How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

OpenAIRE

Chang, Hye-Ja; Kim, Jeong-Won; Ju, Se-Young; Go, Eun-Sun

2012-01-01

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 ...

Improving U.S. Navy Foodservice Management Training. Part 1. Evaluation of the Current System

Science.gov (United States)

1985-11-01

Experience in civilian foodservice before joining Navy? FAST FOOD FRANCHISE BAKERY RESTAURANT COFFEE SHOP CAFETERIA DELICATESSEN NONE WORKED AS...civilian foodservice since joining Navy? FAST FOOD FRANCHISE 12 8 BAKERY 15 5 RESTAURANT 12 18 COFFEE SHOP 8 — CAFETERIA 8 — DELICATESSEN — NONE...food service before joining the Navy? (PLEASE CHECK l^ THAT APPLY TO WHERE YOU WORKED) Fast Food Franchise Cafeteria Bakery Delieateesan

Measuring School Foodservice Workers’ Perceptions of Organizational Culture

Science.gov (United States)

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...

Healthy Foodservice Benchmarking and Leading Practices

Science.gov (United States)

2012-07-01

cafeterias, managed by the Military and companies such Healthy Foodservice Benchmarking and Leading Practices | 7 as ARAMARK (Rolfsen, 2010) and...machine, a cafeteria line, a table where a patron gives his or her selection to a waiter , a cashier’s counter, a drive-thru window, a phone where orders...Nutrition and Weight Management Center at Boston Medical Center, the Medical Director of the Obesity Consult Center at Tufts University School of

Importance of relationship quality and communication on foodservice for the elderly.

Science.gov (United States)

Seo, Sunhee; Back, Ki Joon; Shanklin, Carol W

2011-02-01

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.

Temporal characteristics of decisions in hospital encounters: a threshold for shared decision making? A qualitative study.

Science.gov (United States)

Ofstad, Eirik H; Frich, Jan C; Schei, Edvin; Frankel, Richard M; Gulbrandsen, Pål

2014-11-01

To identify and characterize physicians' statements that contained evidence of clinically relevant decisions in encounters with patients in different hospital settings. Qualitative analysis of 50 videotaped encounters from wards, the emergency room (ER) and outpatient clinics in a department of internal medicine at a Norwegian university hospital. Clinical decisions could be grouped in a temporal order: decisions which had already been made, and were brought into the encounter by the physician (preformed decisions), decisions made in the present (here-and-now decisions), and decisions prescribing future actions given a certain course of events (conditional decisions). Preformed decisions were a hallmark in the ward and conditional decisions a main feature of ER encounters. Clinical decisions related to a patient-physician encounter spanned a time frame exceeding the duration of the encounter. While a distribution of decisions over time and space fosters sharing and dilution of responsibility between providers, it makes the decision making process hard to access for patients. In order to plan when and how to involve patients in decisions, physicians need increased awareness of when clinical decisions are made, who usually makes them, and who should make them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Dimensions of Customer Preference in the Foodservice Industry

OpenAIRE

Abdullah, Firdaus; Abang Abdurahman, Abang Zainoren; Hamali, Jamil

2013-01-01

Today's foodservice industry management must place a high priority on understanding the growing markets resulting from rapid urbanization and rising numbers of tourists. This industry has a huge impact on the global economy but it is affected by customers' ever-changing preferences. Managers need to gain and sustain strategic advantage in this highly competitive industry, thus a local customer preference assessment is crucial. This paper presents the dimensions of customer preference in the f...

Importance of relationship quality and communication on foodservice for the elderly

Science.gov (United States)

Back, Ki Joon; Shanklin, Carol W.

2011-01-01

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

School Foodservice Personnel's Struggle with Using Labels to Identify Whole-Grain Foods

Science.gov (United States)

Chu, Yen Li; Orsted, Mary; Marquart, Len; Reicks, Marla

2012-01-01

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…

Educating Immigrant Hispanic Foodservice Workers about Food Safety Using Visual-Based Training

Science.gov (United States)

Rajagopal, Lakshman

2013-01-01

Providing food safety training to a diverse workforce brings with it opportunities and challenges that must be addressed. The study reported here provides evidence for benefits of using visual-based tools for food safety training when educating immigrant, Hispanic foodservice workers with no or minimal English language skills. Using visual tools…

Prevalence of food production systems in school foodservice.

Science.gov (United States)

Brown, Denise M

2005-08-01

What is the prevalence of central kitchens that use either cook-chill or cook-freeze production systems in school foodservice settings? A descriptive study using a 5-minute telephone survey during normal working hours was conducted. Questions were designed to be easily answered with minimal need to reference other documentation. Five hundred forty school foodservice directors, managers, and supervisors working in school districts of all sizes across the United States were randomly sampled from a national commercial directory of school districts for the study. A total of 353 individuals completed the survey representing 49 of 50 states. Means, standard deviations, and percentages were evaluated for all data collected. Descriptive statistics of school district characteristics, prevalence of production systems, food transport systems, inventory methods and equipment used for reheating food are reported. The most frequently reported production system was on-site kitchens (45.3%) followed by combination production systems (40.5%) where a central kitchen delivered to a number of satellite locations in addition to schools with on-site food preparation. Central kitchens without additional on-site kitchens represented 14.2% of this study. Of those school districts using either central kitchens or combination production systems, 78% reported hot-food preparation using hot-food delivery to satellites. Cook-chill or cook-freeze production systems were reported by 22% of respondents. The high proportion of school districts that prepared and delivered foods hot to satellite sites supports continuing efforts to identify food safety practices and issues related to maintaining food quality in schools.

Food production and service in UK hospitals.

Science.gov (United States)

Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed

2015-01-01

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.

The Hospitable Meal Model

DEFF Research Database (Denmark)

Justesen, Lise; Overgaard, Svend Skafte

2017-01-01

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...

Whole-Grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

Science.gov (United States)

Roth-Yousey, Lori; Barno, Trina; Caskey, Mary; Asche, Kimberly; Reicks, Marla

2009-01-01

Objective: The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods: A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge,…

Diabetes Preparedness in Schools: What Do Foodservice Personnel Need to Know to Respond?

Science.gov (United States)

Grenci, Alexandra

2009-01-01

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…

School Foodservice Employees' Perceptions of Practice: Differences by Generational Age and Hours Worked

Science.gov (United States)

Strohbehn, Catherine; Jun, Jinhyun; Arendt, Susan

2014-01-01

Purpose/Objectives: This study investigated the influences of school foodservice employees' age and average number of hours worked per week on perceived safe food handling practices, barriers, and motivators. Methods: A bilingual survey (English and Spanish) was developed to assess reported food safety practices, barriers, and motivators to…

Work/Life Practices and the Recruitment and Retention of Large School Districts' Foodservice Professionals

Science.gov (United States)

Harrison, Mary Kate

2010-01-01

With the forthcoming retirement of school foodservice directors, the increasing pressures faced by employees at home and work, and the financial constraints of school districts, recruiting and retaining skilled and diverse employees will be challenging. Marketing work/life benefits to potential employees and supporting these policies to current…

How to give the gift of hospitality. Great customer service.

Science.gov (United States)

Schechter, M

1994-08-01

Whether it takes the form of greeting customers with a smile, redressing a diner's grievance or conducting special kitchen tours, providing customer service has become the number-one priority in foodservices coast to coast. Operators share tips & training methods that are helping staffs provide the hospitable services today's customers are demanding.

Role of food safety in procedures adopted for the purchase of minimally processed and fresh vegetables by foodservices

Directory of Open Access Journals (Sweden)

Kátia Regina Martini Rodrigues

2010-12-01

Full Text Available This research was designed to analyze whether the procedures adopted by foodservice establishments for the purchase of minimally processed and fresh vegetables favor the acquisition of safe products. This research investigated the purchasing policies of such establishments, whether self-managed or administered by foodservice contractors, in the municipality of Campinas and its outlying districts. A random sample of thirty-nine establishments participated in the research. The instruments for data collection were pre-tested, and the actual interviews were conducted by trained personnel. Comparative analyses were made using various statistical tests. All of the participating establishments purchase fresh vegetables, although only six of them use minimally processed ones. For most of the establishments, price is at least one of the most important criteria for the selection of a supplier, and they do not normally monitor the safety of the fresh products purchased (51.3%, nor do they make regular technical visits to guarantee quality (46.2%; moreover, most do not carry out a supplier development program. It is suggested that routine technical visits to suppliers should be adopted, as well as the creation of courses, such as those dealing with the safety of vegetables and supplier development, to be offered to foodservices.

The Possibilities of Reducing Food Choice to Improve the Performance of College Foodservices.

Science.gov (United States)

Mirosa, Miranda; Loh, Joanne; Spence, Heather

2016-07-01

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

Review of Application Development and the Patient Encounter Concept within the University of Iowa Hospital Information System

Science.gov (United States)

Wagner, James R.; Wood, David E.

1982-01-01

The logical structure of the patient data base supporting the University of Iowa Hospital Information System has produced significant management reporting capabilities. A technique is discussed for grouping information concerning the services provided by the hospital during each Patient Encounter that allows subsequent analysis by Medical Episode and Financial Account. The implementation of this data organization structure is discussed in the context of the 13 major health care applications implemented at the University of Iowa Hospitals and Clinics.

How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

Science.gov (United States)

Chang, Hye-Ja; Kim, Jeong-Won; Ju, Se-Young; Go, Eun-Sun

2012-08-01

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.

How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

Science.gov (United States)

Kim, Jeong-Won; Ju, Se-Young; Go, Eun-Sun

2012-01-01

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. PMID:22977692

Food-safety educational goals for dietetics and hospitality students.

Science.gov (United States)

Scheule, B

2000-08-01

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.

General Disinfection in Medical and Dental Hospitals, Selection of Disinfectant Type and Problems Encountered

OpenAIRE

Akça, Gülin

2015-01-01

Hospitals are the places where, either the patients or other health workers can encounter with dangerous problem of several bacterial, fungal, viral, parasitic infectious agents, especially the emerging and life threatening ones such as, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis (VRE), Stenotrophomonas sp., and multi drug resistant Acinetobacter sp., Pseudomonas sp.. The reasons of these resistant microorganisms that can threaten the life o...

Use of Visuals for Food Safety Education of Spanish-Speaking Foodservice Workers: A Case Study in Iowa

Science.gov (United States)

Rajagopal, Lakshman

2012-01-01

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…

Mobilizing to Re-value and Re-skill Foodservice Labor in U.S. School Lunchrooms: A Pathway to Community-level Food Sovereignty?

Directory of Open Access Journals (Sweden)

Jennifer E. Gaddis

2014-02-01

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.

Importance–Performance Analysis (IPA) of Foodservice Operation, Dietary Life Education, and Nutrition Counseling Tasks of Nutrition Teachers and Dietitians in Jeju, Korea

Science.gov (United States)

Park, Eun A; Chae, In Sook; Jo, Mi Na

2017-01-01

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

Innovation Processes in Large-Scale Public Foodservice-Case Findings from the Implementation of Organic Foods in a Danish County

DEFF Research Database (Denmark)

Mikkelsen, Bent Egberg; Nielsen, Thorkild; Kristensen, Niels Heine

2005-01-01

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...

[Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

Science.gov (United States)

Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

2018-05-21

The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

Science.gov (United States)

Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

2015-03-31

During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

Significant Trends Are Now Reshaping the Industry Training for Foodservice and Hospitality.

Science.gov (United States)

Reiman, Tyrus

1984-01-01

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)

Cosmopolitan encounters

DEFF Research Database (Denmark)

Plage, Stefanie; Willing, Indigo; Woodward, Ian

2017-01-01

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....... The ethical framework we propose is grounded in reflexive acts of sharing going beyond notions of giving and performing hospitality within a host/guest dyad....

Ways of understanding the encounter with head and neck cancer patients in the hospital dental team--a phenomenographic study.

Science.gov (United States)

Röing, Marta; Hirsch, J-M; Holmström, Inger

2006-10-01

Head and neck cancer is the sixth most common malignancy in the world. Fifty percent of the patients can be cured by surgery, radiotherapy or a combination approach. Head and neck cancer is life-threatening, and treatment may leave the patient with visible facial disfigurements and impairment of functions such as speech and eating. This affects not only the patient, but may arouse difficult feelings in the treatment staff. Dental personnel are involved in all facets of treatment, yet they have no specific training in cancer care. The aim of this study was to describe the variation in ways dental personnel understand and experience the encounter with head and neck cancer patients, as the way of understanding a certain phenomenon is judged to be fundamental to the way we act and form our beliefs. Twenty members of hospital dental teams were interviewed. The interviews focused on experiences of the encounter with head and neck cancer patients. A qualitative research approach, phenomenography, was used in analysing the interviews. The encounter was perceived in three qualitatively different ways: as an act of caring, as a serious and responsible task and as an overwhelming emotional situation. The results indicate that hospital dental personnel are not able to lean on education and professional training in finding ways of dealing with situations with strong emotional impact. This has implications for the treatment of patients with head and neck cancer, as well as education of dental personnel.

Moderating effects of leader-member exchange (LMX) on job burnout in dietitians and chefs of institutional foodservice

Science.gov (United States)

2011-01-01

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. PMID:21487501

Institutional Effectiveness Assessment Process, 1992-93. Executive Summary. Hospitality and Service Occupations Division, Food Sciences Department, Food Production Program, Food Production Management Program, Pastry and Specialty Baking Program.

Science.gov (United States)

South Seattle Community Coll., Washington.

In the 1992-93 academic year, the Hospitality and Food Sciences Department at South Seattle Community College conducted surveys of current and former students and local foodservice employers to determine the level of satisfaction with Department programs. Specifically, the surveys focused on four key outcomes: determining the extent to which…

Career Progression Systems in the Internal Labor Market of the Foodservice Industry and the Role of the National Restaurant Association. Final Report.

Science.gov (United States)

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…

A Comparison of Student Performance in a National Restaurant Association Foodservice Sanitation Exam by Students Taking versus Those Not Taking a Review Seminar.

Science.gov (United States)

Fleury, Ernest

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…

Workplace foodservice; perception of quality and trust.

Science.gov (United States)

Price, Sarah; Hartwell, Heather; Hemingway, Ann; Chapleo, Chris

2016-02-01

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.

Measuring potential access to food stores and food-service places in rural areas in the U.S.

Science.gov (United States)

Sharkey, Joseph R

2009-04-01

Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.

Managers' perceptions of customers' satisfactions with their hospital cafeteria services.

Science.gov (United States)

Johnston, C M; Upton, E M

1991-01-01

It is important that hospital cafeterias deliver products that create customer satisfaction so that financial objectives are met. An exploratory descriptive survey of 12 selected hospital cafeterias used a self-administered questionnaire to determine how satisfied customers were with services provided. It also asked cafeteria managers to give their perceptions of their customers' relative satisfaction/dissatisfaction with the service. Principal components analysis, followed by varimax rotation, identified four underlying constructs of the 15 pre-selected foodservice characteristics used to measure relative satisfaction. A multiple regression model, controlling for country, hospital size and customer demographics, in which the dependent variable was overall rating, found that the independent variables, the underlying rating constructs--food and service--made a much greater impact on overall rating than environment and accessibility. Most cafeteria managers' predictions about their customers' satisfaction were within two standard deviations of their customers' mean scores of satisfaction. While the managers' close association with their service may have accounted for this, it does not necessarily follow that they have the power to implement policy and product improvements.

Emergency Department (ED, ED Observation, Day Hospital, and Hospital Admissions for Adults with Sickle Cell Disease

Directory of Open Access Journals (Sweden)

Susan Silva

2018-02-01

Full Text Available Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC, such as a day hospital (DH or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD VOC, we prospectively compared acute care encounters for utilization of 1 emergency department (ED; 2 ED observation unit; 3 DH, and 4 hospital admission, of two different patient cohorts with SCD presenting to our two study sites. Using a representative sample of patients from each institution, we also tabulated SCD patient visits or admissions to outside hospitals within 20 miles of the patients’ home institutions. Results: Over 30 months 427 patients (297 at Site 1 and 130 at Site 2 initiated 4,740 institutional visits, totaling 6,627 different acute care encounters, including combinations of encounters. The range of encounters varied from a low of 0 (203 of 500 patients [40.6%] at Site 1; 65 of 195 patients [33.3%] at Site 2, and a high of 152 (5/month acute care encounters for one patient at Site 2. Patients at Site 2 were more likely to be admitted to the hospital during the study period (88.4% vs. 74.4%, p=0.0011 and have an ED visit (96.9% vs. 85.5%, p=0.0002. DH was used more frequently at Site 1 (1.207 encounters for 297 patients at Site 1, vs. 199 encounters for 130 patients at Site 2, and ED observation was used at Site 1 only. Thirty-five percent of patients visited hospitals outside their home academic center. Conclusion: In this 30-month assessment of two sickle cell cohorts, healthcare utilization varied dramatically between individual patients. One cohort had more hospital admissions and ED encounters, while the other cohort had more day hospital encounters and used a sickle cell disease

Why should I talk about emotion? Communication patterns associated with physician discussion of patient expressions of negative emotion in hospital admission encounters.

Science.gov (United States)

Adams, Kristen; Cimino, Jenica E W; Arnold, Robert M; Anderson, Wendy G

2012-10-01

To describe hospital-based physicians' responses to patients' verbal expressions of negative emotion and identify patterns of further communication associated with different responses. Qualitative analysis of physician-patient admission encounters audio-recorded between August 2008 and March 2009 at two hospitals within a university system. A codebook was iteratively developed to identify patients' verbal expressions of negative emotion. We categorized physicians' responses by their immediate effect on further discussion of emotion - focused away (away), focused neither toward nor away (neutral), and focused toward (toward) - and examined further communication patterns following each response type. In 79 patients' encounters with 27 physicians, the median expression of negative emotion was 1, range 0-14. Physician responses were 25% away, 43% neutral, and 32% toward. Neutral and toward responses elicited patient perspectives, concerns, social and spiritual issues, and goals for care. Toward responses demonstrated physicians' support, contributing to physician-patient alignment and agreement about treatment. Responding to expressions of negative emotion neutrally or with statements that focus toward emotion elicits clinically relevant information and is associated with positive physician-patient relationship and care outcomes. Providers should respond to expressions of negative emotion with statements that allow for or explicitly encourage further discussion of emotion. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Hospitality and Embodied Encounters in Educational Spaces

Science.gov (United States)

Ruitenberg, Claudia W.

2018-01-01

This short paper responds to the essays by Shilpi Sinha, Shaireen Rasheed, and Lyudmila Bryzzheva. It considers how racial inequality between teachers and students affects the possibilities of educational hospitality, both in cases of white teachers teaching racialized students and in cases of racialized teachers teaching white students. The…

Association of volume of patient encounters with residents' in-training examination performance.

Science.gov (United States)

McCoy, Christopher P; Stenerson, Matthew B; Halvorsen, Andrew J; Homme, Jason H; McDonald, Furman S

2013-08-01

Patient care and medical knowledge are Accreditation Council for Graduate Medical Education (ACGME) core competencies. The correlation between amount of patient contact and knowledge acquisition is not known. To determine if a correlation exists between the number of patient encounters and in-training exam (ITE) scores in internal medicine (IM) and pediatric residents at a large academic medical center. Retrospective cohort study Resident physicians at Mayo Clinic from July 2006 to June 2010 in IM (318 resident-years) and pediatrics (66 resident-years). We tabulated patient encounters through review of clinical notes in an electronic medical record during post graduate year (PGY)-1 and PGY-2. Using linear regression models, we investigated associations between ITE score and number of notes during the previous PGY, adjusted for previous ITE score, gender, medical school origin, and conference attendance. For IM, PGY-2 admission and consult encounters in the hospital and specialty clinics had a positive linear association with ITE-3 % score (β = 0.02; p = 0.004). For IM, PGY-1 conference attendance is positively associated with PGY-2 ITE performance. We did not detect a correlation between PGY-1 patient encounters and subsequent ITE scores for IM or pediatric residents. No association was found between IM PGY-2 ITE score and inpatient, outpatient, or total encounters in the first year of training. Resident continuity clinic and total encounters were not associated with change in PGY-3 ITE score. We identified a positive association between hospital and subspecialty encounters during the second year of IM training and subsequent ITE score, such that each additional 50 encounters were associated with an increase of 1 % correct in PGY-3 ITE score after controlling for previous ITE performance and continuity clinic encounters. We did not find a correlation for volume of encounters and medical knowledge for IM PGY-1 residents or the pediatric cohort.

Reproductive encounters: Negev bedouin women’s lay encounters at childbirth in an Israeli hospital

NARCIS (Netherlands)

Kisch, S.

2009-01-01

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

Reliability of the hospital nutrition environment scan for cafeterias, vending machines, and gift shops.

Science.gov (United States)

Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

2013-08-01

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.

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

Science.gov (United States)

McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

2018-02-01

Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ 2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ 2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ 2 used for the plate waste analysis. Significance was assessed at P<0.05. This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0

Nursing students’ experiences of professional patient care encounters in a hospital unit

DEFF Research Database (Denmark)

Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth

2015-01-01

experiences of professional patient care encounters where students engage with patients and provide nursing care within the basic principles of nursing care relating to the patients’ physiological and psychological needs. Studies that reflect nursing students’ comprehension of or attitudes towards nursing...

Organised Cultural Encounters

DEFF Research Database (Denmark)

Christiansen, Lene Bull; Galal, Lise Paulsen; Hvenegård-Lassen, Kirsten

2017-01-01

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...... perspective on the particular historical and spatial context of any encounter and how this context frames and mediates what takes place during an encounter is applied. While the articles of the issue present different varieties of organised cultural encounters, it is argued that they are not only of the same...

Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

Science.gov (United States)

Koss, Catheryn

2018-01-01

The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

Cultural geography. Different encounters, encountering difference

OpenAIRE

Longhurst, Robyn

2007-01-01

In the first half of this paper it is argued that cultural geography is a dynamic and diverse field that extends well beyond a single branch of human geography. The boundaries between it and other sub-disciplines are often blurred. People have «different» encounters with cultural geography depending on their sub-disciplinary convergences. People also have different encounters with cultural geography depending on where they live and work. «Place matters» in the construction, production and rep...

Mobile encounters

DEFF Research Database (Denmark)

Koefoed, Lasse Martin; Christensen, Mathilde Dissing; Simonsen, Kirsten

2017-01-01

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...

Thinking about the service encounter enhances encounter-related word-of-mouth

DEFF Research Database (Denmark)

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......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....... 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)....

Magical attachment: Children in magical relations with hospital clowns

Directory of Open Access Journals (Sweden)

Lotta Linge

2012-02-01

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.

Encountering Materiality

DEFF Research Database (Denmark)

Svabo, Connie

2016-01-01

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....

77 FR 65555 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Science.gov (United States)

2012-10-29

... the initial data collection for select restaurant facility types, followed by the initial data... period data collection survey measurement) period Restaurants Full Service 2013 2016 2019 Restaurants. Fast Food Restaurants. Institutional Foodservice........ Hospitals 2014 2017 2020 Nursing Homes...

77 FR 36544 - Agency Information Collection Activities; Proposed Collection; Comment Request; Survey on the...

Science.gov (United States)

2012-06-19

... 2013 with the initial data collection for select restaurant facility types, followed by the initial... (baseline collection period data collection survey measurement) period Restaurants Full Service 2013 2016 2019 Restaurants Fast Food Restaurants. Institutional Foodservice........ Hospitals 2014 2017 2020...

[Social problems encountered during prenatal care in a Paris maternity ward].

Science.gov (United States)

Ozguler, A; Alfaro, C; Bonniaus, G; Renders, P; Blot, P; Brodin, M; Lombrail, P

1998-06-01

In 1993, about 2,600 children are born in Robert Debré Hospital (RDH), a hospital specialized in pediatrics and obstetrics located in Paris. One hundred and seventy nine of the mothers contacted the hospital social service during pregnancy. The main goal of this study was to describe the social problems encountered by these women and the solutions proposed by the social service of RDH. The second aim was to describe the socio-demographic profile and medical problems of this population. At first contact, 45% of the women had no social coverage, and only 18% had a steady job. Most social problems were related to administrative procedures. Financial and housing problems were more difficult to solve in this context. These figures reflect the growing problem of precarity, with its consequences. A hospital social service is not the right place to solve these very complex problems. The most worrisome point is that the living conditions of newborn children are often unknown after delivery.

Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses.

Science.gov (United States)

Sevinç, S; Kılıç, S P; Ajghif, M; Öztürk, M H; Karadağ, E

2016-09-01

Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care. The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration. We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi-structured interview with open-ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods. Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey. The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs. It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries. © 2016 International Council of Nurses.

Universalist ethics in extraterrestrial encounter

Science.gov (United States)

Baum, Seth D.

2010-02-01

If humanity encounters an extraterrestrial civilization, or if two extraterrestrial civilizations encounter each other, then the outcome may depend not only on the civilizations' relative strength to destroy each other but also on what ethics are held by one or both civilizations. This paper explores outcomes of encounter scenarios in which one or both civilizations hold a universalist ethical framework. Several outcomes are possible in such scenarios, ranging from one civilization destroying the other to both civilizations racing to be the first to commit suicide. Thus, attention to the ethics of both humanity and extraterrestrials is warranted in human planning for such an encounter. Additionally, the possibility of such an encounter raises profound questions for contemporary human ethics, even if such an encounter never occurs.

Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients.

Science.gov (United States)

Cheung, Grace; Pizzola, Lisa; Keller, Heather

2013-01-01

Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.

Understanding metropolitan patterns of daily encounters.

Science.gov (United States)

Sun, Lijun; Axhausen, Kay W; Lee, Der-Horng; Huang, Xianfeng

2013-08-20

Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters' bounded nature. An individual's encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of "familiar strangers" in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or "structure of co-presence" across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and--particularly--disclosing the impact of human behavior on various diffusion/spreading processes.

Hospital Clostridium difficile infection (CDI) incidence as a risk factor for hospital-associated CDI.

Science.gov (United States)

Miller, Aaron C; Polgreen, Linnea A; Cavanaugh, Joseph E; Polgreen, Philip M

2016-07-01

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.

Investigating Effect of Service Encounter, Value, and Satisfaction on Word of Mouth: An Outpatient Service Context.

Science.gov (United States)

Hsu, Li-Chun

2018-01-13

This study investigates the relationships among service encounter, service value, patient satisfaction, and word-of-mouth (WOM) intention from the viewpoint of interactive marketing. Data were collected using a questionnaire survey. A total of 372 questionnaires were obtained and 350 of these questionnaires were valid (94.09%), and a structural equation model was used to analyze the data. This study proposed seven hypotheses, and five of the seven hypotheses were supported. Service encounters indirectly affect their patient WOM through service value and satisfaction. Therefore, service value and satisfaction play a crucial mediating role in linking service encounters and WOM. This study determined WOM intentions in an outpatient service context and provides crucial business implications for teaching hospitals to enable them to improve their service quality and achieve a sustainable operation.

Investigating Effect of Service Encounter, Value, and Satisfaction on Word of Mouth: An Outpatient Service Context

Directory of Open Access Journals (Sweden)

Li-Chun Hsu

2018-01-01

Full Text Available This study investigates the relationships among service encounter, service value, patient satisfaction, and word-of-mouth (WOM intention from the viewpoint of interactive marketing. Data were collected using a questionnaire survey. A total of 372 questionnaires were obtained and 350 of these questionnaires were valid (94.09%, and a structural equation model was used to analyze the data. This study proposed seven hypotheses, and five of the seven hypotheses were supported. Service encounters indirectly affect their patient WOM through service value and satisfaction. Therefore, service value and satisfaction play a crucial mediating role in linking service encounters and WOM. This study determined WOM intentions in an outpatient service context and provides crucial business implications for teaching hospitals to enable them to improve their service quality and achieve a sustainable operation.

Innovative generativity of digital service encounters

DEFF Research Database (Denmark)

Henten, Anders; Sørensen, Jannick Kirk

2018-01-01

The research question examined in this chapter is how service encounters, based on digital interfaces, differ from face-to-face (f2f) encounters in terms of potential innovative generativity. New computer technologies facilitating big data processing and the development of advanced recommender...... systems and the recent developments of artificial intelligence with respect to cognitive and affective computing will certainly enhance the potential for innovations to be created on the basis of digital service encounters. However, the empathetic understanding of the needs and wants of the service users...... that can be part of the f2f service encounters cannot automatically result from digital service encounters. Digital tools can be developed and used to supplement the impressions that f2f encounters initiate. However, human interpretations and even human f2f encounters will also be needed to maintain...

Research Article Special Issue

African Journals Online (AJOL)

2016-07-16

Jul 16, 2016 ... one of the management concepts considered and studied alwa .... Empowerment and giving freedom to staff are essential strategies to ..... hospitality organization, Journal of Foodservice Business Research, 2010,13(1):36-50. ... empowerment and effectiveness of staff (case study: national bank staff in ...

Encounters with immigrant customers

DEFF Research Database (Denmark)

Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig

2013-01-01

were not sufficiently assessed at the counter (n = 55, 65%), and that their latest encounter with an immigrant customer was less satisfactory than a similar encounter with an ethnic Danish customer (n = 48, 57%) (significantly more pharmacists than assistants: odds ratio, OR, 3.19; 95% confidence...

Stream Lifetimes Against Planetary Encounters

Science.gov (United States)

Valsecchi, G. B.; Lega, E.; Froeschle, Cl.

2011-01-01

We study, both analytically and numerically, the perturbation induced by an encounter with a planet on a meteoroid stream. Our analytical tool is the extension of pik s theory of close encounters, that we apply to streams described by geocentric variables. The resulting formulae are used to compute the rate at which a stream is dispersed by planetary encounters into the sporadic background. We have verified the accuracy of the analytical model using a numerical test.

On spaces of hospitality

DEFF Research Database (Denmark)

Greve, Anni

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 Art of the Encounter

Directory of Open Access Journals (Sweden)

Éric Vautrin

2013-03-01

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.

Physician as partner or salesman? Shared decision-making in real-time encounters.

Science.gov (United States)

Karnieli-Miller, Orit; Eisikovits, Zvi

2009-07-01

The results of recent research have led to the increased advocacy of shared decision-making regarding medical treatment. Nonetheless, only a limited number of studies have focused on the process of decision-making in real-time encounters. The present paper aims to document and analyze this process. Specifically, we assess whether these decisions are the result of partnership or of persuasive tactics based on power and hierarchical relationships. We will describe and analyze different strategies used by pediatric gastroenterologists in breaking bad news encounters, as well as their consequences. The analysis is based on a multi-method, multi-participant phenomenological study on breaking bad news to adolescents and their families regarding a chronic illness. It included 17 units of analysis (actual encounters and 52 interviews with physicians, parents and adolescents). Data were collected from three hospitals in Northern Israel using observations and audiotapes of diagnosis disclosure encounters and audio-taped interviews with all participants. The analysis identified eight different presentation tactics used in actual encounters during which physicians made various use of language, syntax and different sources of power to persuade patients to agree with their preferred treatment choice. The tactics included various ways of presenting the illness, treatment and side effects; providing examples from other success or failure stories; sharing the decision only concerning technicalities; and using plurals and authority. The findings suggest that shared decision-making may be advocated as a philosophical tenet or a value, but it is not necessarily implemented in actual communication with patients. Rather, treatment decisions tend to be unilaterally made, and a variety of persuasive approaches are used to ensure agreement with the physician's recommendation. The discussion is focused on the complexity of sharing a decision, especially in the initial bad news encounter

Encounter with comet Halley

International Nuclear Information System (INIS)

Sagdeev, R.Z.

1989-01-01

This paper reports on an international armada of six spacecraft which encountered the comet Halley and performed in-situ measurements. These encounters led to the discovery of a number of cometary plasma physics phenomena. Another important result was that a value for the average density of the cometary nucleus could be estimated, which is found to be compatible with snow ball models for the nucleus

The Idealized Cultural Encounter

DEFF Research Database (Denmark)

Christiansen, Lene Bull

Studies into cultural encounters have predominantly taken point of departure in ‘problematic encounters’, in which researchers and participants see cultural difference as an obstacle on the road to harmonious relationships (e.g. in ‘the clash of civilisations,’ or in migration/integration studies......). 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...... and cultures. A prominent feature of the organisation is organised cultural encounters between Northern (predominantly Danish) volunteers and Africans, which takes place at ‘training centres’ both in Denmark and in African countries, such as Kenya or Tanzania. In this paper I will outline the theoretical...

A survey of workplace violence against physicians in the hospitals, Myanmar.

Science.gov (United States)

Kasai, Yuichi; Mizuno, Tetsutaro; Sakakibara, Toshihiko; Thu, Si; Kyaw, Thein Aung; Htun, Kyaw Aung

2018-02-15

Workplace violence in hospitals is recently becoming a major global concern in many countries. However, in Myanmar, we have felt that patients and their families have rarely made unreasonable complaints in hospitals, and then, the purpose of this study is to report the current state of workplace violence in hospitals in Myanmar. Participants are 196 physicians (108 males and 88 females) in hospitals in Myanmar. A descriptive survey was conducted in regard to verbal abuse and physical violence from patients or the people concerned. At the results of this study, the percentages of physicians who have encountered verbal abuse and those who have encountered physical violence are markedly low (8.7 and 1.0%, respectively). The present study is the first to report the frequencies of verbal abuse and physical violence against physicians in a least developed country, and the results of the present study are important in terms of discussing workplace violence in hospitals.

Privacy encounters in Teledialogue

DEFF Research Database (Denmark)

Andersen, Lars Bo; Bøge, Ask Risom; Danholt, Peter

2017-01-01

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...

The structure of service quality perceptions for multiple-encounter services.

Science.gov (United States)

Andaleeb, Syed Saad; Kara, Ali

2013-01-01

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.

Research progress on influencing factors of hospital infection and prevention and control measures

Directory of Open Access Journals (Sweden)

He Wenlong

2015-03-01

Full Text Available Hospital infections are associated with the emergence of hospitals. As the understanding of hospital infections deepen and prevention and control measures improve, hospital infections have become manageable. In recent years, affected by the increase in invasive treatment technology, antimicrobial abuse, and other factors, the control of hospital infection has encountered new problems. This paper reviews the influencing factors of hospital infections and their prevention and control measures.

Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences.

Science.gov (United States)

Tavallali, Azar Gashasb; Jirwe, Maria; Kabir, Zarina Nahar

2017-03-01

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.

Encounters in cancer treatment

DEFF Research Database (Denmark)

Høybye, Mette Terp; Tjørnhøj-Thomsen, Tine

2014-01-01

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....

[A tale of two encounters].

Science.gov (United States)

Chanel, Marie-Paule

The moving testimony of a patient shows the impact which a successful encounter can have. Beyond the positive clinical consequences, her rediscovered motivation and pleasure are the essential drivers which have guided her along the pathway of reconstruction. A tale of two encounters which have marked her life course. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Innovation from the ICT-based service encounter

DEFF Research Database (Denmark)

Henten, Anders

2012-01-01

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...

ASRS Reports on Wake Vortex Encounters

Science.gov (United States)

Connell, Linda J.; Taube, Elisa Ann; Drew, Charles Robert; Barclay, Tommy Earl

2010-01-01

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.

Initial Encounters : The Lived Experiences of Buyers

NARCIS (Netherlands)

G. Wright; J.J. Dekker

2012-01-01

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.

The space of togetherness--a caring encounter.

Science.gov (United States)

Holopainen, Gunilla; Kasén, Anne; Nyström, Lisbet

2014-03-01

Encounters in relation to the nurse-patient relationship are often discussed within nursing and caring literature without a reflection on the actual meaning of the concept. Assuming that an encounter is essential for nursing care, this article seeks to create a deeper understanding of the concept through a hermeneutic approach to texts by the philosophers Buber and Marcel. Presence, recognition, availability and mutuality seem to be essential prerequisites for an encounter. As these prerequisites are fulfilled within and between human beings who encounter each other, it is possible to speak of a space of togetherness, a mutual existence, where life's mystery shines forth and caring is realized. The challenge lies in creating these encounters within nursing care. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

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.

Science.gov (United States)

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

2017-03-28

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

Comparison of Cooperative and Noncooperative Purchasing in School Nutrition Programs

Science.gov (United States)

Rice, Beth W.; Strohbehn, Catherine; Shelly, Mark C.; Arendt, Susan; Gregoire, Mary

2010-01-01

Purpose/Objectives: The purpose of this study was to compare food cost and public school foodservice directors' satisfaction between districts participating in school foodservice cooperatives or group purchasing arrangements and districts purchasing independently. It also assessed the prevalence of purchasing cooperatives in school foodservice and…

The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

Science.gov (United States)

Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

2018-02-23

To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

Beyond the Embodied Digital Service Encounter

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk

2018-01-01

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 ...

Termite: Emulation Testbed for Encounter Networks

Directory of Open Access Journals (Sweden)

Rodrigo Bruno

2015-08-01

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.

Global Diabetes Encounters

DEFF Research Database (Denmark)

Juul Nielsen, Annegrete; Langstrup, Henriette

2014-01-01

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...

Frontcountry encounter norms among three cultures

Science.gov (United States)

Jerry J. Vaske; Maureen P. Donnelly; Robert M. Doctor; James P. Petruzzi

1995-01-01

Existing normative studies have focused on backcountry encounter norms reported by North Americans. This study extends previous research by comparing encounter norms reported by three different cultures - North Americans, Europeans, and Japanese - in a frontcountry day use recreation area. Data were obtained from on-site surveys distributed at the Columbia Icefield in...

Due Regard Encounter Model Version 1.0

Science.gov (United States)

2013-08-19

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

High-velocity runaway stars from three-body encounters

Science.gov (United States)

Gvaramadze, V. V.; Gualandris, A.; Portegies Zwart, S.

2010-01-01

We performed numerical simulations of dynamical encounters between hard, massive binaries and a very massive star (VMS; formed through runaway mergers of ordinary stars in the dense core of a young massive star cluster) to explore the hypothesis that this dynamical process could be responsible for the origin of high-velocity (≥ 200 - 400 km s-1) early or late B-type stars. We estimated the typical velocities produced in encounters between very tight massive binaries and VMSs (of mass of ≥ 200 M⊙) and found that about 3 - 4% of all encounters produce velocities ≥ 400 km s-1, while in about 2% of encounters the escapers attain velocities exceeding the Milky Ways's escape velocity. We therefore argue that the origin of high-velocity (≥ 200 - 400 km s-1) runaway stars and at least some so-called hypervelocity stars could be associated with dynamical encounters between the tightest massive binaries and VMSs formed in the cores of star clusters. We also simulated dynamical encounters between tight massive binaries and single ordinary 50 - 100 M⊙ stars. We found that from 1 to ≃ 4% of these encounters can produce runaway stars with velocities of ≥ 300 - 400 km s-1 (typical of the bound population of high-velocity halo B-type stars) and occasionally (in less than 1% of encounters) produce hypervelocity (≥ 700 km s-1) late B-type escapers.

Processing changes across reading encounters.

Science.gov (United States)

Levy, B A; Newell, S; Snyder, J; Timmins, K

1986-10-01

Five experiments examined changes in the processing of a text across reading encounters. Experiment 1 showed that reading speed increased systematically across encounters, with no loss in the extensiveness of analyses of the printed text, as indicated by the ability to detect nonword errors embedded within that passage. Experiment 2 replicated this improved reading fluency with experience and showed that it occurred even with typescript changes across trials, thus indicating that a primed visual operations explanation cannot account for the effect. The third and fourth experiments then extended the study of the familiarity effect to higher level processing, as indicated by the detection of word errors. Familiarity facilitated the detection of these violations at the syntactic-semantic levels. Finally, Experiment 5 showed that these higher level violations continued to be well detected over a series of reading encounters with the same text. The results indicate that prior experience improves reading speed, with no attenuation of analysis of the printed words or of the passage's message.

Dental Encounter System (DES)

Data.gov (United States)

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...

Determinants of customer satisfaction with service encounter

Directory of Open Access Journals (Sweden)

Ariana Nefat

2008-12-01

Full Text Available Service encounters are the focal point of a customer’s perception of a service in terms of its quality, value and customer satisfaction. The paper researches the influence of the components of a service encounter on customer satisfaction. Among several factors that determine customer satisfaction the quality of service, which is related to the characteristics of service, plays an important role. However, a direct insight into the reasons that make a service encounter satisfactory or unsatisfactory is provided by the critical incident technique, where causes of dis/satisfaction differ primarily depending on whether they derive from interpersonal contact or from contact with technology. The evidence of service, which includes people, process and the physical evidence, plays a critical role in a customer’s dis/satisfaction. The influence of these elements cannot be observed separately; it must be observed in their interaction during the delivery of service and their strongest effect is achieved during face-to-face service encounters that have the characteristics of a theatre metaphor. Even though a high level of satisfaction may be achieved after the recovery of a service, enterprises should aim to conduct excellent service encounters right from the start.

Moving Encounters

Directory of Open Access Journals (Sweden)

Ann Deslandes

2011-04-01

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.

Customer-sales employee encounters: a dyadic perspective.

NARCIS (Netherlands)

Dolen, van W.; Lemmink, J.G.A.M.; Ruyter, de J.C.; Jong, de A.

2003-01-01

Although researchers have suggested that the performance of the salesperson during sales encounters is critical, many of the underlying mechanisms that govern the interaction between salespersons and customers are still unclear. In this research, we investigate sales encounters from a new approach

Customer-to-customer roles and impacts in service encounters

OpenAIRE

Lee, Linda

2016-01-01

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...

A Lakatosian Encounter

Science.gov (United States)

Chick, Helen

2010-01-01

There is much to be learned and pondered by reading "Proofs and Refutations," by Imre Lakatos. It highlights the importance of mathematical definitions, and how definitions evolve to capture the essence of the object they are defining. It also provides an exhilarating encounter with the ups and downs of the mathematical reasoning process, where…

Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002-2003.

Science.gov (United States)

Mikkelsen, B E; Beck, A M; Lassen, A

2007-01-01

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

Festival as embodied encounters

DEFF Research Database (Denmark)

Simonsen, Kirsten; Koefoed, Lasse Martin; Neergaard, Maja de

2017-01-01

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...... 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...... ideas of ‘embodiment’ and ‘rhythm’. We explore participant engagement emphasizing bodily practices as well as sensuous experiences, but also differential processes and orientalist images produced in, and through, encounters. Among the range of activities at the festival, we focus on three: food; dance...

Co-creation of Innovations in ICT based service encounters

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk; Henten, Anders

2014-01-01

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...

Value creation and knowledge development in tourism experience encounters

DEFF Research Database (Denmark)

Sørensen, Flemming; Jensen, Jens Friis

2015-01-01

It has been argued that service encounters between front-line employees and users support the development of knowledge about users' needs. However, the potential for this often remains unused, not least in tourism. This article argues that if tourism service encounters are changed into ‘experience...... 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...... were developed into experience encounters. The experiment illustrates the potential that experience encounters have to create knowledge and value, but also suggests some barriers that need to be overcome....

Administrative encounters in general practice: low value or hidden value care?

Science.gov (United States)

Trevena, Lyndal J; Harrison, Christopher; Britt, Helena C

2018-02-19

To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. 1 568 100 GP-patient encounters in Australia, 2000-01 to 2015-16. An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015-16, we also examined other health care provided by GPs at these encounters. During 2015-16, 18.5% (95% CI, 17.7-19.3%) of 97 398 GP-patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0-7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5-4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4-13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7-3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

Awkward Encounters and Ethnography

DEFF Research Database (Denmark)

Koning, Juliette; Ooi, Can-Seng

2013-01-01

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...

Silent loss and the clinical encounter: Parents’ and physicians’ experiences of stillbirth–a qualitative analysis

Directory of Open Access Journals (Sweden)

Kelley Maureen C

2012-11-01

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

Analyzing communication skills of Pediatric Postgraduate Residents in Clinical Encounter by using video recordings.

Science.gov (United States)

Bari, Attia; Khan, Rehan Ahmed; Jabeen, Uzma; Rathore, Ahsan Waheed

2017-01-01

To analyze communication skills of pediatric postgraduate residents in clinical encounter by using video recordings. This qualitative exploratory research was conducted through video recording at The Children's Hospital Lahore, Pakistan. Residents who had attended the mandatory communication skills workshop offered by CPSP were included. The video recording of clinical encounter was done by a trained audiovisual person while the resident was interacting with the patient in the clinical encounter. Data was analyzed by thematic analysis. Initially on open coding 36 codes emerged and then through axial and selective coding these were condensed to 17 subthemes. Out of these four main themes emerged: (1) Courteous and polite attitude, (2) Marginal nonverbal communication skills, (3) Power game/Ignoring child participation and (4) Patient as medical object/Instrumental behaviour. All residents treated the patient as a medical object to reach a right diagnosis and ignored them as a human being. There was dominant role of doctors and marginal nonverbal communication skills were displayed by the residents in the form of lack of social touch, and appropriate eye contact due to documenting notes. A brief non-medical interaction for rapport building at the beginning of interaction was missing and there was lack of child involvement. Paediatric postgraduate residents were polite while communicating with parents and child but lacking in good nonverbal communication skills. Communication pattern in our study was mostly one-way showing doctor's instrumental behaviour and ignoring the child participation.

Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

Directory of Open Access Journals (Sweden)

Lakshmi Rajeswaran

2013-05-01

Full Text Available Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.

Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

Science.gov (United States)

Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

2018-03-20

Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

Close stellar encounters in globular clusters

International Nuclear Information System (INIS)

Bailyn, C.D.

1989-01-01

Stellar encounters are expected to produce a variety of interesting objects in the cores of globular clusters, either through the formation of binaries by tidal capture, or direct collisions. Here, I describe several attempts to observe the products of stellar encounters. In particular, the use of color maps has demonstrated the existence of a color gradient in the core of M15, which seems to be caused by a population of faint blue objects concentrated towards the cluster center. (author)

Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.

Science.gov (United States)

Bao, Yuhua; Fan, Guanrong; Zou, Dongdong; Wang, Tong; Xue, Di

2017-01-01

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.

Shouting in a Desert: Dutch missionary encounters with Javanese Islam, 1850-1910 : Dutch missionary encounters with Javanese Islam, 1850-1910

NARCIS (Netherlands)

M.J. Kruithof (Maryse)

2014-01-01

markdownabstract__Abstract__ ‘‘Shouting in a desert’ Dutch missionary encounters with Javanese Islam’ concentrates on the shifts and developments in the Dutch mission discourse within the period from 1850 to 1910. It explores the Dutch missionary encounter with local communities and is conducted

Common Factors Among Family Medicine Residents Who Encounter Difficulty.

Science.gov (United States)

Binczyk, Natalia M; Babenko, Oksana; Schipper, Shirley; Ross, Shelley

2018-04-01

Residents in difficulty are costly to programs in both time and resources, and encountering difficulty can be emotionally harmful to residents. Approximately 10% of residents will encounter difficulty at some point in training. While there have been several studies looking at common factors among residents who encounter difficulty, some of the findings are inconsistent. The objective of this study was to determine whether there are common factors among the residents who encounter difficulty during training in a large Canadian family medicine residency program. Secondary data analysis was performed on archived resident files from a Canadian family medicine residency program. Residents who commenced an urban family medicine residency program between the years of 2006 and 2014 were included in the study. Five hundred nine family medicine residents were included in data analysis. Residents older than 30 years were 2.33 times (95% CI: 1.27-4.26) more likely to encounter difficulty than residents aged 30 years or younger. Nontransfer residents were 8.85 times (95% CI: 1.17-66.67) more likely to encounter difficulty than transfer residents. The effects of sex, training site, international medical graduate status, and rotation order on the likelihood of encountering difficulty were nonsignificant. Older and nontransfer residents may be facing unique circumstances and may benefit from additional support from the program.

Service encounters as bases for innovation

DEFF Research Database (Denmark)

Sundbo, Jon; Sundbo, Donna; Henten, Anders

2015-01-01

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...... between employees and customers, employees investing stubbornness and time can be a driver for innovation, and several layers of management can be a barrier. In the field experiments three new factors for encounter-based innovation were found: translation, multitasking, and hyper-professionalism. The two...

Predator-prey encounters in turbulent waters

DEFF Research Database (Denmark)

Mann, J.; Ott, Søren; Pécseli, H.L.

2002-01-01

With reference to studies of predator-prey encounters in turbulent waters, we demonstrate the feasibility of an experimental method for investigations of particle fluxes to an absorbing surface in turbulent flows. A laboratory experiment is carried out, where an approximately homogeneous and isot......With reference to studies of predator-prey encounters in turbulent waters, we demonstrate the feasibility of an experimental method for investigations of particle fluxes to an absorbing surface in turbulent flows. A laboratory experiment is carried out, where an approximately homogeneous...

Plankton motility patterns and encounter rates

DEFF Research Database (Denmark)

Visser, Andre; Kiørboe, Thomas

2006-01-01

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...... 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...

Frequency of hospital acquired hyponatremia in a pediatric tertiary care setting

International Nuclear Information System (INIS)

Bibi, S.; Haq, A.U.; Billo, A.G.; Bibi, S.; Gilani, S.Y.H.; Shah, S.R.A.

2015-01-01

Background: Hyponatremia is the most commonly encountered electrolyte disorder in children. In our country the epidemiology of hospital acquired hyponatremia has hardly ever been explored whereas the administration of hypotonic IV fluids is widely practiced here. Therefore we pioneered to conduct this study to determine the frequency of hospital acquired hyponatremia. Method: This was a cross sectional study carried out at Aga Khan University Hospital, Karachi in paediatric ward and ICU over a period of 12 months. All children (>1 month and <15 years of age) admitted in paediatric units and on maintenance IV fluids who had serum sodium level measured on admission were included in the study and followed to identify patients who had a drop in serum sodium during hospitalization. Informed consent was taken from parents and collected data was recorded on a proforma. Results: A total of 865 patients were enrolled in the study. Hyponatremia was recorded in 405 patients on admission (46.8 percentage) while hospital acquired hyponatremia was documented in 240. children (27.7 percentage). Out of these 142 (59.2 percentage) were male and 98 (40.8 percentage) were female. Mean age of children in hospital acquired hyponatremia group was 60.67 months. Severity of hospital acquired hyponatremia was recorded as mild in 191 (79.6 percentage), moderate in 35 (14.6 percentage) and severe in 14 (5.8) children. Major disease categories included gastrointestinal disorder (30.4 percentage), respiratory illness (12.5 percentage), oncological disease (16.3 percentage), cardiovascular disease (11.7 percentage), infectious disease (9.2 percentage) and neurological illness (8.3 percentage). Conclusion: Hospital acquired hyponatremia is frequently encountered in our hospitalized children with majority of them receiving hypotonic IV solutions. (author)

Obstacles to nutrition labeling in restaurants.

Science.gov (United States)

Almanza, B A; Nelson, D; Chai, S

1997-02-01

This study determined the major obstacles that foodservices face regarding nutrition labeling. Survey questionnaire was conducted in May 1994. In addition to demographic questions, the directors were asked questions addressing willingness, current practices, and perceived obstacles related to nutrition labeling. Sixty-eight research and development directors of the largest foodservice corporations as shown in Restaurants & Institutions magazine's list of the top 400 largest foodservices (July 1993). P tests were used to determine significance within a group for the number of foodservices that were currently using nutrition labeling, perceived impact of nutrition labeling on sales, and perceived responsibility to add nutrition labels. Regression analysis was used to determine the importance of factors on willingness to label. Response rate was 45.3%. Most companies were neutral about their willingness to use nutrition labeling. Two thirds of the respondents were not currently using nutrition labels. Only one third thought that it was the foodservice's responsibility to provide such information. Several companies perceived that nutrition labeling would have a potentially negative effect on annual sales volume. Major obstacles were identified as menu or personnel related, rather than cost related. Menu-related obstacles included too many menu variations, limited space on the menu for labeling, and loss of flexibility in changing the menu. Personnel-related obstacles included difficulty in training employees to implement nutrition labeling, and not enough time for foodservice personnel to implement nutrition labeling. Numerous opportunities will be created for dietetics professionals in helping foodservices overcome these menu- or personnel-related obstacles.

Encountering whales: How encounter rates became the basis for managing whaling

Directory of Open Access Journals (Sweden)

Tim D Smith

2009-09-01

Full Text Available Declining rates of encountering whales, including both sighting and catching, were noted by whalers throughout the 19th century, and these declines became the first indication that whaling was adversely affecting whale abundance. The interpretation of declines in both sighting and catch rates proved to be a difficult scientific task. Satisfactory quantitative methods of interpreting changes in whale encounter rates were not developed until the second half of the 20th century. Rates of encountering whales played a key role in the International Whaling Commission (IWC Scientific Committee from its beginning in the early 1950s, as well as in the US in implementing its Marine Mammal Protection Act beginning in the early 1970s. The development of methods of collecting and interpreting sighting and catch data was intimately interwoven with the development of themanagement of whaling and cetacean by-catches in fisheries throughout the world, but especially within the context of the Scientific Committees of the IWC and the North Atlantic Marine Mammal Commission (NAMMCO. Although overfishing of whales was initially identified through the use of sighting rate data, catch rate data provided the IWC’s Committee its first firm footing for management advice. However, it was sighting rate data that ultimately became the basis for the scientific advice on whaling and for management advice in other settings. This led to the development of large scale cetacean sighting programmes, such as the IWC’s International Decade of Cetacean Researchsurveys in Antarctic aboard Japanese ships, the North Atlantic Sighting Surveys (NASS aboard Norwegian, Icelandic, Spanish, Greenlandic and Faroese vessels and aircraft (coordinated by NAMMCO through its Scientific Committee from 1995, and surveys under the US’s Marine Mammal Protection Act and the European Union’s Small Cetacean Abundance in the North Sea (SCANS programme. Fishery independent cetacean sighting surveys

Care interaction adding challenges to old patients’ well-being during surgical hospital treatment

Directory of Open Access Journals (Sweden)

Lisbeth Uhrenfeldt

2015-10-01

Full Text Available Today, hospitals offer surgical treatment within a short hospital admission. This brief interaction may challenge the well-being of old patients. The aim of this study was to explore how the well-being of old hospitalized patients was affected by the interaction with staff during a fast-track surgical treatment and hospital admission for colon cancer. We used an ethnographic methodology with field observations and unstructured interviews focusing on one patient at a time (n=9 during a full day; the hours ranging from 7:45 a.m. to 8 p.m. Participants were between 74 and 85 years of age and of both sexes. The study was reported to the Danish Data Protection Agency with reference number (2007-58-0010. The encounter between old patients and the staff was a main theme in our findings elucidating a number of care challenges. The identified care challenges illustrated “well-being as a matter of different perspectives,” “vulnerability in contrast to well-being,” and “staff mix influencing the care encounter.” The experience of well-being in old cancer patients during hospital admission was absent or challenged when staff did not acknowledge their individual vulnerability and needs.

Risk Assessment of Physical Health Hazards in Al-Azhar University Hospital in New Damietta, Egypt

OpenAIRE

Mohammed El-Hady Imam*, Raed Mohammed Alazab**,

2013-01-01

Introduction: Personnel working in hospitals are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. Objectives: The objectives of this study were to identify physical health hazards in all departments of Al-Azhar University Hospital in new Damietta, to measure risk level of these hazards, and to recognize safety me...

Brain systems underlying encounter expectancy bias in spider phobia.

Science.gov (United States)

Aue, Tatjana; Hoeppli, Marie-Eve; Piguet, Camille; Hofstetter, Christoph; Rieger, Sebastian W; Vuilleumier, Patrik

2015-06-01

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.

Strange culinary encounters:

DEFF Research Database (Denmark)

Leer, Jonatan; Kjær, Katrine Meldgaard

2015-01-01

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....

Junot Díaz’s “Otravida, Otravez” and Hospitalia: The Workings of Hostile Hospitality

OpenAIRE

Manzanas Calvo, Ana María

2013-01-01

[EN]The language of hospitality and its intimate opposite, hostility, reverberates insistently in the current political climate, as countries worry about fortifying their borders against waves of migration. This framework has paved the way for the language of hospitality to return as an apt lens for anatomizing current encounters with the Other. This article argues that the hospitality at the heart of Junot Díaz’s story “Otravida, Otravez” (2012) is one that has turned against ...

Relationship of Ethical Leadership, Corporate Social Responsibility and Organizational Performance

Directory of Open Access Journals (Sweden)

Min-Seong Kim

2018-02-01

Full Text Available Corporate social responsibility (CSR has become a major part of the foodservice industry due to external forces which encourage enterprises’ responsiveness. In reality, consumers’ social concern influences their attitudes towards foodservice firms’ socially responsible practices and purchase decisions, thereby influencing senior management to react. Considering this issue, this study examines the impact of senior management’s ethical leadership in evaluating operational, commercial, and economic performances along with the mediating role of CSR in the foodservice industry. A conceptual model was formulated and empirically tested based on responses from 196 foodservice franchise firms in South Korea. The results indicated ethical leadership significantly influenced CSR and operational performance, while CSR also had a positive effect on operational and commercial performances. Additionally, operational performance had a significantly positive influence on commercial performance, which subsequently enhanced economic performance. Overall, the findings highlight the role that ethical leadership exhibited by senior management of foodservice franchises influenced initiation of CSR activities, which provide implications for research and industry practice and is outlined.

Guest-Host Encounters in Diaspora-Heritage Tourism: The Taglit-Birthright Israel Mifgash (Encounter)

Science.gov (United States)

Sasson, Theodore; Mittelberg, David; Hecht, Shahar; Saxe, Leonard

2011-01-01

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…

The Impact of Value-Orientations on Cross-cultural Encounters and ...

African Journals Online (AJOL)

encounters and mediation in the Tanzanian educational system. The purpose of the article is to give an emic perspective on value-orientations in crosscultural encounters and mediation situations in the educational system, to improve understanding of the conflictive aspects of these encounters. To achieve this purpose, the ...

Predicting Hospital Admission for Emergency Department Patients using a Bayesian Network

OpenAIRE

Leegon, Jeffrey; Jones, Ian; Lanaghan, Kevin; Aronsky, Dominik

2005-01-01

Hospital admission delays in the Emergency Department (ED) reduce volume capacity and contribute to the nation’s ED diversion problem. This study evaluated the accuracy of a Bayesian network for the early prediction of hospital admission status using data from 16,900 ED encounters. The final model included nine variables that are commonly available in many ED settings. The area under the receiver operating characteristic curve was 0.894 (95% CI: 0.887-0.902) for the validati...

An Analysis of the Last Clinical Encounter before Outpatient Mortality among Children with HIV Infection and Exposure in Lilongwe, Malawi.

Directory of Open Access Journals (Sweden)

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.

Using the Systems-Practice Framework to Understand Food Allergen Management Practices at College Catering Operations: A Qualitative Study.

Science.gov (United States)

Verstappen, Jennie; Mirosa, Miranda; Thomson, Carla

2018-03-01

The number of individuals with food allergies or intolerances attending catered university residential colleges is increasing, and safe dining options are required to minimize the risk of allergic reactions and food-induced death. This qualitative research study sought to advance professional knowledge of the factors affecting allergen management practices, particularly pertaining to college foodservices. Three catered residential colleges affiliated with a major university in New Zealand were selected as research sites. The study used an ethnographic approach and systems-practice theory as a framework for data collection and organizing results. Data collection techniques included document analyses (3 hours per site), observations (6 to 8 hours per site), focus groups with foodservice workers (30 to 45 minutes per site, n=16), and interviews with foodservice managers (45 to 90 minutes per interview, n=5). Notes and transcripts were coded through the process of thematic analysis using NVivo for Mac software, version 11.1.1, to identify factors affecting allergen management practices. The main factors affecting allergen management practices at college foodservices included information provided by residents about dietary requirements; communication between residents and foodservice staff; systems for allergen management; attitude of foodservice staff; and college size. Detailed dietary information, effective communication with residents, sufficient resources, clarification of responsibilities, and thorough systems are required for staff to perform safe allergen management practices. Ultimately, successful implementation was predominantly determined by staff attitude. Foodservice managers are advised to identify motivators and address barriers of staff attitudes toward allergen management practices to promote successful implementation. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Hospital readmission after management of appendicitis at freestanding children's hospitals: contemporary trends and financial implications.

Science.gov (United States)

Rice-Townsend, Samuel; Hall, Matthew; Barnes, Jeff N; Baxter, Jessica K; Rangel, Shawn J

2012-06-01

The purpose of this study was to characterize epidemiologic trends and cost implications of hospital readmission after treatment of pediatric appendicitis. We conducted a 5-year retrospective cohort analysis of 30-day readmission rates for 52,054 patients admitted with appendicitis at 38 children's hospitals participating in the Pediatric Health Information System database. Patients were categorized as "uncomplicated" (postoperative length of stay [LOS] ≤ 2 days) or "complicated" (LOS ≥ 3 days and ≥ 4 consecutive days of antibiotics) and analyzed for demographic data, treatment received during the index admission, readmission rates, and excess LOS and hospital-related costs attributable to readmission encounters. The aggregate 30-day readmission rate was 8.7%, and this varied significantly by disease severity and management approach (uncomplicated appendectomy, 5.6%; complicated appendectomy, 12.8%; drainage, 22.6%; antibiotics only, 24.6%; P management approach (uncomplicated appendectomy, $1946 [31% relative increase]; complicated appendectomy, $6524 [53% increase]; drainage, $6827 [48% increase]; antibiotics only, $5835 [58% increase]; P < .0001). In freestanding children's hospitals, readmission after treatment of pediatric appendicitis is a relatively common and costly occurrence. Collaborative efforts are needed to characterize patient, treatment, and hospital-related risk factors as a basis for developing preventative strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

Emotions in relation to healthcare encounters affecting self-esteem.

Science.gov (United States)

Räty, Lena; Gustafsson, Barbro

2006-02-01

This study identifies emotions in patients with epilepsy as a result of confirming and disconfirming healthcare experiences. A discussion of emotions as a motive for patients' goal-directed actions was a further aim of this study. The critical incident method was used for data collection. Emotions occurring in confirming and disconfirming healthcare encounters were analyzed using the Belief-Desire Theory of Emotions and were categorized as basic, complex, or self-evaluating. Confirming encounters aroused emotions like hope, a feeling of security, joy, relief, and pride, while disconfirming encounters aroused emotions like despair, fear, unrest, resignation, shame, and guilt. The emotions identified in the healthcare encounters were recognized as motives for action. An emotion such as a feeling of security aroused a desire in the patients to strengthen their positive self and motivated them to have a constructive and sympathetic attitude toward the healthcare experience. An emotion such as anger caused patients to strive to maintain their self-respect either by avoiding difficult situations and ignoring the problem (patients with a low self-esteem) or by trying to re-create a positive self-image (patients with a high self-esteem). Healthcare encounters between patient and caregiver considerably affect the patient's emotional status and thereby his or her well-being. The importance of establishing healthcare encounters that evoke positive emotions that strengthen patients' resources must be addressed in future nursing care.

Insanity and ethnicity in New Zealand: Māori encounters with the Auckland Mental Hospital, 1860-1900.

Science.gov (United States)

Barry, Lorelle; Coleborne, Catharine

2011-09-01

This article examines Māori patients at the Auckland Mental Hospital between 1860 and 1900.We argue that the patient case notes reveal 'European' categories in which Māori were situated, and demonstrate the extent to which the authorities at the hospital grappled with their appearance, their language and their culture, all of which were elements of their ethnicity. We argue that the use of institutional case records is highly suggestive of some of the historical meanings of insanity for Māori, including the lack of detailed or sustained collection of information about patients' tribal affiliations, the interest shown in their rights to land in maintenance payment inquiries, the experiences of cultural alienation or mate Māori, and the sad outcomes for Māori.

Pain Management for Sickle Cell Disease in the Pediatric Emergency Department: Medications and Hospitalization Trends.

Science.gov (United States)

Cacciotti, Chantel; Vaiselbuh, Sarah; Romanos-Sirakis, Eleny

2017-10-01

The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes. Patients received combination (nonsteroidal anti-inflammatory drug [NSAID] + narcotic) pain medications for initial treatment at a minority of ED encounters (19%). A higher percentage of patients who received narcotics alone as initial treatment were hospitalized as compared with those who received combination treatment initially ( P= 0.0085). Improved patient education regarding home pain management as well as standardized ED guidelines for assessment and treatment of sickle cell pain may result in superior and more consistent patient care.

Live Aircraft Encounter Visualization at FutureFlight Central

Science.gov (United States)

Murphy, James R.; Chinn, Fay; Monheim, Spencer; Otto, Neil; Kato, Kenji; Archdeacon, John

2018-01-01

Researchers at the National Aeronautics and Space Administration (NASA) have developed an aircraft data streaming capability that can be used to visualize live aircraft in near real-time. During a joint Federal Aviation Administration (FAA)/NASA Airborne Collision Avoidance System flight series, test sorties between unmanned aircraft and manned intruder aircraft were shown in real-time at NASA Ames' FutureFlight Central tower facility as a virtual representation of the encounter. This capability leveraged existing live surveillance, video, and audio data streams distributed through a Live, Virtual, Constructive test environment, then depicted the encounter from the point of view of any aircraft in the system showing the proximity of the other aircraft. For the demonstration, position report data were sent to the ground from on-board sensors on the unmanned aircraft. The point of view can be change dynamically, allowing encounters from all angles to be observed. Visualizing the encounters in real-time provides a safe and effective method for observation of live flight testing and a strong alternative to travel to the remote test range.

Binary encounter electron production in ion-atom collisions

International Nuclear Information System (INIS)

Grabbe, S.; Bhalla, C.P.; Shingal, R.

1993-01-01

The binary encounter electrons are produced by hard collisions between the target electrons and the energetic projectiles. Richard et al. found the measured double differential cross section for BEe production at zero degree laboratory scattering angle, in collisions of F q+ with H 2 and He targets, to increase as the charge state of the projectile was decreased. The binary encounter electron production has recently been a subject of detailed investigations. We have calculated the differential elastic scattering cross sections of electrons from several ions incorporating the exchange contribution of the continuum and the bound orbitals in addition to the static potential. The double differential binary encounter electron production cross sections are presented using the impulse approximation

Encounters of The Solar System With Molecular Clouds

International Nuclear Information System (INIS)

Wickramasinghe, J. T.

2008-01-01

The solar system has penetrated about 5 -- 10 giant molecular clouds over its history, and passes within 5 parsecs of a star-forming nebula every 100 million years or so. Numerical simulations of the effect of such encounters in perturbing the Oort cloud of comets are carried out using standard n-body computational techniques. It is found that the ingress of comets into the inner planetary system during such encounters amounts to factors of ∼100 over the average. During an encounter the impact rate of comets onto Earth increases by a comparable factor. The of ages of impact craters on the Earth is shown to be consistent with predictions from the model

First-Year Principal Encounters Homophobia

Science.gov (United States)

Retelle, Ellen

2011-01-01

A 1st-year principal encounters homonegativity and an ethical dilemma when she attempts to terminate a teacher because of the teacher's inadequate and ineffective teaching. The teacher responds by threatening to "out" Ms. L. to the parents.

Hospitality Language In Tourism Field: Facework

Directory of Open Access Journals (Sweden)

Yohanes Kristianto

2017-01-01

Full Text Available This study aims to uncover, analyze, and interpret the reality of hospitality language in tourism from the perspective of the duality. The underlying assumption that language is an action  in social practices. This is shown by the practice of the English language in the service interaction. The structure of the English language is like  schemata of principles for service interaction and at the same time empowering service  provider to perform service interaction To uncover and interpret  hospitality language practice, the theory of structuration is applied. Theory of pragmatics is  used to analyze the linguistic phenomena. Based on the frame of structuration, this  research is identified in four issues, namely (1 the structure of hospitality language, (2 the system of  hospitality language, and (3 hospitality language as a representation facework. Problem (1 and (2 are analyzed by ethnography of communication. Problem (3 is analyzed using speech act theory and politeness theory. This study is a qualitative research, due to explore, pattern, interpreting the language practices, so it does not use statistical analysis to generalize the results. Population is not  in large quantities, but using purposive sample to determine the number of informants based on the criteria and representativeness in service encounter. In addition, language behavior in general is homogeneous. Data collected by the ethnography of communication methods, observation, and recording. The data selected are English due to English as the main foreign language in the service interaction. The findings of this study are: (1 the structure of the hospitality language, namely (a the structure of significance in the form of setting or scene of service encounter, (b the structure of domination, namely participants (tourism practitioners and tourists, (2 the system of  hospitality language in the form of (a the schemata interpretation of act sequences and keys, (b the schemata

Humor During Clinical Practice: Analysis of Recorded Clinical Encounters.

Science.gov (United States)

Phillips, Kari A; Singh Ospina, Naykky; Rodriguez-Gutierrez, Rene; Castaneda-Guarderas, Ana; Gionfriddo, Michael R; Branda, Megan; Montori, Victor

2018-01-01

Little is known about humor's use in clinical encounters, despite its many potential benefits. We aimed to describe humor during clinical encounters. We analyzed 112 recorded clinical encounters. Two reviewers working independently identified instances of humor, as well as information surrounding the logistics of its use. Of the 112 encounters, 66 (59%) contained 131 instances of humor. Humor was similarly frequent in primary care (36/61, 59%) and in specialty care (30/51, 59%), was more common in gender-concordant interactions (43/63, 68%), and was most common during counseling (81/112, 62%). Patients and clinicians introduced humor similarly (63 vs 66 instances). Typically, humor was about the patient's medical condition (40/131, 31%). Humor is used commonly during counseling to discuss the patient's medical condition and to relate to general life events bringing warmth to the medical encounter. The timing and topic of humor and its use by all parties suggests humor plays a role in the social connection between patients and physicians and allows easier discussion of difficult topics. Further research is necessary to establish its impact on clinicians, patients, and outcomes. © Copyright 2018 by the American Board of Family Medicine.

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

African Journals Online (AJOL)

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

Personal Albums and Cultural Encounters

DEFF Research Database (Denmark)

Marselis, Randi Lorenz

2018-01-01

as discussions of representational ethics in relation to anthropological and colonial photography, this article examines the exhibition The Photo Albums at the Dutch National Maritime Museum. Typically, the photo collections of maritime museums include many photographs that represent cultural encounters...

Service Encounter Related Process Quality, Patient Satisfaction, and Behavioral Intention

Directory of Open Access Journals (Sweden)

Nandakumar Mekoth

2011-12-01

Full Text Available This study identifies some of the critical service encounters thatthe outpatients undergo in a health care facility and investigateswhether the service encounter related process quality as perceivedby the patients leads to patient satisfaction, repeat visit, and recommendationintentions. Personal visits, observations, and enquiriesat the outpatient center have been conducted to identifythe various service encounters that outpatients undergo in thehospital. Exit interviews of the outpatients have been conductedto identify service encounter related process quality variableswhich determine patient satisfaction and behavioral intentions.A preliminary scale to measure service encounter related processquality was developed and its factor structure and internal consistencyreliability were established. The study reveals that boththe physician quality and laboratory quality have been found tobe significantly related to patient satisfaction. However, quite interestingly,courtesy shown by the registration or outpatient staff,perceived length of waiting time, or even the salient aspects of theservicescape, did not influence patient satisfaction.

The hospital and the hospital: Infrastructure, human tissue, labour and the scientific production of relational value.

Science.gov (United States)

Street, Alice

2016-12-01

How does science make a home for itself in a public hospital? This article explores how scientists working in 'resource poor' contexts of global health negotiate relationships with their hosts, in this case the doctors, nurses and patients who already inhabit a provincial-level hospital. Taking its lead from recent works on science, ethics and development, this article seeks to 'provincialize the laboratory' by focussing on the scientific tropics as a space of productive encounter and engagement. A view from the hospital reveals the tenuous process of 'setting up' a place for science, in a world that does not immediately recognize its value. The article examines the material exchanges of infrastructure, bodily tissues and labour that enable one young scientist to establish a scientific life for himself. The success of those transactions, it argues, ultimately derives from their objectification of scientific vulnerability and their enactment of relationships of mutual recognition. As opposed to asking how scientific knowledge is produced in the tropics, the view from the hospital challenges us to focus on the establishment of relationships between scientists and their hosts as a productive endeavour in its own right.

Pet ownership increases human risk of encountering ticks.

Science.gov (United States)

Jones, E H; Hinckley, A F; Hook, S A; Meek, J I; Backenson, B; Kugeler, K J; Feldman, K A

2018-02-01

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.

Relationship between occurrence of surgical complications and hospital finances.

Science.gov (United States)

Eappen, Sunil; Lane, Bennett H; Rosenberg, Barry; Lipsitz, Stuart A; Sadoff, David; Matheson, Dave; Berry, William R; Lester, Mark; Gawande, Atul A

2013-04-17

The effect of surgical complications on hospital finances is unclear. To determine the relationship between major surgical complications and per-encounter hospital costs and revenues by payer type. Retrospective analysis of administrative data for all inpatient surgical discharges during 2010 from a nonprofit 12-hospital system in the southern United States. Discharges were categorized by principal procedure and occurrence of 1 or more postsurgical complications, using International Classification of Diseases, Ninth Revision, diagnosis and procedure codes. Nine common surgical procedures and 10 major complications across 4 payer types were analyzed. Hospital costs and revenue at discharge were obtained from hospital accounting systems and classified by payer type. Hospital costs, revenues, and contribution margin (defined as revenue minus variable expenses) were compared for patients with and without surgical complications according to payer type. Of 34,256 surgical discharges, 1820 patients (5.3%; 95% CI, 4.4%-6.4%) experienced 1 or more postsurgical complications. Compared with absence of complications, complications were associated with a $39,017 (95% CI, $20,069-$50,394; P financial consequences for decreasing postsurgical complications.

Controle de perdas de carotenóides em hortaliças preparadas em unidade de alimentação e nutrição hospitalar Control of carotenoid loss in vegetables prepared in a hospital foodservice

Directory of Open Access Journals (Sweden)

Ceres Mattos Della Lucia

2008-10-01

Full Text Available Objetivou-se avaliar procedimentos de manipulação visando o controle de perdas de β-caroteno e licopeno em couve e tomate preparados em uma Unidade de Alimentação e Nutrição (UAN hospitalar. Os critérios adotados não utilizados previamente pela UAN foram: armazenamento por 24 h sob refrigeração (10°C, sanitização por 15 min e distribuição logo após o preparo. As hortaliças foram coletadas após a recepção e depois de cada etapa de manipulação. A análise foi realizada por cromatografia líquida de alta eficiência (CLAE, usando como fase móvel metanol, acetato de etila e acetonitrila (50:40:10. A ANOVA (α = 0,05 foi utilizada para detecção de diferenças significativas. Não foram encontradas diferenças significativas quanto ao conteúdo dos componentes entre as etapas de manipulação, mas houve redução importante das taxas de retenção. Para β-caroteno em couve, verificou-se retenção de 68,2% após 60 minutos de exposição para consumo, enquanto em tomate, 91,96% do conteúdo desse composto foi preservado após 120 minutos de espera até a distribuição. Não foi observada redução importante na taxa de retenção de licopeno. Os procedimentos avaliados na UAN hospitalar contribuíram para controlar as perdas de carotenóides nas hortaliças, pois sua retenção foi elevada, sendo sugerida sua adoção em outras UAN.The aim of this study was to assess the handling procedures of kale and tomatoes in a hospital foodservice (HFS in order to control loss of β-carotene and licopene. The adopted measures, up to then not used by the HFS, were: 24-h storage under refrigeration (10°C, hygienizing for 15 min and distribution immediately after preparation. Vegetable samples were collected after reception and after each stage of manipulation in the HFS. The samples were analyzed using high performance liquid chromatography (HPLC with a mobile phase of methanol, ethyl acetate and acetonitrile (50:40:10. ANOVA (α = 0

Clostridial collagenase ointment and medicinal honey utilization for pressure ulcers in US hospitals.

Science.gov (United States)

Dreyfus, Jill; Delhougne, Gary; James, Roberta; Gayle, Julie; Waycaster, Curtis

2018-04-01

To describe the utilization of clostridial collagenase ointment (CCO) and medicinal honey debridement methods in real-world inpatient and outpatient hospital settings among pressure ulcer (PU) patients and compare the frequency of healthcare re-encounters between CCO- and medicinal honey-treated patients. De-identified hospital discharge records for patients receiving CCO or medicinal honey methods of debridement and having an ICD-9 code for PU were extracted from the US Premier Healthcare Database. Multivariable analysis was used to compare the frequency of inpatient and outpatient revisits up to 6 months after an index encounter for CCO- vs medicinal honey-treated PUs. The study identified 48,267 inpatients and 2,599 outpatients with PUs treated with CCO or medicinal honeys. Among study inpatients, n = 44,725 (93%) were treated with CCO, and n = 3,542 (7%) with medicinal honeys. CCO and medicinal honeys accounted for 1,826 (70%) and 773 (30%), respectively, of study outpatients. In adjusted models, those treated with CCO had lower odds for inpatient readmissions (OR = 0.86, 95% CI = 0.80-0.94) after inpatient index visits, and outpatient re-encounters both after inpatient (OR = 0.73, 95% CI = 0.67-0.79) and outpatient (OR = 0.78, 95% CI = 0.64-0.95) index visits in 6 months of follow-up. The study was observational in nature, and did not adjust for reasons why patients were hospitalized initially, or why they returned to the facility. Although the study adjusted for differences in a variety of demographic, clinical, and hospital characteristics between the treatments, we are not able to rule out selection bias. Patients with CCO-treated PUs returned to inpatient and outpatient hospital settings less often compared with medicinal honey-treated PUs. These results from real-world administrative data help to gain a better understanding of the clinical characteristics of patients with PUs treated with these two debridement methods and

A Model Train-The-Trainer Program for HACCP-Based Food Safety Training in the Retail/Food Service Industry: An Evaluation.

Science.gov (United States)

Martin, Kenneth E.; Knabel, Steve; Mendenhall, Von

1999-01-01

A survey showed states are adopting higher training and certification requirements for food-service workers. A train-the-trainer model was developed to prepare extension agents, health officers, and food-service managers to train others in food-safety procedures. (SK)

Hospital Admissions, Costs, and 30-Day Readmissions Among Newly Diagnosed Nonvalvular Atrial Fibrillation Patients Treated with Dabigatran Etexilate or Warfarin.

Science.gov (United States)

Fonseca, Eileen; Sander, Stephen D; Hess, Gregory P; Ghosh, Sabyasachi

2015-11-01

Oral anticoagulation such as warfarin and dabigatran is indicated for atrial fibrillation (AF) patients at risk of ischemic stroke. Dabigatran etexilate was developed to address the limitations of warfarin, including the need for regular blood monitoring, which has the potential to lead to higher health care resource use, particularly in hospitalized patients. To evaluate whether hospitalization cost, length of hospital stay (LOS), likelihood of readmission within 30 days, and cost of readmissions differed across inpatient encounters among nonvalvular atrial fibrillation (NVAF) patients that were newly diagnosed and newly treated with either dabigatran or warfarin. A retrospective cohort study was conducted using IMS Health's Charge Detail Master (CDM) database. Hospitalizations were identified based on a primary or secondary AF diagnosis, dabigatran or warfarin use, and a discharge date from January 2011 through March 2012. The identified patients without valvular procedures and transient AF were required to have a minimum of 12 months of pharmacy and private practitioner records prior to the inpatient encounter to ensure that they were newly treated on dabigatran or warfarin. Propensity score matching was used to balance baseline characteristics between treatment cohorts. Outcomes assessed were LOS, 30-day readmissions, and costs. Because individual patients could have more than 1 hospital observation, generalized estimating equations (GEE) with a gamma distribution (log link) were used for the analysis of continuous outcome measures (e.g., LOS and costs) and a binominal distribution for dichotomous outcomes (hospital readmissions). Two cohorts were propensity score matched (1:2) on demographic and clinical characteristics. The dabigatran cohort included 646 hospitalizations, and the warfarin cohort included 1,292 hospitalizations. Hospitalizations were on average 13% shorter (4.8 vs. 5.5 days, P  less than  0.001) and cost 12% less ($14,794 vs. $16,826, P�

Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients.

Directory of Open Access Journals (Sweden)

Daniel Martinez-Ramirez

Full Text Available Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medication errors that may occur during hospitalization and its impact on length of hospital stay.A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.A significant effect for dopaminergic administration (p<0.01 on length of hospital stay was observed. Subjects who had delayed administration or missed at least one dose stayed longer (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4. Contraindicated dopamine blocking agents were administered in 23% (71/339 of cases, and this was also significantly related to an increased length of stay (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4, p<0.05. Participants who received a contraindicated dopamine blocker stayed in the hospital longer (M=7.5 days, SD=9.1 compared to those who did not (M=5.9 days, SD=6.8. Neurologists were consulted in 24.5% of encounters. Specialty consultation had no effect on the medication related errors.Missing dopaminergic dosages and administration of dopamine blockers occur frequently in hospitalized Parkinson's disease patients and this may impact length of stay. These potentially modifiable factors may reduce the risk of a longer stay related to hospitalization.

Athletic Training Student Core Competency Implementation During Patient Encounters.

Science.gov (United States)

Cavallario, Julie M; Van Lunen, Bonnie L; Hoch, Johanna M; Hoch, Matthew; Manspeaker, Sarah A; Pribesh, Shana L

2018-03-01

  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

Quantifying the Effects of Gas-Rich Flyby Encounters on Galaxy Evolution

Science.gov (United States)

Dumas, Julie; Holley-Bockelmann, Kelly; Lang, Meagan

2017-01-01

Recent work has shown that flyby encounters may be a common event in a galaxy's lifetime. Galaxy flybys are a one-time encounter when two halos interpenetrate, but unlike a galaxy merger, the two halos later detach. Relatively little work has been done to assess how flybys affect galaxy evolution. We present preliminary results of a suite of high-resolution hydrodynamical + N-body simulations of gas-rich flyby encounters, concentrating on Milky Way-like primaries. We track the bulk changes in structure, star formation history, kinematics, and morphology over a broad span of flyby encounters.

Low velocity encounters of minor bodies with the outer planets

International Nuclear Information System (INIS)

Carusi, A.; Perozzi, E.; Valsecchi, G.B.

1983-01-01

Previous studies of close encounters of minor bodies with Jupiter have shown that the perturbations are stronger either if the encounter is very deep or if the velocity of the minor body relative to the planet is low. In the present research the author investigates the effects of low velocity encounters between fictitious minor bodies and the four outer planets. Two possible outcomes of this type of encounter are the temporary satellite capture of the minor body by the planet, and the exchange of perihelion with aphelion of the minor body orbit. Different occurrence rates of these processes are found for different planets, and the implications for the orbital evolution of minor bodies in the outer Solar System are discussed. (Auth.)

Initiating Service Encounter-based Innovation by Word-of-Business

DEFF Research Database (Denmark)

Mattsson, Jan

2015-01-01

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...... 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....

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

Directory of Open Access Journals (Sweden)

Chang Ching

2008-04-01

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.

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan.

Science.gov (United States)

Chang, Hsin Hsin; Chang, Ching Sheng

2008-04-17

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.

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings

NARCIS (Netherlands)

Hopman, J.; Hakizimana, B.; Meintjes, W.A.; Nillessen, M.; Both, E. de; Voss, A.; Mehtar, S.

2016-01-01

BACKGROUND: Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. AIM: To evaluate the biological contamination

Lessons learned from a whole hospital PACS installation. Picture Archiving and Communication System.

Science.gov (United States)

Pilling, J R

2002-09-01

The Norfolk and Norwich University Hospital has incorporated a fully filmless Picture Archiving and Communication System (PACS) as part of a new hospital provision using PFI funding. The PACS project has been very successful and has met with unanimous acclaim from radiologists and clinicians. A project of this size cannot be achieved without learning some lessons from mistakes and recognising areas where attention to detail resulted in a successful implementation. This paper considers the successes and problems encountered in a large PACS installation.

Ulysses at jupiter: an overview of the encounter.

Science.gov (United States)

Smith, E J; Wenzel, K P; Page, D E

1992-09-11

In February 1992, the Ulysses spacecraft flew through the giant magnetosphere of Jupiter. The primary objective of the encounter was to use the gravity field of Jupiter to redirect the spacecraft to the sun's polar regions, which will now be traversed in 1994 and 1995. However, the Ulysses scientific investigations were well suited to observations of the Jovian magnetosphere, and the encounter has resulted in a major contribution to our understanding of this complex and dynamic plasma environment. Among the more exciting results are (i) possible entry into the polar cap, (ii) the identification of magnetospheric ions originating from Jupiter's ionosphere, lo, and the solar wind, (iii) observation of longitudinal asymmetries in density and discrete wave-emitting regions of the lo plasma torus, (iv) the presence of counter-streaming ions and electrons, field-aligned currents, and energetic electron and radio bursts in the dusk sector on high-latitude magnetic field lines, and (v) the identification of the direction of the magnetic field in the dusk sector, which is indicative of tailward convection. This overview serves as an introduction to the accompanying reports that present the preliminary scientific findings. Aspects of the encounter that are common to all of the investigations, such as spacecraft capabilities, the flight path past Jupiter, and unique aspects of the encounter, are presented herein.

A Lakatosian Encounter with Probability

Science.gov (United States)

Chick, Helen

2010-01-01

There is much to be learned and pondered by reading "Proofs and Refutations" by Imre Lakatos (Lakatos, 1976). It highlights the importance of mathematical definitions, and how definitions evolve to capture the essence of the object they are defining. It also provides an exhilarating encounter with the ups and downs of the mathematical reasoning…

Impact of a DRG-based hospital financing system on quality and outcomes of care in Italy.

Science.gov (United States)

Louis, D Z; Yuen, E J; Braga, M; Cicchetti, A; Rabinowitz, C; Laine, C; Gonnella, J S

1999-01-01

OBJECTIVE: To examine potential changes in quality of care associated with a recent financing system implementation in Italy: in 1995, hospital financing reform implemented in Italy included the introduction of a DRG-based hospital financing system with the goals of controlling the growth of hospital costs and making hospitals more accountable for their productivity. DATA SOURCES: Hospital discharge abstract data from 1993 through 1996 for all hospitals (N=32) in the Friuli-Venezia-Giulia region of Italy. Regional population data were used to calculate rates. STUDY DESIGN: Changes between 1993 and 1996 in hospital admissions, length of stay, mortality rates, severity of illness, and readmission rates were studied for nine common medical and surgical conditions: appendicitis, diabetes mellitus, colorectal cancer, cholecystitis, bronchitis/chronic obstructive pulmonary disease (COPD), bacterial pneumonia, coronary artery disease, cerebrovascular disease, and hip fracture. PRINCIPAL FINDINGS: The total number of ordinary hospital admissions decreased from 244,581 to 204,054 between 1993 and 1996, a population-based decrease of 17.3 percent (p<.001). The mean length of stay decreased from 9.1 days to 8.8 days, resulting in a 21.1 percent decrease in hospital bed days (p<.001). Day hospital use increased sevenfold from 16,871 encounters in 1993 to 108,517 encounters in 1996. The largest decrease in hospital admissions among study conditions was a 41 percent decrease for diabetes (from 2.25 per 1,000 in 1993 to 1.31 in 1996, p<.001). For eight of the nine conditions, severity of illness increased. Differences between severity-adjusted expected and observed in-hospital mortality rates were small. CONCLUSIONS: Observed trends showed a decrease in ordinary hospital admissions, an increase in day hospital admissions, and a greater severity of illness among hospitalized patients. There was little or no change in mortality and readmission rates. Administrative data can be used

Apples versus brownies

DEFF Research Database (Denmark)

Hansen, P. G.; Skov, L. R.; Jespersen, A. M.

2016-01-01

More and more people eat out and, therefore, foodservice business has an increasing influence on people’s dietary intake. Foodservice business should, first and foremost, deliver a nice tasting meal of high quality—but health should not be neglected. Nudging and choice architecture is a field of ...

77 FR 24164 - Submission for OMB Review; Comment Request

Science.gov (United States)

2012-04-23

... Breakfast Program pay indirect costs. The objective of the School Foodservice Indirect Cost Study is to... performance of the functions of the agency, including whether the information will have practical utility; (b... Nutrition Service Title: School Foodservice Indirect Cost Study. OMB Control Number: 0584-NEW. Summary of...

Development of a clinical data warehouse for hospital infection control.

Science.gov (United States)

Wisniewski, Mary F; Kieszkowski, Piotr; Zagorski, Brandon M; Trick, William E; Sommers, Michael; Weinstein, Robert A

2003-01-01

Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse.

Development of a Clinical Data Warehouse for Hospital Infection Control

Science.gov (United States)

Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

2003-01-01

Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

Toddler Developmental Delays After Extensive Hospitalization: Primary Care Practitioner Guidelines.

Science.gov (United States)

Lehner, Dana C; Sadler, Lois S

2015-01-01

This review investigated developmental delays toddlers may encounter after a lengthy pediatric hospitalization (30 days or greater). Physical, motor, cognitive, and psychosocial development of children aged 1 to 3 years was reviewed to raise awareness of factors associated with developmental delay after extensive hospitalization. Findings from the literature suggest that neonatal and pediatric intensive care unit (NICU/PICU) graduates are most at risk for developmental delays, but even non-critical hospital stays interrupt development to some extent. Primary care practitioners (PCPs) may be able to minimize risk for delays through the use of formal developmental screening tests and parent report surveys. References and resources are described for developmental assessment to help clinicians recognize delays and to educate families about optimal toddler development interventions. Pediatric PCPs play a leading role in coordinating health and developmental services for the young child following an extensive hospital stay.

Spacecraft environment during the GIOTTO-Halley encounter: a summary

International Nuclear Information System (INIS)

Young, D.T.

1983-01-01

A summary of the present volume is presented in which the separate disciplines are drawn together to give an overview of the spacecraft environment during the GIOTTO-Halley interaction. Specific recommendations are made as to how the work of the Plasma Environment Working Group might continue to contribute to the GIOTTO program during encounter and post-encounter data analysis. 28 references, 3 tables

Nursing students experienced personal inadequacy, vulnerability and transformation during their patient care encounter: A qualitative meta-synthesis.

Science.gov (United States)

Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth

2018-05-01

To identify, appraise and synthesize the best available evidence exploring nursing students' experiences of professional patient care encounters in a hospital unit. The Joanna Briggs Institute (JBI) guidelines were followed and a meta-synthesis was conducted. Qualitative research articles were considered for inclusion in the review, and JBI's meta-aggregative approach to synthesizing qualitative evidence was followed. An extensive search for relevant literature was undertaken in scientific databases. Data were extracted from the included research articles, and qualitative research findings were pooled using the Qualitative Assessment and Review Instrument. This involved categorization of findings on the basis of similarity of meaning and aggregation of these categories to produce a comprehensive set of synthesized findings. A total of five research articles met the inclusion criteria and were included in the review. The review process resulted in 46 subcategories that were aggregated into 13 categories. The categories generated four synthesized findings: personal existence; personal learning and development; being a professional fellow human; and clinical learning environment. We meta-synthesized that: Nursing students experienced personal inadequacy, vulnerability and a transformation during their patient care encounter. Copyright © 2018 Elsevier Ltd. All rights reserved.

Chronology of a Successful Conversion--Contractor Revives School Lunch Program.

Science.gov (United States)

Johnston, James B.

1994-01-01

A New York State school district employed a management company to privatize the food-service program with the goal of enticing all students to eat lunch. Expertise in marketing, menu planning, and food-service operation turned the program around. Suggests questions to ask when selecting a management company. (MLF)

Comparing systems for costing hospital treatments. The case of stable angina pectoris.

Science.gov (United States)

Larsen, Jytte; Skjoldborg, Ulla Slothuus

2004-03-01

This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

Risks in hospitals. Assessment and Management

Directory of Open Access Journals (Sweden)

Bradea Ioana-Alexandra

2014-12-01

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?

The Power of Citizens and Professionals in Welfare Encounters

DEFF Research Database (Denmark)

Mik-Meyer, Nanna

relationships with welfare workers. However, other factors impact these interactions; factors which often pull in different directions. Welfare encounters are thus influenced by bureaucratic principles and market values as well. Consequently, this book engages with both Weberian (bureaucracy) and Foucauldian...... (market values/NPM) studies when investigating the powerful welfare encounter. The book is targeted Academics, post-graduates, and undergraduates within sociology, anthropology and political science....

Very massive runaway stars from three-body encounters

Science.gov (United States)

Gvaramadze, Vasilii V.; Gualandris, Alessia

2011-01-01

Very massive stars preferentially reside in the cores of their parent clusters and form binary or multiple systems. We study the role of tight very massive binaries in the origin of the field population of very massive stars. We performed numerical simulations of dynamical encounters between single (massive) stars and a very massive binary with parameters similar to those of the most massive known Galactic binaries, WR 20a and NGC 3603-A1. We found that these three-body encounters could be responsible for the origin of high peculiar velocities (≥70 km s-1) observed for some very massive (≥60-70 M⊙) runaway stars in the Milky Way and the Large Magellanic Cloud (e.g. λ Cep, BD+43°3654, Sk -67°22, BI 237, 30 Dor 016), which can hardly be explained within the framework of the binary-supernova scenario. The production of high-velocity massive stars via three-body encounters is accompanied by the recoil of the binary in the opposite direction to the ejected star. We show that the relative position of the very massive binary R145 and the runaway early B-type star Sk-69°206 on the sky is consistent with the possibility that both objects were ejected from the central cluster, R136, of the star-forming region 30 Doradus via the same dynamical event - a three-body encounter.

An analysis of the cultural problems encountered during caregiving by the nurses working in two different regions of Turkey.

Science.gov (United States)

Kilic, Serap Parlar; Besen, Dilek Buyukkaya; Tokem, Yasemin; Fadiloglu, Cicek; Karadag, Gulendam

2014-06-01

The aim of this study was to identify the cultural problems encountered during caregiving by the nurses working in two university hospitals located in western and eastern Turkey. This descriptive, comparative study was conducted between July 2008 and October 2009 with 338 nurses who volunteered to take part in the study. The study data were collected using an individual description questionnaire consisting of 10 questions and another questionnaire consisting of 14 questions to identify the cultural problems encountered by nurses when giving care. The study showed with respect to training received on transcultural nursing that only 59 nurses had this training, but the percentage was higher in the nurses working at the hospital in the west (54.2%) (P > 0.05). It was found that a large number of nurses in the sample group (n = 286) gave care to at least one individual from another culture, but the percentage was significantly higher in the nurses working in the west (56.7%) than in the nurses working in the east (43.3%) (P cultural characteristics of patients were explored, it was found that they experienced problems mostly in 'communication', and the percentage of those having problems was higher in the nurses working in the west (60.8%) (P > 0.05). The problem experienced in this area was mostly because of the fact that patients 'did not speak Turkish' (63.8%). In conclusion, the nurses gave care to patients from different cultures, and most of them had trouble when giving care to patients from different cultures. © 2013 Wiley Publishing Asia Pty Ltd.

How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors.

Science.gov (United States)

Rosenfeld, Lindsay E; Cohen, Juliana Fw; Gorski, Mary T; Lessing, Andrés J; Smith, Lauren; Rimm, Eric B; Hoffman, Jessica A

2017-02-01

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.

Connection between encounter volume and diffusivity in geophysical flows

Science.gov (United States)

Rypina, Irina I.; Smith, Stefan G. Llewellyn; Pratt, Larry J.

2018-04-01

Trajectory encounter volume - the volume of fluid that passes close to a reference fluid parcel over some time interval - has been recently introduced as a measure of mixing potential of a flow. Diffusivity is the most commonly used characteristic of turbulent diffusion. We derive the analytical relationship between the encounter volume and diffusivity under the assumption of an isotropic random walk, i.e., diffusive motion, in one and two dimensions. We apply the derived formulas to produce maps of encounter volume and the corresponding diffusivity in the Gulf Stream region of the North Atlantic based on satellite altimetry, and discuss the mixing properties of Gulf Stream rings. Advantages offered by the derived formula for estimating diffusivity from oceanographic data are discussed, as well as applications to other disciplines.

Challenges in the professional care encounters

DEFF Research Database (Denmark)

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...

Dialysis Modality and Readmission Following Hospital Discharge: A Population-Based Cohort Study.

Science.gov (United States)

Perl, Jeffrey; McArthur, Eric; Bell, Chaim; Garg, Amit X; Bargman, Joanne M; Chan, Christopher T; Harel, Shai; Li, Lihua; Jain, Arsh K; Nash, Danielle M; Harel, Ziv

2017-07-01

Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. Population-based retrospective-cohort observational study. Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada. For those with multiple hospitalizations, we randomly selected a single hospitalization as the index hospitalization. Dialysis modality PD or in-center HD. Propensity scores were used to match each patient on PD therapy to 2 patients on in-center HD therapy to ensure that baseline indicators of health were similar between the 2 groups. All-cause 30-day readmission following the index hospital discharge. 28,026 dialysis patients were included in the study. 4,013 PD patients were matched to 8,026 in-center HD patients. Among the matched cohort, 30-day readmission rates were 7.1 (95% CI, 6.6-7.6) per 1,000 person-days for patients on PD therapy and 6.0 (95% CI, 5.7-6.3) per 1,000 person-days for patients on in-center HD therapy. The risk for a 30-day readmission among patients on PD therapy was higher compared with those on in-center HD therapy (adjusted HR, 1.19; 95% CI, 1.08-1.31). The primary results were consistent across several key prespecified subgroups. Lack of information for the frequency of nephrology physician encounters following discharge from the hospital in both the PD and in-center HD cohorts. Limited validation of International Classification of Diseases, Tenth Revision codes. The risk for 30-day readmission is higher for patients on home-based PD compared to in-center HD therapy. Interventions to improve transitions in care between the

Attributions of Intentions and Fairness Judgments regarding Interracial Peer Encounters

Science.gov (United States)

Killen, Melanie; Kelly, Megan Clark; Richardson, Cameron; Jampol, Noah Simon

2010-01-01

To investigate how adolescents interpret ambiguous actions in hypothetical interracial peer encounters, we conducted a study in which 8th- and 11th-grade students (N = 837) evaluated 4 interracial peer encounters in which the intentions of the protagonist were ambiguous. The sample was evenly divided by gender and included both African American…

Strengthening student communication through pediatric simulated patient encounters

Directory of Open Access Journals (Sweden)

Ryan Whitt

2014-08-01

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.

Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection.

Science.gov (United States)

Cummings, Keith L; Anderson, Deverick J; Kaye, Keith S

2010-04-01

Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown. To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthcare worker during patient care. Two models were created to simulate sequential patient contacts by a hand hygiene-noncompliant healthcare worker. Model 1 involved encounters with patients of unknown MRSA status. Model 2 involved an encounter with an MRSA-colonized patient followed by an encounter with a patient of unknown MRSA status. The probability of new MRSA infection for the second patient was calculated using published data. A simulation of 1 million noncompliant events was performed. Total costs of resulting infections were aggregated and amortized over all events. Duke University Medical Center, a 750-bed tertiary medical center in Durham, North Carolina. Model 1 was associated with 42 MRSA infections (infection rate, 0.0042%). Mean infection cost was $47,092 (95% confidence interval [CI], $26,040-$68,146); mean cost per noncompliant event was $1.98 (95% CI, $0.91-$3.04). Model 2 was associated with 980 MRSA infections (0.098%). Mean infection cost was $53,598 (95% CI, $50,098-$57,097); mean cost per noncompliant event was $52.53 (95% CI, $47.73-$57.32). A 200-bed hospital incurs $1,779,283 in annual MRSA infection-related expenses attributable to hand hygiene noncompliance. A 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital. Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.

Development of a statewide hospital plan for radiologic emergencies

International Nuclear Information System (INIS)

Dainiak, Nicholas; Delli Carpini, Domenico; Bohan, Michael; Werdmann, Michael; Wilds, Edward; Barlow, Agnus; Beck, Charles; Cheng, David; Daly, Nancy; Glazer, Peter; Mas, Peter; Nath, Ravinder; Piontek, Gregory; Price, Kenneth; Albanese, Joseph; Roberts, Kenneth; Salner, Andrew L.; Rockwell, Sara

2006-01-01

Although general guidelines have been developed for triage of victims in the field and for hospitals to plan for a radiologic event, specific information for clinicians and administrators is not available for guidance in efficient management of radiation victims during their early encounter in the hospital. A consensus document was developed by staff members of four Connecticut hospitals, two institutions of higher learning, and the State of Connecticut Department of Environmental Protection and Office of Emergency Preparedness, with assistance of the American Society for Therapeutic Radiology and Oncology. The objective was to write a practical manual for clinicians (including radiation oncologists, emergency room physicians, and nursing staff), hospital administrators, radiation safety officers, and other individuals knowledgeable in radiation monitoring that would be useful for evaluation and management of radiation injury. The rationale for and process by which the radiation response plan was developed and implemented in the State of Connecticut are reviewed. Hospital admission pathways are described, based on classification of victims as exposed, contaminated, and/or physically injured. This manual will be of value to those involved in planning the health care response to a radiologic event

Drug-related police encounters across the globe: How do they compare?

Science.gov (United States)

Hughes, Caitlin E; Barratt, Monica J; Ferris, Jason A; Maier, Larissa J; Winstock, Adam R

2018-06-01

Drug law enforcement subsumes the majority of drug policy expenditure across the globe. Fuelled by knowledge that much of this investment is ineffective or counter-productive there have been increasing calls for cross-national comparisons to identify where policing approaches differ and what types of approaches may be more effective. Yet, to date cross-national comparison of drug law enforcement has proven a methodologically hazardous affair. Using a new drug policing module added to the 2017 Global Drug Survey, this study seeks to provide the first cross-national comparison of the incidence, nature and intensity of illicit drug-related police encounters amongst people who use drugs. The Global Drug Survey was administered in late 2016. Across 26 countries including Australia, Germany, Italy, Mexico, Switzerland, the UK and the USA a total of 45,942 people who had recently used drugs completed the drug policing module. Key variables assessed included the incidence and frequency of drug-related police encounters in the last 12 months that involved: a) being stopped and searched; b) encountering a drug detection dog; c) being given a caution or warning; d) being charged and arrested; and e) paying a bribe. Multi-level models were used to control for pre-existing national differences in drug use prevalence and non-drug specific policing (including the total number of police personnel in each country). Drug-related police encounters were most commonly reported in Italy and Scotland. Conversely, police encounters were most likely to lead to arrest in Norway, Finland and Sweden. The type and locations of encounters further differed across countries, with for example stop and search most reported in Greece and Colombia, and encounters with drug detection dogs most reported in Scotland, Italy, UK and Australia. Multi-level models showed that the incidence of reported policing encounters continued to differ significantly across countries after controlling for pre

Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review.

NARCIS (Netherlands)

Mistiaen, P.; Francke, A.L.; Poot, E.

2007-01-01

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

Problematics of open prostatectomy in an Ivorian District Hospital setting.

Science.gov (United States)

Mgbakor, Anthony Chukwura

2012-09-01

Benign prostatic hypertrophy forms the bulk of urology workload in many sub-Saharan African hospitals. However, its management in secondary hospitals encounters specific problems that are rarely seen in the bigger tertiary institutions. We have tried to describe these difficulties across an account of open prostatectomy in regional secondary referral hospitals in the Côte d'Ivoire. This is a retrospective account of the specific difficulties encountered in the management of 327 consecutive cases of open prostatectomy carried out between August 1991 and September 2007 mainly in two secondary referral hospitals in the Côte d'Ivoire. The difficulties were at different levels: late presentation with 309 (94.5%) of the patients having experienced at least an episode of acute retention of urine, surgery while most patients were still carrying a catheter, minimal investigations carried out, scoring the patients in the IPSS scale, shortage of funds in the course of the management, and surveillance in the immediate postoperative period. The overall results were relatively satisfactory given our conditions of work. The most frequent complications were wound infection (14.7%), bleeding requiring transfusion (8.6%) and re-operation for clot retention (4.3%). We had a case (0.3%) of the rare prostato-rectal fistula which was managed conservatively. There were 4 deaths (1.2%). Open prostatectomy is the only surgical option for the management of benign prostatic hypertrophy in most of the urology centers of sub-Saharan Africa. Concerning its management away from the Tertiary Institutes, the surgery team is faced with specific problems which demand precise adaptations. Despite difficult working conditions, the results are sufficiently encouraging and gratifying to justify its pursuit while Urologists await the availability of equipments for transurethral resection of the prostate and other novel techniques.

Encounter Group Effects of Soccer Team Performance.

Science.gov (United States)

Magen, Zipora

1980-01-01

Suggests that a positive relationship exists between encounter group experience and the soccer team performance--a conclusion worthy of consideration in further research in the fields of psychology and sociology of sports. (Author)

N-Body simulations of tidal encounters between stellar systems

International Nuclear Information System (INIS)

Rao, P.D.; Ramamani, N.; Alladin, S.M.

1985-10-01

N-Body simulations have been performed to study the tidal effects of a primary stellar system on a secondary stellar system of density close to the Roche density. Two hyperbolic, one parabolic and one elliptic encounters have been simulated. The changes in energy, angular momentum, mass distribution, and shape of the secondary system have been determined in each case. The inner region containing about 40% of the mass was found to be practically unchanged and the mass exterior to the tidal radius was found to escape. The intermediate region showed tidal distension. The thickness of this region decreased as we went from hyperbolic encounters to the elliptic encounter keeping the distance of closest approach constant. The numerical results for the fractional change in energy have been compared with the predictions of the available analytic formulae and the usefulness and limitations of the formulae have been discussed. (author)

[Evolution and follow-up of hunger strikers: experience from an interregional hospital secured unit].

Science.gov (United States)

Dubois, F; Sudre, E; Porte, A; Bédry, R; Gromb, S

2011-11-01

A hunger strike is a voluntary fast, performed to protest publicly against an issue deemed unfair. In the case of French prisoners, hospitalization in an interregional hospital secured units (UHSI) may be necessary. A retrospective epidemiological study based on one UHSI medical records was performed on the period of May, 2006 to December, 2008, and focused on symptoms, outcomes and ethical problems encountered. Seven men and one woman with a mean age of 32.6 years were hospitalized in an UHSI, with nine episodes of hunger strike of a median duration of 57 days. Clinical symptoms began after two weeks of voluntary deprivation in the form of dizziness, weakness, muscle pain and headache. Laboratory tests showed hypoglycemia (hunger strikes. All hunger strikes were respected by medical staff, and treatment was based upon surveillance of symptoms, vitamin B and sweetened drinks administration and explanations of the clinical hazards on a daily basis. The special problem encountered in the medical management of these strikers was to convince them to accept treatments in order to avoid a coercive life-saving treatment as requested by French law. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Caring for homeless persons with serious mental illness in general hospitals.

Science.gov (United States)

Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

2013-01-01

The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Rethinking social identity theory in international encounters:

DEFF Research Database (Denmark)

Lauring, Jakob

2008-01-01

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...... 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...... 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...

AN APPLICATION OF ANALYTIC HIERARCHY PROCESS IN THE HOSPITALITY INDUSTRY

Directory of Open Access Journals (Sweden)

DEMET BAYRAKTAR

2013-05-01

Full Text Available AHP is introduced as a decision making tool for the evaluation of investment alternatives in the hospitality industry. Services are intangible and perishable outputs that are created and consumed simultaneously or nearly simultaneously. The AHP, as a systematic approach that encompasses subjective criteria, alleviates the difficulties encountered in the evaluation of service industry operations. The proposed hierarchical structure in this paper deals with a minor investment project of the holiday village. However, it is possible to extend and apply it for larger investment projects in the hospitality industry as a decision making tool through clustering. Expert Choice for Windows (Version 9.0 is used to solve the decision problem.

Hotspots on Io During the Ganymede 2 Encounter

Science.gov (United States)

1996-01-01

The Near Infrared Mapping Spectrometer (NIMS) on the Galileo spacecraft imaged Io at high spectral resolution at a range of 439,000 km (275,000 miles) during the G2 encounter on 6 September 1996. This image shows, on the right, Io as seen by NIMS, centered on 150 W longitude. The image on the left shows the same view point from Voyager data (from the encounters in 1979 and 1980). The NIMS image can be compared to the NIMS hotspot image from the G1 orbit (June 1996) to monitor changes on Io. The most dramatic feature of the G2 image is the hotspot at Malik Patera. Preliminary analysis of the data yields a temperature of at least 1000 K (727 C) for this hotspot, an increase of more than 300 K from the G1 encounter. In the overlap area of the G1 and G2 images all the hotspots seen during the G1 encounter are also seen in the G2 image. Other hotspots were seen, including one at the Pele plume origin site. This image is at the 4 micron band to best view the Malik hotspot. Most of the other hotspots are best seen at longer wavelengths. NIMS is continuing to observe Io to monitor volcanic activity throughout the Galileo mission.The Jet Propulsion Laboratory, Pasadena, CA manages the mission for NASA's Office of Space Science, Washington, DC.This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov.

TQM and lean strategy deployment in Italian hospitals.

Science.gov (United States)

Chiarini, Andrea; Baccarani, Claudio

2016-10-03

Purpose This paper aims to contribute to the debate concerning total quality management (TQM)-Lean strategy in public healthcare by analyzing the deployment path for implementation, the possible benefits that can be achieved and the encountered pitfalls. Design/methodology/approach Three case studies are drawn from three large Italian hospitals with more than 500 beds each and structured with many departments. The hospitals are located in Tuscany, Italy. These three hospitals have embraced TQM and Lean, starting from strategic objectives and their deployment. At the same time, they have also implemented many TQM-Lean tools. The case studies are based on interviews held with four managers in each of these three public hospitals. Findings Results from the interviews show that there is a specific deployment path for TQM-Lean implementation. The hospitals have also achieved benefits linked to patient satisfaction and improved organizational performances. Problems related to organizational and cultural issues, such as senior managers' commitment, staff management, manufacturing culture and tools adaptation, could affect the benefits. Research limitations/implications The research has been carried out in just three Italian public hospitals. Hence, similar investigations could be managed in other countries. Researchers could also use a larger sample and investigate these issues by means of quantitative inquiry. Practical implications Practitioners could try to apply the deployment path revealed by these case studies in other public and private hospitals. Originality/value The results of this research show that there is a specific, new deployment path for implementing TQM-Lean strategy in some public hospitals.

Pipeline negotiations as a challenging setting for organised cultural encounters

DEFF Research Database (Denmark)

Guerrieri, Valeria

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...... 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...

The way we encounter reading material influences how frequently we mind wander

OpenAIRE

Trish L Varao Sousa; Jonathan S A Carriere; Dan eSmilek

2013-01-01

We examined whether different encounters of reading material influence the likelihood of mind wandering, memory for the material, and the ratings of interest in the material. In a within-subjects design participants experienced three different reading encounters: (1) reading a passage aloud, (2) listening to a passage being read to them, and (3) reading a passage silently. Throughout each reading encounter probes were given in order to identify mind wandering. After finishing the passage part...

Web-based versus face-to-face interprofessional team encounters with standardized patients.

Science.gov (United States)

Lempicki, Kelly A; Holland, Christine S

2018-03-01

Challenges exist in developing interprofessional education (IPE) activities including coordinating schedules and obtaining appropriate space for teams to work. Virtual worlds have been explored as a means to overcome some of these challenges. We sought to develop a web-based interprofessional team interaction with a standardized patient (SP), as compared to a face-to-face SP interaction, focusing on the competency area of interprofessional communication. Interprofessional teams of students were randomized to complete a web-based or face-to-face SP encounter. The web-based encounter was conducted via video conference that students accessed using their own electronic device. Interprofessional communication was evaluated by faculty observers and the SPs. Participants of the web-based encounter also completed a perceptions questionnaire. Interprofessional communication was rated as average/above average by the authors and SPs. Perceptions of the web-based encounter were mixed with not all students willing to complete such an encounter again despite finding it enjoyable and a positive learning experience. The need for adequate preparation was identified, including the opportunity to review the patient case before the encounter. The web-based SP encounter afforded students the opportunity to utilize communication technology to provide patient-centered care while collaborating as an interprofessional team. Video conferencing presents an opportunity to bypass some logistical challenges in scheduling IPE experiences and can be implemented as a co-curricular activity, avoiding course revisions. Additional studies are needed to further explore student and patient perspectives and clarify when, and with what level of trainees, the experiences are most valuable. Copyright © 2017 Elsevier Inc. All rights reserved.

Moral Relations in Encounters with Nature

Science.gov (United States)

Andersson, Karin; Öhman, Johan

2015-01-01

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…

Oil spill encounter rate: A means of estimating advancing skimmer performance

International Nuclear Information System (INIS)

Schulze, R.

1993-01-01

A high rate of oil spill recovery can only be achieved if the spilled oil can be collected fast enough for the skimming and pumping systems to operate at their rated capacity. For advancing skimmers, recovery capacity depends on the rate at which the skimming system encounters the oil slick. For these systems, encounter rate depends on skimming speed, sweep width, and the amount of oil available, in this case measured in terms of slick thickness. The computation of the spill encounter rate is described, and a chart is provided that permits the user to determine encounter rate for candidate skimming systems by inspection. Furthermore, a contingency planning worksheet for advancing skimmers is provided that allows the user to evaluate a particular response system. The resulting data can be used to determine the oil slick area that can be covered in a period of time, the volume of oil that can be expected to be recovered in that time based on oil spill planning scenarios, the pumping capacity required for skimming and transfer systems, and the storage requirements for recovered oil. Finally, suggestions are presented on how computations of oil spill encounter rate can be used to make important decisions in procuring advancing skimmers for specific applications. 1 fig., 1 tab

Encountering spiritual tourism in Kathmandu

OpenAIRE

Børø, Nora

2015-01-01

Spiritual tourism as a phenomenon is increasing worldwide. Many have conducted research looking at the intersection between religion and tourism, but few have focused on the host community within these encounters. Many Western tourists arrive in Kathmandu to go on retreats', and to participate in yoga and meditation classes. The majority of these are particularly interested in various forms of Buddhist practice and traditions. In this thesis I have studied how N...

Protoplanetary disc response to distant tidal encounters in stellar clusters

Science.gov (United States)

Winter, A. J.; Clarke, C. J.; Rosotti, G.; Booth, R. A.

2018-04-01

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 contextualize 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.

Domestic Violence Encountered among Kurdish Women

Science.gov (United States)

Ali, Sirwan Kamil

2015-01-01

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…

Encounters on a Shape-changing Bench

DEFF Research Database (Denmark)

Kinch, Sofie; Grönvall, Erik; Petersen, Marianne Graves

2014-01-01

; 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...

Coprophagia in an 8-Year-Old Hospitalized Patient: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Aleksandra Bacewicz

2017-01-01

Full Text Available Consult-liaison psychiatrists often encounter difficult clinical scenarios. We present a pediatric case of presumptive coprophagia. After a negative medical work-up, the pediatrics team asked psychiatry to assist them in managing this relatively rare disorder in the hospital setting. Little is known about the etiology and treatment of coprophagia in the pediatric population. Using the case as a catalyst, we discuss what is known about this disorder as well as treatment strategies in the hospital setting.

Evaluation of the appropriate use of a CIWA-Ar alcohol withdrawal protocol in the general hospital setting.

Science.gov (United States)

Eloma, Amanda S; Tucciarone, Jason M; Hayes, Edmund M; Bronson, Brian D

2018-01-01

The Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar) is an assessment tool used to quantify alcohol withdrawal syndrome (AWS) severity and inform benzodiazepine treatment for alcohol withdrawal. To evaluate the prescribing patterns and appropriate use of the CIWA-Ar protocol in a general hospital setting, as determined by the presence or absence of documented AWS risk factors, patients' ability to communicate, and provider awareness of the CIWA-Ar order. This retrospective chart review included 118 encounters of hospitalized patients placed on a CIWA-Ar protocol during one year. The following data were collected for each encounter: patient demographics, admitting diagnosis, ability to communicate, and admission blood alcohol level; and medical specialty of the clinician ordering CIWA-Ar, documentation of the presence or absence of established AWS risk factors, specific parameters of the protocol ordered, service admitted to, provider documentation of awareness of the active protocol within 48 h of initial order, total benzodiazepine dose equivalents administered and associated adverse events. 57% of patients who started on a CIWA-Ar protocol had either zero or one documented risk factor for AWS (19% and 38% respectively). 20% had no documentation of recent alcohol use. 14% were unable to communicate. 19% of medical records lacked documentation of provider awareness of the ordered protocol. Benzodiazepine associated adverse events were documented in 15% of encounters. The judicious use of CIWA-Ar protocols in general hospitals requires mechanisms to ensure assessment of validated alcohol withdrawal risk factors, exclusion of patients who cannot communicate, and continuity of care during transitions.

Self. Propagating | a strategy of encounter |

Directory of Open Access Journals (Sweden)

Gabrielle Lorraine Fletcher

2015-11-01

Full Text Available This piece mobilises both creative non-fiction and ficto-criticism to expose the necessary terrains of narrativity as a Country of the Lived,  making visible the redactive cartography of the PhD in telling Indigenous selfhood, and mobilising an argument for authentic encounter under the comfortable maps of form.

Quantification classification and management of hospital waste in Lahore city

International Nuclear Information System (INIS)

Khan, M.R.; Riaz, M

2010-01-01

Systematic disposal of hospital waste is a major problem encountered by different countries including Pakistan. Efforts are on the way to achieve this objective techno-economically. To quantify infectious and total waste produced by the hospitals of Lahore, classify it to know the nature of their components and to collect information about its management. The background information and secondary data were collected by consultation of literature in the libraries and visiting different websites on Internet. The primary data were collected by gathering the responses of the Chief Executives, Medical Superintendents and Medical and Environmental Staff of all hospitals scheduled as reference models through interview. The total quantity of infectious waste produced by the hospitals and other health care units is approximately 785 million tons per annum while the total waste including municipal component is approximately 3,925 million tons per annum. The current status of awareness about proper health care waste disposal is improving but at a slow pace. It may be concluded that the management of hospital waste in five hospitals of Lahore city is systematic. However, the staff handling the waste was not fully trained for proper segregation of the hospital wastes. Incinerators being used for waste disposal are a major source of secondary air pollution therefore, this method should be discouraged. Instead, the feasibility of thermoelectric power generation may be looked into. Proper disposal of hospital wastes should be in placed in every hospital and trained staff should be employed for the job. (author)

BodyHeat Encounter: Performing Technology in Pedagogical Spaces of Surveillance/Intimacy

Science.gov (United States)

Fels, Lynn; Ricketts, Kathryn

2015-01-01

What occurs when videographer and performer encounter each other through the lens of a camera? This collaborative performative inquiry focuses on embodiment and emergent narrative as realized through an encounter between technology and the visceral body--a relational body that smells, touches, sees, hears and feels the emergent world through…

Solid waste management in the hospitality industry: a review.

Science.gov (United States)

Pirani, Sanaa I; Arafat, Hassan A

2014-12-15

Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

Acquisition of an Underway CTD System for the Flow Encountering Abrupt Topography DRI

Science.gov (United States)

2015-09-30

Acquisition of an Underway CTD System for the Flow Encountering Abrupt Topography DRI T. M. Shaun Johnston Scripps Institution of Oceanography...westward flow in the North Equatorial Current (NEC) encounters tall, steep, submarine topography and islands. During the Flow Encountering Abrupt... Topography (FLEAT) DRI, investigators will determine: • Whether appreciable energy/momentum is lost from the large-scale NEC flow to smaller scales and

Satisfaction with the outpatient encounter - A comparison of patients' and physicians' views

NARCIS (Netherlands)

Zandbelt, Linda C.; Smets, Ellen M. A.; Oort, Frans J.; Godfried, Mieke H.; de Haes, Hanneke C. J. M.

2004-01-01

OBJECTIVE: To compare patients' and physicians' visit-specific satisfaction in an internal medicine outpatient setting, and to explain their respective views. DESIGN: Patients' and physicians' background characteristics were assessed prior to outpatient encounters. Immediately after the encounter,

Users’ encounter with normative discourses on Facebook

DEFF Research Database (Denmark)

Mathieu, David

2016-01-01

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...... of texts and audiences. Based on a critique of the “participatory paradigm,” a paradigm that situates the locus of agency in the structural opposition between senders and users, in the norms of rational deliberation or in the figure of the activist, gaps are identified which can be filled by adopting...... 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...

Mobbing behaviors encountered by nurse teaching staff.

Science.gov (United States)

Yildirim, Dilek; Yildirim, Aytolan; Timucin, Arzu

2007-07-01

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'.

Effects of Soundscapes on Perceived Crowding and Encounter Norms

Science.gov (United States)

Kim, Sang-Oh; Shelby, Bo

2011-07-01

Soundscapes in recreation settings are becoming an important issue, but there are few studies of the effects of sounds on recreation experiences, especially crowding perceptions and encounter norms. This study compared effects of six types of sounds (an airplane, a truck engine, children playing, birds, water, and a control) on perceived crowding (PC) and encounter norms for hikers. Data were collected from 47 college students through lab experiments using simulated images, with moving hikers inserted in the original photo taken in the Jungmeori area of Mudeungsan Provincial Park in Korea. Overall, the motor-made sounds of the airplane and truck engine increased PC and decreased acceptability ratings, and the natural sounds of birds and water decreased PC and increased acceptability ratings. Ratings of the sound of children playing were similar to those in the control (i.e., no sound). In addition, as numbers of hikers increased, the overall effects of sounds decreased, and there were few significant differences in PC or acceptability ratings at the highest encounter levels. Theoretical and methodological implications are discussed.

Feminist Encounters with Evolutionary Psychology

OpenAIRE

O'Neill, Rachel

2016-01-01

This Section of Australian Feminist Studies is the product of an event that took place at King’s College London in January 2015, hosted as part of the UK-based ‘Critical Sexology’ seminar series. Participants at this event – feminist scholars working across the fields of lin- guistics, cultural studies, sociology, and psychology – were invited to reflect on their encounters with evolutionary psychology (EP). As the event organiser, I was interested to prompt a discussion about how EP shapes t...

Estimating migratory connectivity of birds when re-encounter probabilities are heterogeneous

Science.gov (United States)

Cohen, Emily B.; Hostelter, Jeffrey A.; Royle, J. Andrew; Marra, Peter P.

2014-01-01

Understanding the biology and conducting effective conservation of migratory species requires an understanding of migratory connectivity – the geographic linkages of populations between stages of the annual cycle. Unfortunately, for most species, we are lacking such information. The North American Bird Banding Laboratory (BBL) houses an extensive database of marking, recaptures and recoveries, and such data could provide migratory connectivity information for many species. To date, however, few species have been analyzed for migratory connectivity largely because heterogeneous re-encounter probabilities make interpretation problematic. We accounted for regional variation in re-encounter probabilities by borrowing information across species and by using effort covariates on recapture and recovery probabilities in a multistate capture–recapture and recovery model. The effort covariates were derived from recaptures and recoveries of species within the same regions. We estimated the migratory connectivity for three tern species breeding in North America and over-wintering in the tropics, common (Sterna hirundo), roseate (Sterna dougallii), and Caspian terns (Hydroprogne caspia). For western breeding terns, model-derived estimates of migratory connectivity differed considerably from those derived directly from the proportions of re-encounters. Conversely, for eastern breeding terns, estimates were merely refined by the inclusion of re-encounter probabilities. In general, eastern breeding terns were strongly connected to eastern South America, and western breeding terns were strongly linked to the more western parts of the nonbreeding range under both models. Through simulation, we found this approach is likely useful for many species in the BBL database, although precision improved with higher re-encounter probabilities and stronger migratory connectivity. We describe an approach to deal with the inherent biases in BBL banding and re-encounter data to demonstrate

Scientific misconduct encountered by APAME journals: an online survey.

Science.gov (United States)

Looi, Lai-Meng; Wong, Li Xuan; Koh, Cing Chai

2015-12-01

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.

Choosing a language in international office service encounters

DEFF Research Database (Denmark)

Hazel, Spencer

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...... to a multimodal interaction analysis following the ethnomethodological tradition of Conversation Analysis. Gafaranga, J. (2000). Medium repair vs. other-language repair: Telling the medium of a bilingual conversation. International Journal of Bilingualism, 4(3), 327-350. Hall, J. K., Hellermann, J., & Pekarek...... Preisler (eds.) Language alternation, language choice and language encounter in international education. Dordrecht: Springer Preisler, Bent, Ida Klitgård, and Anne H. Fabricius. (2011). Language and learning in the international university: from English uniformity to diversity and hybridity. Bristol...

Stereotype threat and racial differences in citizens' experiences of police encounters.

Science.gov (United States)

Najdowski, Cynthia J; Bottoms, Bette L; Goff, Phillip Atiba

2015-10-01

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).

THE RINGS OF CHARIKLO UNDER CLOSE ENCOUNTERS WITH THE GIANT PLANETS

Energy Technology Data Exchange (ETDEWEB)

Araujo, R. A. N.; Sfair, R.; Winter, O. C., E-mail: ran.araujo@gmail.com, E-mail: rsfair@feg.unesp.br, E-mail: ocwinter@gmail.com [UNESP - Univ. Estadual Paulista, Grupo de Dinâmica Orbital e Planetologia, CEP 12516-410, Guaratingueta, SP (Brazil)

2016-06-20

The Centaur population is composed of minor bodies wandering between the giant planets that frequently perform close gravitational encounters with these planets, leading to a chaotic orbital evolution. Recently, the discovery of two well-defined narrow rings was announced around the Centaur 10199 Chariklo. The rings are assumed to be in the equatorial plane of Chariklo and to have circular orbits. The existence of a well-defined system of rings around a body in such a perturbed orbital region poses an interesting new problem. Are the rings of Chariklo stable when perturbed by close gravitational encounters with the giant planets? Our approach to address this question consisted of forward and backward numerical simulations of 729 clones of Chariklo, with similar initial orbits, for a period of 100 Myr. We found, on average, that each clone experiences during its lifetime more than 150 close encounters with the giant planets within one Hill radius of the planet in question. We identified some extreme close encounters that were able to significantly disrupt or disturb the rings of Chariklo. About 3% of the clones lose their rings and about 4% of the clones have their rings significantly disturbed. Therefore, our results show that in most cases (more than 90%), the close encounters with the giant planets do not affect the stability of the rings in Chariklo-like systems. Thus, if there is an efficient mechanism that creates the rings, then these structures may be common among these kinds of Centaurs.

Readiness to implement Hazard Analysis and Critical Control Point (HACCP) systems in Iowa schools.

Science.gov (United States)

Henroid, Daniel; Sneed, Jeannie

2004-02-01

To evaluate current food-handling practices, food safety prerequisite programs, and employee knowledge and food safety attitudes and provide baseline data for implementing Hazard Analysis and Critical Control Point (HACCP) systems in school foodservice. One member of the research team visited each school to observe food-handling practices and assess prerequisite programs using a structured observation form. A questionnaire was used to determine employees' attitudes, knowledge, and demographic information. A convenience sample of 40 Iowa schools was recruited with input from the Iowa Department of Education. Descriptive statistics were used to summarize data. One-way analysis of variance was used to assess differences in attitudes and food safety knowledge among managers, cooks, and other foodservice employees. Multiple linear regression assessed the relationship between manager and school district demographics and the food safety practice score. Proper food-handling practices were not being followed in many schools and prerequisite food safety programs for HACCP were found to be inadequate for many school foodservice operations. School foodservice employees were found to have a significant amount of food safety knowledge (15.9+/-2.4 out of 20 possible points). School districts with managers (P=.019) and employees (P=.030) who had a food handler certificate were found to have higher food safety practice scores. Emphasis on implementing prerequisite programs in preparation for HACCP is needed in school foodservice. Training programs, both basic food safety such as ServSafe and HACCP, will support improvement of food-handling practices and implementation of prerequisite programs and HACCP.

Boundary Transgressions: An Issue In Psychotherapeutic Encounter ...

African Journals Online (AJOL)

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 ...

Impacts of market and organizational characteristics on hospital efficiency and uncompensated care.

Science.gov (United States)

Hsieh, Hui-Min; Clement, Dolores G; Bazzoli, Gloria J

2010-01-01

Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.

Comparing Indications for Cardiovascular Admissions into a Nigerian and an Israeli Hospital

Science.gov (United States)

Ukpabi, Ogba Joseph; Uwanurochi, Kelechukwu

2017-01-01

Background: Changing epidemiologic profile with increase in cardiovascular risk factors is well documented in literature. Our study sought to see how this is reflected in cardiovascular admissions into medical wards of a Nigerian and an Israeli hospital. Objective: To compare the range and pattern of cardiovascular admissions encountered in a Nigerian hospital and an Israel hospital. Methods: This was a retrospective study of admission records of patients admitted into both Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria, and Sheba Medical Centre, Israel. Results: Ischemic heart disease (IHD) was the most prevalent among the Israeli hospital's admissions but ranks very low as an indication for admission in Nigeria. The most common causes of admission in Nigeria were hypertension and heart failure (HF). The spectrum of cardiovascular diseases (CVDs) was very limited in the Nigerian hospital, indicating disparity in diagnostic capacity. Conclusion: There were more patients with CVD as a cause of medical admission in the Israel hospital as compared to the Nigerian hospital. Hypertension and HF were prevalent indications for CVD in FMC, Umuahia, Nigeria, while hypertension and IHD were the prevalent indications for admission in Sheba Medical Centre, Israel. Future studies are needed to monitor spectrum and frequency of cardiovascular admissions in view of evolving epidemiological transition in developing countries. PMID:28469120

Interfaith dialogue as moral encounter

DEFF Research Database (Denmark)

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...... between Muslims and Christians and analyse the different moral orders involved and how – following these orders – the participants are expected to deal with differences. Main focus is on how the participants are expected to deal with a requirement of staying the same (as Christian or Muslim) while...

Special relativity a first encounter

CERN Document Server

Giulini, Domenico

2005-01-01

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

Value Encounters - Modeling and Analyzing Co-creation of Value

Science.gov (United States)

Weigand, Hans

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.

Storyboard GALILEO CRUISE SCIENCE OPPORTUNITIES describes asteroid encounters

Science.gov (United States)

1989-01-01

Storyboard with mosaicked image of an asteroid and entitled GALILEO CRUISE SCIENCE OPPORTUNITIES describes asteroid objectives. These objectives include: first asteroid encounter; surface geology, composition size, shape, mass; and relation of primitive bodies to meteorites.

Nature and frequency of exchanges on medications during primary care encounters.

Science.gov (United States)

Richard, Claude; Lussier, Marie-Thérèse

2006-12-01

To describe the exchanges, related to discussion of all medications during primary care medical consultations. Descriptive study of audio recordings of 422 medical encounters. Coding was done with MEDICODE, a validated instrument developed to analyse verbal exchanges on medications. The unit of analysis is the medication. An average of 3.9 medications (S.D.=2.8; range 1-21) are discussed per interview and 4.2 themes are broached for each drug (S.D.=2.6; range 1-17). "Active Discussed", "Represcribed" and "Newly Prescribed" drugs account for 43.1, 16.3 and 10.6%, respectively of all medications discussed. Themes most often discussed are Name, Instructions, Observed Main Effect, Class, Reasons for Taking the Drug, General Use of the Medication, Expected Effect on Symptoms, Form of the Medication, Indications Another Consultation Needed, and Alternative Medication. The least often discussed themes include clinically significant ones such as Possible Adverse Effects, Observed Adverse Effects, Expression of Attitudes and Emotions with regard to the medication, Compliance and Warnings. The average number of themes discussed differed between medications that were prescribed during the encounter, either New prescriptions or Represcribed drugs, compared to medications that were only discussed during the encounter. Our results show that medication discussions are heterogeneous and vary with the status of the medication and the theme. Also, the nature and extent of the discussions about medications do not support the shared-decision making model. Though it is too soon to make specific recommendations about discussions on medications, it seems clear that information-sharing about medications during medical encounters is a process that extends beyond any single encounter. Although communication skills are now part of most medical curriculums, there is an obvious need to put forth the concept of patient medication knowledge-building over multiple physician-patient encounters and

Hyperglycemia and in-hospital outcomes after first myocardial infarction

International Nuclear Information System (INIS)

Khan, A.N.; Ambreen, F.; Qureshi, I.Z.

2006-01-01

To determine in-hospital outcomes post AMI hyperglycemia. 109 patients of acute myocardial infarction were included in this study. Physical examination, ECG tracings, random plasma glucose, serum cholesterol, triglycerides and cardiac enzymes (CPK, LDH and AST) were measured. Hyperglycemic patients (plasma glucose 126 mg/dl) were sub-divided into those with a previous history of diabetes and those without any such history. Post AMI plasma glucose levels were exceptionally higher in female patients aged 61-70 years while they were moderately higher in males of age groups 31-40 and 51-60, and females of age group 41-50 years. In-hospital mortality rate was greater in hyperglycemic patients. Most importantly also, significantly greater complications of the heart were encountered in hyperglycemics. Post AMI patients are at a greater risk of developing diabetes and concurrent AMI attack. (author)

Clinical parameters and challenges of managing cervicofacial necrotizing fasciitis in a Sub-Saharan tertiary hospital

Directory of Open Access Journals (Sweden)

Adeola A Olusanya

2015-01-01

Full Text Available Introduction: Necrotizing fasciitis is a severe soft tissue infection. In our environment, patients presenting with this infection are usually financially incapacitated and, therefore, their management can be challenging. This paper aimed to document the pattern and challenges encountered in the management of cervicofacial necrotizing fasciitis (CNF in the University College Hospital, Ibadan. Materials and Methods: Information such as biodata, site of infection, systemic conditions, widest span of defect, management provided, hospital stay, and outcome of management was prospectively collected on all patients with CNF who presented at the Department of Oral and Maxillofacial Surgery between January 2007 and December 2013. The patients were managed according to a devised protocol of antibiotic therapy, serial debridement and honey dressings. Results: Twenty-four cases of CNF were seen. There were 9 males and 15 females while 70.9% of the patients belonged to the low socioeconomic class. The mean span of wound defect was 12.2 (±8.844 cm. The mean hospital stay was 27.8 (±23.1 days, and scar formation was the most common complication encountered. Conclusion: Our study represents the largest series of CNF from a Nigerian health facility presently. The management of necrotizing fascitis in the maxillofacial region poses a significant challenge to both the surgeon and the patient. However, the mortality rate of CNF in our center appears comparatively low.

Toward a new paradigm in hospital-based pediatric education: the development of an onsite simulator program.

Science.gov (United States)

Weinstock, Peter H; Kappus, Liana J; Kleinman, Monica E; Grenier, Barry; Hickey, Patricia; Burns, Jeffrey P

2005-11-01

The low incidence of crises in pediatrics, coupled with logistic issues and restricted work hours for trainees, hinders opportunities for frequent practice of crisis management and teamwork skills. We hypothesized that a dedicated simulator suite contiguous to the intensive care unit (ICU) would enhance the frequency and breadth of critical-incident training for a range of clinicians. Descriptive study. A tertiary-care pediatric teaching hospital. A realistic pediatric simulator suite was constructed 100 feet from the ICU, at a total base cost of $290,000. The simulation room is an exact replica of an ICU bed space, incorporating high-fidelity mannequin simulators. To capture an even wider audience, a portable unit was also created. Leaders from seven departments-critical care, cardiac intensive care, emergency medicine, transport medicine, anesthesia, respiratory care, and general pediatrics-completed instructor training to ensure effective debriefing techniques. Pediatric staff, including 100% of critical care fellows, 86% of nurses, 90% of respiratory therapists, and 74% of pediatric house staff, participated in >1500 learning encounters per year. All individuals were trained during their normal workday in the hospital. Courses in crisis resource management, skills acquisition, annual review, orientation, and trauma management (1,116, 98, 90, 60, and 60 encounters per year, respectively) were all designed by a multidisciplinary committee to ensure goal-directed education to a range of audiences. Annual costs were on par with those at other centers (approximately 44 dollars per trainee encounter). An onsite and comprehensive simulation program can significantly increase the opportunities for clinicians from multiple disciplines, in the course of their daily routines, to repetitively practice responses to pediatric medical crises. After an initial capital investment, the training appears to be cost-effective. Hospital-based simulator suites may point the way

Multiple Codes, Multiple Impressions: An Analysis of Doctor-Client Encounters in Nigeria

Science.gov (United States)

Odebunmi, Akin

2013-01-01

Existing studies on doctor-client interactions have largely focused on monolingual encounters and the interactional effects and functions of the languages used in the communication between doctors and their clients. They have neither, to a large extent, examined the several codes employed in single encounters and their pragmatic roles nor given…

Avoidance: From threat encounter to action execution

NARCIS (Netherlands)

Arnaudova, I.

2015-01-01

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

Entering a Crack: An Encounter with Gossip

Science.gov (United States)

Henderson, Linda

2014-01-01

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.…

Pharmacy users' expectations of pharmacy encounters: a Q-methodological study.

Science.gov (United States)

Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Asa; Tully, Mary P

2011-12-01

Pharmacy practice is evolving according to general health-care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients' expectations of service encounters at pharmacies is an under-explored topic but crucial to understanding how pharmacy practice can evolve efficiently. To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Eighty-five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual's own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health-care and lifestyle support. The systematic Q-methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients' expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. © 2010 Blackwell Publishing Ltd.

Avoiding humiliations in the clinical encounter.

Science.gov (United States)

Malterud, Kirsti; Hollnagel, Hanne

2007-06-01

To explore potentials for avoiding humiliations in clinical encounters, especially those that are unintended and unrecognized by the doctor. Furthermore, to examine theoretical foundations of degrading behaviour and identify some concepts that can be used to understand such behaviour in the cultural context of medicine. Finally, these concepts are used to build a model for the clinician in order to prevent humiliation of the patient. Empirical studies document experiences of humiliation among patients when they see their doctor. Philosophical and sociological analysis can be used to explain the dynamics of unintended degrading behaviour between human beings. Skjervheim, Vetlesen, and Bauman have identified the role of objectivism, distantiation, and indifference in the dynamics of evil acts, pointing to the rules of the cultural system, rather than accusing the individual of bad behaviour. Examining the professional role of the doctor, parallel traits embedded in the medical culture are demonstrated. According to Vetlesen, emotional awareness is necessary for moral perception, which again is necessary for moral performance. A better balance between emotions and rationality is needed to avoid humiliations in the clinical encounter. The Awareness Model is presented as a strategy for clinical practice and education, emphasizing the role of the doctor's own emotions. Potentials and pitfalls are discussed.

Apology of Immigrant Literature: Toward a Planetary Hospitality?

Directory of Open Access Journals (Sweden)

Meiss, Paula

2010-01-01

Full Text Available This paper suggests the possibility of making use of the narrative of migration as the object of study of a comparatist discipline that takes into account Armando Gnisci’s considerations on hospitality, as well as Gayatri Spivak’s on planetarity and comparative literature. In this sense, the paper aims at suggesting a possible line of research en comparative literature that needs not rely on the concept of national literature to be developed. The analysis of the narrative of migration, through a series of variables well recognised in travel literature, allows both in form and contents a comparatism of the encounter.

Estimating the encounter rate variance in distance sampling

Science.gov (United States)

Fewster, R.M.; Buckland, S.T.; Burnham, K.P.; Borchers, D.L.; Jupp, P.E.; Laake, J.L.; Thomas, L.

2009-01-01

The dominant source of variance in line transect sampling is usually the encounter rate variance. Systematic survey designs are often used to reduce the true variability among different realizations of the design, but estimating the variance is difficult and estimators typically approximate the variance by treating the design as a simple random sample of lines. We explore the properties of different encounter rate variance estimators under random and systematic designs. We show that a design-based variance estimator improves upon the model-based estimator of Buckland et al. (2001, Introduction to Distance Sampling. Oxford: Oxford University Press, p. 79) when transects are positioned at random. However, if populations exhibit strong spatial trends, both estimators can have substantial positive bias under systematic designs. We show that poststratification is effective in reducing this bias. ?? 2008, The International Biometric Society.

Hospital-Based Physicians' Intubation Decisions and Associated Mental Models when Managing a Critically and Terminally Ill Older Patient.

Science.gov (United States)

Haliko, Shannon; Downs, Julie; Mohan, Deepika; Arnold, Robert; Barnato, Amber E

2018-04-01

Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the interviews. We then used Kruskal-Wallis tests to compare the weighted mental model themes of physicians who provided preference-concordant treatment with those who provided preference-discordant treatment. Sixty-six (90%) physicians provided preference-concordant treatment and 7 (10%) provided preference-discordant treatment (i.e., they intubated the patient). Physicians who intubated the patient were more likely to emphasize the reversible and emergent nature of the patient situation (z = -2.111, P = 0.035), their own comfort (z = -2.764, P = 0.006), and rarely focused on explicit patient preferences (z = 2.380, P = 0.017). Post-decisional interviewing with audio/video prompting may induce hindsight bias. The expert model has not yet been validated and may not be exhaustive. The small sample size limits generalizability and power. Hospital-based physicians providing preference-discordant used a different mental model for decision making for a critically and terminally ill simulated case. These differences may offer targets for future interventions to promote preference-concordant care for seriously ill patients.

Resource-driven encounters among consumers and implications for the spread of infectious disease

Science.gov (United States)

Flynn, Jason M.

2017-01-01

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

Islamic Canon law encounters South African financing and banking ...

African Journals Online (AJOL)

Islamic Canon law encounters South African financing and banking institutions: Prospects and possibilities for Islamic economic empowerment and Black Economic Empowerment in a Democratic South Africa.

Use, misuse and extensions of "ideal gas" models of animal encounter.

Science.gov (United States)

Hutchinson, John M C; Waser, Peter M

2007-08-01

Biologists have repeatedly rediscovered classical models from physics predicting collision rates in an ideal gas. These models, and their two-dimensional analogues, have been used to predict rates and durations of encounters among animals or social groups that move randomly and independently, given population density, velocity, and distance at which an encounter occurs. They have helped to separate cases of mixed-species association based on behavioural attraction from those that simply reflect high population densities, and to detect cases of attraction or avoidance among conspecifics. They have been used to estimate the impact of population density, speeds of movement and size on rates of encounter between members of the opposite sex, between gametes, between predators and prey, and between observers and the individuals that they are counting. One limitation of published models has been that they predict rates of encounter, but give no means of determining whether observations differ significantly from predictions. Another uncertainty is the robustness of the predictions when animal movements deviate from the model's assumptions in specific, biologically relevant ways. Here, we review applications of the ideal gas model, derive extensions of the model to cover some more realistic movement patterns, correct several errors that have arisen in the literature, and show how to generate confidence limits for expected rates of encounter among independently moving individuals. We illustrate these results using data from mangabey monkeys originally used along with the ideal gas model to argue that groups avoid each other. Although agent-based simulations provide a more flexible alternative approach, the ideal gas model remains both a valuable null model and a useful, less onerous, approximation to biological reality.

[Hospital costs estimation by micro and gross-costing approaches].

Science.gov (United States)

Guerre, P; Hayes, N; Bertaux, A-C

2018-03-01

Cost analysis has become increasingly commonplace in healthcare facilities in recent years. Regardless of the aim, the first consideration for a hospital costing process is to determine the point of view, or perspective, to adopt. Should the cost figures reflect the healthcare facility's point of view or enlighten perspectives for the public health insurance system? Another consideration is in regard to the method to adopt, as there are several. The two most widely used methods to determine the costs of hospital treatments in France are the micro-costing method and the gross-costing method. The aims of this work are: (1) to describe each of these methods (e.g. data collection, assignment of monetary value to resource consumption) with their advantages and shortcomings as they relate to the difficulties encountered with their implementation in hospitals; (2) to present a review of the literature comparing the two methods and their possible combination; and (3) to propose ways to address the questions that need to be asked before compiling resource consumption data and assigning monetary value to hospital costs. A final diagram summarizes methodologies to be preferred according to the evaluation strategy and the impact on patient care. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Designing new collaborative learning spaces in clinical environments: experiences from a children's hospital in Australia.

Science.gov (United States)

Bines, Julie E; Jamieson, Peter

2013-09-01

Hospitals are complex places that provide a rich learning environment for students, staff, patients and their families, professional groups and the community. The "new" Royal Children's Hospital opened in late 2011. Its mission is focused on improving health and well-being of children and adolescents through leadership in healthcare, research and education. Addressing the need to create "responsive learning environments" aligned with the shift to student-centred pedagogy, two distinct learning environments were developed within the new Royal Children's Hospital; (i) a dedicated education precinct providing a suite of physical environments to promote a more active, collaborative and social learning experience for education and training programs conducted on the Royal Children's Hospital campus and (ii) a suite of learning spaces embedded within clinical areas so that learning becomes an integral part of the daily activities of this busy Hospital environment. The aim of this article is to present the overarching educational principles that lead the design of these learning spaces and describe the opportunities and obstacles encountered in the development of collaborative learning spaces within a large hospital development.

Benefits of an ISO 9001 certification--the case of a Swiss regional hospital.

Science.gov (United States)

Staines, A

2000-01-01

This paper reports the experience of a quality management project leading to an ISO 9001 certification in a Swiss regional hospital. It describes the motivations for the project, the process that was followed and the benefits of the approach. It also shows its limitations, problems encountered as well as costs and resources involved. The emphasis is on practical issues. Choices that were made are discussed and lessons are drawn.

A Survey Instrument for Measuring the Experiential Value of Employee-Tourist Encounters

DEFF Research Database (Denmark)

Mattsson, Jan; Sørensen, Flemming; Jensen, Jens Friis

In this paper, we develop and test a survey instrument that aims at estimating the experiential value of employee-tourist encounters in destination-based tourism companies, as well as the characteristics of encounters that affect such experiential value. We suggest that such an instrument can...... for their visitors, rather than simply delivering service quality....

Psychiatric units in Brazilian general hospitals: a growing philanthropic field.

Science.gov (United States)

Botega, Neury José

2002-06-01

Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations

Science.gov (United States)

Hantel, Andrew; Wroblewski, Kristen; Balachandran, Jay S.; Chow, Selina; DeBoer, Rebecca; Fleming, Gini F.; Hahn, Olwen M.; Kline, Justin; Liu, Hongtao; Patel, Bhakti K.; Verma, Anshu; Witt, Leah J.; Fukui, Mayumi; Kumar, Aditi; Howell, Michael D.; Polite, Blase N.

2016-01-01

Purpose: Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. Methods: This was a retrospective case series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Results: Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Conclusion: Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care. PMID:27601514

Patient-provider interaction during medication encounters: A study in outpatient pharmacies in the Netherlands.

Science.gov (United States)

Koster, Ellen S; van Meeteren, Marijke M; van Dijk, Marloes; van de Bemt, Bart J F; Ensing, Hendrikus T; Bouvy, Marcel L; Blom, Lyda; van Dijk, Liset

2015-07-01

To describe communication between pharmacy staff and patients at the counter in outpatient pharmacies. Both content and communication style were investigated. Pharmaceutical encounters in three outpatient pharmacies in the Netherlands were video-recorded. Videos were analyzed based on an observation protocol for the following information: content of encounter, initiator of a theme and pharmacy staff's communication style. In total, 119 encounters were recorded which concerned 42 first prescriptions, 16 first refill prescriptions and 61 follow-up refill prescriptions. During all encounters, discussion was mostly initiated by pharmacy staff (85%). In first prescription encounters topics most frequently discussed included instructions for use (83%) and dosage instructions (95%). In first refill encounters, patient experiences such as adverse effects (44%) and beneficial effects (38%) were regularly discussed in contrast to follow-up refills (7% and 5%). Patients' opinion on medication was hardly discussed. Pharmacy staff in outpatient pharmacies generally provide practical information, less frequently they discuss patients' experiences and seldom discuss patients' perceptions and preferences about prescribed medication. This study shows there is room for improvement, as communication is still not according to professional guidelines. To implement professional guidelines successfully, it is necessary to identify underlying reasons for not following the guidelines. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Reality of Encounters with Local Life in Other Cultures

Directory of Open Access Journals (Sweden)

Jin-Young Kim

2017-12-01

Full Text Available Equipped with mobile technologies, travelers increasingly seek opportunities to encounter the real lives of the people residing in the focal destination. With this trend of pursuing local life experience, this study investigated how international visitors recognize the lives of people in the focal destination, and whether this recognition is related to satisfaction. Reviews for Teheran’s Grand Bazaar from an online review site, Tripadvisor.com, showed that visitors’ local encounters were linked with favorable emotions (good, interesting, and worthwhile. To lend support to the contact hypothesis, which posits that intercultural experiences can lead to more favorable evaluations of the host community; the visitors who recognized direct and indirect encounters with local life indicated higher satisfaction. Even if brief, the experience of local life appeared to create more intimate feelings for the focal destination. Interestingly, the number of past travel experiences, which was captured by the number of reviews written by the reviewer, was found to have a negative association with satisfaction. We draw further implications for the travelers as well as the local community.

What do medical students learn when they follow patients from hospital to community? A longitudinal qualitative study

Directory of Open Access Journals (Sweden)

Rukshini Puvanendran

2012-07-01

Full Text Available Context: Although longitudinal community-based care of patients provides opportunities for teaching patient centredness and chronic disease management, there is a paucity of literature assessing learning outcomes of these clerkships. This study examines learning outcomes among students participating in longitudinal community based follow-up of patients discharged from the hospital. Methods: The authors conducted a thematic analysis of 253 student narratives written by 44 third-year medical students reflecting on their longitudinal interactions with patients with chronic medical illnesses. The narratives were written over three periods: after acute hospital encounter, after a home visit and at the end of the 10-month follow-up. Analysis involved coding of theme content and counting of aggregate themes. Results: The most frequent theme was ‘chronic disease management’ (25% followed by ‘patient-centred care’ (22%, ‘health care systems’ (20.9%, ‘biomedical issues’ (19.7%, ‘community services’ (9.5% and ‘student's role conflict’ (2.3%. There was a shift in the relative frequency of the different themes, as students moved from hospital to community with their patients. Biomedical (44.3% and health systems (18.2% were the dominant themes following the acute hospitalization encounter. Chronic disease management (35.1% and patient centredness (31.8% were the dominant themes after the 10-month longitudinal follow-up. Conclusion: Longitudinal community-based interaction with patients resulted in learning about chronic disease management, patient centredness and health care systems over time. Students shifted from learning biomedical knowledge during the acute hospitalization, to focus on better understanding of long-term care and patient centredness, at the end of the module.

The importance of motivation, weapons, and foul odors in driving encounter competition in carnivores.

Science.gov (United States)

Allen, Maximilian L; Wilmers, Christopher C; Elbroch, L Mark; Golla, Julie M; Wittmer, Heiko U

2016-08-01

Encounter competition is interference competition in which animals directly contend for resources. Ecological theory predicts the trait that determines the resource holding potential (RHP), and hence the winner of encounter competition, is most often body size or mass. The difficulties of observing encounter competition in complex organisms in natural environments, however, has limited opportunities to test this theory across diverse species. We studied the outcome of encounter competition contests among mesocarnivores at deer carcasses in California to determine the most important variables for winning these contests. We found some support for current theory in that body mass is important in determining the winner of encounter competition, but we found that other factors including hunger and species-specific traits were also important. In particular, our top models were "strength and hunger" and "size and hunger," with models emphasizing the complexity of variables influencing outcomes of encounter competition. In addition, our wins above predicted (WAP) statistic suggests that an important aspect that determines the winner of encounter competition is species-specific advantages that increase their RHP, as bobcats (Lynx rufus) and spotted skunks (Spilogale gracilis) won more often than predicted based on mass. In complex organisms, such as mesocarnivores, species-specific adaptations, including strategic behaviors, aggressiveness, and weapons, contribute to competitive advantages and may allow certain species to take control or defend resources better than others. Our results help explain how interspecific competition shapes the occurrence patterns of species in ecological communities. © 2016 by the Ecological Society of America.

Cultural diversity, democracy and the prospects of cosmopolitanism: a theory of cultural encounters.

Science.gov (United States)

Delanty, Gerard

2011-12-01

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.

Potentials and pitfalls of the encounter between leisure-time centers and primary schools

DEFF Research Database (Denmark)

Ringskou, Lea Thomsen; Gravesen, David Thore

Our research offers a qualitative, in depth-perspective on the encounter between leisure-time centers and primary schools in Denmark. In our presentration we will, in a cross-cultural perspective, reappraise the roles of leisure-time pedagogues and discuss the potentials and pitfalls of the encou......Our research offers a qualitative, in depth-perspective on the encounter between leisure-time centers and primary schools in Denmark. In our presentration we will, in a cross-cultural perspective, reappraise the roles of leisure-time pedagogues and discuss the potentials and pitfalls...... of the encounter between leisure-time centers and primary schools. In 2014, the Danish Primary School was reformed. To a considerable extent, the reform can be understood in response to receding results in international tests (Knudsen 2010). The official aim of the reform is to challenge all pupils, regardless...... the encounter between leisure-time centers and primary schools?...

Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

Directory of Open Access Journals (Sweden)

Reshmi Singh

2018-01-01

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

Supporting statistics in the workplace: experiences with two hospitals

Directory of Open Access Journals (Sweden)

M. Y. Mortlock

2003-01-01

Full Text Available This paper provides some reflections on the promotion of lifelong learning in statistics in the workplace. The initiative from which the reflections are drawn is a collaboration between a university and two public hospitals, of which one of the stated aims is to develop statistical skills among the hospitals' researchers. This is realized in the provision of ‘biostatistical clinics’ in which workplace teaching and learning of statistics takes place in one-on-one or small group situations. The central issue that is identified is the need to accommodate diversity: in backgrounds, motivations and learning needs of workplace learners (in this case medical researchers, in the workplace environments themselves and in the projects encountered. Operational issues for the statistician in providing such training are addressed. These considerations may reflect the experiences of the wider community of statisticians involved in service provision within a larger organization.

Experience of a year of adult hospital dermatology consultations.

Science.gov (United States)

Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P

2015-10-01

Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.

Dyadic Interactions in Service Encounter: Bayesian SEM Approach

Science.gov (United States)

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.

A management plan for hospitals and medical centers facing radiation incidents.

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Border Encounters: American Cultural Politics and the U.S.-Mexico Border

OpenAIRE

Reimer, Jennifer Andrea

2011-01-01

AbstractBorder Encounters: American Cultural Politics and the U.S.-Mexico BorderbyJennifer Andrea ReimerDoctor of Philosophy in Ethnic StudiesUniversity of California, BerkeleyProfessor José David Saldívar, Co-ChairProfessor Laura E. Pérez, Co-ChairBorder Encounters: American Cultural Politics and the U.S.-Mexico Border is a transnational, interdisciplinary cultural study of the contemporary U.S.-Mexico border that argues for the critical role of the international border in the racial past, p...

Physician assistant program education on spirituality and religion in patient encounters.

Science.gov (United States)

Berg, Gina M; Whitney, Melissa P; Wentling, Callie J; Hervey, Ashley M; Nyberg, Sue

2013-01-01

To describe educational practices of physician assistant (PA) programs regarding spirituality and religion discussions during patient encounters. Patients want their health care provider to be aware of their spiritual and religious beliefs. This topic is addressed in physician and nursing education but may not be included in PA programs. Data regarding curriculum were collected via electronic survey emailed to 143 PA programs across the United States. Thirty-eight programs responded for a response rate of 27%. Most (68.4%) program respondents reported students' desire to be trained to discuss spirituality and religion, yet 36.8% do not offer this training. Just over half (69.2%) would consider adding curriculum to teach students to discuss spirituality, but the majority (92.3%) would not add curriculum to discuss religion during patient encounters. PA programs offer training to discuss spirituality in patient encounters but not to discuss religiosity. Programs may want to consider adding some curriculum to increase PAs awareness of spirituality and religion needs of patients.

Beyond cultural competency: Bourdieu, patients and clinical encounters.

Science.gov (United States)

Lo, Ming-Cheng M; Stacey, Clare L

2008-07-01

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.

ACES M and S: Unmitigated Factorial Encounter Study on DAA/TCAS Interoperability

Science.gov (United States)

Thipphavong, David; Cone, Andrew; Park, Chunki; Lee, Seung Man; Santiago, Confesor

2016-01-01

Realization of the expected proliferation of Unmanned Aircraft System (UAS) operations in the National Airspace System (NAS) depends on the development and validation of standards for UAS Detect and Avoid (DAA) Systems. The RTCA Special Committee 228 is charged with leading the development of draft Minimum Operational Performance Standards (MOPS) for UAS DAA Systems. NASA, as a participating member of RTCA SC-228 is committed to supporting the development and validation of draft requirements for DAA alerting and guidance systems. This presentation contains the results of two combinatorial encounter analysis studies using NASA's SAA Control fast-time simulation capability for this purpose. In these studies, encounters between two aircraft were simulated one at a time for the full factorial combination of encounter geometries (e.g., encounter angle, CPA offset) and aircraft performance (e.g., ownership and intruder ground speeds and vertical rates). The first study analyzes the relationships (e.g., timeline) between the different alerting-safety regions in the SC-228 MOPS (in order of increasing severity): 1) DAA warning alert, 2) well clear recovery (WCR) guidance, 3) DAA-Collision Avoidance (CA), and 4) TCAS RA. This study will focus primarily on encounter situations in which TCAS RA occurs prior to any of the other alerting-safety boundaries. In particular, this study will investigate whether using vertical distance or vertical distance at closest point of approach (i.e., vertical miss distance or VMD) is more appropriate for the definition of the DAA-CA region. In addition, cases where transitions between different regions skip an intermediate region will be analyzed. The second study in this presentation explores a proposal to use an altitude rate error threshold to determine if vertical maneuvers are acceptable for DAA WCR guidance against non-cooperative intruders. This study incorporates the radar from the Honeywell sensor model and examines a series of

VizieR Online Data Catalog: Stellar encounters with long-period comets (Feng+, 2015)

Science.gov (United States)

Feng, F.; Bailer-Jones, C. A. L.

2016-07-01

We have conducted simulations of the perturbation of the Oort cloud in order to estimate the significance of known encounters in generating long-period comets. We collected the data of stellar encounters from three sources: (Bailer-Jones, 2015, Cat. J/A+A/575/A35, hereafter BJ15), Dybczynski & Berski (2015MNRAS.449.2459D), and Mamajek et al. (2015ApJ...800L..17M). Following BJ15, we use the term 'object' to refer to each encountering star in our catalogue. A specific star may appear more than once but with different data, thus leading to a different object. (1 data file).

Reflexivity: The Creation of Liminal Spaces--Researchers, Participants, and Research Encounters.

Science.gov (United States)

Enosh, Guy; Ben-Ari, Adital

2016-03-01

Reflexivity is defined as the constant movement between being in the phenomenon and stepping outside of it. In this article, we specify three foci of reflexivity--the researcher, the participant, and the encounter--for exploring the interview process as a dialogic liminal space of mutual reflection between researcher and participant. Whereas researchers' reflexivity has been discussed extensively in the professional discourse, participants' reflexivity has not received adequate scholarly attention, nor has the promise inherent in reflective processes occurring within the encounter. © The Author(s) 2015.

STATE-MANDATED FOOD SAFETY CERTIFICATION REQUIREMENTS FOR RESTAURANTS: A 2002 REVIEW OF STATES

OpenAIRE

Schilling, Brian J.; O'Connor, Jack; Hendrickson, Veronica

2003-01-01

The Food and Drug Administration publishes a Standard Food Code which individual states either ratify, or amend and ratify, as the State Food Code. New Jersey has not adopted any revisions to the FDA Standard Food Code since 1993. Currently, the New Jersey Department of Health and Senior Services is considering the implementation of a mandatory food safety certification program for all of the state's foodservice establishments beginning in April 2003. Foodservice businesses serving "high risk...

Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

Directory of Open Access Journals (Sweden)

Brian Rha

Full Text Available Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking.Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations.The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326 and 93 (95% CI: 80 to 105 encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646 encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others.Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

Diversity, Conflict, and Recognition in Hospital Medical Practice.

Science.gov (United States)

Fortin, Sylvie; Maynard, Serge

2018-03-01

The hospital is a place of encounter between health care providers, patients and family members, the healthy and the suffering, migrants and non-migrants, as well as social and cultural minorities, and majorities of various backgrounds. It is also a space where multiple conceptions of care, life, quality of life, and death are enacted, sometimes inhibiting mutual understanding between caregivers and the cared for, a scenario that in turn may provoke conflict. Through the lens of conflict, we explore in this article the theme of Otherness within the clinic, basing analysis on an ethnographic study conducted in recent years in three cosmopolitan Canadian cities. Daily practices and-on a larger scale-the social space of the clinic become material here for reflecting on recognition (and non-recognition) of the Other as actors in the clinical encounter. The examination of structural and situational conditions that contribute to the emergence of conflict offers an understanding of the diversity of values that pervade the clinic. By way of conclusion, we argue that recognition of diversity, at least on the part of practitioners, is a key condition for the emergence of a pluralist normativity in the social space of the clinic.

Encounters of aircraft with volcanic ash clouds; A compilation of known incidents, 1953-2009

Science.gov (United States)

Guffanti, Marianne; Casadevall, Thomas J.; Budding, Karin

2010-01-01

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

Dental case manager encounters: the association with retention in dental care and treatment plan completion.

Science.gov (United States)

Lemay, Celeste A; Tobias, Carol; Umez-Eronini, Amarachi A; Brown, Carolyn; McCluskey, Amanda; Fox, Jane E; Bednarsh, Helene; Cabral, Howard J

2013-01-01

Little is known about dental case managers as few programs have been scientifically evaluated. The goal of this study was to explore the impact of dental case manager on retention in dental care and completion of treatment plans, while specifically exploring the number of dental case manager encounters. Fourteen programs enrolled people with HIV/AIDS (PLWHA) in dental care and a longitudinal study between 2007 and 2009. The 758 participants had a total of 2715 encounters with a dental case manager over twelve months: 29% had a single encounter; 21% had two; 27% had 3-4 and; 23% had 5-29 encounters. Adjusting for baseline characteristics, participants receiving more encounters were significantly more likely to complete their Phase 1 treatment plan, be retained in dental care, and experience improvements in overall oral health status. Organizations considering efforts to improve the oral health of vulnerable, hard-to-engage populations should consider these findings when planning interventions. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Fungal contamination in hospital environments.

Science.gov (United States)

Perdelli, F; Cristina, M L; Sartini, M; Spagnolo, A M; Dallera, M; Ottria, G; Lombardi, R; Grimaldi, M; Orlando, P

2006-01-01

To assess the degree of fungal contamination in hospital environments and to evaluate the ability of air conditioning systems to reduce such contamination. We monitored airborne microbial concentrations in various environments in 10 hospitals equipped with air conditioning. Sampling was performed with a portable Surface Air System impactor with replicate organism detection and counting plates containing a fungus-selective medium. The total fungal concentration was determined 72-120 hours after sampling. The genera most involved in infection were identified by macroscopic and microscopic observation. The mean concentration of airborne fungi in the set of environments examined was 19 +/- 19 colony-forming units (cfu) per cubic meter. Analysis of the fungal concentration in the different types of environments revealed different levels of contamination: the lowest mean values (12 +/- 14 cfu/m(3)) were recorded in operating theaters, and the highest (45 +/- 37 cfu/m(3)) were recorded in kitchens. Analyses revealed statistically significant differences between median values for the various environments. The fungal genus most commonly encountered was Penicillium, which, in kitchens, displayed the highest mean airborne concentration (8 +/- 2.4 cfu/m(3)). The percentage (35%) of Aspergillus documented in the wards was higher than that in any of the other environments monitored. The fungal concentrations recorded in the present study are comparable to those recorded in other studies conducted in hospital environments and are considerably lower than those seen in other indoor environments that are not air conditioned. These findings demonstrate the effectiveness of air-handling systems in reducing fungal contamination.

Preliminary Uncorrelated Encounter Model of the National Airspace System

National Research Council Canada - National Science Library

Kochenderfer, M. J; Kuchar, J. K; Espindle, L. P; Gertz, J. L

2008-01-01

...) and which may not be in contact with air traffic control. In response to the need to develop a model of these types of encounters, Lincoln Laboratory undertook an extensive radar data collection and modeling effort...

Grassroots Leadership: Encounters with Power Dynamics and Oppression

Science.gov (United States)

Kezar, Adrianna

2011-01-01

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…

Stress Coping Techniques For Female Doctors Encountering Sexual ...

African Journals Online (AJOL)

... Muslim and Christian female doctors encounter with sexual harassment. It was also found that sexual harassment cut across all age groups. The findings of these study indicated that stress coping techniques is an effective method in the reduction of stress posed by sexual harassment on female doctors from their patients.

CLOSE STELLAR ENCOUNTERS IN YOUNG, SUBSTRUCTURED, DISSOLVING STAR CLUSTERS: STATISTICS AND EFFECTS ON PLANETARY SYSTEMS

International Nuclear Information System (INIS)

Craig, Jonathan; Krumholz, Mark R.

2013-01-01

Both simulations and observations indicate that stars form in filamentary, hierarchically clustered associations, most of which disperse into their galactic field once feedback destroys their parent clouds. However, during their early evolution in these substructured environments, stars can undergo close encounters with one another that might have significant impacts on their protoplanetary disks or young planetary systems. We perform N-body simulations of the early evolution of dissolving, substructured clusters with a wide range of properties, with the aim of quantifying the expected number and orbital element distributions of encounters as a function of cluster properties. We show that the presence of substructure both boosts the encounter rate and modifies the distribution of encounter velocities compared to what would be expected for a dynamically relaxed cluster. However, the boost only lasts for a dynamical time, and as a result the overall number of encounters expected remains low enough that gravitational stripping is unlikely to be a significant effect for the vast majority of star-forming environments in the Galaxy. We briefly discuss the implications of this result for models of the origin of the solar system, and of free-floating planets. We also provide tabulated encounter rates and orbital element distributions suitable for inclusion in population synthesis models of planet formation in a clustered environment.

CLOSE STELLAR ENCOUNTERS IN YOUNG, SUBSTRUCTURED, DISSOLVING STAR CLUSTERS: STATISTICS AND EFFECTS ON PLANETARY SYSTEMS

Energy Technology Data Exchange (ETDEWEB)

Craig, Jonathan; Krumholz, Mark R., E-mail: krumholz@ucolick.org [Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064 (United States)

2013-06-01

Both simulations and observations indicate that stars form in filamentary, hierarchically clustered associations, most of which disperse into their galactic field once feedback destroys their parent clouds. However, during their early evolution in these substructured environments, stars can undergo close encounters with one another that might have significant impacts on their protoplanetary disks or young planetary systems. We perform N-body simulations of the early evolution of dissolving, substructured clusters with a wide range of properties, with the aim of quantifying the expected number and orbital element distributions of encounters as a function of cluster properties. We show that the presence of substructure both boosts the encounter rate and modifies the distribution of encounter velocities compared to what would be expected for a dynamically relaxed cluster. However, the boost only lasts for a dynamical time, and as a result the overall number of encounters expected remains low enough that gravitational stripping is unlikely to be a significant effect for the vast majority of star-forming environments in the Galaxy. We briefly discuss the implications of this result for models of the origin of the solar system, and of free-floating planets. We also provide tabulated encounter rates and orbital element distributions suitable for inclusion in population synthesis models of planet formation in a clustered environment.

Close Stellar Encounters in Young, Substructured, Dissolving Star Clusters: Statistics and Effects on Planetary Systems

Science.gov (United States)

Craig, Jonathan; Krumholz, Mark R.

2013-06-01

Both simulations and observations indicate that stars form in filamentary, hierarchically clustered associations, most of which disperse into their galactic field once feedback destroys their parent clouds. However, during their early evolution in these substructured environments, stars can undergo close encounters with one another that might have significant impacts on their protoplanetary disks or young planetary systems. We perform N-body simulations of the early evolution of dissolving, substructured clusters with a wide range of properties, with the aim of quantifying the expected number and orbital element distributions of encounters as a function of cluster properties. We show that the presence of substructure both boosts the encounter rate and modifies the distribution of encounter velocities compared to what would be expected for a dynamically relaxed cluster. However, the boost only lasts for a dynamical time, and as a result the overall number of encounters expected remains low enough that gravitational stripping is unlikely to be a significant effect for the vast majority of star-forming environments in the Galaxy. We briefly discuss the implications of this result for models of the origin of the solar system, and of free-floating planets. We also provide tabulated encounter rates and orbital element distributions suitable for inclusion in population synthesis models of planet formation in a clustered environment.

Social Workers' Reflections on the Therapeutic Encounter With Elder Abuse and Neglect.

Science.gov (United States)

Goldblatt, Hadass; Band-Winterstein, Tova; Alon, Sara

2016-02-24

The aim of this qualitative study was to explore social workers' reflections on their experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect. The research questions were as follows: How do social workers tune themselves toward the therapeutic encounter with elder abuse? How do they position themselves vis-à-vis the clients? How do social workers describe the meaning of the intervention both for the clients and for themselves? What is the added value of the therapeutic encounter in this field for the social workers? Participants were 17 experienced women social workers, who worked with abusers and with abused and neglected older adults in Israel. Data were collected via in-depth semi-structured interviews, which were later transcribed and content analyzed. Two main themes emerged from the findings, emphasizing two key aspects of the social workers' reflective process experienced during the therapeutic encounter: (a) focus on the client: "This is the journey of their lives"-reflection on the therapeutic "journey"; (b) focus on the social worker's inner and professional world: "'There is nothing to be done' is no longer in my vocabulary"-a personal and professional maturation process. The social workers expressed a positive attitude toward their elder clients. A unique dialogue developed in the therapeutic encounter, whereby the social workers considered any change as valuable if it allowed the elders a sense of control and self-worth, whereas the social workers were enriched by the elders' life experience, and matured both personally and professionally. Thus, both sides benefited from this reciprocal relationship. Implications for further research and practice are discussed. © The Author(s) 2016.

Healthy Eating Exploratory Program for the Elderly: Low Salt Intake in Congregate Meal Service.

Science.gov (United States)

Seo, S; Kim, O Y; Ahn, J

2016-03-01

This study reported on an exploratory program to help the low income elderly improve healthy eating behavior, specifically by reducing salt intake. We conducted an exploratory program for 4 weeks for this study. The exploratory program involved offering menus with reduced salt and providing education on healthy eating. After the exploratory program, a survey of the elderly and in-depth interviews allowed us to evaluate the program for foodservice providers (dietitian, social workers, and volunteer workers). This study included both foodservice workers and elderly who actually used the foodservice in a congregate meal service system. This is a unique approach. A congregate meal service center in Seoul, Korea. Seventy four elderly in a congregate meal service center. Demographics were collected, and the healthy eating program and healthy eating education for elderly respondents were evaluated. The elderly showed high satisfaction with the exploratory program for healthy eating. We found no significant differences in satisfaction with the program between the elderly who attended education sessions and those who did not, but more of the elderly from the education sessions showed positive behavioral change intentions. The exploratory program influenced to reduce the salt intake of the elderly in congregate meal service. This study suggests cooperation of foodservice providers and the support of administrators is critical to the success of such programs.

Design of an operations manager selection system in service encounter

Directory of Open Access Journals (Sweden)

Tanawin Nunthaphanich

2015-10-01

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.

Reason for hospital admission: a pilot study comparing patient statements with chart reports.

Science.gov (United States)

Berger, Zackary; Dembitzer, Anne; Beach, Mary Catherine

2013-01-01

Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient's report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians' reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making.

The National Accreditation Board for Hospital and Health Care Providers accreditation programme in India.

Science.gov (United States)

Gyani, Girdhar J; Krishnamurthy, B

2014-01-01

Quality in health care is important as it is directly linked with patient safety. Quality as we know is driven either by regulation or by market demand. Regulation in most developing countries has not been effective, as there is shortage of health care providers and governments have to be flexible. In such circumstances, quality has taken a back seat. Accreditation symbolizes the framework for quality governance of a hospital and is based on optimum standards. Not only is India establishing numerous state of the art hospitals, but they are also experiencing an increase in demand for quality as well as medical tourism. India launched its own accreditation system in 2006, conforming to standards accredited by ISQua. This article shows the journey to accreditation in India and describes the problems encountered by hospitals as well as the benefits it has generated for the industry and patients.

Penguin head movement detected using small accelerometers: a proxy of prey encounter rate.

Science.gov (United States)

Kokubun, Nobuo; Kim, Jeong-Hoon; Shin, Hyoung-Chul; Naito, Yasuhiko; Takahashi, Akinori

2011-11-15

Determining temporal and spatial variation in feeding rates is essential for understanding the relationship between habitat features and the foraging behavior of top predators. In this study we examined the utility of head movement as a proxy of prey encounter rates in medium-sized Antarctic penguins, under the presumption that the birds should move their heads actively when they encounter and peck prey. A field study of free-ranging chinstrap and gentoo penguins was conducted at King George Island, Antarctica. Head movement was recorded using small accelerometers attached to the head, with simultaneous monitoring for prey encounter or body angle. The main prey was Antarctic krill (>99% in wet mass) for both species. Penguin head movement coincided with a slow change in body angle during dives. Active head movements were extracted using a high-pass filter (5 Hz acceleration signals) and the remaining acceleration peaks (higher than a threshold acceleration of 1.0 g) were counted. The timing of head movements coincided well with images of prey taken from the back-mounted cameras: head movement was recorded within ±2.5 s of a prey image on 89.1±16.1% (N=7 trips) of images. The number of head movements varied largely among dive bouts, suggesting large temporal variations in prey encounter rates. Our results show that head movement is an effective proxy of prey encounter, and we suggest that the method will be widely applicable for a variety of predators.

Making hospital mortality measurement more meaningful: incorporating advance directives and palliative care designations.

Science.gov (United States)

Kroch, Eugene A; Johnson, Mark; Martin, John; Duan, Michael

2010-01-01

Accounting for patients admitted to hospitals at the end of a terminal disease process is key to signaling care quality and identifying opportunities for improvement. This study evaluates the benefits and caveats of incorporating care-limiting orders, such as do not resuscitate (DNR) and palliative care (PC) information, in a general multivariate model of mortality risk, wherein the unit of observation is the patient hospital encounter. In a model of the mortality gap (observed - expected from the baseline model), DNR explains 8% to 24% of the gap variation. PC provides additional explanatory power to some disease groupings, especially heart and digestive diseases. One caveat is that DNR information, especially if associated with the later stages of hospital care, may mask opportunities to improve care for certain types of patients. But that is not a danger for PC, which is unequivocally valuable in accounting for patient risk, especially for certain subpopulations and disease groupings.

Effect of Concentrated Language Encounter Method in Developing ...

African Journals Online (AJOL)

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 ...

Exploring Festival Performance as a State of Encounter

Science.gov (United States)

O’Grady, Alice; Kill, Rebekka

2013-01-01

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…

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters.

Science.gov (United States)

Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting

2013-01-16

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. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients' perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients' overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

Science.gov (United States)

2013-01-01

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. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

Directory of Open Access Journals (Sweden)

Chang Ching-Sheng

2013-01-01

Full Text Available 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. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A interpersonal-based medical

Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

Science.gov (United States)

Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

2014-01-01

Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

Encounters between degenerate stars and extrasolar comet clouds

International Nuclear Information System (INIS)

Pineault, S.; Poisson, E.

1989-01-01

Under the assumption that the presence of comet clouds around otherwise normal stars is a common occurrence in the Galaxy, the observational consequences of random penetration encounters between the general Galactic population of degenerate stars and these comet clouds is considered. The only case considered is where the compact stars is a single star. For this scenario, encounters involving neutron stars (NSs) result in impact rates 1000-10,000 times slower than in the model of Tremaine and Zytkow (1986). The rate for white dwarfs (WDs) is larger than the one for NSs by a factor of about 30 times the ratio of the degenerate star number densities. The mean impact rate is significantly increased if the number of comets in a cloud is nearly independent of the mass of the central star. It is concluded that some of the observed gamma-ray bursts may be caused by accretion of comets onto NSs and that this scenario, but with a WD as the accretor, probably contributes to the optical flash background rate. 38 refs

Revisiting Rossion and Pourtois with new ratings for automated complexity, familiarity, beauty, and encounter.

Science.gov (United States)

Forsythe, Alex; Street, Nichola; Helmy, Mai

2017-08-01

Differences between norm ratings collected when participants are asked to consider more than one picture characteristic are contrasted with the traditional methodological approaches of collecting ratings separately for image constructs. We present data that suggest that reporting normative data, based on methodological procedures that ask participants to consider multiple image constructs simultaneously, could potentially confounded norm data. We provide data for two new image constructs, beauty and the extent to which participants encountered the stimuli in their everyday lives. Analysis of this data suggests that familiarity and encounter are tapping different image constructs. The extent to which an observer encounters an object predicts human judgments of visual complexity. Encountering an image was also found to be an important predictor of beauty, but familiarity with that image was not. Taken together, these results suggest that continuing to collect complexity measures from human judgments is a pointless exercise. Automated measures are more reliable and valid measures, which are demonstrated here as predicting human preferences.

Energy modeling issues in quick service restaurants

Energy Technology Data Exchange (ETDEWEB)

Smith, V.A.; Johnson, K.F.

1997-03-01

The complexity of monitoring and modeling the energy performance of food-service facilities was discussed. Usually, less than one third of the energy consumed in a commercial food-service facility is used by equipment and systems typically modeled in building simulation software such as DOE-2. Algorithms have not yet been developed to handle independent makeup air units and the kitchen and dining room HVAC systems. The energy used by food process equipment and water heating is based on customer-volume and operation-hours. Monitoring projects have been undertaken to provide detailed energy use profiles of individual appliances and whole restaurants. Some technical issues that are unique to food-service modeling in current versions of DOE-2.1E software in the context of quick service restaurants, such as difficulties in modelling internal heat gains of hooded cooking appliances and walk-in refrigeration, and system and zone limitations on tracking energy consumption, were discussed. 1 fig.

Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand.

Science.gov (United States)

Yuwanich, Nuttapol; Sandmark, Hélène; Akhavan, Sharareh

2015-10-30

Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. This study aimed to explore nurses' perceptions of occupational stress in an emergency department. A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

The Influence of Physician Communication Style on Overweight Patients’ Perceptions of Length of Encounter and Physician Being Rushed

Science.gov (United States)

Gulbrandsen, Pål; Østbye, Truls; Lyna, Pauline; Dolor, Rowena J.; Tulsky, James A.; Alexander, Stewart C.; Pollak, Kathryn I.

2012-01-01

BACKGROUND AND OBJECTIVES Little is known about how patients and physicians perceive time and the extent to which they perceive the physician being rushed during encounters. One aim of this paper is to examine whether patient and physician characteristics and physician communication influence patient perception of the duration of the encounter and their perception of physicians being rushed. Another aim is to examine the relationship between patient and physician perceptions of physicians feeling rushed. METHODS We audiorecorded 461 encounters of overweight or obese patients with 40 primary care physicians and included 320 encounters in which weight was discussed. We calculated time spent with physician and coded all communication about weight using the Motivational Interview Treatment Integrity scale (MITI). Patients completed post-visit questionnaires in which they reported the estimated duration of the encounter and how rushed they thought the physician was during the encounter. Physicians reported how rushed they felt. RESULTS Patients estimated encounters to be longer than they actually were by an average of 2.6 minutes (SD=11.0). When physicians used reflective statements when discussing weight, patients estimated the encounter to be shorter than when physicians did not use reflective statements (1.17 versus 4.56 minutes more than actual duration). Whites perceived the encounter as shorter than African Americans (1.45 versus 4.28 minutes more than actual duration). Physicians felt rushed in 66% of visits; however, most patients did not perceive this. Internists were perceived to be more rushed than family physicians. CONCLUSIONS There is wide variation in patients’ ability to estimate the length of time they spend with their physician. Some physician and patient characteristics were related to patient perceptions of the length of the encounter. Reflective statements might lead patients to perceive encounters as shorter. Physicians, especially family

What influences the quality of educational encounters between trainer and trainee in vocational training for general practice?

NARCIS (Netherlands)

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

Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study

DEFF Research Database (Denmark)

Tove, Lindhardt; Hallberg, Ingalill Rahm; Poulsen, Ingrid

2008-01-01

BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...

Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: a qualitative study

DEFF Research Database (Denmark)

Lindhardt, Tommi Bo; Hallberg, I.R.; Poulsen, Ingrid

2008-01-01

BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...

A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Formation of massive clouds and dwarf galaxies during tidal encounters

Science.gov (United States)

Kaufman, Michele; Elmegreen, Bruce G.; Thomasson, Magnus; Elmegreen, Debra M.

1993-01-01

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.

Internet advertisements for public sexual encounters among men who have sex with men: are safe behaviors communicated?

Science.gov (United States)

Downing, Martin J

2011-09-01

Public and commercial sex venues typically provide easy access to sexual encounters that are often anonymous and, therefore, may facilitate HIV/STD transmission among those men who attend. Recently, researchers have suggested that men who have sex with men may be using the Internet to search for sexual encounters to occur within sex venues. The current study explored the extent to which men who advertise for public or commercial sexual encounters initially communicate to potential partners their safe-sex intentions. Advertisements for sexual encounters (n = 99) were collected from a publicly accessible website and examined for content related to venue type, sexual behavior, and indications of sexual safety or risk. Word frequencies were calculated to provide a closer investigation of how individuals negotiate safe sex within these communications. The findings revealed that approximately half of the men who advertised for sex in a public or commercial sex venue failed to communicate to potential partners in their initial advertisement a desire to be safe during sexual encounters involving oral and anal practices. Additionally, a small percentage of men advertised specifically for risky encounters (e.g., barebacking). Together, these findings suggest that men do use the Internet to coordinate public sexual encounters, some of which may be unprotected from HIV/STD transmission. Future research should address the process of condom negotiation among men who initially meet their male sex partners on the Internet for subsequent encounters in sex venues.

Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange.

Science.gov (United States)

Bell, Teresa M; Gilyan, Dannielle; Moore, Brian A; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E; Moore, Reilin; Simons, Clark J; Zarzaur, Ben L

2018-01-01

Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide

Challenges Encountered in the Compilation of an Advanced Shona ...

African Journals Online (AJOL)

turvitenskap, Seksjon for Leksikografi, Oslo, Norway. Abstract: This paper highlights the challenges encountered by the African Languages Lexical ... looks at: (a) the limitations of the current Shona orthography, the selection and codification of ... that were suggested, without getting too deeply involved in theoretical issues.

Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires.

Science.gov (United States)

Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

2014-01-01

Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

Availability and Usability of BHO Encounter Data in MAX 2009

Data.gov (United States)

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,...

Development, Validation and Deployment of a Real Time 30 Day Hospital Readmission Risk Assessment Tool in the Maine Healthcare Information Exchange.

Science.gov (United States)

Hao, Shiying; Wang, Yue; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Zheng, Le; Luo, Jin; Hu, Zhongkai; Fu, Changlin; Dai, Dorothy; Wang, Yicheng; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-01-01

Identifying patients at risk of a 30-day readmission can help providers design interventions, and provide targeted care to improve clinical effectiveness. This study developed a risk model to predict a 30-day inpatient hospital readmission for patients in Maine, across all payers, all diseases and all demographic groups. Our objective was to develop a model to determine the risk for inpatient hospital readmission within 30 days post discharge. All patients within the Maine Health Information Exchange (HIE) system were included. The model was retrospectively developed on inpatient encounters between January 1, 2012 to December 31, 2012 from 24 randomly chosen hospitals, and then prospectively validated on inpatient encounters from January 1, 2013 to December 31, 2013 using all HIE patients. A risk assessment tool partitioned the entire HIE population into subgroups that corresponded to probability of hospital readmission as determined by a corresponding positive predictive value (PPV). An overall model c-statistic of 0.72 was achieved. The total 30-day readmission rates in low (score of 0-30), intermediate (score of 30-70) and high (score of 70-100) risk groupings were 8.67%, 24.10% and 74.10%, respectively. A time to event analysis revealed the higher risk groups readmitted to a hospital earlier than the lower risk groups. Six high-risk patient subgroup patterns were revealed through unsupervised clustering. Our model was successfully integrated into the statewide HIE to identify patient readmission risk upon admission and daily during hospitalization or for 30 days subsequently, providing daily risk score updates. The risk model was validated as an effective tool for predicting 30-day readmissions for patients across all payer, disease and demographic groups within the Maine HIE. Exposing the key clinical, demographic and utilization profiles driving each patient's risk of readmission score may be useful to providers in developing individualized post discharge

Meteorology Associated with Turbulence Encounters During NASA's Fall-2000 Flight Experiments

Science.gov (United States)

Hamilton, David W.; Proctor, Fred H.

2002-01-01

Initial flight experiments have been conducted to investigate convectively induced turbulence and to test technologies for its airborne detection. Turbulence encountered during the experiments is described with sources of data measured from in situ sensors, groundbased and airborne Doppler radars, and aircraft video. Turbulence measurements computed from the in situ system were quantified in terms of RMS normal loads (sigma(sub Delta n)), where 0.20 g is less than or equal to sigma(sub Delta n) is less than or equal to 0.30 g is considered moderate and sigma(sub Delta n) is greater than 0.30 g is severe. During two flights, 18 significant turbulence encounters (sigma(sub Delta) is greater than or equal to 0.20 g) occurred in the vicinity of deep convection; 14 moderate and 4 severe. In all cases, the encounters with turbulence occurred along the periphery of cumulus convection. These events were associated with relatively low values of radar reflectivity, i.e. RRF is less than 35 dBz, with most levels being below 20 dBz. The four cases of severe turbulence occurred in precipitation and were centered at the interface between a cumulus updraft turret and a downwind downdraft. Horizontal gradients of vertical velocity at this interface were found to be strongest on the downwind side of the cumulus turrets. Furthermore, the greatest loads to the aircraft occurred while flying along, not orthogonal to, the ambient environmental wind vector. During the two flights, no significant turbulence was encountered in the clear air (visual meteorological conditions), not even in the immediate vicinity of the deep convection.

Unethical Behaviours Preservice Teachers Encounter on Social Networks

Science.gov (United States)

Deveci Topal, Arzu; Kolburan Gecer, Aynur

2015-01-01

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…

Post-traumatic stress disorder among paramedic and hospital emergency personnel in south-east Iran

Institute of Scientific and Technical Information of China (English)

Sedigheh Iranmanesh; Batool Tirgari; Hojat Sheikh Bardsiri

2013-01-01

BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress disorder(PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS:The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University.Using Mississippi PTSD,we assessed the prevalence rate in paramedics(n=150) and emergency personnel(n=250).RESULTS:The two groups had different levels of education,marital status,experience of traumatic events,work hours per month,and gender.Most(94%) of paramedic and hospital emergency personnel reported moderate PTSD.The two groups had significant different levels of PTSD in all subscale.CONCLUSION:The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.

Violence exposure among health care professionals in Saudi public hospitals. A preliminary investigation.

Science.gov (United States)

Algwaiz, Waleed M; Alghanim, Saad A

2012-01-01

To identify the prevalence, causes, types, and sources of workplace violence among health professionals in public hospitals in the Kingdom of Saudi Arabia. This exploratory cross-sectional survey employed self-administered questionnaires to collect data on aspects of workplace violence against physicians and nurses in Saudi hospitals. The questionnaires were distributed randomly to 600 physicians and nurses, of which 383 (63.8%) completed the questionnaires at 2 public hospitals in Riyadh city between May and July 2011. More than two-thirds (67.4%) of respondents reported they were victims of violence in the previous 12 months. Nurses were more likely to be exposed to violent incidents than physicians (pviolence. Verbal abuse was the most common type encountered. The assailants were mostly the patients' relatives or friends, followed by the patients themselves. Reasons for not reporting violent events included: feel it is a part of the job, previous experience of no action, and fear of consequences. Physicians and nurses are at high risk of violent incidents. Health decision makers need to be aware of the potential consequences of such events. Appropriate preventive measures are needed to make hospitals safer environments.

Art viewing directives in hospital settings effect on mood.

Science.gov (United States)

Ho, Rainbow T H; Potash, Jordan S; Fang, Fan; Rollins, Judy

2015-01-01

The purpose of this study was to determine the effect viewing directives can have when encountering art in hospitals. A secondary objective of the study was to understand the responses of viewers to an art exhibit on the theme of medical student empathy toward patient pain and suffering. Displaying art in hospitals has been credited with increasing well-being of patients, visitors, and staff. Generally, hospital curators have focused on the type of art to display (natural, symbolic, and abstract). This focus has neglected the possibility that in addition to the type of art, the way that viewers engage art may also be responsible for the healing effect. Participants (n = 97) were randomly allocated into one of the viewing directives: (1) reflecting on one artwork, (2) creating a drawing or poem in response to one artwork, or (3) no direction. Prior to looking at the art and immediately after, participants were administered the Brief Mood Introspection Scale (BMIS) and offered an opportunity to participate in an interview. Pre-post results of the BMIS demonstrated that viewers who received directions achieved some therapeutic effect. Qualitative themes from the post-exhibit interviews identified that the empathy themed exhibit was well received, although there were differences among responses from patients, visitors, and staff. The results imply that hospitals may consider offering prompts to help viewers engage with art to enhance mood and exhibiting art that demonstrates empathy for patient suffering. © The Author(s) 2015.

Fabricated Childhoods: Uncanny Encounters with the More-than-Human

Science.gov (United States)

Blaise, Mindy

2016-01-01

This article is based on uncanny encounters with Julia deVille's exhibit, "Phantasmagoria". Inspired by Deleuzian-informed research practices, the author experiments with provoking practices to defy dominant developmental notions of childhood. This article reworks a humanist ontology by bringing together the discursive, the material, the…

Spatial variation of pneumonia hospitalization risk in Twin Cities metro area, Minnesota.

Science.gov (United States)

Iroh Tam, P Y; Krzyzanowski, B; Oakes, J M; Kne, L; Manson, S

2017-11-01

Fine resolution spatial variability in pneumonia hospitalization may identify correlates with socioeconomic, demographic and environmental factors. We performed a retrospective study within the Fairview Health System network of Minnesota. Patients 2 months of age and older hospitalized with pneumonia between 2011 and 2015 were geocoded to their census block group, and pneumonia hospitalization risk was analyzed in relation to socioeconomic, demographic and environmental factors. Spatial analyses were performed using Esri's ArcGIS software, and multivariate Poisson regression was used. Hospital encounters of 17 840 patients were included in the analysis. Multivariate Poisson regression identified several significant associations, including a 40% increased risk of pneumonia hospitalization among census block groups with large, compared with small, populations of ⩾65 years, a 56% increased risk among census block groups in the bottom (first) quartile of median household income compared to the top (fourth) quartile, a 44% higher risk in the fourth quartile of average nitrogen dioxide emissions compared with the first quartile, and a 47% higher risk in the fourth quartile of average annual solar insolation compared to the first quartile. After adjusting for income, moving from the first to the second quartile of the race/ethnic diversity index resulted in a 21% significantly increased risk of pneumonia hospitalization. In conclusion, the risk of pneumonia hospitalization at the census-block level is associated with age, income, race/ethnic diversity index, air quality, and solar insolation, and varies by region-specific factors. Identifying correlates using fine spatial analysis provides opportunities for targeted prevention and control.

Hospitals learn their collective power: an isolation gown success story.

Science.gov (United States)

Kressel, Amy B; McVey, Jennie L; Miller, Joan M; Fish, Lauren L

2011-02-01

We describe an investigation and improvement project designed to provide comfortable, affordable, fluid-resistant isolation gowns in response to inadequate compliance with gown use. Infection control and purchasing departments determined number of gowns used, cost/gown, and contract information for our laundry service. We investigated disposable gown options. During a conference call for a multihospital project, we learned that 4 local hospitals all used the same laundry service and that all were dissatisfied with the quality of the reusable gowns. The 4 hospitals resolved to meet with the hospital laundry service to negotiate as a group. In preparation, we both investigated laundry services in neighboring cities and reviewed Centers for Disease Control and Prevention and Occupational Safety and Health Administration isolation gown requirements. Confronted with its major customers acting collectively, the laundry service agreed to identify gowns by age, bring gowns to Occupational Safety and Health Administration compliance, mark grids so gowns could be removed after 75 washes, add 6,000 new gowns, and remove 6,000 old gowns. The cost increase was 3.75¢/gown. After the changeover was complete, reports of fluid leaking through gowns stopped. We saved $187,000 by keeping reusable gowns. When we tried to provide comfortable, affordable, fluid-resistant isolation gowns, we encountered 2 barriers: our city had only 1 hospital laundry service, and disposable gowns were costly. We solved the problem through unusual collaboration: internal (Infection Control and Purchasing) and external (with otherwise competing hospitals). Collaboration and knowledge sharing led to accountability: the hospital to its staff and budget and the laundry service to the hospitals. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Analysis of Work Assignments After Medical Ethics Workshop for First-Year Residents at Siriraj Hospital

Directory of Open Access Journals (Sweden)

Sakda Sathirareuangchai

2016-11-01

Full Text Available Background: Upon entering the residency training program, all 1st year residents at Siriraj Hospital must join medical ethics workshop held by the Division of Postgraduate Studies. At the end of the workshop, the residents were given a work assignment to write a clinical ethics situation they have encountered in their past practice. Methods: This study is an analysis of content described in the work assignments in order to gain the information regarding common medical ethics dilemmas, which the physicians faced in the early days of practice. Results: 740 work assignments were reviewed. The 4 most common ethical principle mentioned in these assign- ments were autonomy (144, 19.5%, palliative care (133, 18.0%, beneficence (121, 16.4%, and confidentiality (110, 14.9%. More than half of the situations described were during their internship (474, 64.1% and tended to distributed equally among community hospital (39.1%, university hospital (28.0%, and general hospital (24.3%. Conclusion: This study should raise the awareness of the medical educator towards these medical ethics issues during curriculum planning.

Inclusion as heterotopia: Spaces of encounter between people with and without intellectual disability

Directory of Open Access Journals (Sweden)

Herman Meininger

2013-08-01

Full Text Available The public space to which - in line with common definitions of inclusion - persons with intellectual disability are designated often turns out to be a space of discrimination. The aim of this study is to identify spaces of encounter. Michel Foucault's concept of heterotopia - 'other spaces' - and its subsequent interpretations are used as an analytical tool for evaluating efforts to include persons with intellectual disability in society. In Foucault's work 'space' refers to geographical places and to 'sites' that can be defined by sets of relations. Among these spaces are 'counter-sites' like large scale residential facilities for people with intellectual disability. Though policies of deinstitutionalisation aim at erasure of these places of exclusion, the results are often disappointing, largely because these policies ignore the analysis of power dynamics that install exclusionary processes and structures. Recent interpretations of the concept of heterotopia position the 'other places' in the middle of ordinary life as social spaces of encounter and dialogue between the 'normal' and the 'abnormal'. Characteristics and practical conditions of such spaces of encounter are explored. These interpretations open up a new conceptualisation of inclusion in terms of niches in which encounter and dialogue are cultivated and an alternative social ordering can be exercised.

Strengthening health promotion in hospitals with capacity building: a Taiwanese case study.

Science.gov (United States)

Lee, Chiachi Bonnie; Chen, Michael S; Chien, Sou-Hsin; Pelikan, Jürgen M; Wang, Ying Wei; Chu, Cordia Ming-Yeuk

2015-09-01

Organizational capacity building for health promotion (HP) is beneficial to the effective implementation of HP in organizational settings. The World Health Organization (WHO) Health Promoting Hospitals' (HPHs) initiative encourages hospitals to promote the health of their stakeholders by developing organizational capacity. This study analyzes an application case of one hospital of the HPH initiative in Taiwan, characterizes actions aiming at building organizational support to strengthen health gains and identifies facilitators of and barriers to the implementation of the HP in this hospital. Case study methodology was used with a triangulation of various sources; thematic analysis was used to analyze qualitative information. This study found a positive impact of the HPH initiative on the case hospital, such as more support from leadership, a fine-tuned HP mission and strategy, cultivated pro-HP habits of physical activities, a supportive intramural structure, an HP-inclusive system, improved management practices and enhanced staff participation. Transformational and transactional enablers are of equal importance in implementing HPH. However, it was also found that the case hospital encountered more transactional barriers than transformational ones. This hospital was hindered by insufficient support from external environments, leadership with limited autonomy and authority, a preference for ideals over professionalism, insufficient participation by physicians, a lack of manpower and time, a merit system with limited stimulating effect, ineffective management practices in weak central project management, a lack of integration, insufficient communication and an inability to inculcate the staff on the importance of HP, and inadequate staff participation. Several implications for other hospitals are suggested. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The third person in the room: frequency, role, and influence of companions during primary care medical encounters.

Science.gov (United States)

Schilling, Lisa M; Scatena, Lisa; Steiner, John F; Albertson, Gail A; Lin, C T; Cyran, Lisa; Ware, Lindsay; Anderson, Robert J

2002-08-01

We wanted to characterize patient accompaniment to medical encounters and to explore the rationale and influence of the companion on the primary care medical encounter. This was a descriptive study. Academic general internal medicine physicians, patients, and patient companions participated. We measured the frequency of waiting and examination room companions, the reasons for accompaniment, the influence on the encounter, and the overall helpfulness of the companion as assessed by patients and companions. We also determined the physicianamprsquos assessment of the companionamprsquos influence, helpfulness, and behavior during the encounter. Companions were in the examination room for 16% of visits; 93% were family members. The rationales for waiting and examination room companions were to help with transportation, provide emotional support, and provide company. Examination room companions helped communicate concerns to the physician, remember the physicianamprsquos advice, make decisions, and communicate their own concerns to the physician. Patients believed that examination room companions influenced 75% of medical encounters, mainly by improving communication between physician and patient. Physicians agreed that examination room companions favorably influenced physician and patient understanding (60% and 46% of encounters, respectively). Patients indicated that waiting and examination room companions were very helpful for 71% and 83% of visits, respectively. Companions frequently accompany patients to their primary care medical encounters. They are often family members, and they assume important roles in enhancing patient and physician understanding.

Challenges teachers encounter in teaching English reading to the ...

African Journals Online (AJOL)

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 ... Data were analysed using Statistical Package for Social Sciences (SPSS) version 24, resulting in descriptive data.

Telephone Encounters Predict Future High Financial Expenditures in Inflammatory Bowel Disease Patients: A 3-Year Prospective Observational Study.

Science.gov (United States)

Click, Benjamin; Anderson, Alyce M; Ramos Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael A; Schwartz, Marc; Swoger, Jason; Barrie, Arthur; Szigethy, Eva; Regueiro, Miguel; Schoen, Robert E; Binion, David G

2018-04-01

Telephone activity is essential in management of complex chronic diseases including inflammatory bowel disease (IBD). Telephone encounters logged in the electronic medical record have recently been proposed as a surrogate marker of disease activity and impending health care utilization; however, the association between telephone calls and financial expenditures has not been evaluated. We performed a 3-year prospective observational study of telephone encounters logged at a tertiary referral IBD center. We analyzed patient demographics, disease characteristics, comorbidities, clinical activity, and health care financial charges by telephone encounter frequency. Eight hundred one patients met inclusion criteria (52.3% female; mean age, 44.1 y), accounted for 12,669 telephone encounters, and accrued $70,513,449 in charges over 3 years. High telephone encounter frequency was associated with female gender (P=0.003), anxiety/depression (Pfinancial charges the following year after controlling for demographic, utilization, and medication covariates. Increased telephone encounters are associated with significantly higher health care utilization and financial expenditures. Increased call frequency is predictive of future health care spending. Telephone encounters are a useful tool to identify patients at risk of clinical deterioration and large financial expense.

Joyful and serious intentions in the work of hospital clowns: A meta-analysis based on a 7-year research project conducted in three parts

Directory of Open Access Journals (Sweden)

Lotta Linge

2013-01-01

Full Text Available The present meta-analysis focuses on a 7-year research project entitled “Hospital clowns—in encounters with ailing children” and funded by the Swedish Childhood Cancer Foundation. The aim of the meta-analysis, which is based on the project's three studies, was to attempt to achieve a deeper psychological and more nuanced understanding of the unique encounters taking place between the hospital clowns and ailing children in the study. The methodological procedures were qualitative and included 51 interviews with four informant groups: the clowns, staff, children, and their parents. The meta-analysis revealed the unique aspects of hospital clowns’ work with respect to: a a quality of care that transcends boundaries, that is, a magical safe area where demands and adjustment were temporarily set aside and where the lighter side of life took precedence; b a non-demanding quality of care, where joy could be experienced without requiring something in return, where the child's terms mattered and where the child perspective was clearly in focus; and c a defusing quality of care, which is expressed as a positive counterweight that was otherwise lacking in medical care, where the hospital clowns used different solutions that bypassed regular hospital routines by temporarily distracting and making things easier for the children, parents, and staff in various care situations. Finally, the aim of the theoretical framework, in its synthesizing form, was to promote further psychological understanding of the area of humor that exists between fantasy and reality—an intermediate or transitional area that the hospital clowns created together with the children. In this transitional area, the hospital clowns’ unique contribution can be interpreted, in psychological terms, as being available as a vicarious therapeutic clown figure in a magical world that parallels reality.

Giant left atrium encountered during right-sided thoracentesis

Directory of Open Access Journals (Sweden)

Rashmi Advani

Full Text Available Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation. Keywords: Giant left atrium, Thoracentesis, Rheumatic heart disease, Ultrasound

Intercultural Reflection through the "Autobiography of Intercultural Encounters": Students' Accounts of Their Images of Alterity

Science.gov (United States)

Méndez García, María del Carmen

2017-01-01

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…

Increasing Throughput: Results from a 42-Hospital Collaborative to Improve Emergency Department Flow.

Science.gov (United States)

Zocchi, Mark S; McClelland, Mark S; Pines, Jesse M

2015-12-01

An 18-month collaborative in 42 hospitals across 16 communities in the United States to improve emergency department (ED) flow was conducted from October 2010 through March 2012. Hospitals were invited to participate through the Aligning Forces for Quality (AF4Q) program. Each participating hospital identified one or more interventions to improve ED flow and submitted data on four measures of ED flow: discharged length of stay (LOS), admitted LOS, boarding time, and left without being seen (LWBS) rates. Participating hospitals also provided quarterly progress reports on challenges encountered and lessons learned. Univariate linear regression was used to assess the effectiveness of interventions at the hospital level, where an improvement was defined as a negative slope in one or more of the throughput indicators. Challenges and lessons learned were tabulated and described. A total of 172 interventions were implemented across the 42 hospitals. Two thirds (n = 28) demonstrated improvement on at least one measure of ED flow. Among hospitals demonstrating improvement, the average reduction in discharged LOS was 26 minutes (95% confidence interval [CI] 11 to 41); admitted LOS, 36.5 minutes (95% CI 20 to 53), boarding time, 20.9 minutes (95% CI 12 to 30), and LWBS seen rates decreased by 1.4 absolute percentage points (95% CI 0.2 to 2.7). Teams were frequently challenged by issues related to leadership, staff buy-in, and resource constraints. The majority of hospitals in this collaborative improved on one or more ED flow measures. Many challenges were shared across hospitals, demonstrating that successful approaches to ED flow improvement require certain fundamental elements, including engaged leadership and staff, and sufficient resources.

Imaging Obsearvations of Jupiter's Sodium Magneto-Nebula During the Ulysses Encounter.

Science.gov (United States)

Mendillo, M; Flynn, B; Baumgardner, J

1992-09-11

Jupiter's great sodium nebula represents the largest visible structure traversed by the Ulysses spacecraft during its encounter with the planet in February 1992. Ground-based imaging conducted on Mount Haleakala, Hawaii, revealed a nebula that extended to at least +/-300 Jovian radii (spanning approximately 50 million kilometers); it was somewhat smaller in scale and less bright than previously observed. Analysis of observations and results of modeling studies suggest reduced volcanic activity on the moon lo, higher ion temperatures in the plasma torus, lower total plasma content in the torus, and fast neutral atomic clouds along the Ulysses inbound trajectory through the magnetosphere. Far fewer neutrals were encountered by the spacecraft along its postencounter, out-of-ecliptic trajectory.

Problems Encountered by Primary School Teachers in the Teaching of Music

Directory of Open Access Journals (Sweden)

Ilgım KILIÇ

2009-04-01

Full Text Available The aim of this research is to identify the problems encountered by primary school teachers and to makesuggestions to solve the problems. This is a descriptive study and also a case study. A questionnaire form wasused for data collection. The surveys were administered on the elementary education teachers working underAnkara Province Directorate of the Ministry of Education in 2006 – 2007 academic year. The data collectedwere analyzed using SPSS program and statistical analyses were carried out. It was concluded that theprimary school teachers’ music education was not sufficient and that they had encountered problems inimproving themselves with regard to music education. A number of suggestions were made in line with theresults obtained.

Crowdsourcing for Context: Regarding Privacy in Beacon Encounters via Contextual Integrity

Directory of Open Access Journals (Sweden)

Bello-Ogunu Emmanuel

2016-07-01

Full Text Available Research shows that context is important to the privacy perceptions associated with technology. With Bluetooth Low Energy beacons, one of the latest technologies for providing proximity and indoor tracking, the current identifiers that characterize a beacon are not sufficient for ordinary users to make informed privacy decisions about the location information that could be shared. One solution would be to have standardized category and privacy labels, produced by beacon providers or an independent third-party. An alternative solution is to find an approach driven by users, for users. In this paper, we propose a novel crowdsourcing based approach to introduce elements of context in beacon encounters.We demonstrate the effectiveness of this approach through a user study, where participants use a crowd-based mobile app designed to collect beacon category and privacy information as a scavenger hunt game. Results show that our approach was effective in helping users label beacons according to the specific context of a given beacon encounter, as well as the privacy perceptions associated with it. This labeling was done with an accuracy of 92%, and with an acceptance rate of 82% of all recommended crowd labels. Lastly, we conclusively show how crowdsourcing for context can be used towards a user-centric framework for privacy management during beacon encounters.

Formation of Tidally Induced Bars in Galactic Flybys: Prograde versus Retrograde Encounters

Science.gov (United States)

Łokas, Ewa L.

2018-04-01

Bars in disk galaxies can be formed by interactions with other systems, including those of comparable mass. It has long been established that the effect of such interactions on galaxy morphology depends strongly on the orbital configuration, in particular the orientation of the intrinsic spin of the galactic disk with respect to its orbital angular momentum. Prograde encounters modify the morphology strongly, including the formation of tidally induced bars, while retrograde flybys should have little effect on morphology. Recent works on the subject reached conflicting conclusions, one using the impulse approximation and claiming no dependence on this angle in the properties of tidal bars. To resolve the controversy, we performed self-consistent N-body simulations of hyperbolic encounters between two identical Milky Way-like galaxies assuming different velocities and impact parameters, with one of the galaxies on a prograde and the other on a retrograde orbit. The galaxies were initially composed of an exponential stellar disk and an NFW dark halo, and they were stable against bar formation in isolation for 3 Gyr. We find that strong tidally induced bars form only in galaxies on prograde orbits. For smaller impact parameters and lower relative velocities, the bars are stronger and have lower pattern speeds. Stronger bars undergo extended periods of buckling instability that thicken their vertical structure. The encounters also lead to the formation of two-armed spirals with strength inversely proportional to the strength of the bars. We conclude that proper modeling of prograde and retrograde encounters cannot rely on the simplest impulse approximation.

Research on the influence that communication in psychiatric encounters has on treatment.

Science.gov (United States)

Cruz, Mario; Pincus, Harold Alan

2002-10-01

The purpose of this article is to inform mental health professionals about the empirical literature on medical and psychiatric encounters and the influence of communicative behaviors on specific encounter outputs and treatment outcomes. A comprehensive review of the health communications literature from 1950 to 2001, using MEDLINE and PsycINFO, was conducted to identify relevant articles on the communication skills of psychiatrists and other physicians. These searches were augmented by personal correspondence with experts on changes in practice patterns in psychiatry and on medical and psychiatric communications research. A review of references within each article and information from the experts identified other relevant articles. Selection was then narrowed to include reports of studies that used structured written instruments that captured relevant physician and patient perceptions of the physician-patient relationship, content analysis of audio- or videotapes of communication in medical or psychiatric encounters, or interaction analysis systems used to categorize audio- or videotaped communicative behaviors in medical or psychiatric encounters. Twenty-five articles in medicine and 34 articles in psychiatry were selected. Medical communication researchers have observed associations between physicians' communicative skills and patients' satisfaction, patients' adherence to treatment recommendations, treatment outputs, and patients' willingness to file malpractice claims. The research has also shown that primary care physicians can be more responsive to patients' concerns without lengthening visits. In psychiatry, the literature can be organized into four discrete categories of research: negotiated treatment and the customer approach, therapeutic alliance, Gottschalk-Gleser content analysis of patients' speech, and content analysis of psychiatric interviews.

Common Ground in Cross Cultural Communication: Sequential and Institutional Contexts in Front Desk Service Encounters.

Science.gov (United States)

Kidwell, Mardi

2000-01-01

Looks at interactions between English-as-a-Second-Language students and English-speaking staff at the front desk of a language institute. Analysis focuses on the sequential organization of front desk encounters, revealing ways the participant's shared orientations to the organization and goals of these encounters facilitate native…

Preg-robbing of Gold by Carbonaceous Materials Encountered in ...

African Journals Online (AJOL)

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 ...

Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters.

Science.gov (United States)

Magruder, Steven F; Henry, J; Snyde, M

2005-08-26

Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

Acupuncture performed by nurses in the recovery room at a Danish biomedical hospital: how patients experience the effect of acupuncture treatment

DEFF Research Database (Denmark)

Larsen, Anne Bolt

2016-01-01

The abstract build on a master thesis submitted to Department of Anthropology, Aarhus University, Denmark. The thesis aims at investigating a new trend in Danish hospitals, where acupuncture increasingly is used in treating post-operative nausea and vomiting (PONV) and pain. It is a novelty...... that patients may receive acupuncture treatment in hospital. No scientific research has been completed to examine patients experience when treated with acupuncture at a modern hospital based on technology and natural science. This study took place in the recovery room at a regional hospital in Denmark, where...... acupuncture during the past 3-4 years has been implemented by nurses as an option for patients with PONV and post-operative pain. The purpose is to analyse the encounter between acupuncture and biomedicine, how patients experience the effect of acupuncture treatment and their view of acupuncture...

Encounter success of free-ranging marine predator movements across a dynamic prey landscape.

Science.gov (United States)

Sims, David W; Witt, Matthew J; Richardson, Anthony J; Southall, Emily J; Metcalfe, Julian D

2006-05-22

Movements of wide-ranging top predators can now be studied effectively using satellite and archival telemetry. However, the motivations underlying movements remain difficult to determine because trajectories are seldom related to key biological gradients, such as changing prey distributions. Here, we use a dynamic prey landscape of zooplankton biomass in the north-east Atlantic Ocean to examine active habitat selection in the plankton-feeding basking shark Cetorhinus maximus. The relative success of shark searches across this landscape was examined by comparing prey biomass encountered by sharks with encounters by random-walk simulations of 'model' sharks. Movements of transmitter-tagged sharks monitored for 964 days (16754 km estimated minimum distance) were concentrated on the European continental shelf in areas characterized by high seasonal productivity and complex prey distributions. We show movements by adult and sub-adult sharks yielded consistently higher prey encounter rates than 90% of random-walk simulations. Behavioural patterns were consistent with basking sharks using search tactics structured across multiple scales to exploit the richest prey areas available in preferred habitats. Simple behavioural rules based on learned responses to previously encountered prey distributions may explain the high performances. This study highlights how dynamic prey landscapes enable active habitat selection in large predators to be investigated from a trophic perspective, an approach that may inform conservation by identifying critical habitat of vulnerable species.

Relationship between Teach-back and patient-centered communication in primary care pediatric encounters.

Science.gov (United States)

Badaczewski, Adam; Bauman, Laurie J; Blank, Arthur E; Dreyer, Benard; Abrams, Mary Ann; Stein, Ruth E K; Roter, Debra L; Hossain, Jobayer; Byck, Hal; Sharif, Iman

2017-07-01

We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter. Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness. Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p=0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI)=4.97 (4.47-5.53)]and negative affect [AOR (95% CI)=5.39 (1.68-17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it. Teach-back was associated with more patient-centered communication and increased affective engagement of parents. Standardizing Teach-back use may strengthen patient-centered communication. Copyright © 2017 Elsevier B.V. All rights reserved.

Application of the binary-encounter theory to proton impact double ionization of atoms. [Cross sections

Energy Technology Data Exchange (ETDEWEB)

Kumar, A; Roy, B N [Bihar Univ. (India). Dept. of Physics

1977-10-21

Proton impact double ionisation of He has been investigated in the double-encounter model of Gryzinski (Phys. Rev.; 138A:305, 322 and 336 (1965)). The binary-encounter expressions developed by Vriens (Proc. Phys. Soc.; 89:13 (1966), Ibid 90:935 (1967)) along with an accurate quantum-mechanical velocity distribution for the bound electrons in both encounters have been used to obtain double-ionisation cross sections. These results have been compared with the experimental observations and earlier calculations by Gryzinski's method. The variation of sigmasub(+)/sigmasub(++) (single-ionisation cross section/double-ionisation cross section) with incident proton energy is also found to be in qualitative agreement with the experimentally observed variation.

Strange culinary encounters::stranger fetichism in "Jamie's Italian escape" and "Gordon's great escape"

OpenAIRE

Leer, Jonatan; Kjær, Katrine Meldgaard

2015-01-01

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 ‘other’ food cultures in these programs, paying special attention to how the encounter with the local Indian and Italian is imagined to be a gateway to an authentic and/or primitive experience. Our main...

Reconsidering Children's Encounters with Nature and Place Using Posthumanism

Science.gov (United States)

Malone, Karen

2016-01-01

This article explores and reconsiders the view of children's encounters with place as central to a place-based pedagogy that seeks to dismantle rather than support constructions of a nature-culture binary. I unpack the current fervour for reinserting the child in nature and nature-based education as a significant phenomenon in environmental and…

An attribution theory perspective on emotional labour in nurse-patient encounters: a nested cross-sectional study in paediatric settings.

Science.gov (United States)

Golfenshtein, Nadya; Drach-Zahavy, Anat

2015-05-01

To understand the role of patients' attributions under the attribution theory framework (locus, controllability, stability) in nurses' performance of surface or deep acting, as they unfold in interactions with different patients. Regulation of emotions at work, or emotional labour, has been conceptualized in terms of two main strategies: surface acting and deep acting. Most prior research tested for between-subject variation in the search for the factors evoking these strategies in nurses, assuming them to be trait-like characteristics. Only scant research has examined how nurses modify their emotional labour strategies in different patient-nurse encounters. A nested cross-sectional design (patients within nurses). Data were collected during 2011-2012 through validated questionnaires from the nursing staff (N = 41) of two paediatric hospital wards and their randomly selected patients (N = 239). Questionnaires were administered to nurses multiple times after encounters with different patients. Analyses were conducted using mixed effects models. In accordance with attribution theory, different combinations of locus, controllability and stability attributions were related to the choice of surface or deep acting. Nurses' perceptions of patients' controllability were associated positively with surface acting and negatively with deep acting. Interaction terms of stability and locus and of controllability and stability, were distinctively associated with deep and surface acting. Findings innovatively introduce the attribution process as an explanatory perspective to nurses' emotional labour and highlight its situational nature, providing a potential tool for emotional labour strategy prediction. Raising nurses' awareness of how they perceive patients may increase control of the strategies employed. © 2015 John Wiley & Sons Ltd.

SCM: a practical tool to implement hospital-based syndromic surveillance.

Science.gov (United States)

Ye, Chuchu; Li, Zhongjie; Fu, Yifei; Lan, Yajia; Zhu, Weiping; Zhou, Dinglun; Zhang, Honglong; Lai, Shengjie; Buckeridge, David L; Sun, Qiao; Yang, Weizhong

2016-06-18

Syndromic surveillance has been widely used for the early warning of infectious disease outbreaks, especially in mass gatherings, but the collection of electronic data on symptoms in hospitals is one of the fundamental challenges that must be overcome during operating a syndromic surveillance system. The objective of our study is to describe and evaluate the implementation of a symptom-clicking-module (SCM) as a part of the enhanced hospital-based syndromic surveillance during the 41st World Exposition in Shanghai, China, 2010. The SCM, including 25 targeted symptoms, was embedded in the sentinels' Hospital Information Systems (HIS). The clinicians used SCM to record these information of all the visiting patients, and data were collated and transmitted automatically in daily batches. The symptoms were categorized into seven targeted syndromes using pre-defined criteria, and statistical algorithms were applied to detect temporal aberrations in the data series. SCM was deployed successfully in each sentinel hospital and was operated during the 184-day surveillance period. A total of 1,730,797 patient encounters were recorded by SCM, and 6.1 % (105,352 visits) met the criteria of the seven targeted syndromes. Acute respiratory and gastrointestinal syndromes were reported most frequently, accounted for 92.1 % of reports in all syndromes, and the aggregated time-series presented an obvious day-of-week variation over the study period. In total, 191 aberration signals were triggered, and none of them were identified as outbreaks after verification and field investigation. SCM has acted as a practical tool for recording symptoms in the hospital-based enhanced syndromic surveillance system during the 41st World Exposition in Shanghai, in the context of without a preexisting electronic tool to collect syndromic data in the HIS of the sentinel hospitals.

Tourism and its discontents : Suri-tourist encounters in southern Ethiopia

NARCIS (Netherlands)

Abbink, J.

2000-01-01

Encounters between foreign tourists and people of different cultural background become very common in a globalized world. The nature of this exchange in cultural terms relates questions of identity construction and the emergence or creation of difference. This article addresses tourist-'native'

HIV-positive migrants’ encounters with the Swedish health care system

DEFF Research Database (Denmark)

Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina

2016-01-01

of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated......Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients....... Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid...

Room with a View: Ethical Encounters in Room 13

Science.gov (United States)

Grube, Vicky

2012-01-01

In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

Encontros de serviço e satisfação de clientes em hospitais Encuentros de los servicios y satisfación de los clientes en hospitales Service encouters and customer satisfaction in hospitals

Directory of Open Access Journals (Sweden)

Gisela Maria Schebella Souto de Moura

2004-08-01

Full Text Available A pesquisa realizada versa sobre os encontros de serviço e a satisfação de clientes em hospitais. O estudo é de natureza exploratória e teve por objetivo identificar os encontros de serviço que ocorrem no hospital e os atributos de satisfação a eles relacionados. Os dados foram coletados com profissionais e clientes de hospitais, no ano de 2003, por meio de entrevistas utilizando a técnica do incidente crítico. A análise de conteúdo evidenciou os atributos de satisfação dos encontros de serviço que compõem os processos de admissão, internação e alta. Os resultados fornecem importantes informações para ao gestor de serviços hospitalares, permitindo o delineamento de ações com foco no cliente.La pesquiza realizada tratase sobre los encuentros de los servicios y la satisfación de los clientes en hospitales. El estudio es de naturaza exploratoria e tiene por objetivo identificar los encuentros de los servicios que acontecen en el hospital y los requisitos de la satisfación a estos relacionados. Los dados fueron coletados con profesionales y clientes de hospitales, em el año de 2003, por medio de entrevistas utilizando la tecnica del episodio crítico. La analisis del contenido resalto los requisitos de la satisfación de los encuentros de los servicios que componen los procesos de admisión, internación y baja del hospital. Los resultados fornecen importantes informaciones para el gestor de servicios hospitalares, permitiendo el delineamiento de las aciones con foco en el cliente.This research is about service encounters and customer satisfaction in hospitals. The study is exploratory and was aimed at identifying the service encounters maintained in hospitals and the satisfaction attributes related to them. The data were collected with hospital professionals and customer, in 2003, by means of interviews using the critical incident technique. The content analysis evidentiated the satisfaction attributes of the service

Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia.

Science.gov (United States)

Ganasegeran, K; Al-Dubai, S A R

2014-01-01

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.

Frequently Encountered Animal Diseases at Animal Hospital Birnin ...

African Journals Online (AJOL)

The least occurring disorders were Fowl typhoid, dislocation, trypanasomosis, pyometra, orf, stomatitis, grass tetany, canine distemper, atresia ani and rectal prolapse 1(0.2%) case each. Information generated can be useful to Government agencies involved in formulating policies and guidelines for prevention and control of ...

Y. Laberge on Raphael-Hernadez and Steen’s AfroAsian encounters: Culture, History, Politics.

Directory of Open Access Journals (Sweden)

2008-12-01

Full Text Available Heike Raphael-Hernadez and Shannon Steen,  Eds. AfroAsian encounters: Culture, History, Politics. New York: New York University Press, 2006.  xxiii + 342 p. An overlooked, interdisciplinary, often innovative book, Afroasian encounters: Culture, History, Politics offers a collection of seventeen new essays related to the African-Asian intersections, cosmopolitanism and cross-cultural theories. In terms of emerging disciplines, we already had Atlantic studies (or "Trans-Atlantic studies", an i...

Challenges encountered by critical care unit managers in the large intensive care units.

Science.gov (United States)

Matlakala, Mokgadi C; Bezuidenhout, Martie C; Botha, Annali D H

2014-04-04

Nurses in intensive care units (ICUs) are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Challenges encountered by critical care unit managers in the large intensive care units

Directory of Open Access Journals (Sweden)

Mokgadi C. Matlakala

2014-04-01

Full Text Available Background: Nurses in intensive care units (ICUs are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. Objectives: The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. Method: A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Results: Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Conclusion: Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Neuropeptides and social behavior of rats tested in dyadic encounters

NARCIS (Netherlands)

Niesink, R.J.M.; Ree, J.M. van

1984-01-01

The effects of various neuropeptides on social behavior was studied in a test procedure in which 7-day isolated animals were tested together with non-isolated partners in dyadic encounters. The short-term isolation procedure increased the frequency and duration of social activities of the rats, but

Encountering Worlds: Performing In/As Philosophy in the Ecological Age

Directory of Open Access Journals (Sweden)

João Florêncio

2015-04-01

Full Text Available Within the context of the ‘Anthropocene’, the current geological epoch marked by the impact of human activity on terrestrial ecosystems and geological formations, this article considers the ways in which the ecological blurring of boundaries between ‘Nature’ and ‘Culture’ might affect existing ontologies of performance. Departing from Richard Bauman’s definition of performance as both communication and enactment, we will use the postulates of Graham Harman’s Object-Oriented Ontology to speculate on what performance might mean beyond the human/nonhuman divide.  Ultimately, it will be claimed, performance, understood as both enactment and unveiling, is at the core of all encounters between all bodies and irrespective of their perceived nature. As a result, the world must once again be thought as theatrum mundi, as a stage where bodies always encounter one another through the contingency of the personae they play, personae that nonetheless are unable to exhaust the full being of the bodies behind them.

Challenges encountered during postgraduate program in orthodontics: An online survey

Directory of Open Access Journals (Sweden)

Amanish Singh Shinh

2017-01-01

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.

Brief encounters: Assembling cosmetic surgery tourism.

Science.gov (United States)

Holliday, Ruth; Bell, David; Cheung, Olive; Jones, Meredith; Probyn, Elspeth

2015-01-01

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.

Strength and Weakness of Crisis Management in Hormozgan Medical University’s Hospitals

Directory of Open Access Journals (Sweden)

Zahra Mastane

2012-02-01

Full Text Available Background & Objective: Various communities continuously try to manage the unexpected events. In this regard, hospitals with providing timely health care services has transformed to the most pragmatic unit of health system. Planning and preparation of them should be strategic policy of health system. This paper aimed to investigate the strength and weakness of crisis management in training hospitals of Hormozgan University of Medical Sciences. Materials & Methods: This is descriptive-analytic research. Research statistical population includes managers, nursing directors, financial directors and masters of crises committee of hospitals, totally 34 persons. Data collected with questionnaire in 8 domains and demographic information. Questionnaire was validated and reliabled. Collected data entered to SPSS and analyzed by descriptive & inferential statistics. Results: Preparedness Rate of Hospitals encounters Unexpected Events was average (50%. Preparedness rate in managerial policies (44.1%, structural and non-structural stability (41.2% and register & informed (47% domains were in average level. In this regard HEICS (32.3%, maneuvers (55.9% and use of relative technologies were in very low grade. Between preparedness rate with crises committee function, training and maneuvers there were meaningful relations (P<0.05. Conclusion: Suitable crises management will be feasible by documented planning, preparing intra and extra organizational relations, reinforcing human resources with organizing, delivering of training and durational maneuvers to them. Keywords: Strength, Weakness, Crisis, Crisis Management Type of Article: Original Article

arXiv Gravitational wave energy emission and detection rates of Primordial Black Hole hyperbolic encounters

CERN Document Server

García-Bellido, Juan

2018-01-01

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 could be within the range of both LIGO (10-1000Hz) and LISA ($10^{-6}-1$ Hz). 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.

Littoral Encounters : The Shore as Cultural Interface in King Horn

NARCIS (Netherlands)

Sobecki, Sebastian

2006-01-01

1. III * Later Medieval: Excluding Chaucer -- Brown et al., 10.1093 ... ... between the Saracens and the londisse men allied to the protagonist (' Littoral Encounters: the Shore as Cultural Interface in King Horn', Al-Mas a ... www.ywes.oxfordjournals.org/cgi/content/full/man0092 2.Murray, Alan V.

'Shakespeare in the bush' and encountering the other in the ...

African Journals Online (AJOL)

'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 ...

A transcultural study of Jordanian nursing students' care encounters within the context of clinical education.

Science.gov (United States)

Nahas, V

2000-06-01

Clinical education is an integral part of nursing education. Clinical teachers are the vital link in this teaching-learning process. The quality and quantity of student-teacher interactions in the clinical area can either facilitate or hinder students' learning. This paper presents a part of a larger study that discovered, described, explained and compared Australian and Jordanian nursing students' caring and non-caring encounters with their clinical teachers within the context of clinical education. The study was guided by Leininger's theory of culture care universality and diversity and Leininger's ethnonursing research method was utilised. The informants consisted of 12 key informants and 35 general informants. Three major themes emerged from the analysis of the data: (1) clinical teacher's caring behaviours; (2) student-teacher caring encounters; and (3) caring encounter consequences. Under these themes, care constructs emerged which gave light to the Jordanian nursing students' care meanings, expressions and values within their cultural environment, social structures and world view. The overall findings revealed that Jordanian nursing students found their clinical experiences as beneficial when their encounters with the clinical teacher were conducted through mothering, translating, sustaining, negotiating and transforming processes.

Nurses' use of pliable and directed strategies when encountering children in child and school healthcare.

Science.gov (United States)

Harder, Maria; Enskär, Karin; Golsäter, Marie

2017-03-01

Nurses in Swedish child and school healthcare need to balance their assignment of promoting children's health and development based on the national health-monitoring programme with their responsibility to consider each child's needs. In this balancing act, they encounter children through directed and pliable strategies to fulfil their professional obligations. The aim of this study was to analyse the extent to which nurses use different strategies when encountering children during their recurrent health visits throughout childhood. A quantitative descriptive content analysis was used to code 30 video recordings displaying nurses' encounters with children (3-16 years of age). A constructed observation protocol was used to identify the codes. The results show that nurses use pliable strategies (58%) and directed strategies (42%) in encounters with children. The action they use the most within the pliable strategy is encouraging (51%), while in the directed strategy, the action they use most is instructing (56%). That they primarily use these opposing actions can be understood as trying to synthesize their twofold assignment. However, they seem to act pliably to be able to fulfil their public function as dictated by the national health-monitoring programme, rather than to meet each child's needs.

Protoplanetary disc truncation mechanisms in stellar clusters: comparing external photoevaporation and tidal encounters

Science.gov (United States)

Winter, A. J.; Clarke, C. J.; Rosotti, G.; Ih, J.; Facchini, S.; Haworth, T. J.

2018-04-01

Most stars form and spend their early life in regions of enhanced stellar density. Therefore the evolution of protoplanetary discs (PPDs) hosted by such stars are subject to the influence of other members of the cluster. Physically, PPDs might be truncated either by photoevaporation due to ultraviolet flux from massive stars, or tidal truncation due to close stellar encounters. Here we aim to compare the two effects in real cluster environments. In this vein we first review the properties of well studied stellar clusters with a focus on stellar number density, which largely dictates the degree of tidal truncation, and far ultraviolet (FUV) flux, which is indicative of the rate of external photoevaporation. We then review the theoretical PPD truncation radius due to an arbitrary encounter, additionally taking into account the role of eccentric encounters that play a role in hot clusters with a 1D velocity dispersion σv ≳ 2 km/s. Our treatment is then applied statistically to varying local environments to establish a canonical threshold for the local stellar density (nc ≳ 104 pc-3) for which encounters can play a significant role in shaping the distribution of PPD radii over a timescale ˜3 Myr. By combining theoretical mass loss rates due to FUV flux with viscous spreading in a PPD we establish a similar threshold for which a massive disc is completely destroyed by external photoevaporation. Comparing these thresholds in local clusters we find that if either mechanism has a significant impact on the PPD population then photoevaporation is always the dominating influence.

Proton therapy in ophthalmology: status report and problems encountered

International Nuclear Information System (INIS)

Chauvel, P.; Iborra-Brassart, N.; Courdi, A.; Herault, J.; Teissier, E.; Pignol, J.P.; Bondiau, P.Y.

1996-01-01

The proton therapy facility of the Centre Antoine-Lacassagne in Nice began of ocular tumors in June 1991. Up to October 1995, a total number of 600 patients were treated. An overview of the cases treated during the first 4 years of activity is given and the main problems encountered in the field, possibly interacting with the accuracy and reliability of the dose distribution, are listed. (author)

Neural Correlates of Racial Ingroup Bias in Observing Computer-Animated Social Encounters

Directory of Open Access Journals (Sweden)

Yuta Katsumi

2018-01-01

Full Text Available Despite evidence for the role of group membership in the neural correlates of social cognition, the mechanisms associated with processing non-verbal behaviors displayed by racially ingroup vs. outgroup members remain unclear. Here, 20 Caucasian participants underwent fMRI recording while observing social encounters with ingroup and outgroup characters displaying dynamic and static non-verbal behaviors. Dynamic behaviors included approach and avoidance behaviors, preceded or not by a handshake; both dynamic and static behaviors were followed by participants’ ratings. Behaviorally, participants showed bias toward their ingroup members, demonstrated by faster/slower reaction times for evaluating ingroup static/approach behaviors, respectively. At the neural level, despite overall similar responses in the action observation network to ingroup and outgroup encounters, the medial prefrontal cortex showed dissociable activation, possibly reflecting spontaneous processing of ingroup static behaviors and positive evaluations of ingroup approach behaviors. The anterior cingulate and superior frontal cortices also showed sensitivity to race, reflected in coordinated and reduced activation for observing ingroup static behaviors. Finally, the posterior superior temporal sulcus showed uniquely increased activity to observing ingroup handshakes. These findings shed light on the mechanisms of racial ingroup bias in observing social encounters, and have implications for understanding factors related to successful interactions with individuals from diverse backgrounds.

Encounters with Pinyon-Juniper influence riskier movements in Greater Sage-Grouse across the Great Basin

Science.gov (United States)

Prochazka, Brian; Coates, Peter S.; Ricca, Mark; Casazza, Michael L.; Gustafson, K. Ben; Hull, Josh M.

2016-01-01

Fine-scale spatiotemporal studies can better identify relationships between individual survival and habitat fragmentation so that mechanistic interpretations can be made at the population level. Recent advances in Global Positioning System (GPS) technology and statistical models capable of deconstructing high-frequency location data have facilitated interpretation of animal movement within a behaviorally mechanistic framework. Habitat fragmentation due to singleleaf pinyon (Pinus monophylla; hereafter pinyon) and Utah juniper (Juniperus osteosperma; hereafter juniper) encroachment into sagebrush (Artemisia spp.) communities is a commonly implicated perturbation that can adversely influence greater sage-grouse (Centrocercus urophasianus; hereafter sage-grouse) demographic rates. Using an extensive GPS data set (233 birds and 282,954 locations) across 12 study sites within the Great Basin, we conducted a behavioral change point analysis and subsequently constructed Brownian bridge movement models from each behaviorally homogenous section. We found a positive relationship between modeled movement rate and probability of encountering pinyon-juniper with significant variation among age classes. The probability of encountering pinyon-juniper among adults was two and three times greater than that of yearlings and juveniles, respectively. However, the movement rate in response to the probability of encountering pinyon-juniper trees was 1.5 times greater for juveniles. We then assessed the risk of mortality associated with an interaction between movement rate and the probability of encountering pinyon-juniper using shared frailty models. During pinyon-juniper encounters, on average, juvenile, yearling, and adult birds experienced a 10.4%, 0.2%, and 0.3% reduction in annual survival probabilities. Populations that used pinyon-juniper habitats with a frequency ≥ 3.8 times the overall mean experienced decreases in annual survival probabilities of 71.1%, 0.9%, and 0.9%. This

Medical Device-Associated Candida Infections in a Rural Tertiary Care Teaching Hospital of India

Directory of Open Access Journals (Sweden)

Sachin C. Deorukhkar

2016-01-01

Full Text Available Health care associated infections (HCAIs add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI, catheter-associated urinary tract infection (CA-UTI, intravascular catheter-related blood stream infections (CR-BSI, and ventilator-associated pneumonia (VAP, were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

National audit of pressure ulcers and incontinence-associated dermatitis in hospitals across Wales: a cross-sectional study.

Science.gov (United States)

Clark, Michael; Semple, Martin J; Ivins, Nicola; Mahoney, Kirsten; Harding, Keith

2017-08-21

The Chief Nurse National Health Service Wales initiated a national survey of acute and community hospital patients in Wales to identify the prevalence of pressure ulcers and incontinence-associated dermatitis. Teams of two nurses working independently assessed the skin of each inpatient who consented to having their skin observed. Over 28 September 2015 to 2nd October 2015, 8365 patients were assessed across 66 hospitals with 748 (8.9%) found to have pressure ulcers. Not all patients had their skin inspected with all mental health patients exempt from this part of the audit along with others who did not consent or were too ill. Of the patients with pressure ulcers, 593 (79.3%) had their skin inspected with 158 new pressure ulcers encountered that were not known to ward staff, while 152 pressure ulcers were incorrectly categorised by the ward teams. Incontinence-associated dermatitis was encountered in 360 patients (4.3%), while medical device-related pressure ulcers were rare (n=33). The support surfaces used while patients were in bed were also recorded to provide a baseline against which future changes in equipment procurement could be assessed. The presence of other wounds was also recorded with 2537 (30.3%) of all hospital patients having one or more skin wounds. This survey has demonstrated that although complex, it is feasible to undertake national surveys of pressure ulcers, incontinence-associated dermatitis and other wounds providing comprehensive and accurate data to help plan improvements in wound care across Wales. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

Directory of Open Access Journals (Sweden)

Zynal Karaca

2013-09-01

Full Text Available Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.Results: The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.Conclusion: There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups. [West J Emerg Med. 2013;14(5:529–541.

Pattern of congenital malformations in newborn: a hospital-based study

Directory of Open Access Journals (Sweden)

Mohamed El Koumi

2013-02-01

Full Text Available Background: Birth defects, encountered frequently by pediatricians, are important causes of childhood morbidity and mortality. Birth defects can be classified based on their severity, pathogenic mechanism or whether they involve a single system or multiple systems. This hospital based prospective descriptive study highlights the prevalence of congenital anomalies (CAs in one year, among liveborn neonates delivered in a university hospital. Design and methods: All women giving birth to babies were included. Demographic details, associated risk factors and the type of CAs in babies were recorded. Diagnosis of CAs was based on clinical evaluation, radiographic examination and chromosomal analysis of newborn whenever recommended. Results: The overall incidence of CAs among liveborn neonates was 2.5%, as most of the cases were referred to Zagazig University Hospital for delivery. The musculoskeletal system (23% was the most commonly involved; followed by central nervous system (20.3%. Involvement of more than one system was observed in (28.6% cases. Out of the maternal and fetal risk factors, parental consanguinity, maternal undernutrition and obesity, positive history of an anomaly in the family, low birth weight(LBW, and prematurity were significantly associated with higher frequency of CAs(p <0.05, with non-significant differences for maternal age and the sex of the neonates. Conclusion : The current study highlighted the point prevalence of congenital anomalies in one year in zagazig university hospital in Egypt. The present study revealed a high prevalence of congenital anomalies in our locality and stressed upon the importance of carrying out a thorough clinical examination of all neonates at birth.

Encounter Probability of Individual Wave Height

DEFF Research Database (Denmark)

Liu, Z.; Burcharth, H. F.

1998-01-01

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....

Being Disoriented: Uncertain Encounters with Disability

Directory of Open Access Journals (Sweden)

Ryan C. Parrey

2016-05-01

Full Text Available Disorienting encounter with disability are those in which the meaning of disability is an open question, and in which our relation to it is questionable. This essay explores the relationship between disability and disorientation on conceptual but also concrete levels. First, I examine the connection between disability and disorientation within disability studies. Second, I provide a preliminary sketch of disorientation through what I call ontic disruption and ontological disorientation. Third, I take up Leder's (1990 articulation of bodily disappearance and embodied dysappearance to address ableist violence. Finally, I develop the notion of dysorientation — a prolonged, persistent or recurrent sense of disorientation — as a useful concept for understanding experiences of ableism but also as a significant meeting point between impairment and disability.

Angular distribution of binary encounter electrons

International Nuclear Information System (INIS)

Liao, C.; Richard, P.; Grabbe, S.

1993-01-01

The double differential cross section, DDCS, of the binary encounter electrons (BEe) in 1 MeV/u F q+ + H 2 (q = 4, 6, 8, 9) is measured from 0 to 70 degrees with respect to the beam direction. At 0 degrees the data confirm the decrease of the cross section with increasing projectile charge state. At larger observation angles, the data are in fair agreement with the prediction proposed by Shingal et al. where the ratio of the DDCS for 6+ ions to bare ions is less than 1 for θ lab > 30 degrees and greater than 1 for θ lab q+ . We also observed that the energies of the BEe peak are charge state, q, independent at 0 degrees observation angle, but q dependent at larger observation angles

Difficulties Encountered by Academicians in Academic Research Processes in Universities

Science.gov (United States)

Yalçin, Sinan; Altun Yalçin, Sema

2017-01-01

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…

With an Open Mind: Openness to Experience Moderates the Effect of Interethnic Encounters on Support for Immigration

DEFF Research Database (Denmark)

Danckert, Bolette; Dinesen, Peter Thisted; Klemmensen, Robert

2017-01-01

to new experiences, react more positively/less negatively to interethnic encounters. We test this conjecture on two surveys collected in Denmark and Canada. In line with our expectations, the analyses suggest that openness positively moderates the effect of interethnic encounters on immigration attitudes...

Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

Science.gov (United States)

Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

2015-01-01

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.

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

Science.gov (United States)

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Encounters with service professionals experienced by children from families with alcohol problems

DEFF Research Database (Denmark)

Werner, Anne; Malterud, Kirsti

2016-01-01

Aim: The aim of this study was to explore encounters with service professionals experienced in childhood and adolescence by children who grew up with parental alcohol abuse. We focused on their accounts from situations indicating children’s struggles or parental drinking problems. Methods: Semi......-structured qualitative interview study was conducted with retrospective data from nine adults. Systematic text condensation was used to understand childhood experiences from encounters with professionals. Results: Participants believed that professionals rarely recognised their parents’ drinking problems. The children...... parental drinking. Even when problems were obvious, participants felt that professionals took no further action. Medical and social problems were managed within very confined perspectives. Conclusions: Specific commitment to confront cultural taboos is needed to attend to children’s unmet needs...

Strange Encounter: Depicting An “Other” Reality for Young Readers

Directory of Open Access Journals (Sweden)

YOU Chengcheng

2015-04-01

Full Text Available This article explores fantastic encounters between humans and non-humans inChinese and Japanese Children’s literature. Naoko Awa’s collection of short storiesThe Fox’s Window and Other Stories is closely read to elucidate narrative features ofwhat I call as “strange encounter”, the magic realistic human-animal encounter inChinese and Japanese cultural context. Chinese supernatural literature and culturaltradition of yaoguai, which have been assimilated into Japanese culture (Japaneseyōkai, are referred to throughout my discussion.  Todorov’s approach to thefantastic, Judith Zeitlin’s study of Strange Tales of Liaozhai Studio, and RosemaryJackson’s study of fantasy are drawn upon to illuminate the meaning of encountersbetween men and animals. I argue that magic realism as a relatively new genrefor young readers, not only reflects the author’s individual creative experienceof the fantastic but also partakes in the sense of an “other” reality that resonatesthroughout a cultural community. Perjumpaan Ganjil: Gambaran suatu Realitas “Liyan” bagi Pembaca Muda.Artikel ini membahas perjumpaan fantastis antara ‘manusia’ dan ‘non-manusia’ didalam sastra anak Cina dan Jepang. Antologi cerita pendek karangan Naoko Awa TheFox’s Window and Other Stories akan dikupas untuk memaparkan fitur naratif yangdisebut sebagai ‘perjumpaan aneh’ (strange encounter, perjumpaan magis-realis antaramanusia dengan binatang dalam konteks kebudayaan Cina dan Jepang. Karya sastrasupernatural Cina dan keberadaan yaoguai yang telah diasimilasi dalam kebudayaanJepang (disebut youkai menjadi sebuah referensi penting dalam artikel ini. Pendekatanfantasi dari Todorov, studi Judith Zeitlin tentang Strange Tales of Liaozhai Studio,dan studi fantasi dari Rosemary Jackson digunakan untuk memperjelas arti dariperjumpaan antara manusia dan binatang. Magis-realis sebagai sesuatu yang baru bagi pembaca muda tidak hanya merefleksikan pengalaman

Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles

NARCIS (Netherlands)

Oerlemans, M.; Dielissen, P.W.; Timmerman, A.; Ram, P.; Maiburg, B.; Muris, J.; Vleuten, C. van der

2017-01-01

BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral

The Tourism Encounter in Community-Based Tourism in Northern Thailand: Empty Meeting Ground or Space for Change?

Directory of Open Access Journals (Sweden)

Claudia Dolezal

2015-12-01

Full Text Available This article offers a contribution to the anthropology of tourism by investigating the tourism encounter in community-based tourism (CBT in Northern Thailand. It does so by discussing MacCannell’s (1992 idea of the Empty Meeting Grounds and Said’s Orientalism (1978, two works that contributed to research on power inequalities between tourists and residents in the developing world. By establishing a relationship between the two and embedding these in the wider literature on the tourism encounter, this article suggests moving away from binaries towards understanding the space of the tourism encounter and its potential for change. Building on empirical research conducted in Ban Mae Kampong, a CBT village in Northern Thailand, findings suggest that CBT shows signs of resident-host interactions that are based on understanding and learning rather than exploitation. While also in CBT friendships and meaning take time to emerge and the ‘Other’ is used as attraction, villagers’ agency and control over tourism are acknowledged. This paper therefore calls for a revisiting of the theoretical grounding that influences our understanding of the tourism encounter and argues for an investigation of community power relations in connection to the tourism encounter and its potential for residents’ empowerment in CBT.

Medical professionalism from a socio-cultural perspective: Evaluating medical residents communicative attitudes during the medical encounter in Malaysia

Directory of Open Access Journals (Sweden)

K Ganasegeran

2014-01-01

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.

Realistic interpretation of quantum mechanics and encounter-delayed-choice experiment

Science.gov (United States)

Long, GuiLu; Qin, Wei; Yang, Zhe; Li, Jun-Lin

2018-03-01

In this paper, a realistic interpretation (REIN) of the wave function in quantum mechanics is briefly presented. We demonstrate that in the REIN, the wave function of a microscopic object is its real existence rather than a mere mathematical description. Specifically, the quantum object can exist in disjointed regions of space just as the wave function is distributed, travels at a finite speed, and collapses instantly upon a measurement. Furthermore, we analyze the single-photon interference in a Mach-Zehnder interferometer (MZI) using the REIN. Based on this, we propose and experimentally implement a generalized delayed-choice experiment, called the encounter-delayed-choice experiment, where the second beam splitter is decided whether or not to insert at the encounter of two sub-waves along the arms of the MZI. In such an experiment, the parts of the sub-waves, which do not travel through the beam splitter, show a particle nature, whereas the remaining parts interfere and thus show a wave nature. The predicted phenomenon is clearly demonstrated in the experiment, thus supporting the REIN idea.

An encounter between psychology and religion: humanistic psychology and the Immaculate Heart of Mary nuns.

Science.gov (United States)

Kugelmann, Robert

2005-01-01

In the 1960s, humanistic psychology changed the relationship between psychology and religion by actively asserting the value of individual experience and self-expression. This was particularly evident in the encounter group movement. Beginning in 1967, Carl Rogers conducted a series of encounter groups, in order to promote "self-directed change in an educational system," for the Sisters of the Immaculate Heart of Mary, a religious order in California running an educational system. William Coulson, one of Rogers's associates in the project, later charged that the encounter groups undermined the religious order and played a major contributing part in the breakup of the order in 1970. The article examines these charges, situating the incident within the context of the changes occurring in religious life and in psychology in the 1960s. The article concludes that an already existing conflict the nuns had with the conservative Cardinal McIntyre of Los Angeles led to the departure of some 300 nuns from the order, who began the Immaculate Heart Community, an organization existing today. Nevertheless, encounter groups proved to be a psychological technology that helped to infuse a modern psychological--specifically, a humanistic psychological--perspective into contemporary religious life. 2005 Wiley Periodicals, Inc.

The Consequences of Service Encounter Failure in Shopping Centers: A Study with Visually Impaired Consumers

Directory of Open Access Journals (Sweden)

Pedro Felipe da Costa Coelho

2017-06-01

Full Text Available The advent of the Brazilian Law on the Inclusion of People with Disabilities, in 2015, has brought a series of implications for marketing researchers, since it concerns the rights to include people with disabilities in public and private consumption spaces, such as shopping malls. Despite the growth of these consumer spaces in Brazil, several failures in service encounters are frequent, especially when consumers are visually impaired. Therefore, this study aims to understand the consequences of service encounters failures in shopping malls for the consumer with visual disabilities. To reach this goal, we used a qualitative approach of phenomenological nature. Data were collected through direct and naturalistic observations and conduct of nine face-to-face interviews with visually impaired consumers. Through content analysis of the results, we concluded that there is a diversity of failures occurred in service encounters, such as excessive piety of sellers to consumers, contempt and the sudden change in the service script. For this reason, the consequences of service encounter failure were from the verbal confrontation and the withdrawal of the transaction to the word-of-mouth and negative expressions of frustration in virtual social networks. This article also presents managerial and academic contributions for marketing researchers.

Encounters for common illnesses in general practice increased in obese patients

NARCIS (Netherlands)

Wayenburg, van C.A.M.; Lerniengre, M.B.T.; Reenen-Schimmel, van A.H.; Bor, J.H.J.; Bakx, J.C.; Staveren, van W.A.; Weel, van C.; Binsbergen, van J.J.

2008-01-01

Background. Obese patients are known to have more chronic medical conditions. Objective. To compare the frequency of encounter for episodes of the 10 most common illnesses in general practice between obese and non-overweight patients. Methods. Data were derived from the Continuous Morbidity

Reading the copepod personal ads : increasing encounter probability with hydromechanical signals

NARCIS (Netherlands)

van Duren, LA; Stamhuis, EJ; Videler, JJ

1998-01-01

Females of the calanoid copepod Temora longicornis react to chemical exudates of male conspecifics with little hops, quite distinct from their normal smooth uniform swimming motion. These hops possibly serve to create a hydrodynamical signal in the surrounding water, to increase encounter

Construct validity of the reporter-interpreter-manager-educator structure for assessing students' patient encounter skills

DEFF Research Database (Denmark)

Tolsgaard, Martin G.; Arendrup, Henrick; Lindhardt, Bjarne O.

2012-01-01

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...... in a two-step procedure. The first step (implemented in 2009) was a randomized, controlled, experimental study in which the performance of three groups (16 fourth-year medical students, 16 sixth-year medical students, and 16 interns) was assessed in two simulated patient encounters. The second step...... (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...

Observations of oral hygiene care interventions provided by nurses to hospitalized older people.

Science.gov (United States)

Coker, Esther; Ploeg, Jenny; Kaasalainen, Sharon; Carter, Nancy

Dependent older hospitalized patients rely on nurses to assist them with the removal of plaque from their teeth, dentures, and oral cavities. Oral care interventions by 25 nurses on post-acute units, where patients have longer hospital stays, were observed during evening care. In addition to efforts to engage patients in oral care, nurses provided the following interventions: (a) supporting the care of persons with dentures; (b) supporting the care of natural teeth; (c) cleansing the tongue and oral cavity; and (d) moisturizing lips and oral tissues. Patients' oral hygiene care was supported in just over one-third of encounters. Denture care was inconsistently performed, and was infrequently followed by care of the oral cavity. Nurses did not encourage adequate self-care of natural teeth by patients, and infrequently moisturized tissues. Evidence-based oral hygiene care standards are required to assist nurses to support patients in achieving optimal oral hygiene outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Desistance from Delinquency through Social Encounters with Significant Others: Case Studies of Japanese Juvenile Criminals

OpenAIRE

SHIRAI, Toshiaki; SATOMI, Akira; KONDO, Junya

2013-01-01

In order to clarify how young people stop delinquency, we conducted life history analysis, survey study and case studies. The findings indicate that, first, the encounter with significant persons can make them stop delinquency through the capacity to tolerate their depression and, second, the psychologists can play a role of the significant other using the framework of rehabilitation institutions. The encounter with significant others offers intrinsic motivation and the readiness for their pe...

VG2 LECP 0.4S HIGH RESOLUTION SATURN NEAR ENCOUNTER DATA

Data.gov (United States)

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...

VG2 LECP 0.4S HIGH RESOLUTION SATURN FAR ENCOUNTER DATA

Data.gov (United States)

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...

Ethics in the bank internet encounter

DEFF Research Database (Denmark)

Rendtorff, Jacob Dahl; Mattsson, Jan

2012-01-01

/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...

Alien encounter a scientific novel

CERN Document Server

Schulze-Makuch, Dirk

2014-01-01

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...

Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

Directory of Open Access Journals (Sweden)

George R Bergus

2010-11-01

Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

Encounters with immigrant customers: perspectives of Danish community pharmacy staff on challenges and solutions.

Science.gov (United States)

Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig; Traulsen, Janine M

2013-06-01

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. A questionnaire was distributed to one pharmacist and one pharmacy assistant employed at each of the 55 community pharmacies located in the five local councils in Denmark with the highest number of immigrant inhabitants. The total response rate was 76% (84/110). Most respondents found that the needs of immigrant customers were not sufficiently assessed at the counter (n = 55, 65%), and that their latest encounter with an immigrant customer was less satisfactory than a similar encounter with an ethnic Danish customer (n = 48, 57%) (significantly more pharmacists than assistants: odds ratio, OR, 3.19; 95% confidence interval, CI, 1.27-8.04). Forty-two per cent (n = 35) perceived that immigrant customers put pressure on pharmacy staff resources, while 27% (n = 23) found that the immigrant customer group make work more interesting. More pharmacists than assistants agreed on the latter (OR, 3.43; 95% CI, 1.04-11.33). Within the past 14 days, 86% (n = 72) experienced that their advice and counselling were not understood by immigrant customers, whereas 49% (n = 41) experienced lack of understanding by ethnic Danes; and 30% (n = 25) had consciously refrained from counselling an immigrant, whereas 19% (n = 16) had done so with an ethnic Dane. Use of under-aged children as interpreters during the past month was reported by 79% of respondents. Regarding suggestions on how to improve encounters with immigrant customers, most respondents listed interventions aimed at patients, general practitioners and pharmaceutical companies. Community pharmacy staff report poorer quality in their encounters with immigrant customers, including sub-optimal counselling and frequent use of under-aged children as

Modeling close encounters with massive asteroids: a Markovian approach. An application to the Vesta family

Science.gov (United States)

Carruba, V.; Roig, F.; Michtchenko, T. A.; Ferraz-Mello, S.; Nesvorný, D.

2007-04-01

Context: Nearly all members of the Vesta family cross the orbits of (4) Vesta, one of the most massive asteroids in the main belt, and some of them approach it closely. When mutual velocities during such close encounters are low, the trajectory of the small body can be gravitationally deflected, consequently changing its heliocentric orbital elements. While the effect of a single close encounter may be small, repeated close encounters may significantly change the proper element distribution of members of asteroid families. Aims: We develop a model of the long-term effect of close encounters with massive asteroids, so as to be able to predict how far former members of the Vesta family could have drifted away from the family. Methods: We first developed a new symplectic integrator that simulates both the effects of close encounters and the Yarkovsky effect. We analyzed the results of a simulation involving a fictitious Vesta family, and propagated the asteroid proper element distribution using the probability density function (pdf hereafter), i.e. the function that describes the probability of having an encounter that modifies a proper element x by Δx, for all the possible values of Δx. Given any asteroids' proper element distribution at time t, the distribution at time t+T may be predicted if the pdf is known (Bachelier 1900, Théorie de la spéculation; Hughes 1995, Random Walks and Random Environments, Vol. I). Results: We applied our new method to the problem of V-type asteroids outside the Vesta family (i.e., the 31 currently known asteroids in the inner asteroid belt that have the same spectral type of members as the Vesta family, but that are outside the limits of the dynamical family) and determined that at least ten objects have a significant diffusion probability over the minimum estimated age of the Vesta family of 1.2 Gyr (Carruba et al. 2005, A&A, 441, 819). These objects can therefore be explained in the framework of diffusion via repeated close

Patients' experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory.

Science.gov (United States)

Björkman, Ida; Simrén, Magnus; Ringström, Gisela; Jakobsson Ung, Eva

2016-10-01

This study aimed to explore patients' experiences of healthcare encounters in severe irritable bowel syndrome. Irritable bowel syndrome is a common functional disorder with symptoms such as abdominal pain and disturbed bowel habits, the cause of which is not completely known. Treatments options are limited, and healthcare encounters in irritable bowel syndrome have been described as unsatisfying and frustrating for both patients and professional healthcare providers. Furthermore, the influence of power on healthcare encounters has long been recognised, especially regarding the disadvantaged position of those suffering from functional illness which cannot be identified by commonly used tests or investigations. We interviewed 10 patients during 2014, all attending an outpatient clinic and suffering from severe irritable bowel syndrome. Relying on narrative and feminist theory, we explored how they actively negotiate professional discourse communicated to them in the clinical encounter. The patients' experiences of healthcare encounters in irritable bowel syndrome were mostly described as negative, and often induced feelings of confusion and self-doubt. Positive encounters were described as being listened to, believed and taken seriously. Narrators found it especially problematic when healthcare professionals described irritable bowel syndrome as a minor disorder with primarily stress or psychological aetiology and put the responsibility for recovery onto the patient. Patients' actively negotiated such professional discourse by presenting a counternarrative describing their own suffering and strengths, experienced healthcare shortcomings and possible organic aetiology of irritable bowel syndrome. Patients suffering from severe irritable bowel syndrome described how they often felt a need to protect their positive identities in the face of trivialisation and disbelief by healthcare professionals. A deepened understanding of patients' experiences of healthcare

Interim communities between singularities: encounters of delicacy, artistic creation and difference

Directory of Open Access Journals (Sweden)

Juliana Araújo Silva

2015-09-01

Full Text Available This article is an outcome of the dissertation “Poetics and marginality: the Project Cidadãos Cantantes experience” that focused on the chorus collective experience, in the project focusing the formation of groupality, the ways of being together or coexisting, and presents an analysis of these procedures. This Project was created on 1992 in the interface of antimanicomial movement. It consists in two workshops: a scenic chorus workshop and a workshop of dance and body expression. Through the project, the authors elaborated a narrative that leads the analyses of the mentioned experience. It is understood that promoting encounters between any kind of people, with or without psychic suffering - and not grouped based on a definition or diagnosis, the project can bring people in a desiring and cooperatively manner-. Therefore, the relationships developed during the project’s workshops strengthen the production of guided encounters in power, in the creation and respect for differences.

Work week duration, work-family balance and difficulties encountered by female and male physicians: results from the French SESMAT study.

Science.gov (United States)

Estryn-Behar, M; Fry, C; Guetarni, K; Aune, I; Machet, G; Doppia, M A; Lassaunière, J M; Muster, D; Pelloux, P; Prudhomme, Ch

2011-01-01

France encounters difficulties attracting physicians to work in hospitals. Organisation at work and at home may be at the heart of the problem for female as well as for male physicians. A comprehensive questionnaire was filled out online by a representative sample of 1924 French hospital physicians. We conducted gender bivariate and multivariate analysis of the risk factors for burnout and intent to leave the profession(ITL). ITL was declared by 17.4% of physicians. According to 41.3% of female physicians (FP), their profession was an obstacle to having children (versus 19.3% for male physicians (MP)). Major factors linked with burnout were Effort/Reward imbalance (FP adjOR = 5.09, MP adjOR = 5.93), Work-family conflicts (FP adjOR = 2.97, MP adjOR = 3.04), and Low quality of teamwork (FP adjOR = 1.82, MP adjOR = 2.68). Major factors linked with ITL were Low quality of teamwork (FP adjOR = 4.49, MP adjOR = 3.03), Patient-related burnout (FP adjOR = 2.10, MP adjOR = 2.35) and General burnout (FP adjOR = 1.85, MP adjOR = 1.45). Excessive job demands are linked with burnout and with work-family conflicts, conducting to difficulties in organising one's life in order to have and raise children. Potential solutions include facilitating teamwork in order to reduce departure, which increase workload on those who stay increasing their work family conflict.

Encountering Gender in Student Life at UDSM: Chrester Tells Her ...

African Journals Online (AJOL)

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.

Transformation of a wave energy spectrum from encounter to absolute domain when observing from an advancing ship

DEFF Research Database (Denmark)

Nielsen, Ulrik Dam

2017-01-01

directly in the encounter domain. The encounter domain is that observed from a ship when it advances in a seaway, whereas the absolute domain is that corresponding to making observations from a fixed point in the inertial frame. Spectrum transformation can be uniquely carried out if the ship sails ”against...

Occupational Accidents among Clinical Staff of Tabriz University Hospitals

Directory of Open Access Journals (Sweden)

Leila Sahebi

2015-07-01

Full Text Available ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each specialty using random selection method. Univariate and multiple regression analyses were employed. The SPSS version 19 was used for data analysis. Results : The one-year prevalence of workplace accident was %21. Women were encountered in workplace accidents more than men (%31.1 vs. % 26.8. The youngest age group (20-30 years experienced the most workplace accidents (%41.5. Carelessness was the main cause of the workplace accidents (%49.3. Reporting rate of the occupational accidents was% 48.3 and the most common cause for not reporting was the fear of being recognized as a less competent individual. Sick leaves due to the severity of the accident was reported %23 (median: 5 days. Over %90 of the accident victims had experienced severe stress and job pressure within the previous year. In multiple regression models, the young staff (20-30 years with severe stress, job pressure and verbal violence victim had more chance of workplace accident.   Conclusion : In addition to the high prevalence of workplace accidents, intensity and consequences of workplace accidents should be considered as well. Providing appropriate methods including prevention of accidents and education of safety along with the assistance of technical staff, managers and attendants would be helpful.

Changes in heart rate associated with contest outcome in agonistic encounters in lobsters.

Science.gov (United States)

Hernáindez-Falcón, Jesús; Basu, Alo C; Govindasamy, Siddhartan; Kravitz, Edward A

2005-03-01

Agonistic contests between lobsters housed together in a confined space progress through encounters of increasing intensity until a dominance relationship is established. Once this relationship is established, losing animals continually retreat from the advances of winners. These encounters are likely to consume much energy in both winning and losing animals. Therefore, one might expect involvement of many physiological systems before, during and after fights. Here, we report effects of agonistic encounters on cardiac frequency in winning and losing adult lobsters involved in dyadic interactions. The results show that: (i) small but significant increases in heart rate are observed upon chemical detection of a conspecific; (ii) during agonistic interactions, further increases in heart rate are seen; and (iii) ultimate winners exhibit greater increases in heart rate lasting longer periods of time compared to ultimate losers. Heart rate in winners remains elevated for at least 15 min after the contests have ended and animals have been returned to their home tanks. Reduced effects are seen in second and third pairings between familiar opponents. The sustained changes in heart rate that we observe in winning lobsters may result from hormonal modulation of cardiac function related to the change in social status brought about by contest outcome.

Hospital staffing and hospital costs.

Science.gov (United States)

Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Examining the spatial distribution of law enforcement encounters among people who inject drugs after implementation of Mexico's drug policy reform.

Science.gov (United States)

Gaines, Tommi L; Beletsky, Leo; Arredondo, Jaime; Werb, Daniel; Rangel, Gudelia; Vera, Alicia; Brouwer, Kimberly

2015-04-01

In 2009, Mexico decriminalized the possession of small amounts of illicit drugs for personal use in order to refocus law enforcement resources on drug dealers and traffickers. This study examines the spatial distribution of law enforcement encounters reported by people who inject drugs (PWID) in Tijuana, Mexico to identify concentrated areas of policing activity after implementation of the new drug policy. Mapping the physical location of law enforcement encounters provided by PWID (n = 461) recruited through targeted sampling, we identified hotspots of extra-judicial encounters (e.g., physical/sexual abuse, syringe confiscation, and money extortion by law enforcement) and routine authorized encounters (e.g., being arrested or stopped but not arrested) using point density maps and the Getis-Ord Gi* statistic calculated at the neighborhood-level. Approximately half of the participants encountered law enforcement more than once in a calendar year and nearly one third of these encounters did not result in arrest but involved harassment or abuse by law enforcement. Statistically significant hotspots of law enforcement encounters were identified in a limited number of neighborhoods located in areas with known drug markets. At the local-level, law enforcement activities continue to target drug users despite a national drug policy that emphasizes drug treatment diversion rather than punitive enforcement. There is a need for law enforcement training and improved monitoring of policing tactics to better align policing with public health goals.

The organisational stressors encountered by athletes with a disability.

Science.gov (United States)

Arnold, Rachel; Wagstaff, Christopher R D; Steadman, Lauren; Pratt, Yasmin

2017-06-01

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.

EJECTION AND CAPTURE DYNAMICS IN RESTRICTED THREE-BODY ENCOUNTERS

International Nuclear Information System (INIS)

Kobayashi, Shiho; Hainick, Yanir; Sari, Re'em; Rossi, Elena M.

2012-01-01

We study the tidal disruption of binaries by a massive point mass (e.g., the black hole at the Galactic center), and we discuss how the ejection and capture preference between unequal-mass binary members depends on which orbit they approach the massive object. We show that the restricted three-body approximation provides a simple and clear description of the dynamics. The orbit of a binary with mass m around a massive object M should be almost parabolic with an eccentricity of |1 – e| ∼ 1/3 1/3 times the binary rotation velocity, it would be abruptly disrupted, and the energy change at the encounter can be evaluated in a simple disruption model. We evaluate the probability distributions for the ejection and capture of circular binary members and for the final energies. In principle, for any hyperbolic (elliptic) orbit, the heavier member has more chance to be ejected (captured), because it carries a larger fraction of the orbital energy. However, if the orbital energy is close to zero, the difference between the two members becomes small, and there is practically no ejection and capture preferences. The preference becomes significant when the orbital energy is comparable to the typical energy change at the encounter. We discuss its implications to hypervelocity stars and irregular satellites around giant planets.

Analyzing effects of service encounter quality on customer satisfaction in banking industry

Directory of Open Access Journals (Sweden)

Hossein Gazor

2012-04-01

Full Text Available Service quality represents a modern approach for quality in enterprises and organizations and serves the development of a truly customer-focused management and culture. Measuring service quality offers an immediate, meaningful and objective feedback about clients' preferences and expectations. In this paper, we study the relationship between customer perceptions from service encounter quality and loyalty of customer to organization and employees. The proposed study is implemented for banking sector in Iran using SERVQUAL factors and considers various factors influencing the quality of service. The results of the survey indicate that service quality systems, customer satisfaction are the most desirable factors based on the feedback we received from the customers. In addition, response to customers and loyalty to employees, service encounter quality, service and loyalty to organization, arrangements are in the next levels, respectively.

Close encounters: Moving along bumps, breaks, and bubbles on expanded trinucleotide tracts

Energy Technology Data Exchange (ETDEWEB)

Polyzos, Aris A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McMurray, Cynthia T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-06-09

Expansion of simple triplet repeats (TNR) underlies greater than 30 severe degenerative diseases. There is a good understanding of the major pathways generating an expansion, and the associated polymerases that operate during gap filling synthesis at these “difficult to copy” sequences. However, the mechanism by which a TNR is repaired depends on the type of lesion, the structural features imposed by the lesion, the assembled replication/repair complex, and the polymerase that encounters it. The relationships among these parameters are exceptionally complex and how they direct pathway choice is poorly understood. In this review, we consider the properties of polymerases, and how encounters with GC-rich or abnormal structures might influence polymerase choice and the success of replication and repair. Insights over the last three years have highlighted new mechanisms that provide interesting choices to consider in protecting genome stability.

Elucidating Dynamical Processes Relevant to Flow Encountering Abrupt Topography (FLEAT)

Science.gov (United States)

2015-09-30

Encountering Abrupt Topography (FLEAT) Bo Qiu Dept of Oceanography, University of Hawaii at Manoa 1000 Pope Rd. Honolulu, HI 96822 phone: (808) 956...c) to explore relevant dynamics by using both simplified models and OGCM output with realistic topography and surface boundary conditions...scale abyssal circulation, we propose to use the Hallberg Isopycnal Model (HIM). The HIM allows sloping isopycnals to interact with bottom topography

On-spot rheumatology consultations in a multilevel geriatric hospital.

Science.gov (United States)

Lubart, Emily; Leibovitz, Arthur; Shapir, Vadim; Segal, Refael

2014-01-01

Musculoskeletal and joint disorders are extremely common in the elderly. They directly affect mobility, gait stability, quality of life, and independence. To assess the nature of joint problems encountered in a geriatric inpatient population and evaluate the contribution of a rheumatologist. We reviewed the rheumatology consultation records that were conducted in a geriatric medical center over a 10 year period. A total of 474 consultations were held; most of these patients (86%) were hospitalized in the acute geriatric departments, 10% in the rehabilitation ward and 4% in the long-term care wards. Some patients were seen more than once. A rheumatologic joint problem was the main reason for hospitalization in 53% of these patients. Monoarthritis was the most frequent complaint (50%), followed by pauciarticular arthritis (two to five joints) in 30% of patients. Arthrocentesis, diagnostic and therapeutic, was performed in 225 patients, most of them in knee joints (81%). The most frequent diagnosis was osteoarthritis with acute exacerbation (28%), followed by gout (18%), pseudo-gout (9%) and rheumatoid arthritis (9%). In 86 cases (18%) the diagnosis was a non-specific rheumatologic problem: arthralgia, nonspecific generalized pain, or fibromyalgia. Prompt and appropriate evaluation, as well as arthrocentesis and treatment initiation, including local injections, were made possible by the presence of an in-house rheumatologist.

Managing pediatric dental trauma in a hospital emergency department.

Science.gov (United States)

Mitchell, Jonathan; Sheller, Barbara; Velan, Elizabeth; Caglar, Derya; Scott, Joanna

2014-01-01

The purpose of this study was to: (1) examine types of dental trauma presenting to a hospital emergency department (ED); (2) describe the medical services provided to these patients; and (3) quantify time spent during ED encounters for dental trauma emergencies. Records of 265 patients who presented to the ED with dental trauma over a three-year period were reviewed. Demographics, injury types, triage acuity, pain scores, and dental/medical treatment and times were analyzed. Patient demographics and injury types were similar to previous studies. Eighty-two percent of patients received mid-level triage scores; 41 percent of patients had moderate to severe pain. The most frequently provided medical services were administration of analgesics and/or prescriptions (78 percent). The mean times were: 51 minutes waiting for a physician; 55 minutes with dentists; and 176 minutes total time. Higher triage acuity and pain levels resulted in significantly longer wait times for physician assessment. Dental evaluation, including treatment, averaged 32 percent of time spent at the hospital. A dental clinic is the most efficient venue for treating routine dental trauma. Patients in this study spent the majority of time waiting for physicians and receiving nondental services. Most patients required no medical intervention beyond prescriptions commonly used in dental practice.

Assessment on nursing serviceat hospital external consulting rooms

Directory of Open Access Journals (Sweden)

Mª Dolores Poyatos Ruiz

2013-05-01

Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.

Hospitality within hospital meals—Socio-material assemblages

DEFF Research Database (Denmark)

Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.

2016-01-01

Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...

Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

Directory of Open Access Journals (Sweden)

Lakshmi Rajeswaran

2013-05-01

Full Text Available Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR with functional equipment and adequate resources. The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts. Die slagoffers van padongelukke, asook persone wat hart- en ander mediese noodtoestande ervaar, kan hulle lewens verloor omdat daar nie opgeleide personeel met funksionele toerusting en voldoende hulpbronne beskikbaar is om effektiewe kardiopulmonale resussitasie (KPR te doen nie. Die studie het ten doel

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

Directory of Open Access Journals (Sweden)

Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

Researching Children's Rights in Education: Sociology of Childhood Encountering Educational Theory

Science.gov (United States)

Quennerstedt, Ann; Quennerstedt, Mikael

2014-01-01

This paper aims to explore and develop a theoretical approach for children's rights research in education formed through an encounter between the sociology of childhood and John Dewey's educational theory. The interest is mainly methodological, in the sense that the primary ambition of the investigation is to suggest a fruitful and useful…

Quality in practice: integrating routine collection of patient language data into hospital practice.

Science.gov (United States)

Hudelson, Patricia; Dominicé Dao, Melissa; Durieux-Paillard, Sophie

2013-09-01

Timely identification of patients' language needs can facilitate the provision of language-appropriate services and contribute to quality of care, clinical outcomes and patient satisfaction. At the University Hospitals of Geneva, Switzerland, timely organization of interpreter services was hindered by the lack of systematic patient language data collection. We explored the feasibility and acceptability of a procedure for collecting patient language data at the first point of contact, prior to its hospital-wide implementation. During a one-week period, receptionists and triage nurses in eight clinical services tested a new procedure for collecting patient language data. Patients were asked to identify their primary language and other languages they would be comfortable speaking with their doctor. Staff noted patients' answers on a paper form and provided informal feedback on their experience with the procedure. Registration staff encountered few difficulties collecting patient language data and thought that the two questions could easily be incorporated into existing administrative routines. Following the pilot test, two language fields with scroll-down language menus were added to the electronic patient file, and the subsequent filling-in of these fields has been rapid and hospital wide. Our experience suggests that routine collection of patient language data at first point of contact is both feasible and acceptable and that involving staff in a pilot project may facilitate hospital-wide implementation. Future efforts should focus on exploring the sensitivity and specificity of the proposed questions, as well as the impact of data collection on interpreter use.

Emotional cues and concerns in hospital encounters with non-Western immigrants as compared with Norwegians: an exploratory study.

Science.gov (United States)

Kale, Emine; Finset, Arnstein; Eikeland, Hanne-Lise; Gulbrandsen, Pål

2011-09-01

To identify potential barriers in communication with non-Western immigrant patients by comparing the frequency and nature of emotional cues and concerns, as well as physician responses during consultations, between ethnically Norwegian patients and immigrant patients in a general hospital setting. Consultations with 56 patients (30 non-Western immigrants and 26 ethnic Norwegians) were coded using the Verona Coding Definitions of Emotional Sequences (VR-CoDES) and the Verona Codes for Provider Responses (Verona Codes-P). There were no significant differences in frequencies of cues and concerns between immigrant and Norwegian patients. However, the immigrant patients with high language proficiency expressed more concerns compared to immigrant patients with language problems and Norwegian patients. Moreover, more concerns were expressed during consultations with female physicians than with male physicians. Expression of cues and concerns in immigrant patients is dependent on the patient's language proficiency and the physician's gender. Providers should recognize that immigrant patients may have many emotional cues and concerns, but that language problems may represent a barrier for the expression of these concerns. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Problems Encountered by Religious Vocational Secondary School and Other Secondary School Students in Physical Education and Sports Activities

Science.gov (United States)

Bar, Mustafa; Yaman, Menzure Sibel; Hergüner, Gülten

2016-01-01

The study aimed to determine problems encountered by Religious Vocational Secondary School and other Secondary School students in physical education and sports activities and to compare these problems according to school type and gender. A questionnaire named "Problems encountered in attending to physical education and sports activities"…

From welcome to well . come: the mobilities, temporalities and geopolitics of contemporary hospitality – commentary to Gill

Directory of Open Access Journals (Sweden)

Roger Norum

2018-05-01

Full Text Available In this reflection, I take Nick Gill’s contribution to this issue on the politics of hospitality and welcome as a point of departure to address three specific concerns, framed by the context of contemporary global mobility. First, I argue that various aspects of the recent so-called European migration crisis enable us to further question some of the long-fixed categories through which mobile actors are often classified. Second, I speak to the critical nature of temporality as a governing factor not just in how states manage mobile peoples, but in how people imagine, understand and experience individual and group processes of welcome. Finally, I suggest that just as geopolitical discourse plays a clear role in how migration is understood and experienced, so too are geopolitics deeply embedded in the encounters, practices and regimes of hospitality across tourism.

Intimate Encounters: Affective Economies in Cuba and the Dominican Republic

Directory of Open Access Journals (Sweden)

Amalia L. Cabezas

2011-10-01

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

Variation of the binary encounter peak energy as a function of projectile atomic number

International Nuclear Information System (INIS)

Sanders, J.M.

1994-01-01

The energy of the binary encounter peak, in spectra of electrons emitted at 0 degrees with respect to the projectile beam direction, has been studied to investigate its dependence on the atomic number of the projectile ion. The projectiles all had the same squared velocity of 0.6 MeV/u, and all had the same charge q=7. The Z of the projectiles ranged from 8 to 35, and the target was H 2 . The Energy E BEP of the binary encounter peak and also the energy t of the cusp formed by electron loss or electron capture to the projectile continuum (ELC or ECC) were obtained from fits to the spectra. Considerable care was required in fitting the cusp in order to properly ascertain the cusp energy. The energy shift ΔE, defined as the difference between 4t and E BEP , was obtained for each projectile. It is found that the energy shift decreases as the projectile Z increases. This trend is the opposite of that seen for projectile charge where the shift increases as q increases. Such a trend is not well described by the simple elastic scattering model of binary encounter electron production

Developing social standards for wilderness encounters in Mount Rainier National Park: Manager-defined versus visitor-defined standards

Science.gov (United States)

Kristopher J. Lah

2000-01-01

This research compared the differences found between manager-defined and visitor-defined social standards for wilderness encounters in Mount Rainier National Park. Social standards in recreation areas of public land are defined by what is acceptable to the public, in addition to the area’s management. Social standards for the encounter indicator in Mount Rainier’s...

The views of domestic staff and porters when supporting patients with dementia in the acute hospital: An exploratory qualitative study.

Science.gov (United States)

Ashton, Caroline; Manthorpe, Jill

2017-01-01

There is increasing recognition that very many hospital patients have dementia but there are many concerns about the quality of care and support they receive. Consequently there have been numerous calls for hospital staff to have dementia training. While cleaning or domestic staff and porters form considerable parts of the hospital workforce they are infrequently considered in discussions of dementia care training and practice. This exploratory study aimed to investigate the experiences of domestic staff and porters working in an acute hospital setting who are in contact regularly with patients with dementia. Semi-structured interviews were undertaken in 2016 with seven domestic staff and five porters in one English acute hospital to investigate their views and experiences. Data were analysed thematically by constant comparison technique and theoretical sampling. Themes were identified and realistic concepts developed. Participants observed that caring attitudes and behaviour in their encounters with patients with dementia are important but challenging to put into practice. Several would have valued more information about dementia. Some noted situations in the hospital stay that seemed particularly difficult for patients with dementia such as travelling to different parts of the hospital for treatments. The study suggests the need for improving the dementia-related knowledge and skills of all non-clinical staff especially those new to the NHS. The impact of witnessing dementia symptoms and distress on emotional well-being requires further research so that ancillary staff can improve the hospital stay of patients with dementia.

Focus Groups as Transformative Spiritual Encounters

Directory of Open Access Journals (Sweden)

Sharon Moloney PhD

2011-03-01

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.

Wellness Tourism among Seniors in Taiwan: Previous Experience, Service Encounter Expectations, Organizational Characteristics, Employee Characteristics, and Customer Satisfaction

Directory of Open Access Journals (Sweden)

Kaung-Hwa Chen

2015-08-01

Full Text Available This study aimed to investigate the influence of the service encounter expectations of senior customers during wellness tours on customer satisfaction. The organizational attributes of hotels, organizational characteristics and employee characteristics, were adopted as mediating variables. A total of 346 valid questionnaires were retrieved from 50 year-old and above seniors in Taiwan. The results showed that the service encounter expectations of seniors had an indirect influence on customer satisfaction and the organizational attributes mediated the service encounter expectations of seniors and customer satisfaction. The moment of truth in the interactions between service staff members and seniors represents the pivotal management implication of this study.

Switches to English during French Service Encounters: Relationships with L2 French Speakers' Willingness to Communicate and Motivation

Science.gov (United States)

McNaughton, Stephanie; McDonough, Kim

2015-01-01

This exploratory study investigated second language (L2) French speakers' service encounters in the multilingual setting of Montreal, specifically whether switches to English during French service encounters were related to L2 speakers' willingness to communicate or motivation. Over a two-week period, 17 French L2 speakers in Montreal submitted…

Spatial capture-recapture models for search-encounter data

Science.gov (United States)

Royle, J. Andrew; Kery, Marc; Guelat, Jerome

2011-01-01

1. Spatial capture–recapture models make use of auxiliary data on capture location to provide density estimates for animal populations. Previously, models have been developed primarily for fixed trap arrays which define the observable locations of individuals by a set of discrete points. 2. Here, we develop a class of models for 'search-encounter' data, i.e. for detections of recognizable individuals in continuous space, not restricted to trap locations. In our hierarchical model, detection probability is related to the average distance between individual location and the survey path. The locations are allowed to change over time owing to movements of individuals, and individual locations are related formally by a model describing individual activity or home range centre which is itself regarded as a latent variable in the model. We provide a Bayesian analysis of the model in WinBUGS, and develop a custom MCMC algorithm in the R language. 3. The model is applied to simulated data and to territory mapping data for the Willow Tit from the Swiss Breeding Bird Survey MHB. While the observed density was 15 territories per nominal 1 km2 plot of unknown effective sample area, the model produced a density estimate of 21∙12 territories per square km (95% posterior interval: 17–26). 4. Spatial capture–recapture models are relevant to virtually all animal population studies that seek to estimate population size or density, yet existing models have been proposed mainly for conventional sampling using arrays of traps. Our model for search-encounter data, where the spatial pattern of searching can be arbitrary and may change over occasions, greatly expands the scope and utility of spatial capture–recapture models.

Dealing with Moms and Dads: Family Dilemmas Encountered by Youth Program Leaders

Directory of Open Access Journals (Sweden)

Aisha Griffith

2014-06-01

Full Text Available The leaders of youth programs encounter a range of challenging situations that involve youth’s parents or families. This qualitative study obtained data on the variety and nature of these family-related “dilemmas of practice.” Longitudinal interviews with leaders of 10 high quality programs for high-school-aged youth yielded narrative information on a sample of 32 family dilemmas that they had encountered. Grounded theory analysis identified four categories of family dilemmas: 1 problems at home that become a concern to the leader, 2 parents’ expectations are incongruent with program norms or functioning, 3 parents do not support youth’s participation in the program or an aspect of the program, and 4 communicating with parents on sensitive matters. Each of these categories of dilemmas entailed distinct considerations and underlying issues that effective leaders need to be able to understand.

Ecopoetic Encounters: Amnesia and Nostalgia in Alexis Wright's Environmental Fiction

OpenAIRE

Barras Arnaud

2015-01-01

In Carpentaria (2006) and The Swan Book (2013), Alexis Wright establishes an allegorical mode where she reimagines Europeans' first encounters with Australia from an Aboriginal environmental perspective. In this narrative system, the discovery of Australia is not realised by exploring colonisers, but by vulnerable strangers who apprehend the continent both experientially and linguistically. In Carpentaria, the Stranger-figure of Elias Smith is left amnesic after surviving a shipwreck during a...

VERSIONS VERSUS BODIES: TRANSLATIONS IN THE MISSIONARY ENCOUNTER IN AMAZONIA

OpenAIRE

Vilaça, Aparecida

2016-01-01

Abstract This paper analyzes the two distinct concepts of translation at work in the encounter between the Amazonian Wari' and the New Tribes Mission evangelical missionaries, and the equivocations stemming from this difference. While the missionaries conceive translation as a process of converting meanings between languages, conceived as linguistic codes that exist independently of culture, for the Wari', in consonance with their perspectivist ontology, it is not language that differentiates...

Close encounters for the first time: Helicase interactions with DNA damage.

Science.gov (United States)

Khan, Irfan; Sommers, Joshua A; Brosh, Robert M

2015-09-01

DNA helicases are molecular motors that harness the energy of nucleoside triphosphate hydrolysis to unwinding structured DNA molecules that must be resolved during cellular replication, DNA repair, recombination, and transcription. In vivo, DNA helicases are expected to encounter a wide spectrum of covalent DNA modifications to the sugar phosphate backbone or the nitrogenous bases; these modifications can be induced by endogenous biochemical processes or exposure to environmental agents. The frequency of lesion abundance can vary depending on the lesion type. Certain adducts such as oxidative base modifications can be quite numerous, and their effects can be helix-distorting or subtle perturbations to DNA structure. Helicase encounters with specific DNA lesions and more novel forms of DNA damage will be discussed. We will also review the battery of assays that have been used to characterize helicase-catalyzed unwinding of damaged DNA substrates. Characterization of the effects of specific DNA adducts on unwinding by various DNA repair and replication helicases has proven to be insightful for understanding mechanistic and biological aspects of helicase function in cellular DNA metabolism. Published by Elsevier B.V.

FORMATION OF CENTAURS’ RINGS THROUGH THEIR PARTIAL TIDAL DISRUPTION DURING PLANETARY ENCOUNTERS

Energy Technology Data Exchange (ETDEWEB)

Hyodo, Ryuki; Charnoz, Sébastien [Institut de Physique du Globe, F-75005 Paris, France (France); Genda, Hidenori [Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo 152-8550 (Japan); Ohtsuki, Keiji [Department of Planetology, Kobe University, Kobe 657-8501 (Japan)

2016-09-01

Centaurs are minor planets orbiting between Jupiter and Neptune that have or had crossing orbits with one or more giant planets. Recent observations and reinterpretation of previous observations have revealed the existence of ring systems around 10199 Chariklo and 2060 Chiron. However, the origin of the ring systems around such a minor planet is still an open question. Here, we propose that the tidal disruption of a differentiated object that experiences a close encounter with a giant planet could naturally form diverse ring–satellite systems around the Centaurs. During the close encounter, the icy mantle of the passing object is preferentially ripped off by the planet's tidal force and the debris is distributed mostly within the Roche limit of the largest remnant body. Assuming the existence of a 20−50 wt% silicate core below the icy mantle, a disk of particles is formed when the objects pass within 0.4–0.8 of the planet's Roche limit with the relative velocity at infinity 3−6 km s{sup −1} and 8 hr initial spin period of the body. The resultant ring mass is 0.1%–10% of the central object's mass. Such particle disks are expected to spread radially, and materials spreading beyond the Roche limit would accrete into satellites. Our numerical results suggest that ring formation would be a natural outcome of such extreme close encounters, and Centaurs can naturally have such ring systems because they cross the orbits of the giant planets.

FORMATION OF CENTAURS’ RINGS THROUGH THEIR PARTIAL TIDAL DISRUPTION DURING PLANETARY ENCOUNTERS

International Nuclear Information System (INIS)

Hyodo, Ryuki; Charnoz, Sébastien; Genda, Hidenori; Ohtsuki, Keiji

2016-01-01

Centaurs are minor planets orbiting between Jupiter and Neptune that have or had crossing orbits with one or more giant planets. Recent observations and reinterpretation of previous observations have revealed the existence of ring systems around 10199 Chariklo and 2060 Chiron. However, the origin of the ring systems around such a minor planet is still an open question. Here, we propose that the tidal disruption of a differentiated object that experiences a close encounter with a giant planet could naturally form diverse ring–satellite systems around the Centaurs. During the close encounter, the icy mantle of the passing object is preferentially ripped off by the planet's tidal force and the debris is distributed mostly within the Roche limit of the largest remnant body. Assuming the existence of a 20−50 wt% silicate core below the icy mantle, a disk of particles is formed when the objects pass within 0.4–0.8 of the planet's Roche limit with the relative velocity at infinity 3−6 km s"−"1 and 8 hr initial spin period of the body. The resultant ring mass is 0.1%–10% of the central object's mass. Such particle disks are expected to spread radially, and materials spreading beyond the Roche limit would accrete into satellites. Our numerical results suggest that ring formation would be a natural outcome of such extreme close encounters, and Centaurs can naturally have such ring systems because they cross the orbits of the giant planets.

An Analysis of the Interaction Effect between Employee Technical and Emotional Competencies in Emotionally Charged Service Encounters

OpenAIRE

Delcourt, Cécile; Gremler, Dwayne; De Zanet, Fabrice; van Riel, Allard

2017-01-01

Purpose—Customers often experience negative emotions during service experiences. The ways that employees manage customers’ emotions and impressions about whether the service provider is concerned for them in such emotionally charged service encounters (ECSEs) is crucial, considering the criticality of the encounter. Drawing on cognitive appraisal theory, this study proposes that two key competencies—employee emotional competence (EEC) and employee technical competence (ETC)—affect negative cu...

Nursing documentation: experience of the use of the nursing process model in selected hospitals in Ibadan, Oyo State, Nigeria.

Science.gov (United States)

Ofi, Bola; Sowunmi, Olanrewaju

2012-08-01

The descriptive study was conducted to determine the extent of utilization of the nursing process for documentation of nursing care in three selected hospitals, Ibadan, Nigeria. One hundred fifty nurses and 115 discharged clients' records were selected from the hospitals. Questionnaires and checklists were used to collect data. Utilization of nursing process for care was 100%, 73.6% and 34.8% in the three hospitals. Nurses encountered difficulties in history taking, formulation of nursing diagnoses, objectives, nursing orders and evaluation. Most nurses disagreed or were undecided with the use of authorized abbreviations and symbols (34.3%, 40.3% and 69.5%), recording errors that occurred during care (37.1%, 56.1% and 52.2%) and inclusion of change in clients' condition (54.3%, 56.1% and 73.8%). Most nurses appreciated the significance of documentation. Lack of time, knowledge and need for extensive writing are the major barriers against documentation. Seventy-seven point four per cent of the 115 clients' records from one hospital showed evidence of documentation, no evidence from the other two. Study findings have implications for continuing professional education, practice and supervision. © 2012 Blackwell Publishing Asia Pty Ltd.

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists.

Science.gov (United States)

Rosenkrantz, Andrew B; Hirsch, Joshua A; Allen, Bibb; Wang, Wenyi; Hughes, Danny R; Nicola, Gregory N

2017-03-01

In implementing the Merit-Based Incentive Payment System (MIPS), CMS will provide special considerations to physicians with infrequent face-to-face patient encounters by reweighting MIPS performance categories to account for the unique circumstances facing these providers. The aim of this study was to determine the impact of varying criteria on the fraction of radiologists who are likely to receive special considerations for performance assessment under MIPS. Data from the 2014 Medicare Physician and Other Supplier file for 28,710 diagnostic radiologists were used to determine the fraction of radiologists meeting various proposed criteria for receiving special considerations. For each definition, the fraction of patient-facing encounters among all billed codes was determined for those radiologists not receiving special considerations. When using the criterion proposed by CMS that physicians will receive special considerations if billing ≤25 evaluation and management services or surgical codes, 72.0% of diagnostic radiologists would receive special considerations, though such encounters would represent only 2.1% of billed codes among remaining diagnostic radiologists without special considerations. If CMS were to apply an alternative criterion of billing ≤100 evaluation and management codes exclusively, 98.8% of diagnostic radiologists would receive special considerations. At this threshold, patient-facing encounters would represent approximately 10% of billed codes among remaining radiologists without special considerations. The current CMS proposed criterion for special considerations would result in a considerable fraction of radiologists being evaluated on the basis of measures that are not reflective of their practice and beyond their direct control. Alternative criteria could help ensure that radiologists are provided a fair opportunity for success in performance review under the MIPS. Copyright © 2016 American College of Radiology. Published by Elsevier

Report on the observed response of Javan lutungs (Trachypithecus auratus mauritius) upon encountering a reticulated python (Python reticulatus).

Science.gov (United States)

Tsuji, Yamato; Prayitno, Bambang; Suryobroto, Bambang

2016-04-01

We observed an encounter between a reticulated python (Python reticulatus) and a group of wild Javan lutungs (Trachypithecus auratus mauritius) at the Pangandaran Nature Reserve, West Java, Indonesia. A python (about 2 m in length) moved toward a group of lutungs in the trees. Upon seeing the python, an adult male and several adult female lutungs began to emit alarm calls. As the python approached, two adult and one sub-adult female jumped onto a branch near the python and began mobbing the python by shaking the branch. During the mobbing, other individuals in the group (including an adult lutung male) remained nearby but did not participate. The python then rolled into a ball-like shape and stopped moving, at which point the lutungs moved away. The total duration of the encounter was about 40 min, during which time the lutungs stopped feeding and grooming. Group cohesiveness during and after the encounter was greater than that before the encounter, indicating that lutungs adjust their daily activity in response to potential predation risk.

The encounter with God in myth and madness.

Science.gov (United States)

Doerr, Otto; Velásquez, Oscar

2007-07-03

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

The encounter with God in myth and madness

Directory of Open Access Journals (Sweden)

Doerr Otto

2007-07-01

Full Text Available Abstract Background 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? Results 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

Astrometry of 2014MU69 for New Horizons encounter

Science.gov (United States)

Buie, Marc

2017-08-01

We propose 12 orbits of time to make high-precision astrometric measurments of the New Horizons extendedmission target, (486958) 2014MU69. These observations are in direct support of the navigation of New Horizonsleading up to its encounter in Jan 2019. These visits represent an optimized plan for improved orbit estimates that willcomplete as the target becomes directly observable by New Horizons. This astrometry is a key element leadingup to a close investigation of a Cold-Classical Kuiper Belt Object, one of the most primitive members of our solarsystem.

The joy of discovery great encounters along the way

CERN Document Server

Thirring, Walter

2011-01-01

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

Physician Encounters with Human Trafficking: Legal Consequences and Ethical Considerations

OpenAIRE

Todres, Jonathan

2017-01-01

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...

Assessment of the Gaussian Covariance Approximation over an Earth-Asteroid Encounter Period

Science.gov (United States)

Mattern, Daniel W.

2017-01-01

In assessing the risk an asteroid may pose to the Earth, the asteroids state is often predicted for many years, often decades. Only by accounting for the asteroids initial state uncertainty can a measure of the risk be calculated. With the asteroids state uncertainty growing as a function of the initial velocity uncertainty, orbit velocity at the last state update, and the time from the last update to the epoch of interest, the asteroids position uncertainties can grow to many times the size of the Earth when propagated to the encounter risk corridor. This paper examines the merits of propagating the asteroids state covariance as an analytical matrix. The results of this study help to bound the efficacy of applying different metrics for assessing the risk an asteroid poses to the Earth. Additionally, this work identifies a criterion for when different covariance propagation methods are needed to continue predictions after an Earth-encounter period.

The impact of personal connection on customer behaviours (word-of-mouth intention and retention) in service encounters

OpenAIRE

Chen, Ning; Zhao, Qi; Ardley, Barry

2015-01-01

In services marketing it is widely acknowledged that a relationship approach may facilitate in customer retention and enhance customer loyalty, and further influence customer post-purchase behaviours e.g. word-of-mouth. In this study, a specific relationship in service encounters, personal connections between customers and service employees, is explored in its indications on different outcomes from service encounters including three types of word-of-mouth behaviour intention and retention. Th...

Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

Science.gov (United States)

Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

2016-01-01

Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014-2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university

Directory of Open Access Journals (Sweden)

Omid Barati

2016-01-01

Full Text Available Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively. Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

Can hospitals compete on quality? Hospital competition.

Science.gov (United States)

Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

2015-09-01

In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

How superdiffusion gets arrested: ecological encounters explain shift from Lévy to Brownian movement

Science.gov (United States)

de Jager, Monique; Bartumeus, Frederic; Kölzsch, Andrea; Weissing, Franz J.; Hengeveld, Geerten M.; Nolet, Bart A.; Herman, Peter M. J.; van de Koppel, Johan

2014-01-01

Ecological theory uses Brownian motion as a default template for describing ecological movement, despite limited mechanistic underpinning. The generality of Brownian motion has recently been challenged by empirical studies that highlight alternative movement patterns of animals, especially when foraging in resource-poor environments. Yet, empirical studies reveal animals moving in a Brownian fashion when resources are abundant. We demonstrate that Einstein's original theory of collision-induced Brownian motion in physics provides a parsimonious, mechanistic explanation for these observations. Here, Brownian motion results from frequent encounters between organisms in dense environments. In density-controlled experiments, movement patterns of mussels shifted from Lévy towards Brownian motion with increasing density. When the analysis was restricted to moves not truncated by encounters, this shift did not occur. Using a theoretical argument, we explain that any movement pattern approximates Brownian motion at high-resource densities, provided that movement is interrupted upon encounters. Hence, the observed shift to Brownian motion does not indicate a density-dependent change in movement strategy but rather results from frequent collisions. Our results emphasize the need for a more mechanistic use of Brownian motion in ecology, highlighting that especially in rich environments, Brownian motion emerges from ecological interactions, rather than being a default movement pattern. PMID:24225464

How superdiffusion gets arrested: ecological encounters explain shift from Lévy to Brownian movement.

Science.gov (United States)

de Jager, Monique; Bartumeus, Frederic; Kölzsch, Andrea; Weissing, Franz J; Hengeveld, Geerten M; Nolet, Bart A; Herman, Peter M J; van de Koppel, Johan

2014-01-07

Ecological theory uses Brownian motion as a default template for describing ecological movement, despite limited mechanistic underpinning. The generality of Brownian motion has recently been challenged by empirical studies that highlight alternative movement patterns of animals, especially when foraging in resource-poor environments. Yet, empirical studies reveal animals moving in a Brownian fashion when resources are abundant. We demonstrate that Einstein's original theory of collision-induced Brownian motion in physics provides a parsimonious, mechanistic explanation for these observations. Here, Brownian motion results from frequent encounters between organisms in dense environments. In density-controlled experiments, movement patterns of mussels shifted from Lévy towards Brownian motion with increasing density. When the analysis was restricted to moves not truncated by encounters, this shift did not occur. Using a theoretical argument, we explain that any movement pattern approximates Brownian motion at high-resource densities, provided that movement is interrupted upon encounters. Hence, the observed shift to Brownian motion does not indicate a density-dependent change in movement strategy but rather results from frequent collisions. Our results emphasize the need for a more mechanistic use of Brownian motion in ecology, highlighting that especially in rich environments, Brownian motion emerges from ecological interactions, rather than being a default movement pattern.

Patient participation during oncological encounters: barriers and facilitators experienced by elderly cancer patients.

NARCIS (Netherlands)

Noordman, J.; Driesenaar, J.A.; Henselmans, I.; Heijmans, M.; Verboom, J.; Dulmen, S. van

2017-01-01

Objective: To enhance patient participation during (oncological) encounters, this study aims to gain insight into communication barriers and supportive interventions experienced by elderly patients with cancer. Method: A mixed method design, including both quantitative (secondary survey data

Moving beyond the language barrier: the communication strategies used by international medical graduates in intercultural medical encounters.

Science.gov (United States)

Jain, Parul; Krieger, Janice L

2011-07-01

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.

Learned Helplessness Encountered by Michael Oher in the Blind Side Movie

OpenAIRE

PAMUNGKAS, DIMAS PROBO

2014-01-01

Pamungkas, Dimas Probo. 2014. Learned Helplessness Encountered by Michael Oher in The Blind Side Movie. Study Program of English, Department of Languages and Literature, Faculty of Culture Studies, Universitas Brawijaya. Supervisor: Dyah Eko Hapsari;Co-supervisor: Sarlettina Vidyayani EkaKeywords: Learned Helplessness, African-American, Psychological, Social Behavior, Depression, The Blind Side.Social behavior shows several interactions between person and social situations, which stress...

The Impact of Hospital and Patient Factors on the Emergency Department Decision to Admit.

Science.gov (United States)

Warner, Leah S Honigman; Galarraga, Jessica E; Litvak, Ori; Davis, Samuel; Granovsky, Michael; Pines, Jesse M

2018-02-01

Substantial variation exists in rates of emergency department (ED) admission. We examine this variation after accounting for local and community characteristics. Elucidate the factors that contribute to admission variation that are amenable to intervention with the goal of reducing variation and health care costs. We conducted a retrospective cross-sectional study of 1,412,340 patient encounters across 18 sites from 2012-2013. We calculated the adjusted hospital-level admission rates using multivariate logistic regression. We adjusted for patient, provider, hospital, and community factors to compare admission rate variation and determine the influence of these characteristics on admission rates. The average adjusted admission rate was 22.9%, ranging from 16.1% (95% confidence interval [CI] 11.5-22%) to 32% (95% CI 26.0-38.8). There were higher odds of hospital admission with advancing age, male sex (odds ratio [OR] 1.20, 95% CI 1.91-1.21), and patients seen by a physician vs. mid-level provider (OR 2.26, 95% CI 2.23-2.30). There were increased odds of admission with rising ED volume, at academic institutions (OR 2.23, 95% CI 2.20-2.26) and at for-profit hospitals (OR 1.15, 95% CI 1.12-1.18). Admission rates were lower in communities with a higher per capita income, a higher rate of uninsured patients, and in more urban hospitals. In communities with the most primary providers, there were lower odds of admission (OR 0.60, 95% CI 0.57-0.68). Variation in hospital-level admission rates is associated with a number of local and community characteristics. However, the presence of persistent variation after adjustment suggests there are other unmeasured variables that also affect admission rates that deserve further study, particularly in an era of cost containment. Copyright © 2017 Elsevier Inc. All rights reserved.

Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

Science.gov (United States)

De Geyndt, Willy

2017-04-01

Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

Encountering Heidi: meeting others as a central aspect of the river experience

Science.gov (United States)

Lilian Jonas; Kevin Larkin

2000-01-01

Over the past few decades, numerous studies have investigated relationships between encounters and the backcountry recreation experience. Although academics and professionals may recognize that meeting others in backcountry areas could result in positive interactions that are beneficial to the experience, research directed at the positive aspects of intergroup...

Influence of alcohol on condom use pattern during non-spousal sexual encounter in male migrant workers in north India.

Science.gov (United States)

Rizwan, S A; Kant, S; Goswami, K; Rai, S K; Misra, P

2014-01-01

Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India. A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out. A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders. Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.

Greetings and Politeness in Doctor-Client Encounters in Southwestern

Directory of Open Access Journals (Sweden)

Akin Odebunmi

2013-05-01

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.

Radar Astrometry of Asteroid 99942 (2004 MN4): Predicting the 2029 Earth Encounter and Beyond

Science.gov (United States)

Giorgini, J. D.; Benner, L. A. M.; Nolan, M. C.; Ostro, S. J.

2005-08-01

Asteroid 2004 MN4 is expected to pass 4.6 (+/- 1.6) Earth-radii above the surface of the Earth on 2029-Apr-13. Such close approaches by objects as large as 2004 MN4 (D ≳ 0.3 km) are thought to occur at ≳ 1000-year intervals on average. 2004 MN4 is expected to reach 3rd magnitude and thus be visible to the unaided eye. With a disk 2-4 arcseconds across, it may be resolved by ground-based telescopes. Arecibo (2380-MHz) delay-Doppler radar astrometry, obtained in late January 2005, significantly corrected 2004 MN4's orbit by revealing a 1.4 arcsecond bias in pre-discovery optical measurements. Doppler-shifted echoes were acquired 4.8σ (176.4 mm/s) away from the predicted frequency on Jan 27. Range on Jan 29 was found to be 747 km (2.8σ ) closer to Earth than the pre-radar orbit predicted. Incorporation of these delay-Doppler measurements into a new weighted least-squares orbit solution moved the 2029-Apr-13 encounter prediction 5σ closer to the Earth, illustrating the problematic nature of prediction and statistical analysis with single-apparition optical data-sets. Without delay-Doppler data, the bias was not apparent, even when optical measurements spanned a full orbit period. The current combined data-set does not permit reliable trajectory propagation to encounters beyond 2029; Monte Carlo analysis shows that, by 2036, the 3σ confidence region wraps >300 degrees of heliocentric longitude around the Sun, with some sections of this statistical region experiencing low-probability encounters with the Earth in the 2030's, gravitationally scattering some possible trajectories inward to the orbit of Venus, or outward toward Mars. Future measurements from radar opportunities in August 2005 and May 2006 (SNR ≈5-10) have the potential to eliminate statistical encounters in the 2030's. Delay-Doppler astrometry from 2013 (SNR ≈30) should permit deterministic encounter prediction through 2070, shrinking the along-track uncertainty in 2036 by two orders of magnitude

LHC experiences close encounters with UFOs

CERN Multimedia

Mike Lamont for the LHC Team

2011-01-01

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...

Close encounters of the prototype kind

CERN Multimedia

2005-01-01

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...

Frontline employees' intercultural competence: Does it impact customers' evaluations of intercultural service encounters?

NARCIS (Netherlands)

Hoefnagels, A.H.J.M.; Bloemer, J.M.M.; Pluymaekers, M.

2014-01-01

Globalization has led to an exponential growth of intercultural service encounters. In view of the importance of customer-orientation in services, we investigate the effect of the frontline employee’s intercultural competence on customer’s affective and cognitive evaluations of intercultural

Difficulties EFL Jordanian University Students Encounter in Translating English Idioms into Arabic

Science.gov (United States)

Alrishan, Amal; Smadi, Oqlah

2015-01-01

This study aimed at investigating the difficulties that Jordanian EFL University students encounter in translating English idioms into Arabic. The participants of the study were all M.A translation students at Yarmouk University and the University of Jordan who were selected purposefully. The total number of the students who participated in the…

Seasonal and among-stream variation in predator encounter rates for fish prey

Science.gov (United States)

Bret C. Harvey; Rodney J. Nakamoto

2013-01-01

Recognition that predators have indirect effects on prey populations that may exceed their direct consumptive effects highlights the need for a better understanding of spatiotemporal variation in predator–prey interactions. We used photographic monitoring of tethered Rainbow Trout Oncorhynchus mykiss and Cutthroat Trout O. clarkii to quantify predator encounter rates...

DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

Directory of Open Access Journals (Sweden)

Tanushree

2016-03-01

Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

Diarrheagenic pathogens in adults attending a hospital in Singapore.

Science.gov (United States)

Chau, Man Ling; Hartantyo, Sri Harminda Pahm; Yap, Min; Kang, Joanne Su Lin; Aung, Kyaw Thu; Gutiérrez, Ramona Alikiiteaga; Ng, Lee Ching; Tam, Clarence C; Barkham, Timothy

2016-01-28

Singapore's diarrhoeal notification system is based on specific pathogens. Official data may thus be skewed towards notifiable diseases. Limited information is available on the profiles of aetiological agents responsible for acute gastroenteritis (AGE) cases, especially among the adult population. To understand the frequency and distribution of potential causative agents of diarrheal disease in Singapore, we screened adults' stool samples collected from a large public hospital. The stool samples were screened for 18 diarrheagenic pathogens using a combination of commercial multiplex polymerase chain reaction (PCR), in-house singleplex PCR and immunochromatographic assays. One hundred adult faecal samples that were collected from October 2013 to January 2014 for routine diagnostic purposes and submitted for culture at Tan Tock Seng Hospital, Singapore were used. Pathogens were detected in 32% of the samples. The predominant organisms encountered were norovirus genogroup II (11%), Aeromonas spp. (9%) and Campylobacter spp. (5%). One sample was positive for both verocytotoxigenic E. coli (VTEC) and E. coli O157:H7. Two other samples were positive for VTEC only, and one other sample was positive for E. coli O157:H7 only. Astrovirus, C. perfringens, Shigella spp. and toxigenic C. difficile were each detected in 2% of the samples. Cryptosporidium parvum, Giardia lamblia, group A rotavirus, Salmonella spp. and Vibrio spp. were each detected in 1% of the samples. No L. monocytogenes, Y. enterocolitica, enteric adenovirus, or norovirus genogroup I were detected. Our preliminary findings suggest that pathogens causing non-notifiable diseases might have contributed considerably to the adult hospitalised AGE cases. However, as the samples were from an adult hospital, the data obtained may not be representative of the whole community. Thus, a larger study to collect clinical samples and risk exposure data from primary healthcare clinics and children hospital is planned for, to

The hospital doctor in legislation and medical deontology: tension between profession and institution.

Science.gov (United States)

Schutyser, K

1998-01-01

1. Every health policy should make clear the organization of its offer of care; also, more particularly, the role of the individual professionals and their groups, as well as the role of the services and institutions, all within the chosen private, public or mixed framework. 2. Both in public law and in private law as well as in deontology, clear rules will have to be formulated concerning the relationship of doctor-patient and institution-patient; therefore also concerning the relationship of hospital-doctor. 3. It is evident that the lack of clarity frequently encountered in the Belgian and many other national legal systems with respect to these matters is unfortunately also reflected in international health law. 4. The issue of the legal relationships in the patient-doctor-hospital triangle should no longer be delayed until the catastrophic moment when medical liability should be considered. 5. Can we indeed speak of integral quality of a hospital, when it is anything but clear whether it concerns a single integrated enterprise or a roof under which two or more enterprises or entrepreneurs organize their own separate services to the clients? 6. Although the decision is a societal matter, the organisations of institutions and professionals should (continue to) play an important role in the preparation of this debate, which must bring the necessary clarity to the present relations and preferably also about the future options with respect to these relations. 7. A fundamental question, which remains to be solved for the future health policy, appears to be whether hospitals can be integrated institutions and, in the affirmative, whether they should be so. 8. The law, with priority to deontology, should formulate basic rules to clarify all possibilities in the patient-hospital-doctor triangle relationship--which is evolving into a polygon through fusion and group practices--and especially to trace out the consequences of health policy options with regard to the

Beyond the interface: Encountering artifacts in use

DEFF Research Database (Denmark)

Bødker, Susanne; Bannon, Liam

1991-01-01

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...... 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...... in HCi, she came across the cognitive science framework, but she felt that its methods did not provide much help for concrete design in real life situations. In many ways our personal histories reflect some of the developments within the HCI area - the search for more theoretical frameworks...

Encountering women veterans with military sexual trauma.

Science.gov (United States)

Conard, Patricia L; Young, Cathy; Hogan, LaMicha; Armstrong, Myrna L

2014-10-01

As women veterans (WVs) are returning from Operation Iraqi Freedom and Operation Enduring Freedom with military sexual trauma (MST), the purpose of this article is twofold. First, important exploratory questions that can assist with a thorough assessment and history are presented as well as the applicable treatment for any new, recurrent, or unresolved symptoms that involve MST. Review of multiple literary materials, as well as a clinical situation. WVs will be encountered in a variety of military or civilian primary and community care healthcare settings. Every woman (and man) in the civilian sector should be asked, "Have you ever served in the military?" Recognition, acknowledgment, and applicable interventions for MST and associated comorbidities, especially post-traumatic stress disorder, are presented as currently 80-90% of MST experiences have gone unreported. Immediate treatment and follow-up are critical for the well-being of the WVs. © 2014 Wiley Periodicals, Inc.

Managing uncertainty: a grounded theory of stigma in transgender health care encounters.

Science.gov (United States)

Poteat, Tonia; German, Danielle; Kerrigan, Deanna

2013-05-01

A growing body of literature supports stigma and discrimination as fundamental causes of health disparities. Stigma and discrimination experienced by transgender people have been associated with increased risk for depression, suicide, and HIV. Transgender stigma and discrimination experienced in health care influence transgender people's health care access and utilization. Thus, understanding how stigma and discrimination manifest and function in health care encounters is critical to addressing health disparities for transgender people. A qualitative, grounded theory approach was taken to this study of stigma in health care interactions. Between January and July 2011, fifty-five transgender people and twelve medical providers participated in one-time in-depth interviews about stigma, discrimination, and health care interactions between providers and transgender patients. Due to the social and institutional stigma against transgender people, their care is excluded from medical training. Therefore, providers approach medical encounters with transgender patients with ambivalence and uncertainty. Transgender people anticipate that providers will not know how to meet their needs. This uncertainty and ambivalence in the medical encounter upsets the normal balance of power in provider-patient relationships. Interpersonal stigma functions to reinforce the power and authority of the medical provider during these interactions. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. However, these theories ignore how hierarchies of power in social relationships serve to maintain and reinforce inequalities. The findings of this study suggest that interpersonal stigma also functions to reinforce medical power and authority in the face of provider uncertainty. Within functional theories of stigma, it is important to acknowledge the role of power and to understand how stigmatizing attitudes function to maintain

Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.

Science.gov (United States)

Morris, Andrea M; Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Dobalian, Aram

2016-05-05

Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts. Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff

Households' Stories of Their Encounters with a Plug-In Hybrid Electric Vehicle

Science.gov (United States)

Caperello, Nicolette D.; Kurani, Kenneth S.

2012-01-01

One way to progress toward greenhouse gas reductions is for people to drive plug-in hybrid electric vehicles (PHEVs). Households in this study participated in a 4- to 6-week PHEV driving trial. A narrative of each household's encounter with the PHEV was constructed by the researchers from multiple in-home interviews, questionnaires completed by…

Two massive stars possibly ejected from NGC 3603 via a three-body encounter

Science.gov (United States)

Gvaramadze, V. V.; Kniazev, A. Y.; Chené, A.-N.; Schnurr, O.

2013-03-01

We report the discovery of a bow-shock-producing star in the vicinity of the young massive star cluster NGC 3603 using archival data of the Spitzer Space Telescope. Follow-up optical spectroscopy of this star with Gemini-South led to its classification as O6 V. The orientation of the bow shock and the distance to the star (based on its spectral type) suggest that the star was expelled from the cluster, while the young age of the cluster (˜2 Myr) implies that the ejection was caused by a dynamical few-body encounter in the cluster's core. The relative position on the sky of the O6 V star and a recently discovered O2 If*/WN6 star (located on the opposite side of NGC 3603) allows us to propose that both objects were ejected from the cluster via the same dynamical event - a three-body encounter between a single (O6 V) star and a massive binary (now the O2 If*/WN6 star). If our proposal is correct, then one can `weigh' the O2 If*/WN6 star using the conservation of the linear momentum. Given a mass of the O6 V star of ≈30 M⊙, we found that at the moment of ejection the mass of the O2 If*/WN6 star was ≈175 M⊙. Moreover, the observed X-ray luminosity of the O2 If*/WN6 star (typical of a single star) suggests that the components of this originally binary system have merged (e.g., because of encounter hardening).

Toward a Theory of the Educational Encounter: Gert Biesta's Educational Theory and the Right to the City

Science.gov (United States)

Ford, Derek R.

2013-01-01

This paper outlines a theory of the educational encounter, the space of, and the right to that encounter. Situated in response to neoliberal educational reforms, this theory is developed through a reading and synthesis of the educational theory of Gert Biesta, the architectural component of his theory, and literature on the right to the city. The…

Hospital waste management in nonteaching hospitals of Lucknow City, India

Directory of Open Access Journals (Sweden)

Manish Kumar Manar

2014-01-01

Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

The application of hospitality elements in hospitals.

Science.gov (United States)

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

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.

Uncorrelated Encounter Model of the National Airspace System, Version 2.0

Science.gov (United States)

2013-08-19

can exist to certify avoidance systems for operational use. Evaluations typically include flight tests, operational impact studies, and simulation of...appropriate for large-scale air traffic impact studies— for example, examination of sector loading or conflict rates. The focus here includes two types of...between two IFR aircraft in oceanic airspace. The reason for this is that one cannot observe encounters of sufficient fidelity in the available data