Satisfaction with emergency department service among non-English-speaking background patients

Objective: The present study aims to investigate non-English-speaking background (NESB) patients’ satisfaction with hospital ED service and compare it with that of English-speaking background (ESB) patients. Methods: A cross-sectional survey was conducted at the ED of an adult tertiary referral hospital in Queensland, Australia. Patients assigned an Australasian Triage Scale score of 3, 4 or 5 were surveyed in the ED, before and after their ED service. Pearson χ2- test and multivariate logistic regression analyses were performed to examine the differences between the ESB and NESB groups in terms of patient-reported satisfaction. Results: In total, 828 patients participated in the present study. Although the overall satisfaction with the service was high – 95.1% (ESB) and 90.5% (NESB) – the NESB patients who did not use an interpreter were less satisfied with their ED service than the ESB patients (odds ratio 0.5, 95% confidence interval 0.3–0.8, P = 0.013). The promptness of service received the lowest satisfaction rates (ESB 85.4% [82.4–88.0], NESB 74.5% [68.5– 79.7], P < 0.001), whereas courtesy and friendliness received the highest satisfaction rates (ESB 98.8 [97.6–99.4], NESB 97.0 [93.9–98.5], P = 0.063). All participants reported the promptness of service (33.5%), quality and professional care (18.5%) and communication (17.6%) as the most important elements of ED service. Conclusion: The NESB patients were significantly less satisfied than the ESB patients with the ED service. Use of an interpreter improved the NESB patients’ level of satisfaction. Further research is required to examine what NESB patients’ expectations of ED service are.

Student satisfaction with models of field placement supervision

Field placements provide social work students with the opportunity to integrate their classroom learning with the knowledge and skills used in various human service programs. The supervision structure that has most commonly been used is the intensive one-to-one, clinical teaching model. However, this model is being challenged by significant changes in educational and industry sectors, which have led to an increased use of alternative fieldwork structures and supervision arrangements, including task supervision, group supervision, external supervision, and shared supervisory arrangements. This study focuses on identifying models of supervision and student satisfaction with their learning experiences and the supervision received on placement. The study analysed responses to a questionnaire administered to 263 undergraduate social work students enrolled in three different campuses in Australia after they had completed their first or final field placement. The study identified that just over half of the placements used the traditional one student to one social work supervisor model. A number of “emerging” models were also identified, where two or more social workers were involved in the professional supervision of the student. High levels of dissatisfaction were reported by those students who received external social work supervision. Results suggest that students are more satisfied across all aspects of the placement where there is a strong on-site social work presence.

Student satisfaction with models of field placement supervision

Field placements provide social work students with the opportunity to integrate their classroom learning with the knowledge and skills used in various human service programs. The supervision structure that has most commonly been used is the intensive one-to-one, clinical teaching model. However, this model is being challenged by significant changes in educational and industry sectors, which have led to an increased use of alternative fieldwork structures and supervision arrangements, including task supervision, group supervision, external supervision, and shared supervisory arrangements. This study focuses on identifying models of supervision and student satisfaction with their learning experiences and the supervision received on placement. The study analysed responses to a questionnaire administered to 263 undergraduate social work students enrolled in three different campuses in Australia after they had completed their first or final field placement. The study identified that just over half of the placements used the traditional one student to one social work supervisor model. A number of “emerging” models were also identified, where two or more social workers were involved in the professional supervision of the student. High levels of dissatisfaction were reported by those students who received external social work supervision. Results suggest that students are more satisfied across all aspects of the placement where there is a strong on-site social work presence.

A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

The individual and collective effect of U.S. colonialism in Puerto Rico : a scale construction and validation, with implications for social work education and practice.

Tesis (Doctor en Filosofía con Orientación en Trabajo Social y Políticas Comparadas de Bienestar Social) UANL, 2011.

Does Satisfaction with Democracy really increase Happiness? Direct Democracy and Individual Satisfaction in Switzerland

This paper takes the influential “direct democracy makes people happy”-research as a starting point and asks whether direct democracy impacts individual satisfaction. Unlike former studies we distinguish two aspects of individual satisfaction, namely satisfaction with life (“happiness”) and with how democracy works. Based on multilevel analysis of the 26 Swiss cantons we show that the theoretical assumption on which the happiness hypothesis is based has to be questioned, as there is very little evidence for a robust relationship between satisfaction with democracy and life satisfaction. Furthermore, we do not find a substantive positive effect of direct democracy on happiness. However, with respect to satisfaction with democracy, our analysis shows some evidence for a procedural effect of direct democracy, i.e. positive effects related to using direct democratic rights, rather than these rights per se.

"I take care of my own" : a field study on how leadership handles conflict between individual and collective incentives

From the early literature on the role of firm managers (Alchian and Demsetz 1972) to the industrial organisation on contracts and mechanism design (Laont and Martimort 2009), economists have given a lot of attention to find solutions to the imperfect alignment between individuals' incentives and an organisation's collective goals (Prendergast 1999). In that literature a key role of managers is to monitor individuals to reward behaviour aligned with the collective goals and reduce sub- optimal behaviour, such as shirking. How- ever, another strand of literature, since Akerlof (1982), has put forward a vision of reciprocal behaviour between an organisation's leadership and its members: gifts (high wages, recognition) from the organisation are reciprocated by high effort from the members of the organisation. By rewarding individual members (rather than strictly monitoring them), organisations may benefit from greater effort and cohesion. Experimental research in organizational economics has provided mixed results suggesting that agents do react to personal incentives but also that reciprocal behaviour can play a substantial role (Camerer and Weber 2012).

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Microfoundations of HRM effects: Individual and Collective Attitudes and Performance

Previous research on Human Resource Management (HRM) has focused extensively on the potential relationships between the use of HRM practices and organizational performance. Extant research in HRM has been based on the underlying assumption that HRM practices can enhance organizational performance through their impact on positive employee attitudes and performance, that is, employee reactions to HRM. At the current state of research however, it remains unclear how employees come to perceive and react to HRM practices and to what extent employees in organizations, units and teams react to such practices in similar or widely different ways. In fact, recent HRM studies indicate that employee reactions to HRM may be far less homogeneous than assumed. This raises the question of whether or not the linkage between HRM and organizational outcomes can be explained by employee reactions in terms of attitudes and performance, if these reactions are largely idiosyncratic. Accordingly, this thesis aims to shed light on the processes that shape individuals’ reactions to HRM practices and how these processes may influence the variance or sharedness in such reactions among employees in organizations, units and teams. By theoretically developing and empirically examining the effects of employee perceptions of HRM practices from the perspective of ‘HRM as signaling’ and psychological contract theory, the main contributions of this thesis focus on the following research questions: i) How employee perceptions of the HRM practices relate to individual and collective employee attitudes and performance. ii) How employee perceptions of HRM practices relates to variance in employee attitudes and performance. iii) How collective employee performance mediates the relationship between employee perceptions of HRM practices and organizational performance. Regarding the first research questions the findings indicate that individuals do respond positively to HRM practices by adjusting their felt obligations towards the employer. This finding is in line with the idea of HRM as a signaling device where each HRM practice, implicitly or explicitly, sends signals to employees about promised rewards (inducements) and behaviors (obligations) expected in return. The relationship was also confirmed at the group level of analysis. What is more, variance was found to play an important role in that employee groups with more similar perceptions about the HRM system displayed a stronger relationship between HRM and employee obligations. Concerning the second question the findings were somewhat contradictory in that a strong HRM system was found negatively related to variance in employee performance but not employee obligations. Regarding the third question, the findings confirmed linkages between the HRM system and organizational performance at the group level and the HRM system and employee performance at the individual level. Also, the entire chain of links from the HRM system through variance in employee performance, and further through the level of employee performance to organizational performance was significant.

Occurrence of mycobacteria in bovine milk samples from both individual and collective bulk tanks at farms and informal markets in the southeast region of Sao Paulo, Brazil

Background: Mycobacterium spp. is one of the most important species of zoonotic pathogens that can be transmitted from cattle to humans. The presence of these opportunistic, pathogenic bacteria in bovine milk has emerged as a public-health concern, especially among individuals who consume raw milk and related dairy products. To address this concern, the Brazilian control and eradication program focusing on bovine tuberculosis, was established in 2001. However, bovine tuberculosis continues to afflict approximately 1,3 percent of the cattle in Brazil. In the present study, 300 samples of milk from bovine herds, obtained from both individual and collective bulk tanks and informal points of sale, were cultured on Löwenstein-Jensen and Stonebrink media. Polymerase chain reaction (PCR)-based tests and restriction-enzyme pattern analysis were then performed on the colonies exhibiting phenotypes suggestive of Mycobacterium spp., which were characterized as acid-fast bacilli.Results: Of the 300 bovine milk samples that were processed, 24 were positively identified as Mycobacterium spp.Molecular identification detected 15 unique mycobacterial species: Mycobacterium bovis, M. gordonae, M. fortuitum, M. intracellulare, M. flavescens, M. duvalii, M. haemophilum, M. immunogenum, M. lentiflavum, M. mucogenicum, M. novocastrense, M. parafortuitum, M. smegmatis, M. terrae and M. vaccae. The isolation of bacteria from the various locations occurred in the following proportions: 9 percent of the individual bulk-tank samples, 7 percent of the collective bulk-tank samples and 8 percent of the informal-trade samples. No statistically significant difference was observed between the presence of Mycobacterium spp. in the three types of samples collected, the milk production profiles, the presence of veterinary assistance and the reported concerns about bovine tuberculosis prevention in the herds.Conclusion: The microbiological cultures associated with PCR-based identification tests are possible tools for the investigation of the presence of Mycobacterium spp. in milk samples. Using these methods, we found that the Brazilian population may be regularly exposed to mycobacteria by consuming raw bovine milk and related dairy products. These evidences reinforces the need to optimize quality programs of dairy products, to intensify the sanitary inspection of these products and the necessity of further studies on the presence of Mycobacterium spp. in milk and milk-based products. © 2013 Franco et al.; licensee BioMed Central Ltd.

Consumer satisfaction with primary care provider choice and associated trust

Trust is important in medical relationships and for the achievement of better health outcomes. Developments in managed care in the recent years are believed to affect the quality of healthcare services delivery and to undermine trust in the healthcare provider. Physician choice has been identified as a strong predictor of provider trust but has not been studied in detail. Consumer satisfaction with primary care provider (PCP) choice includes having or not having physician choice. This dissertation developed a conceptual framework that guided the study of consumer satisfaction with PCP choice as a predictor of provider trust, and conducted secondary data analyses examining the association between PCP choice and trust, by identifying factors related to PCP choice satisfaction, and their relative importance in predicting provider trust. The study specific aims were: (1) to determine variables related to the factors: consumer characteristics and health status, information and consumer decision-making, consumer trust in providers in general and trust in the insurer, health plan financing and plan characteristics, and provider characteristics that may relate to PCP choice satisfaction; (2) to determine if the factors in aim one are related to PCP choice satisfaction; and (3) to analyze the association between PCP choice satisfaction and provider trust, controlling for potential confounders. Analyses were based on secondary data from a random national telephone survey in 1999, of residential households in the United States which included respondents aged over 20 and who had at least two visits with a health professional in the past two years. Among 1,117 eligible households interviewed (response rate 51.4%), 564 randomly selected to respond to insurer related questions made up the study sample. Analyses using descriptive statistics, and linear and logistic regressions found continual effective care and interaction with the PCP beyond the medical setting most predictive of PCP choice satisfaction. Four PCP choice satisfaction factors were also predictive of provider trust. Findings highlighted the importance of the PCP's professional and interpersonal competencies for the development of sustainable provider trust. Future research on the access, utilization, cognition, and helpfulness of provider specific information will further our understanding of consumer choice and trust. ^

Read this if you plan to breathe this summer : advisory for those with asthma & breathing problems and for children, older adults, and people who work outdoors.

Mode of access: Internet.

Modern geography : a description of the empires, kingdoms, states, and colonies ; with the oceans, seas, and isles ; in all parts of the world : including the most recent discoveries, and political alterations, digested on a new plan /

Mode of access: Internet.

Analytical concordance to the Bible on an entirely new plan, containing about 311,000 references, subdivided under the Hebrew and Greek originals, with the literal meaning and pronunciation of each, designed for the simplest reader of the English Bible, /

Mode of access: Internet.