Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital

This study examined the level of patient satisfaction and nursing staff work satisfaction at an urban public hospital in the Southwestern United States. The primary objectives of this study were to determine: (1) the level of overall patient satisfaction and satisfaction with specific dimensions of hospital care; (2) the differences in patient satisfaction according to demographic characteristics (age, gender, ethnicity, and education completed) and predispositional factors (perceived health status, perceived level of pain, prior contact with the hospital, and hospital image) and the relative importance of each variable on patient satisfaction; (3) the level of overall work satisfaction and satisfaction with specific dimensions of work experienced by the medical/surgical nursing staff; (4) the differences in work satisfaction experienced by the nursing staff based on demographic variables (age, gender, ethnicity, and marital status) and professional factors (education completed, staff position, the number of years employed with the hospital, and number of years employed in nursing) and the relative importance of each variable on work satisfaction; and (5) to determine the effect of the nursing work milieu on patient and staff satisfaction.^ The study findings showed that patients experienced a moderate to low level of satisfaction with the dimensions of hospital care (admission process, daily care, information, nursing care, physician care, other hospital staff, living arrangements, and overall care). Of the eight dimensions of care, patients reported a relatively positive level of satisfaction (75 percent or better) with only one dimension: physician care. Ethnicity, perceived health status, and hospital image were significantly related to patient satisfaction. Hispanic patients, those who were in good health, and those who felt the hospital had a good image in their community were most satisfied with hospital care. Patients also reported areas of hospital care that needed the most improvement. Responses included: rude staff, better nursing care, and better communication.^ Findings from the nursing satisfaction survey indicated a low level of satisfaction with the dimensions of work (autonomy, pay, professional status, interaction, task requirements, and organizational policies). Only one dimension of work, professional status, received a mean satisfaction score in the positive range. Additionally, staff members were unanimously dissatisfied with their salaries. Frequently mentioned work-related problems reported by the staff included: staffing shortages, heavy patient loads. and excessive paperwork.^ The nursing milieu appeared to have had a significant effect on the satisfaction levels of patients nursing staff employees. The nursing staff were often short staffed, which increased the patient-to-nurse ratio. Consequently, patients did not receive the amount of attention and care they expected from the nursing staff. Crowded patient rooms allowed for little personal space and privacy. Dissatisfaction with living conditions served to influence patients' attitudes and satisfaction levels. These frustrations were often directed toward their primary caregivers, the nursing staff. Consequently, the nursing milieu appeared to directly affect and influence the satisfaction levels of both patients and staff. (Abstract shortened by UMI). ^

Impact of case-relevant and case-irrelevant communication within the surgical team on surgical-site infection

BACKGROUND Surgical-site infections (SSIs) are the most common complications after surgery. An influence from talking and distractions during surgery on patient outcomes has been suggested, but there is limited evidence. The aim of this prospective observational study was to assess the relationship between intraoperative communication within the surgical team and SSI, and between intraoperative distractions and SSI. METHODS This prospective observational study included patients undergoing elective, open abdominal procedures. For each procedure, intraoperative case-relevant and case-irrelevant communication, and intraoperative distractions were observed continuously on site. The influence of communication and distractions on SSI after surgery was assessed using logistic regressions, adjusting for risk factors. RESULTS A total of 167 observed procedures were analysed; their mean(s.d.) duration was 4·6(2·1) h. A total of 24 SSIs (14·4 per cent) were diagnosed. Case-relevant communication during the procedure was independently associated with a reduced incidence of organ/space SSI (propensity score-adjusted odds ratio 0·86, 95 per cent c.i. 0·77 to 0·97; P = 0·014). Case-irrelevant communication during the closing phase of the procedure was independently associated with increased incidence of incisional SSI (propensity score-adjusted odds ratio 1·29, 1·08 to 1·55; P = 0·006). Distractions had no association with SSI. CONCLUSION More case-relevant communication was associated with fewer organ/space SSIs, and more case-irrelevant communication during wound closure was associated with incisional SSI.

Investigator/IRB-led community communication in genetic research: A descriptive feasibility pilot study

This pilot study, conducted in the Houston, TX, area, established a structured dialogue among a university Institutional Review Board, its researchers, and its local community members (i.e. pool of potential research participants) for the purpose of further educating all three parties about genetic research and community concerns related to such research. An IRB-designed educational presentation aimed at assisting potential subjects in making an informed decision to participate in genetic research was provided to four community groups (n=54); this presentation also included a current example of genetic research being conducted in the community as explained by the researcher, and a question-and-answer session designed to assist the IRB and the researcher in understanding the community's concerns about genetic research. Comparisons of pre- and post- presentation community questionnaires indicate that the joint presentation was effective in increasing community knowledge about genetic research, most notably related to the risks and benefits of this research to the individual, as well as the understanding that protections are in place for research participants. While researchers are optimistic about the idea of a collaborative effort with the IRB and the community, the feasibility of such a program and the benefit to the participating researchers remain unclear; additional research is necessary to establish the most effective method of communication for all groups involved, as well as to obtain statistically significant results with regard to race/ethnicity, gender, and education levels of community participants. ^

Exploring parental factors and their influence on early adolescent sexual health

Black and Hispanic youth experience the largest burden of sexually transmitted infections, teen pregnancy, and childbirth (Hamilton, Martin, & Ventura, 2011). Minority youth are disporportionately more likely to sexually debut at every age and debut before the age of 13 compared to whites (Centers for Disease Control and Prevention, 2011). However, there is little known about pre-coital sexual activity or protective parental factors in early adolscent minority youth. Parental factors such as parent-child communication and parental monitoring influence adolescent sexual behaviors and pre-coital sexual behaviors in early adolescence. Three distinct methods were used in this dissertation. Study one used qualitative methods, semi-structured, in-depth, individual interviews, to explore parent-child communication in African American mother-early adolescent son dyads. Study two used quantitative methods, secondary data analysis of a cross sectional study, to conduct a moderation analysis. For study three, I conducted a systematic review of parent-based adolescent sexual health interventions. Study one found that mothers feel comfortable talking about sex with adolescents, provide a two-prong sexual health message, and want their sons to tell their when they are thinking of having sex. Study found that parental monitoring moderates the relation between parent-child communication and pre-coital sexual behaviors. Study three found that interventions use a variety of theory, methods, and strategies and that no parent-based programs target faith-based organizations, mother-son or father-daughter dyads, or parents of LGBTQ youth. Adolescent sexual health interventions should consider addressing youth-to-parent disclosure of sexual activity or intentions to debut, addressing both parent-child sexual health communication and parental monitoring, and using a theoretical framework.^

Distributes award protocol: A cooperation and communication method for robots.

In this Master’s Thesis a new Distributed Award Protocol (DAP) for robot communication and cooperation is presented. Task assignment (contract awarding) is done dynamically with contracts assigned to robots based upon the best bid received. Instead of having a manager and a contractor it is proposed a fully distributed bidding/awarding mechanism without a distinguished master. The best bidding robots are awarded with contract for execution. The contractors make decisions locally. This brings the following benefits: no communication bottleneck, low computational power requirement, increased robustness. DAP can handle multitasking. Tasks can be injected into system during the execution of already allocated tasks. As tasks have priorities, in the next cycle after taking into account actual bid parameters of all robots, tasks can be re-allocated. The aim is to minimize a global cost function which is a compromise between cost of task execution and cost of resources usage. Information about tasks and bid values is spread among robots with the use of a Round Robin Route, which is a novel solution proposed in this work. This method allows also identifying failed robots. Such failed robot is eliminated from the list of awarded robots and its replacement is found so the task is still executed by a team. If the failure of a robot was temporary (e.g. communication noise) and the robot can recover, it can again participate in the next bidding/awarding process. Using a bidding/awarding mechanism allows robots to dynamically relocate among tasks. This is also contributes to system robustness. DAP was evaluated through multiple experiments done in the multi-robot simulation system. Various scenarios were tested to check the idea of the main algorithm. Different failures of robots (communication failures, partial hardware malfunctions) were simulated and observations were made regarding how DAP recovers from them. Also the DAP flexibility to environment changes was watched. The experiments in the simulated environment confirmed the above features of DAP.

Soft Skills: A Comparative Analysis Between Online and Classroom Teaching

Currently the Spanish universities are making a great effort to effectively incorporate the development and assessment of generic skills in their training programs. Information and communications technologies (ICT) offer a wide range of possibilities but create uncertainty among teachers about the process and results. It is considered of interest to conduct a study to analyze the extent to which social skills like commitment, communication and teamwork are acquired by students and teachers. It seeks to ascertain the influence of the learning context, online or classroom training, in the development of these personal skills among the participants in the sample. For this study two universities have been chosen, Universidad a Distancia de Madrid (UDIMA) offering online training environment, and Universidad Politécnica de Madrid (UPM) with classroom training modality. A total of 257 individuals, 230 students and 27 teachers have answered the survey called Evalsoft. This instrument was designed in the project with the same name by a research team from Universidad Complutense of Madrid (UCM). Some interesting conclusions can be highlighted: it is in the online context where there are higher levels of commitment and teamwork than in the classroom modality; teachers have higher social skills that students and these improve with age. Sex and the training program appear to influence these social skills.

Linking tourism, retirement migration and social capital

A general trend in the study of international retirement migration has been the increased attention paid to the social contacts and network connections of the migrants in both the destination and the origin areas. These studies have examined the extent to which migrants build social relationships with their neighbours and the host society while also maintaining social links with their countries of origin, addressing the central role that leisure travel plays in sustaining increasingly dispersed social networks and maintaining the social capital of these networks and of the individuals involved in them. Using a case study approach to examine British retirement migration to Spain, we explore the relevance of transnational social networks in the context of international retirement migration, particularly the intensity of bidirectional visiting friends and relatives (VFR) tourism flows and the migrants’ social contacts with friends and/or family back in their home country. Building on the concept of social capital and Putnam's distinction between bonding and bridging social capital, we propose a framework for the analysis of the migrants’ international social networks. The results of a study conducted based on a sample of 365 British retirees living in the coast of Alicante (Spain) show both the strength of the retirees’ international bonding social capital and the role of ‘VFR's travel and communication technologies in sustaining the migrants’ transnational social practices and, ultimately, their international bonding social capital. It also provides evidence for the reinforcing links between tourism-related mobility and amenity-seeking migration in later life.

Assessment of Web Content Accessibility Levels in Spanish Official Online Education Environments

Diversity-based designing, or the goal of ensuring that web-based information is accessible to as many diverse users as possible, has received growing international acceptance in recent years, with many countries introducing legislation to enforce it. This paper analyses web content accessibility levels in Spanish education portals according to the international guidelines established by the World Wide Web Consortium (W3C) and the Web Accessibility Initiative (WAI). Additionally, it suggests the calculation of an inaccessibility rate as a tool for measuring the degree of non-compliance with WAI Guidelines 2.0 as well as illustrating the significant gap that separates people with disabilities from digital education environments (with a 7.77% average). A total of twenty-one educational web portals with two different web depth levels (42 sampling units) were assessed for this purpose using the automated analysis tool Web Accessibility Test 2.0 (TAW, for its initials in Spanish). The present study reveals a general trend towards non-compliance with the technical accessibility recommendations issued by the W3C-WAI group (97.62% of the websites examined present mistakes in Level A conformance). Furthermore, despite the increasingly high number of legal and regulatory measures about accessibility, their practical application still remains unsatisfactory. A greater level of involvement must be assumed in order to raise awareness and enhance training efforts towards accessibility in the context of collective Information and Communication Technologies (ICTs), since this represents not only a necessity but also an ethical, social, political and legal commitment to be assumed by society.

Relationship between sociometric types and academic achievement in a sample of compulsory secondary education students

The aim of this study was to analyse the relationship between sociometric types, behavioural categories and academic achievement in a sample of 1,349 compulsory secondary education students (51.7% boys), ranging in age from 12 to 16 years. The students’ sociometric identification was performed by using the Programa Socio and academic performance was measured by school marks provided by teachers in the subjects of Spanish language, mathematics and average academic performance. The results show that sociometric types were significant predictors of academic achievement, as students who were rated positively by their peers (popular, leaders, collaborators and good students) were more likely to have high academic achievement (in mathematics, Spanish language and average academic achievement) than students rated negatively by peers (rejected-aggressive, rejected-shy, neglected and bullies).

Selection of the N-Acylhomoserine Lactone-Degrading Bacterium Alteromonas stellipolaris PQQ-42 and of Its Potential for Biocontrol in Aquaculture

The production of virulence factors by many pathogenic microorganisms depends on the intercellular communication system called quorum sensing, which involves the production and release of signal molecules known as autoinducers. Based on this, new-therapeutic strategies have emerged for the treatment of a variety of infections, such as the enzymatic degradation of signaling molecules, known as quorum quenching (QQ). In this study, we present the screening of QQ activity amongst 450 strains isolated from a bivalve hatchery in Granada (Spain), and the selection of the strain PQQ-42, which degrades a wide range of N-acylhomoserine lactones (AHLs). The selected strain, identified as Alteromonas stellipolaris, degraded the accumulation of AHLs and reduced the production of protease and chitinase and swimming motility of a Vibrio species in co-cultivation experiments in vitro. In the bio-control experiment, strain PQQ-42 significantly reduced the pathogenicity of Vibrio mediterranei VibC-Oc-097 upon the coral Oculina patagonica showing a lower degree of tissue damage (29.25 ± 14.63%) in its presence, compared to when the coral was infected with V. mediterranei VibC-Oc-097 alone (77.53 ± 13.22%). Our results suggest that this AHL-degrading bacterium may have biotechnological applications in aquaculture.

Transport and communication:

At head of title, no. 1- : Official statistics, commonwealth of Australia. Commonwealth Bureau of census and statistics, Melbourne.

An Evaluation handbook for health education programs in alcohol and substance abuse /

Mode of access: Internet.

Nutrition education resource guide for American Indians and Alaska natives : a selected annotated bibliography for the Food Distribution Program on Indian Reservations.

Mode of access: Internet.

The railroad as an element in education, rev. and enl. with new illustrations.

Mode of access: Internet.