled-in transference and hollowed-out transference) a third kind: the matricial-space transference. She argues that together with the hollowed-out transference, which is related to the primal seduction, the matricial-space transference, which relates to the matricial position in the parent/analyst, is provoked by the analyst. If the hollowed-out transference assures the moving-on of the analysis, the matricial-space transference, in combination with the hollowed-out transference, is prerequisite for transformation to occur and may be deciphered specifically in 'impasse' situations, at what she coined 'subjectal moments'. As a conclusion, while insisting on the need for asymmetry in the analytic encounter, she suggests the existence in the human neonate of a need for ethics, and she questions the origin of the human capacity to be responsible toward the other. She illustrates her argument using clinical material from her own work alongside that of other authors.
Kelso, T. S.; Alfano, S.
While many satellite operators are aware of the possibility of a collision between their satellite and another object in earth orbit, most seem unaware of the frequency of near misses occurring each day. Until recently, no service existed to advise satellite operators of an impending conjunction of a satellite payload with another satellite, putting the responsibility for determining these occurrences squarely on the satellite operator's shoulders. This problem has been further confounded by the lack of a timely, comprehensive data set of satellite orbital element sets and computationally efficient tools to provide predictions using industry-standard software. As a result, hundreds of conjunctions within 1 km occur each week, with little or no intervention, putting billions of dollars of space hardware at risk, along with their associated missions. As a service to the satellite operator community, the Center for Space Standards & Innovation (CSSI) offers SOCRATES-Satellite Orbital Conjunction Reports Assessing Threatening Encounters in Space. Twice each day, CSSI runs a list of all satellite payloads on orbit against a list of all objects on orbit using the catalog of all unclassified NORAD two-line element sets to look for conjunctions over the next seven days. The runs are made using STK/CAT-Satellite Tool Kit's Conjunction Analysis Tools-together with the NORAD SGP4 propagator in STK. This paper will discuss how SOCRATES works and how it can help satellite operators avoid undesired close approaches through advanced mission planning.
Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin; Yang, Hong-Seuk
An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation.
Full Text Available This essay considers Tim Crouch's "I Shakespeare", a suite of monologue plays based on "The Tempest" ("I, Caliban", 2003, "A Midsummer Night's Dream" ("I, Peaseblossom", 2004, "Macbeth" ("I, Banquo", 2005, "Twelfth Night" ("I, Malvolio", 2010 and "Julius Caesar" ("I, Cinna (the poet", 2012. While originally designed for a young audience, Crouch's adaptations have been performed in a variety of theatrical contexts that have added new and probably unforeseen dimensions to their negotiations with Shakespeare. In my analysis I turn to the notion of mobility as a key analytical tool to elucidate the method, aims, as well as the broader cultural meaning of Tim Crouch's reworkings. In his hands, Shakespeare is mobilized as a powerful resource to activate spectators and emphasize their co-authorship in the process of theatre. Through a combination of textual strategies and performance methods, the monologues construct the identities of Shakespeare's characters as multiple and mutable and, in parallel, cast their addressees in fluid, often contradictory roles. My main line of argument is that the plays' propensity of motion is rooted in their emphasis on Shakespeare as a highly mobile cultural signifier which seems confirmed by the monologues' journeys outside the UK. The further adaptational practices triggered by these encounters with foreign audiences are testament to the flexibility of Crouch's dramaturgy of process and its aptitude to accommodate new discursive identities and adjust to each new context of reception.
Gneiding, Kathrina; Frodl, Reinhard; Funke, Guido
In the present study, 50 strains of yellow-pigmented gram-positive rods that had been isolated from human clinical specimens and collected over a 5-year period were further characterized by phenotypic and molecular genetic methods. All 50 strains belonged to the genus Microbacterium, and together they represented 18 different species. Microbacterium oxydans (n = 11), M. paraoxydans (n = 9), and M. foliorum (n = 7) represented more than half of the strains included in the present study. The isolation of strains belonging to M. hydrocarbonoxydans (n = 2), M. esteraromaticum (n = 1), M. oleivorans (n = 1), M. phyllosphaerae (n = 1), and M. thalassium (n = 1) from humans is reported for the first time. Microbacterium sp. strain VKM Ac-1389 (n = 1) and the previously uncultured Microbacterium sp. clone YJQ-29 (n = 1) probably represent new species. Comprehensive antimicrobial susceptibility data are given for the 50 Microbacterium isolates. This study is, so far, the largest on Microbacterium spp. encountered in human clinical specimens and outlines the heterogeneity of clinical Microbacterium strains. PMID:18799696
Gneiding, Kathrina; Frodl, Reinhard; Funke, Guido
In the present study, 50 strains of yellow-pigmented gram-positive rods that had been isolated from human clinical specimens and collected over a 5-year period were further characterized by phenotypic and molecular genetic methods. All 50 strains belonged to the genus Microbacterium, and together they represented 18 different species. Microbacterium oxydans (n = 11), M. paraoxydans (n = 9), and M. foliorum (n = 7) represented more than half of the strains included in the present study. The isolation of strains belonging to M. hydrocarbonoxydans (n = 2), M. esteraromaticum (n = 1), M. oleivorans (n = 1), M. phyllosphaerae (n = 1), and M. thalassium (n = 1) from humans is reported for the first time. Microbacterium sp. strain VKM Ac-1389 (n = 1) and the previously uncultured Microbacterium sp. clone YJQ-29 (n = 1) probably represent new species. Comprehensive antimicrobial susceptibility data are given for the 50 Microbacterium isolates. This study is, so far, the largest on Microbacterium spp. encountered in human clinical specimens and outlines the heterogeneity of clinical Microbacterium strains.
Carpenter, J. Russell
An implicit, but not necessarily obvious, assumption in all of the current techniques for assessing satellite collision probability is that the relative position uncertainty is perfectly correlated in time. If there is any mis-modeling of the dynamics in the propagation of the relative position error covariance matrix, time-wise de-correlation of the uncertainty will increase the probability of collision over a given time interval. The paper gives some examples that illustrate this point. This paper argues that, for the present, Monte Carlo analysis is the best available tool for handling low-velocity encounters, and suggests some techniques for addressing the issues just described. One proposal is for the use of a non-parametric technique that is widely used in actuarial and medical studies. The other suggestion is that accurate process noise models be used in the Monte Carlo trials to which the non-parametric estimate is applied. A further contribution of this paper is a description of how the time-wise decorrelation of uncertainty increases the probability of collision.
Kabirzadeh, R.; Knudsen, D. J.; Bounds, S. R.; Clemmons, J. H.; Pfaff, R. F.; Wallis, D. D.
The GEODESIC sounding rocket encountered dozens of localized, VLF-wave-filled density depletions in an auroral return current region at altitudes between 900-1000 km. While these are similar to well-studied lower-hybrid “spikelets”, which are electrostatic, many of the GEODESIC events exhibited strong VLF magnetic field enhancements as well. In the present study we show that these magnetic field fluctuations can be interpreted as the result of B-aligned electron currents driven by fluctuating electric fields parallel to B. This observation suggests that the electromagnetic wave-filled cavities are signatures of unstable filaments of return current fluctuating at VLF frequencies. We argue that the cavities’ spatial dimensions, their location inside the return current region and their total radiated power are consistent with the properties of VLF saucer source regions inferred from earlier satellite observations [James, J. Geophys. Res., 81, 501, 1976; Ergun et al., Geophys. Res. Lett., 28, 3805, 2001] taken at higher altitudes.
de Jong, Arie N.; Winkel, Hans; Kemp, Rob A. W.
Birds are a potential source of frequent false alarms in Infrared Search and Track (IRST) systems. One reason is that the signals, generated by birds at short ranges (1-2 km) in IR sensors may be of the same magnitude as the signals generated by real targets (missiles) at long ranges (10-20 km). Another reason is that new generations of IRSTs have more sensitivity which brings more birds within the detection range. Furthermore military operations tend to be held more and more in coastal zones, where the frequency of occurrence of birds is greater than in the open ocean. Finally, the variety in type of birds and their flight characteristics and signature is larger. In the paper attention is spent on the IR signatures of birds in various backgrounds, including rapid variations in signature due to wing motions. Basically, these fluctuations and the flight pattern of a bird provide opportunities to encounter bird alarms in next generation IRSTs, using multiple Focal Plan Array cameras with high frame rates. One has to take into account in this process the difference between signal variations due to wing motions and scintillation for long range targets above the horizon.
Full Text Available Abstract Background The efficiency of lymph nodes depends on tissue structure and organization, which allow the coordination of lymphocyte traffic. Despite their essential role, our understanding of lymph node specific mechanisms is still incomplete and currently a topic of intense research. Results In this paper, we present a hybrid discrete/continuous model of the lymph node, accounting for differences in cell velocity and chemotactic response, influenced by the spatial compartmentalization of the lymph node and the regulation of cells migration, encounter, and antigen presentation during the inflammation process. Conclusion Our model reproduces the correct timing of an immune response, including the observed time delay between duplication of T helper cells and duplication of B cells in response to antigen exposure. Furthermore, we investigate the consequences of the absence of dendritic cells at different times during infection, and the dependence of system dynamics on the regulation of lymphocyte exit from lymph nodes. In both cases, the model predicts the emergence of an impaired immune response, i.e., the response is significantly reduced in magnitude. Dendritic cell removal is also shown to delay the response time with respect to normal conditions.
Lacan's quilting point connects a network of signifiers with the lived world as a place of voices, memory, and adaptation "seen in" the mirror of language. Crossing cultures can obscure the ways we make sense of the world. Some planes of signification, in aiming to be universal in their knowledge (such as the natural sciences), try to track objects and events independent of our thoughts about them and the ways that signifiers may slide past each other. However, cross-structural comparison and the analysis of cross cultural encounters cannot treat its objects of interest that way. Thus we need a theory and methodology that effectively connects the multilayered discourses of subjectivities from diverse cultures and allows triangulation between them in relation to points of shared experience. At such points we need a critical attitude to our own framework and an openness to the uneasy reflective equilibrium that uncovers assumptions and modes of thinking that will hamper us. Quilting points are such points where different discourses converge on a single event or set of events so as to mark "vertical" connections allowing tentative alignments between ways of meaning so that we can begin to build real cross-cultural understanding.
Balcells, Marc; Borne, Kirk D.; Hoessel, John G.
This paper describes results obtained on a simulation of two high-velocity encounters of NGC 4782/4783 and NGC 2672/2673 binary elliptical galaxies which differ substantially in mass ratio (about 1 for the first pair, and about 10 for the second). CCD images and velocities obtained from digital spectra were used to constrain simulations of the galaxy collisions. The binary orbital elements, the orientation of the orbit in the sky, the time since pericenter, and the dynamical mass of the pair were derived. Results suggested that the dumb-bell galaxy NGC 4782/4783 is not a supermassive galaxy, as was claimed earlier on the basis of the high relative velocity and high central dispersion, but has a moderate mass to luminosity ratio M/L(B) of about 10. It was concluded that its trajectory changed from hyperbolic to elliptical as a result of energy lost during the collision. It was found that the NGC 2672/2673 also has a moderate M/L(B) of about 7.
Full Text Available Aim: Sudden neurologic states of various aetiology are the major reason for medical teams to be dispatched and often result in hospitalization of the patient. The purpose of this work was the analysis of the aforementioned neurologic states and pinpointing the type of patients the Emergency Medical Service teams have encountered in Rybnik with respect to the said states. Method: Analysed material consisted of Medical Emergency Action cards that were used by Emergency Medical Service Independent Public Healthcare District Hospital No. 3 in Rybnik in the year 2013. Five hundred and twenty-three cases were selected as consistent with sudden neurologic states. Result: A higher incidence of studied diseases was noted among male patients, whereas in females presenting with these states, the age was higher, with the exception of syncope. The analysis revealed the presence of characteristic symptoms in relevant emergency conditions. During the evaluation of psychomotor abilities, a prevalence of patients whose state qualified as normal, and in the case of stroke as “slowed down” was recorded. Brain damage in all states except for stroke was classified as mild. The study noted high blood glucose level disparities between measurements. Conclusion: Strokes occurred most often in patients over 60 years old. The observed signs were consistent with those described in the literature. Blood glucose test results in some patients allowed suspicion of diabetes, or ruled out hypoglycaemia. The majority of studied patients revealed mild brain injury. Alcohol had a significant effect on the incidence of head injuries and seizures.
Gehlbach, S H; Wall, J B
We reviewed medical records of 53 children who ingested poison and were treated as inpatients and 107 who were treated as outpatients in a Southeastern community hospital. Findings included a much higher incidence of petroleum distillate poisoning than is found nationally, and a low frequency of aspirin ingestions. Data on packaging of the poisons indicate that one third was stored in food containers. Of the products encountered, 33% currently require safety packaging but were found in obsolete containers.
Faull, Christina; Windridge, Kate; Ockleford, Elizabeth; Hudson, Michael
The prompt availability of medications to manage symptoms is key to high quality end-of-life care and anticipatory prescribing of these drugs is thought good practice. This study explored the challenges encountered by primary and community health professionals in Leicestershire and Rutland related to anticipatory prescribing when caring for terminally ill patients who wish to remain at home to die. A qualitative study was conducted using eight focus groups (54 participants) and nine individual interviews with a purposively sampled range of health professionals providing care for people who wished to die at home. Themes were identified iteratively via constant comparison. Challenges fell into four categories: resourcing concerns, professional expertise/experience, professionals' relationships with patients, and professionals' relationships with other professionals. The latter included the most serious perceived challenges. Links between community and hospital care providers and between 'usual' hours and 'out-of-hours' care providers were seen as particularly unstable. These findings suggest that building and maintaining trusting, responsive, personal links between professionals, both within and between teams, is essential when implementing good practice guidelines about anticipatory end-of-life prescribing in the community. The need for good communication and relationships between patients and professionals and maintaining expertise and confidence in end-of-life care are also key factors in the effective use of anticipatory prescribing for symptom management for dying patients.
Mikkelsen, B E; Beck, A M; Lassen, A
Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. The purpose of this study was to investigate whether the increased focus on nutritional problems in patients and nursing home residents has resulted in measurable progress. A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n=96) and nursing homes (n=898) in 1995 and 2002/3 (n=90) and (n=682), respectively. The study used compliance with selected issues in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food and nutrition contact persons, employing official recommendations and offering choice between three different menu energy levels. Hospitals had a higher compliance compared to nursing homes. In 1995, this was the case for all questions asked and differences were statistically significant. Also in 2002/3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results are analysed over the 8-year period. The only progress for nursing homes was that more homes had implemented feedback routines on acceptability of food service in 2002/3 than in 1995. The difference was statistically significant. For hospitals, however, no progress was found between 1995 and 2002/3. The attempts to improve the nutritional status of hospital patients and nursing home residents seem to have failed. Still, the initiatives taken to improve the situation seem relevant. Especially the nursing homes might
Full Text Available In 1983 Giulio Einaudi asked Primo Levi to translate Kafka’s Trial for the new series «Scrittori tradotti da scrittori». The proposal sounded original and provocative, and Levi accepted eagerly. The translation, however, had a negative effect on him. While working on The Trial, Levi relived his Auschwitz season, revived his deepest fears, and fell back into depression: he felt as if he was himself on trial. This was partially due to a clash of literary styles as well as to two contrasting – and yet at times kindred – conceptions of language and communication. The present study addresses the following questions: were Levi and Kafka’s literary styles as opposed as Levi implies? How is Levi’s “obscure part” connected to Kafka? Why did Levi associate The Trial with his Holocaust experience and identify himself with Josef K.? What does Levi’s encounter with Kafka tell us about the shame of being human and our capacity to give an account of ourselves? By investigating Levi’s uncanny encounter with Kafka, my essay will discuss Levi’s theory of language, showing how the Levi-Kafka intersection opens up new ways of interpreting Levi’s concerns about communication, the work of the witness, moral responsibility, and shame, which coalesced into the reflections of The Drowned and the Saved.Nel 1983 Giulio Einaudi chiese a Primo Levi di tradurre Il processo di Kafka per la nuova serie Scrittori tradotti da scrittori. La proposta parse a Levi originale ed intelligente, sicché la accettò immediatamente. La traduzione ebbe tuttavia un effetto negativo su di lui. Mentre lavorava al Processo, Levi rivisse la stagione di Auschwitz, risentì le sue più profonde paure e ricadde in depressione. Si sentiva come se fosse lui stesso processato. Ciò era in parte dovuto a due opposte concezioni di stile letterario e a due divergenti – anche se a volte paradossalmente affini – concezioni del linguaggio e della comunicazione. Il presente
Adelaine, Sabrina A; Shoaf, Kimberly; Harvey, Caitlin
There is no standard guidance for strategies for hospitals to use to coordinate with other agencies during a disaster. This study analyzes successful strategies and barriers encountered by hospitals across the nation in coordinating and collaborating with other response agencies. Quantitative and qualitative data were collected from a web-based study from 577 acute care hospitals sampled from the 2013 American Hospital Association (AHA) database. The results were analyzed using descriptive statistics. The most common barriers to collaboration are related to finances, ability to communicate, and personnel.
Jensen, Tina Blegind; Aanestad, Margunn
propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology......The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... adoption, these concepts help us appreciate and put special emphasis on particular aspects of the adoption process: the mutual and co-constitutive relationship between the users and the technology and the continued coexistence of both positive and negative attitudes among the users. The findings suggest...
Brown, Joel D; Kwee, Sandi
The authors describe a patient in whom pararenal splenosis nodules were initially interpreted as probable pheochromocytoma. A 22-year-old man with chronic glomerulonephritis, hypertension and a childhood history of splenectomy was hospitalized for a hypertensive emergency. He did not improve with aggressive antihypertensive therapy. A pheochromocytoma was suspected, and a renal ultrasound and a magnetic resonance imaging showed 2 left pararenal masses. Laboratory evaluation for pheochromocytoma and aldosteronoma were negative. Biopsies of the masses were planned, but the masses were subsequently shown to be splenic tissue by a (99m)technnetium heat-damaged red blood cell scan. Ectopic splenic masses, eg, splenosis or accessory spleens, should be considered in patients with undiagnosed abdominal or kidney masses and a history of splenectomy.
Chambers, L. H.; Davis, A.; Paglierani, R.
In 2000, while visiting Arches National Park in Utah, I had my first encounter with my science in the context of interpretation. During a ranger walk, a student intern at the park explained the concept of the radiation budget (for the desert surface, in her case) to the group of visitors. As a NASA scientist on the Clouds and the Earth's Radiant Energy System (CERES) science team, a team whose entire focus is on understanding Earth's energy budget, that visit made quite an impression on me: here was my science connected to the immediate and personal experience of that desert environment in a way that even my then 4-year-old daughter could take something from. Some years later, when I was invited to speak to a group of interpreters through the NASA/National Park Service "Earth to Sky" project, I jumped at the chance. Since then, I have had several opportunities to interact with interpreters, through additional "Earth to Sky" workshops as well as during a meeting of the National Association for Interpretation in my hometown. While I was invited to speak to these groups as a subject matter expert, I always learned at least as much as they did from the interaction. The standard practice for Earth to Sky is to pair presenters with an interpreter coach to help fine-tune the presentation for the audience - a valuable practice for presentations to any audience, if one can find an appropriate coach. The mere idea that interpretation is a profession, with research and guidelines and best practices, was completely eye opening to me at one of my first Earth to Sky events. So how to leverage interpretation for science communication? Rather than expecting busy scientists to learn everything about interpretation, a more effective approach is likely the one taken in the Earth to Sky workshop series, where scientists and interpreters work together for an intensive period to share information and approaches, and the interpreters are then able to take appropriate science elements to
between two IFR aircraft in oceanic airspace. The reason for this is that one cannot observe encounters of sufficient fidelity in the available data...does not observe a sufficient number of encounters between instrument flight rules ( IFR ) and non- IFR traffic beyond 12 NM from the shore. 4 TABLE 1...Encounter model categories. Aircraft of Interest Intruder Aircraft Location Flight Rule IFR VFR Noncooperative Noncooperative Conventional
This paper argues that the various encounters of female slum residents residing in Delhi’s margins with identification documents shape certain instrumental and symbolic forms of knowledge about the city. Urban poor women’s encounters with identity documents produce ‘piecemeal pedagogies’ in which these women try to educate themselves and each other about bureaucratic channels and application procedures in and through handling documents. Such encounters also yield thick knowledge about the cit...
Westin, Lars; Danielson, Ella
Aim. The aim of the study was to describe and interpret the meaning of nurses' experiences of caring encounters with residents in nursing homes. Background. Life for residents in nursing homes can be characterized as a process of decreased physical and psychological resources. Therefore, encounters with nurses are important activities for providing meaning and security for the residents. Research in this field has previously focused on communication, attitudes and job satisfaction, but gives limited knowledge about what the human encounters in this context mean for the nurses. Method. A hermeneutic method was used in this study. Interviews were conducted with 14 nurses from two nursing homes about their experiences of caring encounters. The transcribed interview texts were interpreted as a whole. Results. In the interpretation of the text concerning the meaning of nurses' experiences of encounters with resident's four themes and 11 subthemes emerged. The comprehensive interpretation mainly showed possible ways available being present, being significant and being aware of opportunities for the nurse to find meaning in the encounter with the resident, but impossible ways as being inadequately were also revealed. Conclusion. This study shows the importance of caring encounters between nurses and residents in nursing homes. The good encounters provide various possible ways for nurses to find meaning and a sense of communion with residents. However, bad encounters, described as being inadequate, were found to inhibit nurses from finding meaning in their encounters with residents. Relevance to clinical practice. Meeting the needs of older people in nursing homes requires special knowledge about the importance of the caring encounter. Therefore, nurses in this care context need supervision and continuous education in order to gain relevant knowledge about the meaning of caring encounters for themselves and residents.
Miller, Aaron C; Polgreen, Linnea A; Cavanaugh, Joseph E; Polgreen, Philip M
Environmental risk factors for Clostridium difficile infections (CDIs) have been described at the room or unit level but not the hospital level. To understand the environmental risk factors for CDI, we investigated the association between institutional- and individual-level CDI. We performed a retrospective cohort study using the Healthcare Cost and Utilization Project state inpatient databases for California (2005-2011). For each patient's hospital stay, we calculated the hospital CDI incidence rate corresponding to the patient's quarter of discharge, while excluding each patient's own CDI status. Adjusting for patient and hospital characteristics, we ran a pooled logistic regression to determine individual CDI risk attributable to the hospital's CDI rate. There were 10,329,988 patients (26,086 cases and 10,303,902 noncases) who were analyzed. We found that a percentage point increase in the CDI incidence rate a patient encountered increased the odds of CDI by a factor of 1.182. As a point of comparison, a 1-percentage point increase in the CDI incidence rate that the patient encountered had roughly the same impact on their odds of acquiring CDI as a 55.8-day increase in their length of stay or a 60-year increase in age. Patients treated in hospitals with a higher CDI rate are more likely to acquire CDI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Oregon State Dept. of Education, Salem. Div. of Vocational Education.
This publication recognizes the constantly changing requirements of the food service industry and varying conditions for employment opportunities. It addresses the goal of relevance in education by enabling the educator to make timely adjustments in the subject matter of the food service curriculum. There are six sections in this publication, each…
products, such as milk , yogurt, cheese, or fot·tified soy beverages. 6 Cho ose a vat-iety of protein foods, which include seafood, lean meat and...skim milk and non- cheese dairy products); and Qualifying individual items (e.g., appetizers, side dishes, and desserts) must have - ≤ 250 calories...dairy (i.e., ≥ ½ cup 2%, 1% or skim milk and dairy products); Offer at least one other individual item that has - ≤ 200 calories; - the same
De Bolle, Leen; Mehuys, Els; Christiaens, Thierry; Van Tongelen, Inge; Remon, Jean-Paul; Boussery, Koen
To characterise patient encounters during routine drug dispensing in community pharmacies. Cross-sectional survey in community pharmacies (Belgium). Fifty-four per cent of all encounters (N = 1650) concerned patients carrying a prescription, of which 39% were prescriptions for new medication and 61% were repeat prescriptions. In 62% of all encounters, patients asked for non-prescribed medication. Almost one-third of self-medication requests related to special patient populations (mainly children and elderly). CONCLUSIONS : Many encounters related to self-medication, and a substantial number of these self-medication requests concerned vulnerable patient populations. © 2014 Royal Pharmaceutical Society.
Wagner, Karla D; Liu, Lin; Davidson, Peter J; Cuevas-Mota, Jazmine; Armenta, Richard F; Garfein, Richard S
Accidental overdose, driven largely by opioids, is a leading cause of death among people who inject drugs (PWIDs). We conducted secondary analysis of data from a cohort of PWIDs to identify venues where high-risk PWID could be targeted by overdose education/naloxone distribution (OEND) programs. 573 PWIDs completed a quantitative survey between June, 2012 and January, 2014, which was analyzed using multivariable logistic regression. The dependent variable was a dichotomous indicator of experiencing a heroin/opioid-related overdose in the past six months. Independent variables included: demographics, drug use behavior, and encounters with two venues - the health care and criminal justice systems - that could serve as potential venues for OEND programs. Almost half (41.5%) reported ever experiencing a heroin/opioid overdose, and 45 (7.9%) reported experiencing at least one heroin/opioid overdose in the past six months. In the final multivariable model, receiving care in a hospital in the past six months (Adjusted Odds Ratio [AdjOR] 4.08, 95% Confidence Interval [C.I.] 2.07, 8.04, popioid overdose in the past six months. Identifying venues outside of those that traditionally target services to PWIDs (i.e., syringe exchange programs) will be critical to implementing OEND interventions at a scale sufficient to address the growing epidemic of heroin/opioid related deaths. Clinical settings, such as hospitals, and drug-related encounters with law enforcement officers are promising venues for the expansion of OEND programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
To explore the nature of interactions between midwives and breast-feeding women within postnatal wards. A critical ethnographic study using participant observation and focused interviews. Two maternity units in Northern England, UK. 61 postnatal women and 39 midwives. The interactions between midwives and women were encompassed by the global theme of 'taking time and touching base'. However, most encounters were characterised by an absence of 'taking time' or 'touching base'. This related to midwives' experiences of temporal pressure and inability to establish relationality with women due to their working patterns. The global theme was underpinned by five organising themes: 'communicating temporal pressure'; 'routines and procedures'; 'disconnected encounters'; 'managing breast feeding'; and 'rationing information'. The organisational culture within the postnatal wards contributed to midwives experiencing profound temporal pressures and an inability to establish relationality with women. Within this context, the needs of breast-feeding women for emotional, esteem, informational and practical support were largely unmet. Transformative action is required to dramatically reorganise the provision of hospital-based, postnatal ward midwifery care in parts of the UK. This should include a re-conceptualisation of caring time, with recognition that midwives need sufficient time in order to give time to others. This, in turn, requires recognition that caring time is cyclical and rhythmical, allowing for relationality, sociability, mutuality and reciprocity. The midwifery staffing structure in postnatal wards needs to be reviewed, as it is unacceptable to midwives and service users for staff to be rapidly relocated according to other demands within the institution. Most radically, it is argued that now is the time to reconsider the suitability of the hospital as the place and space within which women commence their breast-feeding journey.
Hospitality and the hospitality industry need to be reevaluated in the era of the new prosumer and smart prosuming machines. Traditional notions of hospitality hearken back to an earlier era and ongoing changes are forcing us to reconsider them. Among those changes are the decline of settings that offer hospitality; the ...
Mistiaen, P.; Francke, A.L.; Poot, E.
BACKGROUND: Many patients encounter a variety of problems after discharge from hospital and many discharge (planning and support) interventions have been developed and studied. These primary studies have already been synthesized in several literature reviews with conflicting conclusions. We
Forgas, Joseph P.; Brown, L. B.
Slides showing realistic dyadic encounters in naturalistic settings, using different combinations of behavioral and environmental cues, were the stimuli. Sixty students rated their perception of these encounters on six scales, and the relative importance of environmental cues in social perception is discussed. (Editor/RK)
Méndez García, María del Carmen
The Council of Europe's "Autobiography of Intercultural Encounter" (AIE) is a tool to develop intercultural competence (IC) in education by encouraging users to reflect upon and learn from momentous intercultural encounters they have experienced face to face. Its parallel resource, the "Autobiography of Intercultural Encounters…
This paper aims to examine the impact of service encounter quality on servicevalue evaluation within a higher education context, especially in classlearning process. Service encounter quality was approached with threedimensions, they are : instructor interaction competencies, instructor taskcompetencies and student interaction competencies. Service valueevaluation in this study was called as learning experience value. Somequstionares were distributed to 306 students in some classes. The data ...
Koefoed, Lasse Martin; Simonsen, Kirsten; Christensen, Mathilde Dissing
The paper explores modes of encounters in the everyday practice of bus travel. Particularly, it addresses cross-cultural encounters located in the tension between familiarity and difference, between inclusion and exclusion. The paper is located in contemporary thoughts, approaching public transport...
Cafaro, Angelo; Vilhjalmsson, Hannes Högni; Bickmore, Timothy; Heylen, Dirk K.J.; Johansdottir, Kamilla Run; Valgardsson, Gunnar Steinn; Nakano, Y.; Neff, M.; Paiva, A.; Walker, M.
In first encounters people quickly form impressions of each other’s personality and interpersonal attitude. We conducted a study to investigate how this transfers to first encounters between humans and virtual agents. In the study, subjects’ avatars approached greeting agents in a virtual museum
In this manuscript, I interrogate the concept of "quality" encounter programs for youth in conflict zones. I focus on two Israeli organizations implementing encounters for Jewish and Palestinian citizens, and draw upon narratives of former participants as articulated during life history narratives to illustrate divergent emphases in each…
Duseja, Reena; Bardach, Naomi S; Lin, Grace A; Yazdany, Jinoos; Dean, Mitzi L; Clay, Theodore H; Boscardin, W John; Dudley, R Adams
Return visits to the emergency department (ED) or hospital after an index ED visit strain the health system, but information about rates and determinants of revisits is limited. To describe revisit rates, variation in revisit rates by diagnosis and state, and associated costs. Observational study using the Healthcare Cost and Utilization Project databases. 6 U.S. states. Adults with ED visits between 2006 and 2010. Revisit rates and costs. Within 3 days of an index ED visit, 8.2% of patients had a revisit; 32% of those revisits occurred at a different institution. Revisit rates varied by diagnosis, with skin infections having the highest rate (23.1% [95% CI, 22.3% to 23.9%]). Revisit rates also varied by state. For skin infections, Florida had higher risk-adjusted revisit rates (24.8% [CI, 23.5% to 26.2%]) than Nebraska (10.6% [CI, 9.2% to 12.1%]). In Florida, the only state with complete cost data, total revisit costs for the 19.8% of patients with a revisit within 30 days were 118% of total index ED visit costs for all patients (including those with and without a revisit). Whether a revisit reflects inadequate access to primary care, a planned revisit, the patient's nonadherence to ED recommendations, or poor-quality care at the initial ED visit remains unknown. Revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits. Agency for Healthcare Research and Quality.
Hakre, Shilpa; Brett-Major, David M; Singer, Darrell E; O'Connell, Robert J; Sateren, Warren B; Sanchez, Jose L; Agan, Brian K; Michael, Nelson L; Scott, Paul T
Active duty US Army and Air Force military personnel undergo mandatory biennial HIV antibody screening. We compared pre- and post-HIV seroconversion health status by conducting a case-control study, which evaluated all medical encounters and sociodemographic factors among incident HIV seroconverters and HIV-negative controls from June 2000 through February 2004. A total of 274 HIV seroconverters and 6205 HIV-negative personnel were included. In multivariate analysis restricted to male personnel (cases = 261, controls = 5801), single marital status (adjusted odds ratio [AOR] = 14.37), clinical indicators or symptoms within four years of HIV diagnosis (AOR = 6.22), black race (AOR = 5.88), nonindicator clinical syndromes within 2 years of HIV diagnosis (AOR = 3.31), any mental disorder within 4 years of HIV diagnosis (AOR = 3.04), increasing service-connected time (AOR = 1.69), and older age (AOR = 1.12) were associated with HIV diagnosis among males. A prior history of a sexually transmitted infection (STI) was associated with post-HIV seroconversion STI (OR(M-H) = 4.10). Similarly, a prior history of mental disorder was associated with post-HIV seroconversion mental disorder (OR(M-H) = 4.98). Forty-seven (18%) male cases were hospitalized at least once after HIV diagnosis; infectious diseases, and mental disorders made up 53% of initial admissions. HIV seroconversion was associated with increased health care-seeking behavior, STIs, and mental disorders, some of which may be amenable to screening. The higher STI rate after HIV diagnosis may partially be a consequence of monitoring, but secondary transmission of STI and possibly HIV require further definition and subsequent tailored preventive interventions.
Bakke, Håkon Kvåle; Steinvik, Tine; Angell, Johan; Wisborg, Torben
Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. We conducted a telephone survey of 1000 respondents who were representative of the Norwegian population. Respondents were asked where and when they had first aid training, if they had ever encountered situations where first aid was necessary, and stratified by occupation. First aid included cardio-pulmonary resuscitation (CPR) and basic life support (BLS). To test theoretical first aid knowledge, respondents were subjected to two hypothetical first aid scenarios. Among the respondents, 90% had received first aid training, and 54% had undergone first aid training within the last 5 years. The workplace was the most common source of first aid training. Of the 43% who had been in a situation requiring first aid, 89% had provided first aid in that situation. There were considerable variations among different occupations in first aid training, and exposure to situations requiring first aid. Theoretical first aid knowledge was not as good as expected in light of the high share who had first aid training. In the presented scenarios 42% of respondent would initiate CPR in an unconscious patient not breathing normally, and 46% would provide an open airway to an unconscious road traffic victim. First aid training was correlated with better theoretical knowledge, but time since first aid training was not. A high proportion of the Norwegian population had first aid training, and interviewees reported high willingness to provide first aid. Theoretical first aid knowledge was worse than expected. While first aid is part of national school curriculum, few have listed school as the source for their first aid training.
Background: The irrational use of drugs remains a key health problem in many developing countries. The prevalence of irrational drug use and factors associated with it were investigated at Kapiri Mposhi District Hospital in Zambia. Methods: The outpatient records (n = 680) of clinical encounters from the hospital registry ...
Rey-Bellet, Sarah; Dubois, Julie; Vannotti, Marco; Zuercher, Marili; Faouzi, Mohamed; Devaud, Karen; Rodondi, Nicolas; Rodondi, Pierre-Yves
At the beginning of the medical encounter, clinicians should elicit patients' agendas several times using open-ended questions. Little is known, however, about how many times physicians really solicit a patient's agenda during follow-up encounters. The objective was to analyze the number of agenda solicitations by physicians, of agendas initiated by physicians, and of patients' spontaneous agendas during the beginning and the entire encounter. We analyzed 68 videotaped follow-up encounters at a university primary care outpatient clinic. The number of different types of agenda setting was searched for and analyzed using negative binomial regression or logistic regression models. Physicians solicited agendas a mean ± SD of 0.8 ± 0.7 times/patient during the first 5 minutes and 1.7 ± 1.2 times/patient during the entire encounter. Physicians in 32.4% of encounters did not solicit the patient agenda, and there were never more than two physician's solicitations during the first 5 minutes. The mean number of physician's solicitations of the patients' agenda was 42% lower among female physicians during the first 5 minutes and 34% lower during the entire encounter. The number of agendas initiated by physicians was 1.2 ± 1.2/patient during the beginning and 3.2 ± 2.3/patient during the entire encounter. In 58.8% of the encounters, patients communicated their agendas spontaneously. There were twice as many patient spontaneous agendas (IRR = 2.12, p = .002) with female physicians than with males. This study showed that agenda solicitation with open-ended questions in follow-up encounters does not occur as often as recommended. There is thus a risk of missing new agendas or agendas that are important to the patient.
Sharp, Adam L; Klau, Marc H; Keschner, David; Macy, Eric; Tang, Tania; Shen, Ernest; Munoz-Plaza, Corrine; Kanter, Michael; Silver, Matthew A; Gould, Michael K
To assess acute sinusitis (AS) encounters in primary care (PC), urgent care (UC), and emergency department (ED) settings for adherence to recommendations to avoid low-value care. A retrospective, observational study of adult AS encounters (2010-2012) within a large integrated healthcare system. We compared ED and UC encounters with PC visits, adjusting for differences in patient characteristics. adherence to recommendations to avoid antibiotics and a computed tomography (CT) scan of the face, head, or sinuses. length of symptoms and adherence with AS recommendations. Of 152,774 AS encounters, 89.2% resulted in antibiotics and 1.1% resulted in a CT scan. Compared with PC encounters, ED encounters were less likely to result in antibiotics (adjusted odds ratio [AOR], 0.57; 95% CI, 0.50-0.65) but more likely to result in a CT scan (AOR, 59.4; 95% CI, 51.3-68.7), while UC encounters were more likely to result in both antibiotics (AOR, 1.12; 95% CI, 1.08-1.17) and CT imaging (AOR, 2.4; 95% CI, 2.1-2.7). Chart review of encounters resulting in antibiotics found that 50% were inappropriately prescribed for symptoms of ≤7 days' duration (95% CI, 41%-58%), while 35% were appropriately prescribed for symptoms of ≥14 days' duration (95% CI, 27%-44%). Only 29% (95% CI, 22%-36%) of encounters were consistent with guideline-adherent care. AS encounters in an integrated health system infrequently result in CT imaging, but antibiotic treatment is common. Differences exist across acute care settings, but improved antibiotic stewardship is needed in all settings.
Aim To investigate participants' experiences of visiting hospitalised friends and family members in adult acute medical or surgical wards in NHS hospitals in England, to improve knowledge of hospital visiting practices and to inform future policy-making and professional practice. Method A review of the contextual influences and the literature identified that hospital visitors might experience many of the characteristics of liminality, which is a state of being between two social structures or ways of being. In 2013, a total of 17 semi-structured, recorded and transcribed interviews were conducted with participants who had been hospital visitors in the period 2011-2013. The transcribed interviews underwent a thematic analysis. Liminality was then used as an analytic lens, and was central to the theoretical framework that was constructed to further consider the experiences of hospital visitors. Findings Participants experienced the hospitalisation of their friend or family member and their subsequent role as hospital visitors as a suspension of their everyday lives. Liminality was a predominant and consistent theme of the interviews. Five main themes of liminality were identified in relation to hospital visitors' experiences: total obedience; loss of status; ambiguity and being betwixt and between; uncertainty; and structure and communitas. The findings suggested that nurses consider the area behind the nurses' station as 'back stage'; a place they can use for downtime, socialising and computer work. In contrast, hospital visitors perceive the nurses' station to be a continuation of the ward, where they expect professional 'front stage behaviour' from staff. Conclusion When hospital visitors, already discomfited in their liminal status, encounter nurses' 'back-stage behaviour' at the nurses' station, their feelings of marginalisation, exclusion and mistrust increase. This may lead them to judge that the nurses lack professionalism and care, which can lead them to
Aljabre, Salih H.M.
Hospitals are important sites for the generation of hazardous waste. Each hospital has its own profile for the generation and transportion of waste according to its location. It is extremely important to manage hospital generated waste properly in order to avoid health and environmental risks. This article reports the plan designed and used by the hospital waste management committee in King Fahad Hospital of the University , Alhkobar, Saudi Arabia, for the safe management of hospital generated waste starting from the collection areas to the final disposal procedure. The plan was in four stages: background information, identification of problems, intervention and monitoring. The possible solutions for problems encountered are suggested. This plan which was efficient and cost effective can be used in other medical establishments. PMID:23008674
Full Text Available Abstract Background Studies show that when the Baby Friendly Hospital Initiative (BFHI is implemented breastfeeding rates increase. However, there are likely to be various barriers to BFHI implementation. This article reports on an empirical study of government-directed BFHI implementation in the New Zealand public hospital system. It focuses primarily on the barriers encountered through implementing the first Two Steps of the BFHI: developing BFHI policy and communicating it to staff; and providing necessary staff training. Methods Qualitative interview data were collected from six lactation consultants. These interviewees emerged via a purposive sample of public hospitals that represent the full range of New Zealand public hospitals. Using a content analysis technique, key themes were drawn from the transcribed interview data. Results Analysis revealed eight themes: the hospitals were in varying stages of BFHI policy development; hospital policy was not necessarily based on government policy; hospital policies were communicated in differing ways and dependent on resources; factors outside of hospital control impacted on capacity to improve breastfeeding rates; and complex organisational matters pose a barrier to educating personnel involved in the birthing process. Conclusion The findings of this study provide empirical support for prior articles about the process of BFHI policy development and implementation. The study also shows that implementation is multi-faceted and complex.
Spilman, Darin R.
The dynamic responses of a jet-transport aircraft to two types of single-axis wind vortex encounters are studied. Aircraft attitude, flight path angle, and aerodynamic angle excursions are analyzed and dominating dynamic forcing effects are identified for each encounter. A simple departure-preventing LQR controller is designed to demonstrate the benefits of using automatic control to reduce the wind vortex hazard. A Proportional-Integral-Filter controller structure successfully regulates the critical parameters, roll angle, phi, and sideslip angle, beta, for the two different vortex encounters considered in this study.
Tyuse, Sabrina W; Cooper-Sadlo, Shannon; Underwood, Sarah E
Increasingly, older adults who experience a mental health crisis come to the attention of crisis intervention team (CIT) law enforcement officers. These encounters are due largely to a lack of local mental health care resources. With few options available, individuals call 911 for assistance when an older adult exhibits alarming behavior. This article provides a profile of older adults encountered by CIT officers, identifies the reasons for the 911 call for assistance, and finds what predictors are associated with outcomes of those encounters. We found that these older adults were mostly female, Caucasian, diagnosed with depression, and attempting or threatening suicide.
transcriptions of interviews and transcriptions. Research limitations/implications – Only one Scandinavian company and a limited number of informants were activated. Also, the time period only included the initiation phase of service encounter-based innovation. Practical implications – Three different strategies...... in an emerging innovation field, open/user-driven innovation. Theory from business marketing, service encounter and innovation is also used.......Purpose – This paper aims to set up a natural experiment as action research and to develop a framework of cognitive distance of informants to improve the initiation of service encounter-based innovation. Design/methodology/approach – Natural experiment as action research in one Scandinavian case...
Calvin A. Brown III
Full Text Available Introduction: Pre-hospital airway management is a key component of resuscitation although the benefit of pre-hospital intubation has been widely debated. We report a large series of pre-hospital emergency airway encounters performed by air-transport providers in a large, multi-state system. Methods: We retrospectively reviewed electronic intubation flight records from an 89 rotorcraft air medical system from January 01, 2007, through December 31, 2009. We report patient characteristics, intubation methods, success rates, and rescue techniques with descriptive statistics. We report proportions with 95% confidence intervals and binary comparisons using chi square test with p-values <0.05 considered significant. Results: 4,871 patients had active airway management, including 2,186 (44.9% medical and 2,685 (55.1% trauma cases. There were 4,390 (90.1% adult and 256 (5.3% pediatric (age ≤ 14 intubations; 225 (4.6% did not have an age recorded. 4,703 (96.6% had at least one intubation attempt. Intubation was successful on first attempt in 3,710 (78.9% and was ultimately successful in 4,313 (91.7%. Intubation success was higher for medical than trauma patients (93.4% versus 90.3%, p=0.0001 JT test. 168 encounters were managed primarily with an extraglottic device (EGD. Cricothyrotomy was performed 35 times (0.7% and was successful in 33. Patients were successfully oxygenated and ventilated with an endotracheal tube, EGD, or surgical airway in 4809 (98.7% encounters. There were no reported deaths from a failed airway. Conclusion: Airway management, predominantly using rapid sequence intubation protocols, is successful within this high-volume, multi-state air-transport system. [West J Emerg Med. 2014;15(2:188–193.
credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.
Chang, Hsin Hsin; Chang, Ching Sheng
in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.
Ganasegeran, K; Al-Dubai, S A R
The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Cross-sectional survey, in a Malaysian public health hospital. A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...
National Aeronautics and Space Administration — This data set contains calibrated images of comet 9P/Tempel 1 acquired by the Deep Impact Medium Resolution Instrument Visible CCD during the encounter phase of the...
National Aeronautics and Space Administration — This data set contains calibrated images of comet 9P/Tempel 1 acquired by the Deep Impact Medium Resolution Instrument Visible CCD during the encounter phase of the...
National Aeronautics and Space Administration — This data set contains raw 9P/Tempel 1 and calibration images acquired by the Deep Impact Medium Resolution Instrument Visible CCD during the encounter phase of the...
National Aeronautics and Space Administration — This data set contains reduced images of comet 9P/Tempel 1 acquired by the Deep Impact Medium Resolution Instrument Visible CCD during the encounter phase of the...
National Aeronautics and Space Administration — This data set contains raw 9P/Tempel 1 and calibration images acquired by the Deep Impact Medium Resolution Instrument Visible CCD during the encounter phase of the...
Rosenbaum, Daryl A; Davis, Stephen W
...: Descriptive epidemiology. Methods: Physicians assigned to travel abroad with the under-17 men’s and women’s US national soccer teams during a 2-year period documented all encounters with team and staff members...
U.S. Geological Survey, Department of the Interior — This data contains two tables of live-dead encounter histories of Black Brant geese banded 4 breeding locations in the Arctic of northern Alaska and western Canada...
Roth, D. C.; Taylor, T. H.; Jacobson, R. A.; Lewis, G. D.
Voyager's flyby of Neptune in August of 1989 was the most distant planetary encounter ever achieved. Round trip light travel time was more than eight hours, exceeding view periods at two of the three tracking station sites. Consequently, the majority of radiometric tracking was accomplished by transmitting the uplink from one station, and receiving the downlink at a different station. This procedure defines three-way data. Dependence on three-way data for orbit determination is one distinguishing element of Voyager's successful encounter with Neptune. This paper addresses the performance of three-way range and Doppler data supporting pre-encounter orbit determination and post-encounter orbit reconstruction. Also, calibrations which reduce systematic errors inherent to three-way data are described and analyzed.
National Aeronautics and Space Administration — This far encounter step data set consists of the counting rate and flux data for electrons and ions from the Low Energy Charged Particle (LECP) experiment on Voyager...
National Aeronautics and Space Administration — This far encounter step data set consists of the counting rate and flux data for electrons and ions from the Low Energy Charged Particle (LECP) experiment on Voyager...
National Aeronautics and Space Administration — This far encounter step data set consists of the counting rate and flux data for electrons and ions from the Low Energy Charged Particle (LECP) experiment on Voyager...
輿, 幸雄; 下田, 好行
There are few educational practices for learning about interpersonal relationships in extra-curricular activities. Learning about relationships is important for students these days. In this report, a plan of learning about relationships with structured group encounter is suggested.
National Aeronautics and Space Administration — This far encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 1 while the spacecraft...
National Aeronautics and Space Administration — This far encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 2 while the spacecraft...
National Aeronautics and Space Administration — This far encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 2 while the spacecraft...
National Aeronautics and Space Administration — This far encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 2 while the spacecraft...
National Aeronautics and Space Administration — This far encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 1 while the spacecraft...
The most appropriate way of theorizing cultural diversity is to situate it in the context of a broader relational theory of culture in which the key dynamic is cultural encounters. The relational conception of culture places the emphasis on the relations between social actors and the processes by which some of these relations generate enduring cultural regularities and forms. This has important implications for political community and in particular for cosmopolitanism. It is in relationships that cultural phenomena are generated and become the basis of different kinds of political community. The paper outlines a typology of six kinds of cultural encounters and discusses four major cultural trends that variously emerge from these encounters. This approach with its emphasis on cultural encounters is the broad sociological context in which questions about cultural change and the prospects of cosmopolitanism should be discussed. © London School of Economics and Political Science 2011.
Dominic Hurst; Sharon Mickan
.... The aims of this review were to identify sources of information and professional experiences encountered by healthcare workers and from this to build a classification system, for use in future...
National Aeronautics and Space Administration — This near encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 1 while the spacecraft...
National Aeronautics and Space Administration — This near encounter data set consists of electron and ion counting rate data from the Low Energy Charged Particle (LECP) experiment on Voyager 1 while the spacecraft...
National Aeronautics and Space Administration — This near encounter step data set consists of the counting rate and flux data for electrons and ions from the Low Energy Charged Particle (LECP) experiment on...
U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Hurst, Dominic; Mickan, Sharon
Implementation science seeks to promote the uptake of research and other evidence-based findings into practice, but for healthcare professionals, this is complex as practice draws on, in addition to scientific principles, rules of thumb and a store of practical wisdom acquired from a range of informational and experiential sources. The aims of this review were to identify sources of information and professional experiences encountered by healthcare workers and from this to build a classification system, for use in future observational studies, that describes influences on how healthcare professionals acquire and use information in their clinical practice. This was a mixed studies systematic review of observational studies. OVID MEDLINE and Embase and Google Scholar were searched using terms around information, knowledge or evidence and sharing, searching and utilisation combined with terms relating to healthcare groups. Studies were eligible if one of the intentions was to identify information or experiential encounters by healthcare workers. Data was extracted by one author after piloting with another. Studies were assessed using the Mixed Methods Appraisal Tool (MMAT). The primary outcome extracted was the information source or professional experience encounter. Similar encounters were grouped together as single constructs. Our synthesis involved a mixed approach using the top-down logic of the Bliss Bibliographic Classification System (BC2) to generate classification categories and a bottom-up approach to develop descriptive codes (or "facets") for each category, from the data. The generic terms of BC2 were customised by an iterative process of thematic content analysis. Facets were developed by using available theory and keeping in mind the pragmatic end use of the classification. Eighty studies were included from which 178 discreet knowledge encounters were extracted. Six classification categories were developed: what information or experience was encountered
Green, Michael J.
Previous research on leader effectiveness in intercultural encounters has focused on the ‘cultural congruence proposition’ which indicates that leaders from one culture encountering followers from a different culture should modify their behaviour away from their own values towards the collective values of the followers in order to enhance their effectiveness. This proposition appears to contradict the basic tenets of authentic leadership theory which indicate that effective leaders align thei...
Chang Ching-Sheng; Chen Su-Yueh; Lan Yi-Ting
Abstract Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies...
Motamedi, Mahnaz; MERGHATI-KHOEI, Effat; Shahbazi, Mohammad; Rahimi-Naghani, Shahrzad; Salehi, Mehrdad; Karimi, Mehrdad; Hajebi, Ahmad; Khalajabadi-Farahani, Farideh
Background The purpose of this study is to assess attitudes toward premarital dating and sexual encounters in individuals aged 15?49 years in Tehran. Methods Utilizing the attitudes section of an original cross-sectional study (n?=?755) aimed at assessing sexual health needs of adults, this paper examined personal attitudes towards premarital dating, non-sexual relationships and sexual encounters in both male and female adults aged between 15?49 years. Multi-stage cluster random sampling and ...
Naval Health Research Center Estimating Rates of Motor Vehicle Crashes Using Medical Encounter Data: A Feasibility Study Cynthia J...undertaken to determine whether medical encounter data can be used to estimate rates of nonfatal motor vehicle crashes (MVCs) among U.S. Navy and Marine...be involved in severe crashes. Motor vehicle crash rates among junior enlisted personnel were higher in the Navy than in the Marine Corps (2.7% vs
Korosec, Lauren; Balenko, Krista; Hagens, Simon
Specialist physicians require clinical information for patient visits in ambulatory encounters, some of which they may access via digital health solutions. This study explored the completeness of information for patient care and the consequences of gaps for ambulatory specialist services provided in ambulatory settings in Canada. A sample of specialist physicians practising in outpatient clinics was recruited from a health care provider research panel. The study (n=1800 patient encounters) looked at the completeness of patient information experienced by physicians who work in environments with rich health information exchange (Connected) and a comparison cohort with less information available electronically (Unconnected). Unconnected physicians were significantly more likely to be missing information they needed for patient encounters (13% of encounters for Unconnected physicians vs 7% for Connected physicians). Unconnected physicians were also more likely to report that missing information had consequences (23% vs 13% of encounters). Lab results were the most common type of patient information missing for both Unconnected and Connected specialists (25% for Unconnected physicians vs 11% Connected physicians). The results from this study indicate that Canadian physicians commonly experience information gaps in ambulatory encounters, and that many of these gaps are of consequence to themselves, their patients, and the healthcare system. Wasting physician and patient time, as well as being forced to proceed with incomplete information, were the most common consequences of information gaps reported.
Full Text Available Pope Francis is the first Jesuit pope and has made economic inequality a theme of his pontificate. This article shows that Pope Francis diagnoses economic inequality as both a structural problem and a problem of virtue, and that the virtue he calls for in response is what James F. Keenan, SJ has called Jesuit hospitality. Reviewing contemporary theological work on hospitality, I show that Francis’ Jesuit hospitality shares many features with hospitality as described by feminist theologians. Namely, it is risky, takes place across difference, acknowledges the marginality of both host and guest, and promises mutual benefit to each party. Francis’ account of the spiritual practice of encounter provides a concrete vision of Jesuit hospitality in action. This article contributes to existing literature on the uniquely Jesuit nature of Francis’ theology and to work showing the resonance of his intellectual standpoint with feminist approaches. It proposes a Christian virtue response to the pressing contemporary problem of economic inequality.
Full Text Available The aim of the present study was to achieve a theoretical understanding of several different-age children's experiences of magic relations with hospital clowns in the context of medical care, and to do so using psychological theory and a child perspective. The method used was qualitative and focused on nine children. The results showed that age was important to consider in better understanding how the children experienced the relation with the hospital clowns, how they described the magical aspects of the encounter and how they viewed the importance of clown encounters to their own well-being. The present theoretical interpretation characterized the encounter with hospital clowns as a magical safe area, an intermediate area between fantasy and reality. The discussion presented a line of reasoning concerning a magical attachment between the child and the hospital clowns, stating that this attachment: a comprised a temporary relation; b gave anonymity; c entailed reversed roles; and d created an emotional experience of boundary-transcending opportunities.
Tang, Amy S; Kruger, Jenna F; Quan, Judy; Fernandez, Alicia
Resident physicians' use of professional interpreters drives communication with hospitalized patients with limited English proficiency (LEP). We surveyed residents from three specialties across two hospitals affiliated with one academic medical institution about their communication with their last hospitalized LEP patient. Among 149 respondents (73% response rate), 71% reported using professional interpreters for fewer than 60% of hospital encounters. Most (91%) perceived their quality of communication with hospitalized LEP patients as worse than with English-speaking patients. Professional interpreter use varied substantially by resident and by hospital encounter, with more reporting use of ad hoc interpreters, their own language skills, or not talking to the patient due to time constraints during pre-rounds (39%), team rounds (49%), or check-ins (40%) than during procedural consents (9%) or family meetings (17%). The reported variation suggests targets for quality improvement efforts and the need for clear enforceable guidelines on resident communication with hospitalized LEP patients.
Boendermaker, PM; Ket, P; Dusman, H; Schuling, J; Van der Vleuten, CPM; Tan, LHC
This study of educational encounters between a trainer and a trainee in vocational training for general practice investigates the quality of the encounter. The study focuses on the relation between the quality of the encounter and elements such as presence of feedback, duration, use of media, etc. A
Borchering, Rebecca K; Bellan, Steve E; Flynn, Jason M; Pulliam, Juliet R C; McKinley, Scott A
Animals share a variety of common resources, which can be a major driver of conspecific encounter rates. In this work, we implement a spatially explicit mathematical model for resource visitation behaviour in order to examine how changes in resource availability can influence the rate of encounters among consumers. Using simulations and asymptotic analysis, we demonstrate that, under a reasonable set of assumptions, the relationship between resource availability and consumer conspecific encounters is not monotonic. We characterize how the maximum encounter rate and associated critical resource density depend on system parameters like consumer density and the maximum distance from which consumers can detect and respond to resources. The assumptions underlying our theoretical model and analysis are motivated by observations of large aggregations of black-backed jackals at carcasses generated by seasonal outbreaks of anthrax among herbivores in Etosha National Park, Namibia. As non-obligate scavengers, black-backed jackals use carcasses as a supplemental food resource when they are available. While jackals do not appear to acquire disease from ingesting anthrax carcasses, changes in their movement patterns in response to changes in carcass abundance do alter jackals' conspecific encounter rate in ways that may affect the transmission dynamics of other diseases, such as rabies. Our theoretical results provide a method to quantify and analyse the hypothesis that the outbreak of a fatal disease among herbivores can potentially facilitate outbreaks of an entirely different disease among jackals. By analysing carcass visitation data, we find support for our model's prediction that the number of conspecific encounters at resource sites decreases with additional increases in resource availability. Whether or not this site-dependent effect translates to an overall decrease in encounters depends, unexpectedly, on the relationship between the maximum distance of detection and
Grundström, Hanna; Alehagen, Siw; Kjølhede, Preben; Berterö, Carina
To identify and describe the experience of healthcare encounters among women with endometriosis. Endometriosis is a "hidden" chronic gynaecological disease appearing in every 10th woman of fertile age. Different manifestations of pain are the main symptoms, often leading to impaired physical and mental health, and lower quality of life. Previous research on healthcare experiences among women with endometriosis has focused on diagnostic delay and experiences of encountering general practitioners. A qualitative, interpretive, phenomenological approach was used. We interviewed nine women aged 23-55, with a laparoscopy-confirmed diagnosis of endometriosis. The interviews were recorded and transcribed verbatim. The data were analysed following the steps of the interpretive phenomenological approach. Two themes were identified in the interview transcripts: being treated with ignorance and being acknowledged. The essence: "the double-edged experience of healthcare encounters" emerged from the themes. The women's experience was double-edged as it involved contradictory feelings: the encounters were experienced as both destructive or constructive. On the one hand, the destructive side was characterised by ignorance, exposure and disbelief. On the other hand, the constructive side made the women feel acknowledged and confirmed, boosting their self-esteem. The new and important aspects of the findings are that the experience of healthcare encounters is for the first time expressed as double-edged: both destructive and constructive. The experience was of specific importance as it affected the women's perceptions of themselves and of their bodies. The information about the constructive side of the experience is of clinical valuable for all healthcare professionals (nurses, midwives and doctors) encountering these women, as it provides a new level of understanding of the experiences. The findings demonstrate both psychological and practical aspects that can help professionals to
Savinetti, Nicol Marie Foulkes
to their legislated social rights in their home country diversely, depending on the country of origin, duration of stay and whether they are the employed or accompanying partner among other factors; both the employed partner and the accompanying partner’s reliance on the company for social support increases...
Hung, H.; Jacquemin, C.
This work is about the remediation of one of Mark Rothko's Seagram murals through the composition of several online sources and additional digital rendering. Based on reproductions of Rothko's "Red on Maroon" found on the Internet, and using computer graphics compositing associated with moiré and
On 6 April from 4 p.m. to 6 p.m. an unusual videoconference will take place between Paris, Switzerland and the United States and will be transmitted live on the Internet. This will be the Live Webcast of the Géants de l'infiniment Petit, an exhibition on the theme of particle physics, which will run from 6 and 25 April 2004 at the Palais de la Découverte. Physicists from CERN, FNAL (Chicago) and SLAC (Stanford) will reply to visitors' questions and to those left by surfers on the Palais de la Découverte's web site. All this information can be found at: http://www.palais-decouverte.fr/expos/geants/index.htm
an artist today, and how these relate to cultural structures, can serve to explain some of the cultural structures that organize the world of art. In this thesis, my empirical starting point is the local context of a Danish art school and global attitudes to cultural policy-making and art education......By studying what goes on in the world of art, it is possible not only to make observations about art and the artist but also to understand how modern-day culture is being organized and negotiated. From this perspective, understanding the experiences of autonomy and contemporaneity in being...... on individual artists, acting in and making sense of the cultural structures of the world of art. My research process has been guided by critical realism and the methodological meta-approach of engaging with complexity through reflexive research. In this sense, the title “Aesthetic Encounters” refers not only...
Foulkes, Nicol Marie
of the challenges they face in coping with diversity. In stark contrast, India, even with the exponential growth in its economy in recent years, is still home to some of the most poverty stricken regions of the world, with over 90% of the active labour force in unorganized work and without any social protection...
Lassen, Agnete Kjeldal Wisti
On the basis of the seals from a merchant archive from the ancient city of Kanesh in Turkey, the dissertation attempts to reinterpret the style, chronology, and use patterns of the Old Assyrian seals. The seal was a central administrative tool in the period, and every person in Kanesh, regardless...... increasing hybridization of the seal imagery in unison with increased cultural contacts between Assyrians and Anatolians. The Assyrian presence in Anatolia also stimulated the creation of an independent Anatolian seal production, which disappeared or was completely transformed when the contact seized...
This article divides into two roughly equal parts, both of which aim to address the "act" rather than the "art" of drawing. The second part focuses on a theoretical discussion of drawing. The first bears on a number of themes including the role of drawing in colonial history, drawing and data collection, and drawing and memory.…
Tasso's epic poem about the first crusade is related to contemporary Turkish threats; it was influential all over Europe, in Dukrovnik Gundulic wrote an imitation ono the Polish-Turkish war and the death of Osman II, in Hungary Zrinyi wrote about the fall of Sziget with a view of national unty...
Costello, M M
With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.
This literature review examines the effects of hospitalization on the young child and suggests ways in which parents and hospital personnel can protect children from the potentially harmful emotional and intellectual effects of hospitalization. The history of attitudes toward the hospitalization of children is discussed. Children's emotional…
Najdowski, Cynthia J; Bottoms, Bette L; Goff, Phillip Atiba
We conducted 2 studies to investigate how cultural stereotypes that depict Blacks as criminals affect the way Blacks experience encounters with police officers, expecting that such encounters induce Blacks to feel stereotype threat (i.e., concern about being judged and treated unfairly by police because of the stereotype). In Study 1, we asked Black and White participants to report how they feel when interacting with police officers in general. As predicted, Blacks, but not Whites, reported concern that police officers stereotype them as criminals simply because of their race. In addition, this effect was found for Black men but not Black women. In Study 2, we asked Black and White men to imagine a specific police encounter and assessed potential downstream consequences of stereotype threat. Consistent with Study 1, Black but not White men anticipated feeling stereotype threat in the hypothetical police encounter. Further, racial differences in anticipated threat translated into racial differences in anticipated anxiety, self-regulatory efforts, and behavior that is commonly perceived as suspicious by police officers. By demonstrating that Blacks might expect to be judged and treated unfairly by police because of the negative stereotype of Black criminality, this research extends stereotype threat theory to the new domain of criminal justice encounters. It also has practical implications for understanding how the stereotype could ironically contribute to bias-based policing and racial disparities in the justice system. (c) 2015 APA, all rights reserved).
Full Text Available Abstract Information regarding spatio-temporal relationships and encounters of sympatric domestic sheep, Alpine ibex (Capra ibex ibex and Alpine chamois (Rupicapra rupicapra rupicapra in the Swiss Alps were systematically registered to evaluate the possibility of an interspecific transmission of infectious agents on pastures. Observations were performed in alpine regions of four Swiss cantons during the 1997 and 1998 mountain summer grazing season. In the main study area, Val Chamuera (canton of Grisons, a consistent reduction in the number of ibexes was observed after the arrival of sheep on the pasture. Some ibexes remained for a longer time in the area, but in general, ibexes and sheep did not use the same compartments of the area simultaneously. However, a salt lick for sheep attracted the ibexes, and several encounters were recorded in the compartments close to this salt lick. Several encounters registered in other areas of the Swiss Alps also occurred in the neighbourhood of a salt lick; however, in other cases different species were attracted by rich pastures. The study indicates that encounters (0-50 m between free-ranging individuals of different Caprinae species, domestic and wild, are not uncommon events in the Alps. Therefore, encounters can be considered to be a predisposing factor for interspecific transmission of infectious agents such as Mycoplasma conjunctivae, causing keratoconjunctivitis in chamois, ibex, domestic sheep and goats.
Morgan, Simon; Henderson, Kim; Tapley, Amanda; Scott, John; van Driel, Mieke; Thomson, Allison; Spike, Neil; McArthur, Lawrie; Presser, Jenny; Magin, Parker
Consulting with patients is the core learning activity of Australian family medicine (general practice/GP) training, providing a rich source of reflective learning for trainees. We have developed a reflective learning program for postgraduate vocational trainees based on clinical encounters. The Registrar Clinical Encounters in Training (ReCEnT) program is an educational program documenting GP trainees' consultations in five Australian GP training providers. Trainees record patient demographics, consultation details, problems managed, management practices and educational factors from sixty consecutive consultations per six-month training term. Trainees receive a detailed feedback report comparing individual data to aggregated trainee data and national GP data. The patient encounter system provides multiple opportunities for reflective learning across a number of domains of exposure and practice. Reflection can occur during completion of the encounter form; as self-reflection on the feedback report; as facilitated reflection with the GP trainer and medical educator; and as part of integration of data into teaching. We have identified areas for further development, including enhancing the reflective skills of trainees and trainers. The ReCEnT patient encounter program provides a rich platform for reflective learning for vocational trainees and supports development of skills in lifelong learning.
van der Kwaak, Anke; Ferris, Kristina; van Kats, Jetty; Dieleman, Marjolein
Adequately assessing quality of care poses enormous challenges. While conducting fieldwork, we were struck by the need for a framework that encapsulates provider-client encounters. Little evidence exists concerning the most effective training, and management of health staff engaged in sexuality, reproductive health and HIV related health services. This paper proposes a framework for analysing these encounters. This paper is based on five studies. Mixed method studies were carried out in Uganda and Kenya. Two additional studies looked into the effect of HIV on health worker performance in Uganda and Zambia. As a result of the findings, a desk review looked into factors affecting provider-client encounters in order to improve the responsiveness of programs. Positive encounters between provider and client are built on trust and respect, consist of communication, practice and process, and are influenced by space, place and context. Combining these facets allows for a better understanding of their interactions. A holistic perspective in which the breadth of dynamics and processes are described should be used when assessing the quality of provider-client encounters. Within training, management and human resource planning, these dynamics need to be utilized to realize the best possible care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Estrada, Robin Dawson; Messias, DeAnne K Hilfinger
Language asymmetry between patients and providers may influence the context, content, and quality of health care communication, affecting patient outcomes and contributing to health disparities. This research examined interpreter-mediated, primary care encounters between English-speaking nurse practitioners and Spanish-speaking adult patients. Situational analysis guided the collection, analysis, and interpretation of audio-recorded clinical encounter data. Interpreter-mediated communication was situated within intersecting social, economic, political, and health systems contexts. Three modes of collaborative knowledge generations were Constructing Connections, Constructing Mutual Understanding, and Constructing Effective Systems Navigation Strategies. These findings illustrate how interactants contributed individual and collective knowledge across multiple systems to address patient concerns. The analysis revealed ways in which communication processes may influence both providers' diagnostic and interventional decision-making and patients' understanding and potential compliance. Ongoing preparation and support for intraprofessional collaboration is needed to ensure effective communication and mitigate untoward effects of language asymmetries in clinical encounters.
Fröhlich-Gildhoff, Klaus; von Kleist, Carolin; Kerscher-Becker, Jutta; Döther, Sabrina
Supporting Early Childhood Teacher's Competences in the Encounter with Refugee Children and their Families Children and families with experiences as refugees bring out a challenge for the professionals in early childhood institutions (kindergarten). A curriculum to strengthen the competencies of early childhood teacher teams in the encounter with children and families with flight experiences was developed, implemented and evaluated. The article shows the objectives of this curriculum and the first evaluation results. The evaluation with qualitative and quantitative methods shows an increase of self-assessed security and competences in the pedagogical contact/encounter with the target group. A relevant success factor was the adaptation of the frame curriculum to the needs and situation of the specific early childhood teacher teams.
Farrugia, Adrian; Fraser, Suzanne
This article investigates the ways new forms of addiction are encountered by professionals working in the area of alcohol and other drugs. Combining interviews with policymakers, service providers, and peer advocates in three countries (Australia, Canada, and Sweden), and Mike Michael's utilization of the notion of prehension for science communication, we track the notions of addiction, drugs, and subjectivity that emerge when alcohol and other drug professionals encounter what Fraser, Moore and Keane call the addicting of nonsubstance-related practices. The analysis has three parts: constituting addiction unity, questioning addiction unity, and conflicting logics of addicting processes. We argue that specific articulations of drugs and health and specific health professional and addiction subjects are made anew in these encounters. These notions of drugs, health, and subjectivity shape how alcohol and other drug professionals engage with substance-related addictions. In concluding, we consider the implications of new addictions for professional practice.
Kazimierczak, Karolina A
This article critically examines the significance of relational approaches for sociological understandings of clinical interactions, relations and practices, by exploring the ways in which relational theories and concepts have been employed in the recent sociological accounts of clinical encounters to trouble the classical dyadic models of clinical interaction and the related atomistic conceptions of agency and accountability. Reading this work through the theoretical contributions from feminist science studies scholarship, and particularly the work of Donna Haraway and Karen Barad, the article proposes an alternative understanding of clinical interactions, relations and practices, where relations are conceived as constitutive of individuals (objects/bodies and their attributes/identities), rather than being constituted by encounters between individuals. Key for this understanding is the reconceptualisation of clinical encounter as an apparatus of bodily production through which different agents (patients, clinicians, diseases and healthcare services) are materialised and enacted.
We describe in detail gravitational wave bursts from Primordial Black Hole (PBH) hyperbolic encounters. The bursts are one-time events, with the bulk of the released energy happening during the closest approach, which can be emitted in frequencies that are within the range of LIGO (10-800Hz). Furthermore, we correct the results for the power spectrum of hyperbolic encounters found in the literature and present new exact and approximate expressions for the peak frequency of the emission. Note that these GW bursts from hyperbolic encounters between PBH are complementary to the GW emission from the bounded orbits of BHB mergers detected by LIGO, and help breaking degeneracies in the determination of the PBH mass, spin and spatial distributions.
Lounsbery, Jody L; Pereira, Chrystian R; Harris, Ila M; Moon, Jean Y; Westberg, Sarah M; Kolar, Claire
To determine if the amount of exposure to patient encounters and clinical skills correlates to student clinical competency on ambulatory care advanced pharmacy practice experiences (APPEs). Students in ambulatory care APPEs tracked the number of patients encountered by medical condition and the number of patient care skills performed. At the end of the APPE, preceptors evaluated students' competency for each medical condition and skill, referencing the Dreyfus model for skill acquisition. Data was collected from September 2012 through August 2014. Forty-six responses from a student tracking tool were matched to preceptor ratings. Students rated as competent saw more patients and performed more skills overall. Preceptors noted minimal impact on workload. Increased exposure to patient encounters and skills performed had a positive association with higher Dreyfus stage, which may represent a starting point in the conversation for more thoughtful design of ambulatory care APPEs.
Bae, Gi Yeul; Flombaum, Jonathan I
Why can we track only so many objects? We addressed this question by asking when and how tracking errors emerge. To test the hypothesis that many tracking errors are target/nontarget confusions emerging from close encounters, we compared standard multiple-object tracking trials with trials on which a nontarget turned a random color whenever it approached within 4° of a target. This manipulation significantly improved performance by alleviating the correspondence challenge of a close encounter. Two control experiments showed that color change benefits were not merely due to target recovery. Follow-up experiments demonstrated that color change benefits did not accrue monotonically with distance but, instead, seemed to obey a step function; and an additional experiment demonstrated that, without color changes, the frequency of close encounters predicts tracking performance. Taken together, these experiments suggest that uncertainty about target location imposes the primary constraint on tracking, at times causing errors by leading to confusions between targets and nontargets.
Zhang, Jinping; Lin, Xiaomin; Zhao, Yong; Hong, Yang
Rainfall and reference crop evapotranspiration are random but mutually affected variables in the irrigation district, and their encounter situation can determine water shortage risks under the contexts of natural water supply and demand. However, in reality, the rainfall and reference crop evapotranspiration may have different marginal distributions and their relations are nonlinear. In this study, based on the annual rainfall and reference crop evapotranspiration data series from 1970 to 2013 in the Luhun irrigation district of China, the joint probability distribution of rainfall and reference crop evapotranspiration are developed with the Frank copula function. Using the joint probability distribution, the synchronous-asynchronous encounter risk, conditional joint probability, and conditional return period of different combinations of rainfall and reference crop evapotranspiration are analyzed. The results show that the copula-based joint probability distributions of rainfall and reference crop evapotranspiration are reasonable. The asynchronous encounter probability of rainfall and reference crop evapotranspiration is greater than their synchronous encounter probability, and the water shortage risk associated with meteorological drought (i.e. rainfall variability) is more prone to appear. Compared with other states, there are higher conditional joint probability and lower conditional return period in either low rainfall or high reference crop evapotranspiration. For a specifically high reference crop evapotranspiration with a certain frequency, the encounter risk of low rainfall and high reference crop evapotranspiration is increased with the decrease in frequency. For a specifically low rainfall with a certain frequency, the encounter risk of low rainfall and high reference crop evapotranspiration is decreased with the decrease in frequency. When either the high reference crop evapotranspiration exceeds a certain frequency or low rainfall does not exceed a
Martínez-Barbosa, C. A.; Jílková, L.; Portegies Zwart, S.; Brown, A. G. A.
The frequency of Galactic stellar encounters the Solar system experienced depends on the local density and velocity dispersion along the orbit of the Sun in the Milky Way galaxy. We aim at determining the effect of the radial migration of the solar orbit on the rate of stellar encounters. As a first step, we integrate the orbit of the Sun backwards in time in an analytical potential of the Milky Way. We use the present-day phase-space coordinates of the Sun, according to the measured uncertainties. The resulting orbits are inserted in an N-body simulation of the Galaxy, where the stellar velocity dispersion is calculated at each position along the orbit of the Sun. We compute the rate of Galactic stellar encounters by employing three different solar orbits - migrating from the inner disc, without any substantial migration and migrating from the outer disc. We find that the rate for encounters within 4 × 105 au from the Sun is about 21, 39 and 63 Myr-1, respectively. The stronger encounters establish the outer limit of the so-called parking zone, which is the region in the plane of the orbital eccentricities and semi-major axes where the planetesimals of the Solar system have been perturbed only by interactions with stars belonging to the Sun's birth cluster. We estimate the outer edge of the parking zone at semimajor axes of 250-1300 au (the outwards and inwards migrating orbits reaching the smallest and largest values, respectively), which is one order of magnitude smaller than the determination made by Portegies Zwart & Jílková. We further discuss the effect of stellar encounters on the stability of the hypothetical Planet 9.
Warrington, Steven; Beeson, Michael; Bradford, Amber
End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators. Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury. That video was shown during a lecture at the Council of EM Residency Director's Academic Assembly with attendees asked to evaluate the "resident" using one of eight possible ESE forms randomly distributed. Descriptive statistics were used to analyze the results with Fleiss' kappa to evaluate inter-rater agreement. Most of the 324 respondents were leadership in residency programs (66%), with a range of 29-47 responses per evaluation form. Few individuals (5%) felt they were experts in assessing residents based on EM milestones. Fleiss' kappa ranged from 0.157 - 0.308 and did not perform much better in two post-hoc subgroup analyses. The kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents. Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment. Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents.
Full Text Available Introduction: End-of-shift evaluation (ESE forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM educators. Methods: Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury. That video was shown during a lecture at the Council of EM Residency Director’s Academic Assembly with attendees asked to evaluate the “resident” using one of eight possible ESE forms randomly distributed. Descriptive statistics were used to analyze the results with Fleiss’ kappa to evaluate inter-rater agreement. Results: Most of the 324 respondents were leadership in residency programs (66%, with a range of 29-47 responses per evaluation form. Few individuals (5% felt they were experts in assessing residents based on EM milestones. Fleiss’ kappa ranged from 0.157 - 0.308 and did not perform much better in two post-hoc subgroup analyses. Conclusion: The kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents. Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment. Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents. [West J Emerg Med. 2017;18(3518-524.
Full Text Available Achieving facile specific recognition is essential for intrinsically disordered proteins (IDPs that are involved in cellular signaling and regulation. Consideration of the physical time scales of protein folding and diffusion-limited protein-protein encounter has suggested that the frequent requirement of protein folding for specific IDP recognition could lead to kinetic bottlenecks. How IDPs overcome such potential kinetic bottlenecks to viably function in signaling and regulation in general is poorly understood. Our recent computational and experimental study of cell-cycle regulator p27 (Ganguly et al., J. Mol. Biol. (2012 demonstrated that long-range electrostatic forces exerted on enriched charges of IDPs could accelerate protein-protein encounter via "electrostatic steering" and at the same time promote "folding-competent" encounter topologies to enhance the efficiency of IDP folding upon encounter. Here, we further investigated the coupled binding and folding mechanisms and the roles of electrostatic forces in the formation of three IDP complexes with more complex folded topologies. The surface electrostatic potentials of these complexes lack prominent features like those observed for the p27/Cdk2/cyclin A complex to directly suggest the ability of electrostatic forces to facilitate folding upon encounter. Nonetheless, similar electrostatically accelerated encounter and folding mechanisms were consistently predicted for all three complexes using topology-based coarse-grained simulations. Together with our previous analysis of charge distributions in known IDP complexes, our results support a prevalent role of electrostatic interactions in promoting efficient coupled binding and folding for facile specific recognition. These results also suggest that there is likely a co-evolution of IDP folded topology, charge characteristics, and coupled binding and folding mechanisms, driven at least partially by the need to achieve fast association
... 16 for a list of other organizations that work to improve hospital quality. 12 Section 2: A Closer Look At Hospital Quality How can I find information about hospital quality? Medicare publishes information about hospital quality on the Hospital Compare ...
França, Urbano L; McManus, Michael L
To provide metrics for quantifying the capability of hospitals and the degree of care regionalization. Administrative database covering more than 10 million hospital encounters during a 3-year period (2012-2014) in Massachusetts. We calculated the condition-specific probabilities of transfer for all acute care hospitals in Massachusetts and devised two new metrics, the Hospital Capability Index (HCI) and the Regionalization Index (RI), for analyzing hospital systems. The HCI had face validity, accurately differentiating academic, teaching, and community hospitals of varying size. Individual hospital capabilities were clearly revealed in "fingerprints" of their condition-specific transfer behavior. The RI also performed well, with those of specific conditions successfully quantifying the concentration of care arising from regulatory and public health activity. The median RI of all conditions within the Massachusetts health care system was 0.21 (IQR, 0.13-0.36), with a long tail of conditions that were very highly regionalized. Application of the HCI and RI metrics together across the entire state identified the degree of interdependence among its hospitals. Condition-specific transfer activity, as captured in the HCI and RI, provides quantitative measures of hospital capability and regionalization of care. © Health Research and Educational Trust.
Tolsgaard, Martin G; Arendrup, Henrik; Lindhardt, Bjarne O
PURPOSE: The aim of this study, done in Denmark, was to explore the construct validity of a Reporter-Interpreter-Manager-Educator (RIME)-structured scoring format for assessing patient encounter skills. METHOD: The authors developed a RIME-structured scoring form and explored its construct validity...... (carried out during 2009-2010) was an observational study of patient encounter skills where clinician examiners used the scoring form in end-of-clerkship oral examinations of three consecutive cohorts of a total of 547 fourth-year medical students. RESULTS: In the experimental study, RIME scores showed...
This study was based on videotaped material from sessions in a self-development group. The purpose was to examine how the group leader can use words, body language, positioning and touch to create and handle encounters with the group members in ways that are optimal for achieving desirable changes. The main theoretical framework is Stern’s work on the present moment. The study also draws heavily on family theoretical work like that of Michael White and Salvador Minuchin. Encounters from the v...
Encountering the other in a significant way requires more than a generalized knowledge of cultural characteristics-or cultural competency. In this column, the author describes encountering the other from the humanbecoming theory perspective and proposes a teaching-learning process of ongoing cultural learning that pushes the boundaries of the familiar and expands horizons of understanding. The model encourages healthcare providers to shift their epistemological location and view the world from the perspective of the other, thereby increasing their capacity to care for and be with the other in meaningful ways.
Licoppe, C; Inada, Yoriko
We report a comparative ethnographic study of a proximity-based mobile video game (Dragon Quest 9) in Japan: the Nintendo DS game terminals may recognize one another and allow players to exchange game resources when they are close to one another. Because different communication infrastructures are available, situations of encounter are shown to be potentially seamful and to support multi-layered participation frames. Our observations show a variety of encounter formats, among whom timid...
Giuggioli, Luca; Pérez-Becker, Sebastian; Sanders, David P.
We develop an analytical method to calculate encounter times of two random walkers in one dimension when each individual is segregated in its own spatial domain and shares with its neighbor only a fraction of the available space, finding very good agreement with numerically exact calculations. We model a population of susceptible and infected territorial individuals with this spatial arrangement, and which may transmit an epidemic when they meet. We apply the results on encounter times to determine analytically the macroscopic propagation speed of the epidemic as a function of the microscopic characteristics: the confining geometry, the animal diffusion constant, and the infection transmission probability.
Mario Eduardo Giraldo Oliveros
Full Text Available We present a perspective on the interpersonal element of service in which economic and social collaboration takes place in real time: the service encounter. We view it as a site of conflict for power and control where social identities are anchored and collective meanings are constituted and reproduced. Our theoretical underpinning is taken from the Activity Theory (AT to shed light on the service encounter as a contradictory, political locus of tension between providers and customers (internal and external in the Higher Education (HE market.
Full Text Available Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials and Methods: A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Analysis: Statistical Package of Social Sciences (SPSS® (version 16.0, IBM, Armonk, NY was used. Cronbach′s alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Results: Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%. Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. Conclusion: The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.
Anderson, David W.
This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.
Hortaliças in natura ou minimamente processadas em unidades de alimentação e nutrição: quais aspectos devem ser considerados na sua aquisição? Fresh or minimally processed vegetables in foodservices: what aspects should be considered when purchasing them?
Gabriel Carvalho Degiovanni
costs of gross weight considering the correction for net yield were compared with the costs of minimally processed vegetables supplied by the manufacturer during two different periods. Results The costs of minimally processed zucchini, carrot, chayote and arracacha were 8.6%, 14.1%, 4.6% and 13.5% lower than their respective fresh counterparts at time 1, a fact that did not repeat itself at time 2, when these vegetables were less expensive when bought fresh. Conclusion In conclusion, numerous factors associated or not with the food directly influence the magnitude of the losses that occur during processing. The working methods and final objectives of each foodservice should define which product is more advantageous since costs vary and production can be affected by seasonality and the supply and demand of the food item, with repercussions on the quality management of the foodservice.
Descrição sócio-demográfica, laboral e de saúde dos trabalhadores do setor de serviços de alimentação dos restaurantes populares do estado do Rio de Janeiro Sociodemographic, labor, and health characteristics of workers from popular foodservices in the state of Rio de Janeiro, Brazil
Odaleia Barbosa de Aguiar
Full Text Available OBJETIVO: Este artigo tem o objetivo de descrever uma população de trabalhadores de alimentação coletiva com foco nos perfis sócio-demográfico, laboral e de saúde. MÉTODOS: O estudo, do tipo seccional, foi realizado com 426 trabalhadores dos restaurantes populares do Estado do Rio de Janeiro, com um questionário aplicado por entrevistadores treinados. Os testes para fins de verificação de associação foram o quiquadrado de Pearson, e, alternativamente, o teste exato de Fisher para amostras pequenas. RESULTADOS: Os homens representaram 62,7% do total de trabalhadores. A idade média dos funcionários foi de 35,1 anos, (DP=10,3. Quanto à escolaridade, somente 11,3% possuíam escolaridade menor que quatro anos e 42,2% entre cinco e oito anos de escolaridade. Os incômodos ambientais apresentaram a seguinte ordem decrescente de importância na percepção dos trabalhadores: temperatura (90,1%, ruído (51,2%, esforço físico (36,2% e luminosidade (10,5%. Os relatos de doenças com diagnóstico médico apresentaram prevalência de: 15,0% "doença osteomusculares relacionadas ao trabalho (DORT"; 14,3% hipertensão arterial sistêmica; 12,7%, gastrite e 2,1%, diabete Mellitus tipo II. Em relação aos acidentes de trabalho 20,2% relataram ter sofrido corte, seguido de contusão com 16,0%, nos últimos doze meses. CONCLUSÃO: A análise dos dados permitiu concluir que, embora os diferentes cargos sofram a ação do ambiente de trabalho, da remuneração e da qualificação, estas questões estiveram mais associadas aos auxiliares de serviços gerais.OBJECTIVE: This study described a population of foodservice workers, focusing on their sociodemographic, labor and health characteristics. METHODS: This sectional study included 426 (98% workers of popular foodservices of the state of Rio de Janeiro who answered a questionnaire administered by trained interviewers. Associations were investigated with the Pearson's chi-square test or the Fisher
Jain, Parul; Krieger, Janice L
To understand the communication strategies international medical graduates use in medical interactions to overcome language and cultural barriers. In-depth interviews were conducted with 12 international physicians completing their residency training in internal medicine in a large hospital in Midwestern Ohio. The interview explored (a) barriers participants encountered while communicating with their patients regarding language, affect, and culture, and (b) communication convergence strategies used to make the interaction meaningful. International physicians use multiple convergence strategies when interacting with their patients to account for the intercultural and intergroup differences, including repeating information, changing speaking styles, and using non-verbal communication. Understanding barriers to communication faced by international physicians and recognizing accommodation strategies they employ in the interaction could help in training of future international doctors who come to the U.S. to practice medicine. Early intervention could reduce the time international physicians spend navigating through the system and trying to learn by experimenting with different strategies which will allow these physicians to devote more time to patient care. We recommend developing a training manual that is instructive of the socio-cultural practices of the region where international physician will start practicing medicine. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Fox, Justin P; Burkardt, Deepika D'Cunha; Ranasinghe, Isuru; Gross, Cary P
Ambulatory surgery centers now report immediate hospital transfer rates as a measure of quality. For patients undergoing colonoscopy, this measure may fail to capture adverse events, which occur after discharge yet still require a hospital-based acute care encounter. We conducted this study to estimate rates of immediate hospital transfer and hospital-based acute care following outpatient colonoscopy performed in ambulatory surgery centers. Using state ambulatory surgery databases from the 2009-2010 Healthcare Cost and Utilization Project, we identified adult patients who underwent colonoscopy. Immediate hospital transfer and overall acute health care utilization in the 14 days following colonoscopy was determined from corresponding inpatient, ambulatory surgery, and emergency department databases. To compare rates across centers while accounting for differences in patient populations, we calculated risk-standardized rates using hierarchical generalized linear modeling. The final sample included 1,137,381 colonoscopy discharges from 1019 centers. At the ambulatory surgery center level, the median risk-standardized hospital transfer rate was 0.0% (interquartile range=0.0%), whereas the hospital-based acute care rate was 2.1% (interquartile range=0.6%), with few centers (N=36) having no observed encounters. No correlation was noted between the risk-standardized hospital transfer and hospital-based acute care rates (volume weighted correlation coefficient=0.04, P=0.16). Patients more frequently experience hospital-based acute care encounters after colonoscopy than the need for immediate hospital transfer. Broadening existing quality measures to include hospital-based acute care in the postdischarge period may provide a more complete measure of quality.
Guffanti, Marianne; Casadevall, Thomas J.; Budding, Karin
Information about reported encounters of aircraft with volcanic ash clouds from 1953 through 2009 has been compiled to document the nature and scope of risks to aviation from volcanic activity. The information, gleaned from a variety of published and other sources, is presented in database and spreadsheet formats; the compilation will be updated as additional encounters occur and as new data and corrections come to light. The effects observed by flight crews and extent of aircraft damage vary greatly among incidents, and each incident in the compilation is rated according to a severity index. Of the 129 reported incidents, 94 incidents are confirmed ash encounters, with 79 of those having various degrees of airframe or engine damage; 20 are low-severity events that involve suspected ash or gas clouds; and 15 have data that are insufficient to assess severity. Twenty-six of the damaging encounters involved significant to very severe damage to engines and (or) airframes, including nine encounters with engine shutdown during flight. The average annual rate of damaging encounters since 1976, when reporting picked up, has been approximately 2 per year. Most of the damaging encounters occurred within 24 hours of the onset of ash production or at distances less than 1,000 kilometers from the source volcanoes. The compilation covers only events of relatively short duration for which aircraft were checked for damage soon thereafter; documenting instances of long-term repeated exposure to ash (or sulfate aerosols) will require further investigation. Of 38 source volcanoes, 8 have caused 5 or more encounters, of which the majority were damaging: Augustine (United States), Chaiten (Chile), Mount St. Helens (United States), Pacaya (Guatemala), Pinatubo (Philippines), Redoubt (United States), Sakura-jima (Japan), and Soufriere Hills (Montserrat, Lesser Antilles, United Kingdom). Aircraft have been damaged by eruptions ranging from small, recurring episodes to very large
Full Text Available In a complex world, characterized by a multitude of risks, managers need to manage the risks they encounter, in an efficient way and in the shortest time possible. In the current economic crisis, the concept of hospital risk management, as the process in which is identified, analyzed, reduced, or avoided a risk that may affect the hospital, gained great importance. The Romanian health system, distinguished by: lack of transparency, poor funding, the loss of the valuable medical staff, lack of hospitals in villages and small towns, inability to engage patients due to the old and poor equipment, lack of research and problems in information privacy and cyber-security, requires an appropriate management, enabling risk managers to take decisions in order to avoid the occurrence of risks. Important for the functioning of every hospital is the perception of patients and their degree of satisfaction, regarding the quality of services, which depend largely on the quality of human resources. But what are the human resources weaknesses and risks from the patient point of view? What are the risk indicators which must be monitored to avoid risks? And also, which is the most useful method for measurement and assessment of risk?