Effect of functional gain on satisfaction with medical rehabilitation after stroke

Objective: To examine the association between gain in motor and cognitive functional status with patient satisfaction 3-6 mo after rehabilitation discharge. Design: Patient satisfaction and changes in functional status were examined in 18,375 patients with stroke who received inpatient medical rehabilitation. Information was obtained from 144 hospitals and rehabilitation facilities contributing records to the Uniform Data System for Medical Rehabilitation and the National Follow-up Services. Results: Data analysis revealed significant (P < 0.05) differences in satisfaction responses based on whether information was collected from patient self-report or from a family member proxy, and the two subsets were analyzed separately. Logistic regression revealed the following significant predictors of satisfaction for data collected from stroke patients: cognitive and motor gain, rehospitalization, who the patient was living with at follow-up, age, and follow-up therapy. In the patient-reported data subset, compared with patients who showed improved cognitive or motor functional status, those with no change, respectively, had a 31% and 33% reduced risk of dissatisfaction. In addition, rehospitalized patients had a higher risk of dissatisfaction. For the proxy reported data subset, significant influences on satisfaction were health maintenance, rehospitalization, stroke type, ethnicity, cognitive FIM(TM) gain, length of stay, and follow-up therapy. Conclusions: Ratings of satisfaction with rehabilitation services were affected by change in functional status and whether the information was collected from patient rating or proxy response.

A moderniza????o do estado e a ger??ncia p??blica

O artigo analisa a problem??tica da moderniza????o do Estado vista como um processo de constitui????o de cidadania e de otimiza????o dos recursos p??blicos. Os autores focalizam, por um lado, o atendimento aos usu??rios, a qualidade dos servi??os e a transpar??ncia. Por outro lado, a incorpora????o de t??cnicas de gest??o avan??adas ?? considerada indispens??vel para o aumento da efic??cia e da efici??ncia no setor p??blico. Os principais problemas discutidos no artigo incluem: racionalidade do setor p??blico racionalidade das empresas privadas; incentivos e motiva????o dos servidores p??blicos; rigidez dos procedimentos administrativos; margem de decis??o dos gestores; sistemas de acesso a informa????o; import??ncia da gest??o de pessoal e da valoriza????o do trabalho no setor p??blico; papel dos gerentes na moderniza????o das institui????es p??blicas; cargos de carreira, cargos de confian??a; mecanismos de recrutamento e reten????o e sistemas de capacita????o dos servidores p??blicos. Os autores concluem que, devido ??s inova????es constantes em mat??ria de ger??ncia p??blica, n??o existe hoje um perfil gerencial definitivo como resposta ??s necessidades do Estado. Pelo contr??rio, o que se observa ?? uma crescente complexidade da gest??o p??blica que continuar?? oscilando entre a pol??tica e a tecnocracia, entre a maior flexibilidade e as exig??ncias de controle, entre a ado????o das t??cnicas de gest??o e a recupera????o da tradi????o administrativa e a cultura da fun????o p??blica.

UN Security Council decision-making: testing the bribery hypothesis

Liberal-Institutionalism and Structural Realism expectations about international organizations are confronted by looking at if and how US-controlled international aid is granted, and particularly if it is related or not to political affinity and to United Nations Security Council (UNSC) non-permanent membership. A preliminary assessment suggests that these relations only hold for the period of the Cold War, and, even then, only when UNSC non-permanent membership is in years in which the Security Council was deemed very important.

Profiling consumer behaviour in cross-border tourism destinations

Tourism is a phenomenon that moves millions of people around the world, taking as a major driver of the global economy. Such relevance is reflected in the proliferation of studies in the overall area known as tourism, under various perspectives and backgrounds. In the light of such multitude of insights our study aims at gaining a deeper understanding of customer profiling and behavior in cross-border tourism destinations. Previous studies conducted in such contexts suggest that cross-border regions (CBRs) are an attractive and desirable idea, yet requiring further theoretical and empirical research. The new configuration of many CBRs calls for a debate on issues concerning its development, raising up important dimensions, such as, organization and planning of common tourism destinations. There is still a gap in the understanding of destination management in CBRs and the customer profile and motivations. Overall this research aims at attaining a deeper understanding of the profile and behavior of consumers in tourism settings, addressing the predisposition for the destination. The study addresses the following research question: “What factors influence customer behavior and attitudes in a CBRs tourism destination?” To address our question we will take an interdisciplinary perspective bringing together inputs from marketing, tourism and local economics. When addressing consumer behavior in tourism previous studies considered the following constructs: involvement, place attachment, satisfaction and destination loyalty. In order to establish the causal relationships in our theoretical model, we intend to develop a predominant quantitative design, yet we plan to conduct exploratory interviews. In the analysis and discussion of results, we intend to use Structural Equation Modeling. It will further allow understanding how the constructs in the research model relate to each other in the specified context. Results are also expected to have managerial implications. Consequently our results may assist decision makers in developing their local policies.

Consumer behavior and profile in cross border tourism destinations

Tourism is a phenomenon that moves millions of people around the world, taking as a major driver of the global economy. Such relevance is reflected in the proliferation of studies in the overall area known as tourism, under various perspectives and backgrounds. In the light of such multitude of insights our study aims at gaining a deeper understanding of customer profiling and behavior in cross-border tourism destinations. Previous studies conducted in such contexts suggest that cross-border regions (CBRs) are an attractive and desirable idea, yet requiring further theoretical and empirical research. The new configuration of many CBRs calls for a debate on issues concerning its development, raising up important dimensions, such as, organization and planning of common tourism destinations. There is still a gap in the understanding of destination management in CBRs and the customer profile and motivations. Overall this research aims at attaining a deeper understanding of the profile and behavior of consumers in tourism settings, addressing the predisposition for the destination. The study addresses the following research question: “What factors influence customer behavior and attitudes in a CBRs tourism destination?” To address our question we will take an interdisciplinary perspective bringing together inputs from marketing, tourism and local economics. When addressing consumer behavior in tourism previous studies considered the following constructs: involvement, place attachment, satisfaction and destination loyalty. In order to establish the causal relationships in our theoretical model, we intend to develop a predominant quantitative design, yet we plan to conduct exploratory interviews. In the analysis and discussion of results, we intend to use Structural Equation Modeling. It will further allow understanding how the constructs in the research model relate to each other in the specified context. Results are also expected to have managerial implications. Consequently our results may assist decision makers in developing their local policies.

Annotation taken, in the perspective of criminal and constitutional law, as well as in criminology, to the decision of the portuguese constitutional court, of January 13, 2011 – with respect to the problems of “consent” and “medical act”

1 – Summary of the decision taken by the Portuguese Constitutional Court, of January 13, 2011; 2 – Complete text of the decision of the Portuguese Constitutional Court, of January 13, 2011, Judge Maria João ANTUNES (Reporter), Judge Carlos Pamplona de OLIVEIRA, Judge José Borges SOEIRO, Judge Gil GALVÃO, Judge Rui Manuel Moura RAMOS (President) –in terms of the tribunalconstitucional.pt, August 1, 2011; 3 – Brief annotation to the problem of the “medical act”; 3.1 – Plus some conclusions on the brief annotation to the problem of the “medical act”; 3.2 – Brief annotation to the problem of “consent”– continuation of the previous comments; 4 – Conclusions. It must never be forgotten that “consent” does not stand as the only cause of exclusion of unlawfulness.

An empirical assessment of customer satisfaction and quality of servisse: Comparing Servqual and Servperf

This paper assesses the validity and reliability of two instruments measuring quality of service, the SERVPERF and SERVQUAL scales, replicated in a novel cultural settings, a Portuguese energy company. To provide insights and strategies for managerial intervention, a relation between customers’ satisfaction and quality of service is established. The empirical study suggests a superior convergent and predictive validity of SERVPERF scale to measure quality of service in this settings when comparing to SERVQUAL. The main differences of this study with previous ones, are that this one resorts on a confirmatory factor analysis, the validation of the instruments is performed by using the same measures suggested by their creators and extends the line of research to a novel cultural settings, a Portuguese energy company. Concerning the relationship between service quality and customers’ satisfaction, all of the quality of service attributes correlate almost equally to the satisfaction ones, with a lower weight concerning tangibles.

An empirical assessment of customer satisfaction and quality of service: comparing SERVQUAL and SERVPERF

This paper assesses the validity and reliability of two instruments measuring quality of service, the SERVPERF and SERVQUAL scales, replicated in a novel cultural settings, a Portuguese energy company. To provide insights and strategies for managerial intervention, a relation between customers’ satisfaction and quality of service is established. The empirical study suggests a superior convergent and predictive validity of SERVPERF scale to measure quality of service in this settings when comparing to SERVQUAL. The main differences of this study with previous ones, are that this one resorts on a confirmatory factor analysis, the validation of the instruments is performed by using the same measures suggested by their creators and extends the line of research to a novel cultural settings, a Portuguese energy company. Concerning the relationship between service quality and customers’ satisfaction, all of the quality of service attributes correlate almost equally to the satisfaction ones, with a lower weight concerning tangibles.

Linking customer satisfaction, quality, and strategic planning

By acknowledging and dissecting the interconnected roles of customer satisfaction, quality, and strategic planning, this paper provides an analytical framework for creating a customer-driven organization and culture. It shows how quality starts and ends with the customer. Companies that are achieving long-term continuous improvement in quality tailored to customer satisfaction possess lasting characteristics such as customer orientation, customer consciousness, and customer responsiveness. In doing so, they liberate the quality concept from the narrow product or service focus to encompass total conformance to customer requirements in spite of the existing functionalization and departmentalization of modern complex structures. In addition to these key components, a customer-driven organization demands building and nurturing a customer satisfaction culture and value system that makes quality improvement and heightened concern for customer satisfaction a permanent aspect of organizational life.

Focusing illusion in satisfaction with life among college students living in Brazil

Literature shows that there are significant associations between health and happiness. Various countries are considering, contemplating or formally incorporating the happiness variable into their public health policies. Moreover, the private sector has shown interest in the topic. Based on that This article examines the biases in the perception of satisfaction with life among young adults in two Brazilian cities. The study explores the associations between aspects of life and perception of happiness because public policies associated with happiness require an improved understanding of the subjectivity of the sense of well-being. A survey conducted among 368 college students enabled analysis through Multivariate Analysis of Covariance (MANCOVA) and linear regression. The results suggest that, although there were no significant differences in general satisfaction with life between the two cities, there were indications of focusing illusion in the perception of happiness caused by expectations arising from the feeling of personal insecurity in a metropolis.