Factors surgical team members perceive influence choices of wearing or not wearing personal protective equipment during operative /invasive procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

Reaching an Underserved Wine Customer: Connecting with the African American Wine Consumer

Marketing strategies addressing underserved African American wine customers’ needs that also positively impact producers’ and retailers’ clientele was the impetus for this exploratory, qualitative paper. African Americans demonstrate a thirst to elevate their education about and be more involved in the wine industry as evidenced by the proliferation of African American wine-tasting groups designed to help educate and expose their membership to a variety of wines. Moreover, compared to the average adult, African-American wine drinkers are 241% more likely to have spent $20 or more on a bottle of store bought wine (Arbitron, 2005). Despite African Americans’ representation as one of the fastest growing ethnic minority segments in the U.S., wine industry strategies don't appear to connect with this market segment. Like Alice in Wonderland, we characterize this phenomenon by suggesting this market segment is ‘peering through the looking glass’. Three focus groups were conducted to specify possible targeted media strategies as well as to identify attitudes and opinions that influence this segment's wine purchasing and consumption behaviors. Industry strategies were suggested that would appear to benefit producers, retailers, and this customer segment. The results of the research will be used to inform a quantitative instrument in order to generalize findings beyond the context of the exploratory setting.

Factors Surgical Team Members Perceive Influence Choices of Wearing or not Wearing Personal Protective Equipment During Operative/Invasive Procedures

Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.

Função compras no setor público: fatores preponderantes para o alcance da celeridade dos pregões eletrônicos da Base Aérea de Natal

This study discusses the issue of deadlines in the purchasing process within the Federal Public Administration. Your main goal is to analyze the main factors that influenced, mainly in the implementation of sub-phases of electronic trading in BANT, in 2014, as service to the principle of celerity. The research is descriptive since they were identified and analyzed the factors that influenced in terms of purchases, through direct observation and interviews. Based on the theoretical framework, the purchasing function, four dimensions of analysis were established: "Legislation and procurement processes", "Structure and Organization of the purchasing department", "purchasing systems" and "Human Resources of the purchasing department." Analysis showed that, unlike what happens in the private sector, the public procurement sector has not reached a strategic status within organizations, which brings harmful consequences to the speed of the purchases. It was found that there is a need for greater involvement of the purchasing department staff and criers in the formulation of the organization's purchasing strategies and that these purchases elements present, about their attitudes, a hybrid profile, proactive regarding specifications of the items, but reactive in relation to the need to urgently purchase, due to the lack of a better plan, which overloads the work of the sector. The observation of these strategic aspects of the procurement function in BANT influenced the finding that the lack of staff and expertise in investments plus the lack of rigor and formality of legislation, among other factors, contributed mainly to the lack of speed of processes.

Student Independent Projects 2012: Sustainable Resource Management

Everyday Millions of disposable plates, cups and utensils are used in fast food establishments, cafeterias, restaurants and homes worldwide. These single-use disable plates, cup and utensils, when of polystyrene or plastic, do not biodegrade and decompose like fruit, vegetables or meat; they only breakdown into smaller pieces on a physical level. This lack of decomposition means that these products persist and accumulate in landfills consuming the available space and contaminate the surrounding area. With an ever growing global population, the disposable waste generated annually is increasing and landfills worldwide are rapidly filling. Therefore, more landfills are needed sooner but they are expensive to create, they consume a large amount of usable space and can harm the environment. In order to reduce the dependence on landfills, the waste can be diverted through recycling programs, reducing human consumption and purchasing reusable and/or compostable materials. These methods of waste reduction would be implemented at the municipal level but it would be possible to change provincial and state legislation so that municipalities would be required to do so rather than of their own volition. If initiated worldwide than the amount of waste produced by humans would be greatly reduced and the dependence on landfills would decrease.

Patterns of dynamic changes in supply management – a triadic approach

Research has followed a network perspective of supply management from as early as the publication of Krajlic matrix. This portfolio approach is still static. Recently the triad is interpreted as the smallest unit of a network through which dynamics can be studied. Analyzing triads seems to be a promising way through which a deeper insight into the dynamics of supplier development can be gained. Using case study approach the paper investigates this dynamics with a special emphasis on coopetitive behavior. Analyzing a triadic sourcing setting operating in a make to engineer (and order) environment we show the importance of governance.

Jogos de negócio : o que leva o docente de cursos da área de Ciências Sociais Aplicadas a adotar a ferramenta de ensino

The Business Games are a growing teaching strategy and alternative to the academic front through the new process of Teaching and Learning. Through literature review and semi-structured interviews, this work addresses the teachers considering their subjectivity in deciding JN as the three profiles suggested by Faria and Wellington (2004): those who use it, those who stopped using and those who do not. The research corpus is limited to contributions of 22 respondents between master and doctors teachers of Applied Social Sciences area courses in colleges of Brasília (DF), Goiânia (GO), Ribeirão Preto (SP) and Uberlandia (MG). The content analysis of the interviews allowed to infer that: (1) join the teaching strategy is a commitment to a complex planning, with constant training and proactivity related to student feedback; (2) abandons the practice is becoming less common, because managers tend to recommend it and there are more and more software available for specific disciplines. Its discussed also other contributions (motivations) given by respondents of the three groups that were not found in the literature. It is hoped that this work will serve (1) incentive to teachers on the use of Business Games as a teaching strategy (2) consultation by managers when they decide about purchasing simulation software. Finally, stands out that the educational success of JN depends not only on the various motivations of teachers, as well as the interest and commitment of the student.

Differences in expenditure and amounts of fresh foods, fruits & vegetables and fish purchased in urban and rural Scotland

Peer reviewed

Differences in expenditure and amounts of fresh foods, fruits & vegetables and fish purchased in urban and rural Scotland

Peer reviewed

The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk - study protocol for a clustered controlled trial

Background: Dietary behaviour interventions have the potential to reduce diet-related disease. Ample opportunity exists to implement these interventions in the workplace. The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace settings. Methods/design: A clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted. The complex intervention design has been developed using the Medical Research Council's framework and the National Institute for Health and Clinical Excellence (NICE) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-randomized designs. It will draw on a soft paternalistic 'nudge' theoretical perspective. It will draw on a soft paternalistic "nudge" theoretical perspective. Nutrition education will include three elements: group presentations, individual nutrition consultations and detailed nutrition information. Environmental dietary modification will consist of five elements: (a) restriction of fat, saturated fat, sugar and salt, (b) increase in fibre, fruit and vegetables, (c) price discounts for whole fresh fruit, (d) strategic positioning of healthier alternatives and (e) portion size control. No intervention will be offered in workplace A (control). Workplace B will receive nutrition education. Workplace C will receive nutrition education and environmental dietary modification. Workplace D will receive environmental dietary modification alone. A total of 448 participants aged 18 to 64 years will be selected randomly. All permanent, full-time employees, purchasing at least one main meal in the workplace daily, will be eligible. Changes in dietary behaviours, nutrition knowledge, health status with measurements obtained at baseline and at intervals of 3 to 4 months, 7 to 9 months and 13 to 16 months will be recorded. A process evaluation and cost-effectiveness economic evaluation will be undertaken. Discussion: A 'Food Choice at Work' toolbox (concise teaching kit to replicate the intervention) will be developed to inform and guide future researchers, workplace stakeholders, policy makers and the food industry. Trial registration: Current Controlled Trials, ISRCTN35108237.

Understanding Antenatal Genetics Services in Sri Lanka: Current Landscape of Screening and Diagnostic Services and Contextual Factors Influencing Their Availability and Uptake

Background: Too little information is available on Sri Lanka’s current capacity to provide community genetic services—antenatal genetic services in particular—to understand whether building that capacity could further improve and reduce disparity in maternal and child health. This qualitative research project seeks to gather information on congenital disorders, routine antenatal care, and the current state of antenatal screening testing services within that routine antenatal to assess the feasibility of and the need for scaling up antenatal genetics services in Sri Lanka. Methods: Nineteen key informant (KI) interviews were conducted with stakeholders in antenatal care and genetic services. Seven focus group discussions were held with a total of 56 Public Health Midwives (PHMs), the health workers responsible for antenatal care at the field level. Transcripts for all interviews and FGDs were analyzed for key themes, and themes were categorized to address the specific aims of the project. Results: Antenatal genetic services play a minor role in antenatal care, with screening and diagnostic procedures available in the private sector and paid for out-of-pocket. KIs and PHMs expect that demand for antenatal genetic services will increase as patients’ purchasing power and knowledge grow but note that prohibitive abortion laws limit the ability of patients to act on test results. Genetic services compete for limited financial and human resources in the free public health system, and inadequate information on the prevalence of congenital disorders limits the ability to understand whether funding for services related to those disorders should be increased. A number of alternatives to scaling up antenatal genetic services within the free health system might be better suited to the Sri Lankan structural and social context. Conclusions: Scaling up antenatal genetic services within the public health system is not feasible in the current financial, legal, and human resource context. Yet current availability and utilization patterns contribute to regional and economic disparities, suggesting that stasis will not bring continued improvements in maternal and child health. More information on the burden of congenital disorders is necessary to fully understand if and how antenatal genetic service availability should be increased in Sri Lanka, but even before that information is gathered, examination of policies for patient referral, termination of pregnancy, and government support for individuals with genetic disease are steps that might bring extend improvements and reduce disparity in maternal and child health.

Essays in Empirical Operations Management: Bayesian Learning of Service Quality and Structural Estimation of Complementary Product Pricing and Inventory Management

This dissertation contributes to the rapidly growing empirical research area in the field of operations management. It contains two essays, tackling two different sets of operations management questions which are motivated by and built on field data sets from two very different industries --- air cargo logistics and retailing.

The first essay, based on the data set obtained from a world leading third-party logistics company, develops a novel and general Bayesian hierarchical learning framework for estimating customers' spillover learning, that is, customers' learning about the quality of a service (or product) from their previous experiences with similar yet not identical services. We then apply our model to the data set to study how customers' experiences from shipping on a particular route affect their future decisions about shipping not only on that route, but also on other routes serviced by the same logistics company. We find that customers indeed borrow experiences from similar but different services to update their quality beliefs that determine future purchase decisions. Also, service quality beliefs have a significant impact on their future purchasing decisions. Moreover, customers are risk averse; they are averse to not only experience variability but also belief uncertainty (i.e., customer's uncertainty about their beliefs). Finally, belief uncertainty affects customers' utilities more compared to experience variability.

The second essay is based on a data set obtained from a large Chinese supermarket chain, which contains sales as well as both wholesale and retail prices of un-packaged perishable vegetables. Recognizing the special characteristics of this particularly product category, we develop a structural estimation model in a discrete-continuous choice model framework. Building on this framework, we then study an optimization model for joint pricing and inventory management strategies of multiple products, which aims at improving the company's profit from direct sales and at the same time reducing food waste and thus improving social welfare.

Collectively, the studies in this dissertation provide useful modeling ideas, decision tools, insights, and guidance for firms to utilize vast sales and operations data to devise more effective business strategies.

SINGLE STAGE LED DRIVER TECHNOLOGY WITH LOW FREQUENCY RIPPLE CANCELLATION

Because of high efficacy, long lifespan, and environment-friendly operation, LED lighting devices become more and more popular in every part of our life, such as ornament/interior lighting, outdoor lightings and flood lighting. The LED driver is the most critical part of the LED lighting fixture. It heavily affects the purchasing cost, operation cost as well as the light quality. Design a high efficiency, low component cost and flicker-free LED driver is the goal. The conventional single-stage LED driver can achieve low cost and high efficiency. However, it inevitably produces significant twice-line-frequency lighting flicker, which adversely affects our health. The conventional two-stage LED driver can achieve flicker-free LED driving at the expenses of significantly adding component cost, design complexity and low the efficiency. The basic ripple cancellation LED driving method has been proposed in chapter three. It achieves a high efficiency and a low component cost as the single-stage LED driver while also obtaining flicker-free LED driving performance. The basic ripple cancellation LED driver is the foundation of the entire thesis. As the research evolving, another two ripple cancellation LED drivers has been developed to improve different aspects of the basic ripple cancellation LED driver design. The primary side controlled ripple cancellation LED driver has been proposed in chapter four to further reduce cost on the control circuit. It eliminates secondary side compensation circuit and an opto-coupler in design while at the same time maintaining flicker-free LED driving. A potential integrated primary side controller can be designed based on the proposed LED driving method. The energy channeling ripple cancellation LED driver has been proposed in chapter five to further reduce cost on the power stage circuit. In previous two ripple cancellation LED drivers, an additional DC-DC converter is needed to achieve ripple cancellation. A power transistor has been used in the energy channeling ripple cancellation LED driving design to successfully replace a separate DC-DC converter and therefore achieved lower cost. The detailed analysis supports the theory of the proposed ripple cancellation LED drivers. Simulation and experiment have also been included to verify the proposed ripple cancellation LED drivers.

Financial media, globalisation, and China’s economic integration: comparing narrative construction of the Economist and Caijing

In June 2015, legal frameworks of the Asian Infrastructural Investment Bank were signed by its 57 founding members. Proposed and initiated by China, this multilateral development bank is considered to be an Asian counterpart to break the monopoly of the World Bank and the International Monetary Fund. In October 2015, China’s Central Bank announced a benchmark interest rate cut to combat the economic slowdown. The easing policy coincides with the European Central Bank’s announcement of doubts over US Fed’s commitment to raise interest rates. Global stock markets responded positively to China’s move, with the exception of the indexes from Wall Street (Bland, 2015; Elliott, 2015). In the meantime, China’s ‘One Belt, One Road’ (or New Silk Road Economic Belt) became atopic of discourse in relation to its growing global economy, as China pledged $40 billion to trade and infrastructure projects (Bermingham, 2015). The foreign policy aims to reinforce the economic belt from western China through Central Asia towards Europe, as well as to construct maritime trading routes from coastal China through the South China Sea (Summers, 2015). In 2012, The Economist launched a new China section, to reveal the complexity of the‘meteoric rise’ of China. John Micklethwait, who was then the chief editor of the magazine, said that China’s emergence as a global power justified giving it a section of its own(Roush, 2012). In July 2015, Hu Shuli, the former chief editor of Caijing, announced the launch of a think tank and financial data service division called Caixin Insight Group, which encompasses the new Caixin China Purchasing Managers Index (PMI). Incooperation with with Markit Group, a principal global provider of PMI, the index soon became a widely cited economic indicator. One anecdote from November’s Caixin shows how much has changed: in a high-profile dialogue between Hu Shuli and Kevin Rudd, Hu insisted on asking questions in English; interestingly, the former Prime Minister of Australia insisted on replying in Chinese. These recent developments point to one thing: the economic ascent of China and its increasing influence on the power play between economics and politics in world markets. China has begun to take a more active role in rule making and enforcement under neoliberal frameworks. However, due to the country’s size and the scale of its economy in comparison to other countries, China’s version of globalisation has unique characteristics. The ‘Capitalist-socialist’ paradox is vital to China’s market-oriented transformation. In order to comprehend how such unique features are articulated and understood, there are several questions worth investigating in the realms of media and communication studies,such as how China’s neoliberal restructuring is portrayed and perceived by different types of interested parties, and how these portrayals are de-contextualised and re-contextualised in global or Anglo-American narratives. Therefore, based on a combination of the themes of globalisation, financial media and China’s economic integration, this thesis attempts to explore how financial media construct the narratives of China’s economic globalisation through the deployment of comparative and multi-disciplinary approaches. Two outstanding elite financial magazines, Britain’s The Economist, which has a global readership and influence, and Caijing, China’s leading financial magazine, are chosen as case studies to exemplify differing media discourses, representing, respectively, Anglo-American and Chinese socio-economic and political backgrounds, as well as their own journalistic cultures. This thesis tries to answer the questions of how and why China’s neoliberal restructuring is constructed from a globally-oriented perspective. The construction primarily involves people who are influential in business and policymaking. Hence, the analysis falls into the paradigm of elite-elite communication, which is an important but relatively less developed perspective in studying China and its globalisation. The comparing of characteristics of narrative construction are the result of the textual analysis of articles published over a ten-year period (mid-1998 to mid-2008). The corpus of samples come from the two media outlets’ coverage of three selected events:China becoming a member of the World Trade Organization, its outward direct investment, and the listing of stocks of Chinese companies in overseas exchanges, which are mutually exclusive in sample collection and collectively exhaustive in the inclusion of articles regarding China’s economic globalisation. The findings help to understand that, despite language, socio-economic and political differences, elite financial media with globally-oriented readerships share similar methods of and approaches to agenda setting, the evaluation of news prominence, the selection of frame, and the advocacy of deeply rooted neoliberal ideas. The comparison of their distinctive features reflects the different phases of building up the sense of identity in their readers as global elites, as well as the different economic interests that are aligned with the corresponding readerships. However, textual analysis is only relevant in terms of exploring how the narratives are constructed and the elements they include; textual analysis alone prevents us from seeing the obstacles and the constrains of the journalistic practices of construction. Therefore, this thesis provides a brief discussion of interviews with practitioners from the two media, in order to understand how similar or different narratives are manifested and perceived, how the concept of neoliberalism deviates from and is justified in the Chinese context, and how and for what purpose deviations arise from Western to Chinese contexts. The thesis also contributes to defining financial media in the domain of elite communication. The relevant and closely interlocking concepts of globalisation, elitism and neoliberalism are discussed, and are used as a theoretical bedrock in the analysis of texts and contexts. It is important to address the agenda-setting and ideological role of elite financial media, because of its narrative formula of infusing business facts with opinions,which is important in constructing the global elite identity as well as influencing neoliberal policy-making. On the other hand, ‘journalistic professionalism’ has been redefined, in that the elite identity is shared by the content producer, reader and the actors in the news stories emerging from the much-compressed news cycle. The professionalism of elite financial media requires a dual definition, that of being professional in the understanding of business facts and statistics, and that of being professional in the making sense of stories by deploying economic logic.

The elderly care and domestic services sector during the recent economic crisis. The case of Italy, Spain and France.

Over the past ten years in Italy, Spain and France, the demographic pressure and the increasing women’s participation in labour market have fuelled the expansion of the private provision of domestic and care services. In order to ensure the difficult balance between affordability, quality and job creation, each countries’ response has been different. France has developed policies to sustain the demand side introducing instruments such as vouchers and fiscal schemes, since the mid of the 2000s. Massive public funding has contributed to foster a regular market of domestic and care services and France is often presented as a “best practices” of those policies aimed at encouraging a regular private sector. Conversely in Italy and Spain, the development of a private domestic and care market has been mostly uncontrolled and without a coherent institutional design: the osmosis between a large informal market and the regular private care sector has been ensured on the supply side by migrant workers’ regularizations or the introduction of new employment regulations . The analysis presented in this paper aims to describe the response of these different policies to the challenges imposed by the current economic crisis. In dealing with the retrenchment of public expenditure and the reduced households’ purchasing power, Italy, Spain and France are experiencing greater difficulties in ensuring a regular private sector of domestic and care services. In light of that, the paper analyses the recent economic conjuncture presenting some assumptions about the future risk of deeper inequalities rising along with the increase of the process of marketization of domestic and care services in all the countries under analysis.