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.

Page from Non-Military Ledger- 1811

A page from a non-military ledger that contains the prices of domestic items around the year 1811.

Establishing an EGFR mutation screening service for non-small cell lung cancer - sample quality criteria and candidate histological predictors.

INTRODUCTION: EGFR screening requires good quality tissue, sensitivity and turn-around time (TAT). We report our experience of routine screening, describing sample type, TAT, specimen quality (cellularity and DNA yield), histopathological description, mutation result and clinical outcome. METHODS: Non-small cell lung cancer (NSCLC) sections were screened for EGFR mutations (M+) in exons 18-21. Clinical, pathological and screening outcome data were collected for year 1 of testing. Screening outcome alone was collected for year 2. RESULTS: In year 1, 152 samples were tested, most (72%) were diagnostic. TAT was 4.9 days (95%confidence interval (CI)=4.5-5.5). EGFR-M+ prevalence was 11% and higher (20%) among never-smoking women with adenocarcinomas (ADCs), but 30% of mutations occurred in current/ex-smoking men. EGFR-M+ tumours were non-mucinous ADCs and 100% thyroid transcription factor (TTF1+). No mutations were detected in poorly differentiated NSCLC-not otherwise specified (NOS). There was a trend for improved overall survival (OS) among EGFR-M+ versus EGFR-M- patients (median OS=78 versus 17 months). In year 1, test failure rate was 19%, and associated with scant cellularity and low DNA concentrations. However 75% of samples with poor cellularity but representative of tumour were informative and mutation prevalence was 9%. In year 2, 755 samples were tested; mutation prevalence was 13% and test failure only 5.4%. Although samples with low DNA concentration (2.2 ng/μL), the mutation rate was 9.2%. CONCLUSION: Routine epidermal growth factor receptor (EGFR) screening using diagnostic samples is fast and feasible even on samples with poor cellularity and DNA content. Mutations tend to occur in better-differentiated non-mucinous TTF1+ ADCs. Whether these histological criteria may be useful to select patients for EGFR testing merits further investigation.

Reports. Dept. of Military Affairs and Selective Service System

Title Varies: Reports. Dept. of Military Affairs and Selective Service System; Reports. Military Dept., Civil Defense Agency and Selective Service System

Study of Military Air Transport Service. Hearings before a special subcommittee, Eighty-fifth Congress, second session. May 19, June 12-13, 1958.

Mode of access: Internet.

Scalability of Multicast Delivery for Non-sequential Streaming Access

To serve asynchronous requests using multicast, two categories of techniques, stream merging and periodic broadcasting have been proposed. For sequential streaming access where requests are uninterrupted from the beginning to the end of an object, these techniques are highly scalable: the required server bandwidth for stream merging grows logarithmically as request arrival rate, and the required server bandwidth for periodic broadcasting varies logarithmically as the inverse of start-up delay. However, sequential access is inappropriate to model partial requests and client interactivity observed in various streaming access workloads. This paper analytically and experimentally studies the scalability of multicast delivery under a non-sequential access model where requests start at random points in the object. We show that the required server bandwidth for any protocols providing immediate service grows at least as the square root of request arrival rate, and the required server bandwidth for any protocols providing delayed service grows linearly with the inverse of start-up delay. We also investigate the impact of limited client receiving bandwidth on scalability. We optimize practical protocols which provide immediate service to non-sequential requests. The protocols utilize limited client receiving bandwidth, and they are near-optimal in that the required server bandwidth is very close to its lower bound.

Dinámicas de externalización entre las ONG locales y las ONG extranjeras (terceros actores) presentes en Egipto: 2004-2009 (TERCEROS ACTORES) PRESENTES EN EGIPTO: 2004-2009

El propósito de la presente monografía es evaluar el papel de las ONG internacionales en la apertura de espacios de participación política para la sociedad civil en Egipto. En ese sentido, se analiza el contexto de oportunidades políticas locales y transnacionales del país, así como los procesos de articulación entre la política local e internacional a través de los niveles de integración entre sus actores. Mediante una investigación de tipo cualitativa basada en los desarrollos sobre teorías de la acción colectiva planteados por Sidney Tarrow, Charles Tilly, Robert Benford y David Snow, y las teorías sobre redes transnacionales de defensa desarrolladas por Margaret Keck y Kathryn Sikkink, se avanza hacia la identificación del desarrollo de procesos de externalización como medio para el fortalecimiento de organizaciones locales como alternativa de oposición política.

Aproximación al manejo de la seguridad ambiental canadiense y estadounidense frente a la degradación del sistema de la los Grandes Lagos. Periodo 1995-2000

El propósito de la presente monografía es determinar la relación entre la degradación y navegación en los Grandes Lagos en la noción de seguridad ambiental de Estados Unidos y Canadá en un entorno de interdependencia entre 1995 - 2000. En ese sentido, se busca determinar como los recursos de poder de Canadá y Estados Unidos en la relación degradación-navegación transforma la noción de seguridad ambiental. De este modo, se analiza el concepto de seguridad ambiental desde la navegación, elemento esencial para entender la relación bilateral dentro del sistema de los Grandes Lagos. Esta investigación de tipo cualitativo que responde a las variables de la seguridad ambiental planteadas por Barry Buzan, Thomas Homer-Nixon, y Stephan Libiszewski, y a la teoría de la Interdependencia Compleja por Robert Keohane y Joseph Nye, pretende avanzar hacia la complejización de la dimensión ambiental lejos de la tradicional definición antropocéntrica.

The devil is in the details. Information warfare in the light of Russia's military doctrine. OSW Point of View 50, May 2015

By highlighting informational threats and giving them a military dimension, the authors of the Russian Federation's military doctrine have outlined the concept of information warfare. It is a kind of combat conducted by both conventional and indirect methods, open and concealed, using military and civilian structures. It has two dimensions: broader ("non-nuclear containment", i.e. combat waged on various levels - political, economic, diplomatic, humanitarian, military) and narrower (as an element supporting of action). An analysis of these issues enables us to identify several rising trends over the period 2000-2014 in Russian security policy. These boil down to a blurring of the boundaries between internal and external threats, introducing non-military methods and organisational structures to armed combat, and conferring an ideological character on this combat. This leads to a blurring of the contours of inter-state conflicts, which allows Russia to take part in armed conflicts in which it is not officially a party.

A Temporary Hometown: Gendered Labor and Social Citizenship in Bremerton, Washington, a Domestic Military Colony

Thesis (Master's)--University of Washington, 2016-06