Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

'I'd like to know what causes it, you know, anything I've done?' Are we meeting the information and support needs of patients with macular degeneration? A qualitative study

Objective: To examine patients' experiences of information and support provision for age-related macular degeneration (AMD) in the UK. Study design: Exploratory qualitative study investigating patient experiences of healthcare consultations and living with AMD over 18 months. Setting: Specialist eye clinics at a Birmingham hospital. Participants: 13 patients diagnosed with AMD. Main outcome measures: Analysis of patients' narratives to identify key themes and issues relating to information and support needs. Results: Information was accessed from a variety of sources. There was evidence of clear information deficits prior to diagnosis, following diagnosis and ongoing across the course of the condition. Patients were often ill informed and therefore unable to self-advocate and recognise when support was needed, what support was available and how to access support. Conclusions: AMD patients have a variety of information needs that are variable across the course of the condition. Further research is needed to determine whether these experiences are typical and identify ways of translating the guidelines into practice. Methods of providing information need to be investigated and improved for this patient group.

Board composition, ownership structure and dividend policies in an emerging market: further evidence from CASE 50

Purpose – The purpose of this study is to examine dividend policies in an emerging capital market, in a country undergoing a transitional period. Design/methodology/approach – Using pooled cross-sectional observations from the top 50 listed Egyptian firms between 2003 and 2005, this study examines the effect of board of directors’ composition and ownership structure on dividend policies in Egypt. Findings – It is found that there is a significant positive association between institutional ownership and firm performance, and both dividend decision and payout ratio. The results confirm that firms with a higher return on equity and a higher institutional ownership distribute higher levels of dividend. No significant association was found between board composition and dividend decisions or ratios. Originality/value – This study provides additional evidence of the applicability of the signalling model in the emerging market of Egypt. It was found that despite the high institutional ownership and the closely held nature of the firms, which imply lower agency costs, the payment of higher dividend was considered necessary to attract capital during this transitional period.

Mere equities and third parties in leasehold law

Examines the concept of a "mere equity" in the context of the Land Registration Act 2002 s.116(b). Considers, by reference to case law, the nature and status of a mere equity and equities coming within the category of equitable rights binding third parties, including a landlord's right to rectification of a lease, the right to set aside a lease and a tenant's right to relief against forfeiture of a lease. Comments on the extent to which s.116(b) requires a mere equity to be more than just procedural and to be an equitable proprietary right capable of binding successors in title.

A taxonomy of measures for consumer-based brand equity:drawing on the views of managers in Europe

Purpose: The purpose of this paper is to identify the components of consumer-based brand equity from the perspective of experts in brand management in the UK, Germany and Greece. Design/methodology/approach: Data were collected from semi-structured interviews with senior brand consultants and managers, five in the UK, five in Germany and five in Greece. Findings: The findings suggested four categories of measures which can be used to define brand equity. These are the consumers' understanding of brand characteristics; consumers' brand evaluation; consumers' affective response towards the brand; and consumers' behaviour towards the brand. Specific dimensions are identified as indicators of each category. Research limitations/implications: Although the focus of this study is Europe, data were only collected from the UK, Germany and Greece, countries representing three of the five European cultural clusters. The resultant taxonomy adds to the fragmented literature on brand equity measurement by proposing four categories to gauge brand equity. Practical implications: The suggested taxonomy provides indicators of a framework managers could use when assessing brand equity. Originality/value: There is little agreement on what constitutes brand equity and therefore measures of brand equity are fragmented. To date, the views of practicing managers have not been taken into account in research. This paper draws on the views of practitioners and academics to suggest a taxonomy of categories of measures for brand equity. © Emerald Group Publishing Limited.

Nonlinear inverse synthesis and eigenvalue division multiplexing in optical fiber channels

We scrutinize the concept of integrable nonlinear communication channels, resurrecting and extending the idea of eigenvalue communications in a novel context of nonsoliton coherent optical communications. Using the integrable nonlinear Schrödinger equation as a channel model, we introduce a new approach - the nonlinear inverse synthesis method - for digital signal processing based on encoding the information directly onto the nonlinear signal spectrum. The latter evolves trivially and linearly along the transmission line, thus, providing an effective eigenvalue division multiplexing with no nonlinear channel cross talk. The general approach is illustrated with a coherent optical orthogonal frequency division multiplexing transmission format. We show how the strategy based upon the inverse scattering transform method can be geared for the creation of new efficient coding and modulation standards for the nonlinear channel. © Published by the American Physical Society.

Sexuality and Christianity:understanding the attitudes and negotiations of young adults in the UK

Christianity has historically incorporated numerous strands of thinking on sexuality; in some cases, problematizing sexuality through the endorsement of celibacy and asceticism while at other historical and contextual moments, marriage and procreation become ideals (Price 2006). Contemporary Christians negotiate many sexual scripts (including ‘secular’ ones), but ‘appropriate’ Christian sexuality is still usually defined in terms of monogamy, the containment of sex within marriage, and heterosexuality. This chapter will explore the attitudes, beliefs and practices toward sexuality of young Christian women and men aged between 18 and 25 and living in the UK, based on a qualitative and quantitative research project entitled Religion, Youth and Sexuality: A Multi-faith Exploration, which utilized questionnaires, in-depth interviews and video diaries. The chapter will consider the variations in attitude between young people from different Christian denominations in relation to three themes: sex outside of marriage, celibacy and monogamy.

The influence of culture and market orientation on services brands:insights from Irish banking and retail firms

Purpose: This paper aims to examine the influence of the culture of the service firm on its interpretation of the role of the brand and on the development and implementation of its brand values. Design/methodology/approach: A grounded theory approach was used. Interviews were conducted with 20 managers within two leading banking firms in Ireland and two leading grocery retailers in Ireland. Findings: The development of the brand, and its role within the firm, is closely related to the firm's culture. The research shows obstacles and opportunities created by the cultural context of firms wishing to disseminate and embed a set of brand values. The paper presents an "involvement model" of brand values implementation and outlines changes required to implement brand values. Research limitations/implications: The study was bound by access to firms, and managers' availability. The authors sought an insight into the relationship between each firm's culture and its brands. They advocate quantitative research to further investigate the findings within these service sectors and to test proposed antecedents (transformational leadership, employee involvement) and outcomes (employee-based brand equity and consumer-based brand equity) of values adoption. Practical implications: The paper identifies aspects of retail and banking cultures which support or detract from brand development. In particular, it presents the learnings from successful brand values implementation in a clan culture, aspects of which are applicable across other cultures. Originality/value: The paper provides valuable insights into the role of the brand within the service firm and the positive and negative influence of context on brand values and their development and implementation. © Emerald Group Publishing Limited.

Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public.

Fair price and its effect on willingness to purchase

The purpose of the present research is to demonstrate the influence of a fair price (independent of the subjective evaluation of the price magnitude) on buyers' willingness to purchase. The perceived fairness of a price is conceived to have three components: perceived equity, perceived need, and inferred compliance of the seller to the process rules of pricing. These components reflect the Theories of Distributive Justice (as adjusted for conditions of need) and Procedural Justice.^ The effect of the three components of a fair price on willingness to purchase is depicted in a theoretically causal chain model. Based on the Theories of Dissonance and Attribution, conditions of inequity and need activate concerns for Procedural Justice. Under conditions of inequity and need, buyers tend to infer that the seller has not complied with the generally accepted pricing practices, thus violating the social norms of Procedural justice. Inferred violations of Procedural Justice influence the buyer's attitude toward the seller. As predicted by the Theory of Reasoned Action, attitude is then positively related to willingness to purchase.^ The model was tested with a survey-based experiment conducted with 408 respondents. Two levels of both equity and need were manipulated with scenarios, a common research method in studies of Distributive and Procedural Justice. The data were analyzed with a structural equation model using LISREL. Although the effect of the "need" manipulation was insignificant, the results indicated a good fit of the model (Chi-square = 281, Degrees of Freedom = 104, Goodness of Fit Index =.924). The conclusion is that the fairness of a price does have a significant effect on willingness to purchase, independent of the subjective evaluation of the objective price. ^

An analysis of the themes of environmental sustainability in the United States curriculum science content standards

This study examined how the themes of environmental sustainability are evident in the national, state and local standards that guide k–12 science curriculum. The study applied the principles of content analysis within the framework of an ecological paradigm. In education, an ecological paradigm focuses on students' use of a holistic lens to view and understand material. The intent of this study was to analyze the seventh grade science content standards at the national, state, and local textbook levels to determine how and the extent to which each of the five themes of environmental sustainability are presented in the language of each text. The themes are: (a) Climate Change Indicators, (b) Biodiversity, (c) Human Population Density, (d) Impact and Presence of Environmental Pollution, (e) Earth as a Closed System. The research study offers practical insight on using a method of content analysis to locate keywords of environmental sustainability in the three texts and determine if the context of each term relates to this ecological paradigm. Using a concordance program, the researcher identified the frequency and context of each vocabulary item associated with these themes. Nine chi squares were run to determine if there were differences in content between the national and state standards and the textbook. Within each level chi squares were also run to determine if there were differences between the appearance of content knowledge and skill words. Results indicate that there is a lack of agreement between levels that is significant p < .01. A discussion of these results in relation to curriculum development and standardized assessments followed. The study found that at the national and state levels, there is a lack of articulation of the goals of environmental sustainability or an ecological paradigm. With respect to the science textbook, a greater number of keywords were present; however, the context of many of these keywords did not align with the discourse of an ecological paradigm. Further, the environmental sustainability themes present in the textbook were limited to the last four chapters of the text. Additional research is recommended to determine whether this situation also exists in other settings.

The use of hyphenated spectrometric techniques for the environmental forensic assessment of non-traditional pollutants and degradates in the greater Florida Everglades

A comprehensive investigation of sensitive ecosystems in South Florida with the main goal of determining the identity, spatial distribution, and sources of both organic biocides and trace elements in different environmental compartments is reported. This study presents the development and validation of a fractionation and isolation method of twelve polar acidic herbicides commonly applied in the vicinity of the study areas, including e.g. 2,4-D, MCPA, dichlorprop, mecroprop, picloram in surface water. Solid phase extraction (SPE) was used to isolate the analytes from abiotic matrices containing large amounts of dissolved organic material. Atmospheric-pressure ionization (API) with electrospray ionization in negative mode (ESP-) in a Quadrupole Ion Trap mass spectrometer was used to perform the characterization of the herbicides of interest. ^ The application of Laser Ablation-ICP-MS methodology in the analysis of soils and sediments is reported in this study. The analytical performance of the method was evaluated on certified standards and real soil and sediment samples. Residential soils were analyzed to evaluate feasibility of using the powerful technique as a routine and rapid method to monitor potential contaminated sites. Forty eight sediments were also collected from semi pristine areas in South Florida to conduct screening of baseline levels of bioavailable elements in support of risk evaluation. The LA-ICP-MS data were used to perform a statistical evaluation of the elemental composition as a tool for environmental forensics. ^ A LA-ICP-MS protocol was also developed and optimized for the elemental analysis of a wide range of elements in polymeric filters containing atmospheric dust. A quantitative strategy based on internal and external standards allowed for a rapid determination of airborne trace elements in filters containing both contemporary African dust and local dust emissions. These distributions were used to qualitative and quantitative assess differences of composition and to establish provenance and fluxes to protected regional ecosystems such as coral reefs and national parks. ^

Left behind: A farmer's fate in the age of sustainable development

Globalization is eroding the livelihoods of small farmers, a significant and vulnerable class, particularly in the developing world. The cost-price squeeze stemming from trade liberalization places farmers in a race to the bottom that leads to displacement, poverty, and environmental degradation. Scholars and activists have proposed that alternative trade initiatives offer a unique opportunity to reverse this trend by harnessing the power of the markets to reward producers of goods with embedded superior cultural, environmental, and social values. Alternative trade via certification schemes have become a de facto prescription for any location where there is a need to conciliate economic interest with conservation imperatives. Partnerships among commodity production farmers, elite manufacturers and wealthy northern consumers/activists do not necessarily have win-win outcomes. Paradoxically, the partnerships of farmers with external agencies have unexpected results. These partnerships develop into dependent relationships that become unsustainable in the absence of further transfers of capital. The institutions born of these partnerships are fragile. When these fledging institutions fail, farmers are left in the same situation that they were before the partnership, with only minor improvements to show after spending considerable amounts of social and financial capital. I hypothesize that these failures are born out of a belief in a universal understanding of sustainability. A discursive emphasis on consensus, equity and mutual benefit hides the fact that what for consumers it is a matter of choice, for producers is a matter of survival. The growth in consumers’ demand for certified products creates a race for farmers to meet these standards. My findings suggest that this race generates economically perverse effects. First, producers enter into a certification treadmill. Second, the local need for economic sustainability is ignored. Third, commodity based alternative trade schemes increase the exposure of communities to global shocks. I conclude by calling for a careful reassessment of sustainable development projects that promote certification schemes. The designers and implementers of these programs must include farmers’ agenda in the planning of these programs.

Contemporary aspects of dividends: Before and during the financial crisis

The number of dividend paying firms has been on the decline since the popularity of stock repurchases in the 1980s, and the recent financial crisis has brought about a wave of dividend reductions and omissions. This dissertation examined the U.S. firms and American Depository Receipts that are listed on the U.S. equity exchanges according to their dividend paying history in the previous twelve quarters. While accounting for the state of the economy, the firm’s size, profitability, earned equity, and growth opportunities, it determines whether or not the firm will pay a dividend in the next quarter. It also examined the likelihood of a dividend change. Further, returns of firms were examined according to their dividend paying history and the state of the economy using the Fama-French three-factor model. Using forward, backward, and step-wise selection logistic regressions, the results show that firms with a history of regular and uninterrupted dividend payments are likely to continue to pay dividends, while firms that do not have a history of regular dividend payments are not likely to begin to pay dividends or continue to do so. The results of a set of generalized polytomous logistic regressions imply that dividend paying firms are more likely to reduce dividend payments during economic expansions, as opposed to recessions. Also the analysis of returns using the Fama-French three factor model reveals that dividend paying firms are earning significant abnormal positive returns. As a special case, a similar analysis of dividend payment and dividend change was applied to American Depository Receipts that trade on the NYSE, NASDAQ, and AMEX exchanges and are issued by the Bank of New York Mellon. Returns of American Depository Receipts were examined using the Fama-French two-factor model for international firms. The results of the generalized polytomous logistic regression analyses indicate that dividend paying status and economic conditions are also important for dividend level change of American Depository Receipts, and Fama-French two-factor regressions alone do not adequately explain returns for these securities.

Standards for Tourism Management Success: U.S. National Park Managers

National park managers are the subjects in the fifth segment of a study examining the skills and abilities needed to be successful tourism managers. The authors discuss these skills and their impact on successful tourism management.