Impact of implementing an exclusively dedicated respiratory isolation room in a Brazilian tertiary emergency department

Background Occupational risk due to airborne disease challenges healthcare institutions. Environmental measures are effective but their cost-effectiveness is still debatable and most of the capacity planning is based on occupational rates. Better indices to plan and evaluate capacity are needed. Goal To evaluate the impact of installing an exclusively dedicated respiratory isolation room (EDRIR) in a tertiary emergency department (ED) determined by a time-to-reach-facility method. Methods A group of patients in need of respiratory isolation were first identified-group I (2004; 29 patients; 44.1 +/- 3.4 years) and the occupational rate and time intervals (arrival to diagnosis, diagnosis to respiratory isolation indication and indication to effective isolation) were determined and it was estimated that adding an EDRIR would have a significant impact over the time to isolation. After implementing the EDRIR, a second group of patients was gathered in the same period of the year-group II (2007; 50 patients; 43.4 +/- 1.8 years) and demographic and functional parameters were recorded to evaluate time to isolation. Cox proportional hazard models adjusted for age, gender and inhospital respiratory isolation room availability were obtained. Results Implementing an EDRIR decreased the time from arrival to indication of respiratory isolation (27.5 +/- 9.3 X 3.7 +/- 2.0; p = 0.0180) and from indication to effective respiratory isolation (13.3 +/- 3.0 X 2.94 +/- 1.06; p = 0.003) but not the respiratory isolation duration and total hospital stay. The impact on crude isolation rates was very significant (8.9 X 75.4/100.000 patients; p < 0.001). The HR for effective respiratory isolation was 26.8 (95% CI 7.42 to 96.9) p < 0.001 greater for 2007. Conclusion Implementing an EDRIR in a tertiary ED significantly reduced the time to respiratory isolation.

Communicating trustworthiness and building trust in interorganizational virtual organizations

We propose a theory of trust in interorganizational virtual organizations that focuses on how trustworthiness can be communicated and trust built in this environment. The theory highlights three issues that must be dealt with if the potential obstacles to the development of trust in the virtual context are to be overcome. These are communication of trustworthiness facilitated by reliable Information and Communication Technology (ICT), establishment of a common business understanding, and strong business ethics. We propose four specific propositions relating to these issues, and suggest topics to be explored in future research. (C) 2001 Elsevier Science Inc. All rights reserved.

Conceptualising the virtual and the posthuman

This article aims to explore the relations between technology and the subject. With new media intensifying the provisionality of discursive structures and in turn embodied experiences, questions pertaining to virtuality have become vital, particularly since Western society's increasing reliance on technologies now permeates our everyday practices. While many theorists often resort to a reification of the subject when conceptualising the posthuman condition, this analysis will recover the notion of embodiment in order to avoid such technological determinism. Tracing this complexity in contemporary texts can be achieved through various means. Here, the focus will remain on how narrative frameworks can create new possibilities for understanding and interpreting shifting subjectivities in the digital age. To explore this, I shall provide an analysis of a contemporary film, Being John Malkovich, which has been chosen due to its unexpected success at the box office, indicating how finely attuned the film is to contemporary concerns.

Extending Learning Opportunities through a virtual faculty

This paper presents the notion of a virtual faculty as a viable alternative to extending and maintaining learner opportunities for students in regional universities or at universities where specialisations in which they are interested may not be offered. Staff from a number of Australian Universities participated in a CUTSD project to explore the viability of establishing a virtual faculty using videoconferencing as the medium of delivery. The success of this project was the result of close collaboration at a number of levels within the participating institutions and a willingness to explore effective approaches to teaching and learning for a videoconference environment.

Preparing students for the virtual organisation: an evaluation of learning with virtual learning technologies

The paper explores the development of learning behaviours in a virtual management course and the factors that impacted on this development. Data suggest that most teams experienced three kinds of learning behaviours – social, operational and content learning. We propose that the need for technical expertise and team participation will vary during these different stages of learning. Addressing the characteristics of these stages, we comment on the development of a ‘completion phase’ of team development. We argue that the extent to which teams demonstrate different learning stages has a significant impact on the development of on-line learning behaviours. Discussing these results, we suggest why different teams develop distinct learning behaviours, with accordant emphasis on teaching as a moderating and co ordinating role, despite current virtual team pedagogical expectations.

Clinical Research: Room for all?

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