Should I stay or should I go? Patient understandings of and responses to source-isolation practices,

Isolation of patients, who are colonised or infected with a multidrug-resistant organism (source-isolation), is a common practice in most acute health-care settings, to prevent transmission to other patients. Efforts to improve the efficacy of source-isolation in hospitals focus on healthcare staff compliance with isolation precautions. In this article we examine patients’ awareness, understandings and observance of source-isolation practices and directives with a view to understanding better the roles patients play or could play in transmitting, or limiting transmission, of multidrug-resistant organisms (MRO). Seventeen source-isolated adult surgical patients and two relatives participated in video-reflexive ethnography and interviews. We learned that, although most of these patients wanted to protect themselves and others from colonisation/infection with a MRO, they had a limited understanding of what precautions they could take while in isolation and found it difficult to obtain ongoing information. Thus, many patients regularly left their source-isolation rooms without taking appropriate precautions and were potentially contributing to environmental contamination and transmission. Some patients also interacted with other patients and their personal belongings in ways that exposed other patients, unnecessarily, to colonisation/infection risk. By not providing patients with adequate information on infection risk or how they could contribute to their own safety or that of others, they are denied the opportunity to fully engage in their healthcare. To improve the efficacy of source-isolation and contact precautions in general, patient care providers should consider colonised or infected patients as active partners in reducing transmission and involve patients and relatives in regular, ongoing conversations about transmission prevention.Keywords: Patient involvement, patient experience, patient engagement, patient- and family-centred care, source-isolation, MRSA, infection prevention and control, qualitative methods, health literacyThis study was funded by the National Health and Medical Research Council (project grant # 1009178

Should I stay or should I go

Negative consequences of anthropogenic sound on wildlife is a well-established phenomenon and have received substantial attention in scientific literature. This evokes questions of what type of sounds perceived as disturbing or aversive to animals. Further knowledge on this matter may contribute to development of acoustic tools to mitigate human-wildlife conflicts by deter animals from conflict areas. However, the use of acoustic stimuli as a deterrent agent, often lack long-term effects due to rapid habituation. The aim of my experiment is to examine how animals respond to novel acoustic stimuli and what factors that affect habituation to acute sound. I subjected free-ranging roe deer (Capreolus capreolus) to a sudden novel sound with no ecological relevance and followed individual response over time. Individuals was either subjected to low (40 dB, n=19) or high sound volume (70 dB, n=26). My results conclude that novel sound of high volume did not evoke a stronger response than a sound of lower sound volume, and that sound volume had no effect on habituation. Age, and whether individuals were alone or in a group, were factors that have the largest effect on response to sound. Fawns had lower response to the sound at their first exposure and expressed more pronounced habituation compared to older individuals. Animals in groups responded less strong compared to single animals. However, fawns were to a greater extent accompanied by other animals, compared to adults, which might contribute to their lower response. I found no difference in response to sound between males and females. Variation in response to sound were higher between individuals than within individuals, which indicate a personality aspect in sound reactivity. To determine if response to sound was linked to other traits in the tested population, I used data on response to handling during a capture event. However, no correlation between docility and sound reactivity were found. This indicate that the observed inter-individual variation in these behaviours are dependent on context rather than being part of a general personality trait. The results from my study contribute to a greater understanding on how acute sounds affect wild animals and may be of use to estimate habituation rate to sound.Ljud förknippade med mänsklig aktivitet kan i många fall innebära störningar för djurlivet, men ljudsignaler kan också användas för att lösa vissa av de konflikter som kan uppstå mellan människa och djur. Det har exempelvis gjorts försök att skrämma bort skadedjur från områden där de är oönskade eller för att varna vilda djur för annalkande trafik och på så sätt minska risken för olyckor. Ett återkommande problem i flera av de studier som gjorts är att ljudets skrämmande eller varnande effekt avtar i takt med att djuren vänjer sig vid ljuden. Det finns därför ett behov av mer kunskap om vilka ljud som upplevs som skrämmande och hur snabbt djur vänjer sig vid dessa. Syftet med min studie var att undersöka hur vilda rådjur upplever plötsliga och nya ljud. Jag har tittat på hur de reagerar första gången de överraskas av ljudet, hur snabbt de vänjer sig, samt vilka faktorer som påverkar reaktion och tillvänjning. Mitt försök genomfördes på märkta vilda rådjur, vilket gjorde det möjligt att följa individer över tid. En rörelseaktiverad högtalare placerades vid platser där djuren matas regelbundet under vintersäsongen. Vid hälften av platserna spelades det upp ett högt ljud (70 dB) och vid resterande hälften ett lägre ljud (40 dB). Mina resultat bygger på 45 märkta individer som observerats när de aktiverade ljudet. Vid första aktiveringen reagerade fjolårskid mindre än vuxna rådjur. Yngre djur vande sig också snabbare vid ljudet jämfört med äldre djur. Djur som hade sällskap av andra individer reagerade mindre på ljudet än de djur som var ensamma. Att kid var mindre påverkade än vuxna kan delvis förklaras med att de oftare observerades i grupp med andra individer. Överraskande nog fann jag ingen skillnad i reaktion eller tillvänjning mellan de djur som upplevdes det högre ljudet och de djur som upplevde det lägre ljudet. Ljudnivån verkar alltså inte ha någon mätbar påverkan på hur skrämmande de upplever ett överraskande nytt ljud. Det var stor variation mellan individer i hur de reagerade, vilket indikerar att det finns en personlighetsaspekt i hur rådjur upplever plötsliga ljud. Tidigare studier har funnit en konsekvent variation mellan individer kring hur de reagerar på hantering vid fångst. Alla märkta individer som deltog i mitt experiment har blivit fångade vid minst ett tillfälle, men jag fann inget samband mellan reaktion på plötsliga ljud och beteende vid fångst. Något stöd för generella personlighetsdrag som är konsekventa i flera olika situationer hittades således inte. Min förhoppning är att resultaten från studien kan bidra till ökad kunskap om hur vilda djur reagerar på plötsliga ljud och i vilken utsträckning de kan förväntas vänja sig vid dessa. Ökad kunskap inom detta område är användbar vid utveckling av metoder som använder ljud för att förhindra viltolyckor på vägar och järnväg

Should I stay, or should I go?

In this narrative, I explore the thoughts and emotions that drive the decision of whether to transfer residency programs. I focus on the difficulty of making a career decision with limited information, and the difficulty of exploring the possibility of a transfer while still remaining part of an ongoing residency program. Although residency transfers are a taboo topic, they are remarkably common. Many residents go through this process feeling alone; I hope to convey that these feelings are common. More understanding of the transfer process is needed, particularly in light of the ongoing unmatched Canadian medical graduate crisis and in light of high rates of burnout, to understand the drivers behind resident wellness and satisfaction.&nbsp

Should I stay or should I go : Irregularly somewhere in the middle

Refugees and migration are a great challenge in world politics. The global challenge of refugees and human rights is a complex and broad topic within the international law to which the States are trying to find effective measures and solutions fast. This thesis is about to provide knowledge and better qualified arguments for discussions as well as for sustainable legislation and practices, taking also the process economic point of view into the consideration. This thesis is especially an analysis of the asylum interview´s significance, and its role as a fork on the road of becoming irregular migrant. This research deal with asylum processes among national, regional and international legal frameworks, and clarifies how Finland and Finnish legislation, regulations, policies and practices are positioned into the international legislation and regulations. The research focusses on the role of national and international legislation and practices in creating irregular migrants. Epistemic violence and challenges in linguistic exchanges are of great importance in this thesis. With this research, I will show how the society, consciously or unconsciously, creates a group of people living in a vulnerable situation, and show the importance of the asylum interview in terms of process economy and legal security by bringing together elements from legal dogmatics as well as from sociology of law. As a material I have used mainly primary and secondary sources, mostly law and politics documents. The main purpose is to provide critical, yet constructive and pragmatic views on migration. Pakolaisuus ja maahanmuutto ovat merkittävä ja ajankohtainen haaste maailman politiikassa. Pakolaisuus ja ihmisoikeudet muodostavat globaalisti hyvin monitahoisen ja laajan teeman kansainvälisten oikeuden sisällä, johon valtiot pyrkivät löytämään tehokkaita välineitä ja ratkaisuja nopeasti. Tämä tutkielma tarjoaa tietoa ja ymmärrystä sekä laadukkaampia perusteita keskusteluun, ja myös kestävämmän lainsäädännön ja käytänteiden pohjaksi, ottaen myös prosessi-ekonomiset näkökohdat huomioon. Tämä tutkielma on erityisesti analyysi turvapaikkapuhuttelun merkityksestä ja sen roolista osana polkua kohti paperittomuutta. Tämä tutkielma käsittelee turvapaikkaprosesseja kansallisen, paikallisen ja kansainvälisen lainsäädännön puitteissa ja selventää, miten Suomi ja Suomen lainsäädäntö, säännökset ja politiikka sekä käytänteet asemoituvat kansainvälisessä kentässä. Tutkimus keskittyy kansallisen ja kansainvälisen lainsäädännön ja käytänteiden rooliin paperittomuuden ilmiön muodostamisessa. Episteminen väkivalta sekä haasteet kielellisessä kommunikaatiossa ovat keskeisessä asemassa tässä tutkielmassa. Tällä tutkimuksella osoitan, miten yhteiskunta tiedostaen tai tiedostamatta luo heikossa asemassa olevaa ihmisryhmää, ja osoitan turvapaikkapuhuttelun merkityksen turvapaikkamenettelyssä prosessiekonomian ja oikeusturvan näkökulmasta yhdistäen elementtejä oikeusdogmatiikasta sekä oikeussosiologiasta. Materiaalina olen käyttänyt pääasiallisesti voimassaolevaa lainsäädäntöä ja sitä koskevia valmisteluasiakirjoja sekä poliittisia ja oikeustieteellisiä artikkeleita. Ensisijainen tarkoitus on tuottaa kriittisiä, kuitenkin rakentavia ja pragmaattisia, näkökulmia maahanmuuton haasteisiin

Should I stay or should I go?: the rhetoric of "scorned political wives"

2010 Fall.Includes bibliographical references.This thesis examines the rhetoric of Elizabeth Edwards and Jenny Sanford, two "scorned political wives." In the wake of their husbands' extramarital affairs, Edwards and Sanford needed to respond to embarrassing and identity-challenging rhetorical situations. Forced to defend their choices as wives and mothers, Edwards and Sanford answered the question, "Should I stay or should I go?" Although their persuasive purposes were quite different, Edwards and Sanford each employed effective rhetoric to heighten their credibility and restore their place in society. Elizabeth Edwards chose to preserve her marriage, while Jenny Sanford decided to sever her marital bonds. By examining the themes and persuasive strategies each woman used to meet her overall goals, this thesis uncovers lines of argument, or topoi, that may be characteristic of an emerging genre of "scorned political wives.

Should I stay or should I go? Understanding Poland's adherence to gold, 1928-1936

'Der folgende Aufsatz untersucht die Entscheidung der polnischen Regierung, während der Großen Depression den Goldstandard nicht zu verlassen. Polen blieb dem Goldstandard bis zum April 1936 treu und kann auf Grund einer massiven Deflation und eines kompletten Kollaps der Industriellen Produktion als eines der schlimmsten Beispiele der Großen Depression angesehen werden. Mit Hilfe eines ökonometrischen Ansatzes kann gezeigt werden, dass sich der polnische Fall deutlich von den Erfahrungen anderer europäischer Nationen unterscheidet. Es wird argumentiert, dass die polnische Geldpolitik hauptsächlich durch nicht-ökonomische Erwägungen beeinflusst und vor allem unter der Regierung Pilsudski durch das Ziel geprägt wurde, Polens Unabhängigkeit gegen fremde (vor allem deutsche) Einflüsse zu verteidigen. Die hier präsentierten Belege unterstützen eine solche Interpretation bis zur Mitte des Jahres 1933. Ironischerweise kam es kurz nach Polens Beitritt zum ‚gold bloc' zu einer umfassenden strategischen Neuorientierung, die den Weg für den Austritt im Jahre 1936 bereitete.' (Autorenreferat)'This paper examines the decision of the Polish government to adhere to the gold standard during the Great Depression. Poland did not leave gold until April 1936 and suffered through one of the worst examples of a depression, with massive deflation and a complete collapse of industrial production. The Polish case stands out against the experience of other European countries as can be shown in an econometric framework. The author argues that Poland's monetary policy was largely determined by non-economic considerations, especially attempts of the Pilsudski regime to defend Poland against foreign (esp. German) aggression. He provides evidence that strongly supports this view until about mid-1933. Ironically, just after Poland had joined the gold-bloc there were signs of a broad strategic reorientation, which paved the way for an exit in 1936.' (author's abstract

Should I Stay or Should I Go? Compassion Organizing and the University Advancement Workplace

Compassion organizing has been described within positive organizational scholarship as an organization’s response to pain and suffering in organizational behavior and also the ability for organizations to flourish and promote joy and fulfillment in the workplace. Compassion organizing has been examined in organizational life through the four areas of noticing, feeling, acting, and sense-making. Previous research has focused on business and healthcare workplaces and has shown that compassion organizing is both an organizational and interpersonal social process. Because of the limited existing research on compassion organizing in the higher education workplace (and none with respect to the university advancement workplace), the purpose for conducting this study was to explore the possible effects (if any) of compassion organizing on the university advancement workplace and the voluntary employee turnover and workplace satisfaction of major gift officers within this organization. This study utilized a phenomenological research design to gather information via semi-structured interviews from 8 major gift officers within public 4-year higher education institutions. The findings suggested that compassion organizing does play a role in the voluntary turnover of major gift officers in institutional advancement workplaces, especially as it relates to the development employee’s relationship and interactions with their supervisors and leaders. Study participants described both positive and negative experiences with compassion organizing in their workplaces as well as specific behaviors and processes that could foster compassion organizing in the institutional advancement department. Further, study participants described the negative and significant effect of the voluntary turnover in the university advancement workplace on the culture and environment of the organization as a whole. The results are important for institutional and departmental leaders to foster and grow a compassionate workplace environment whereby it is possible to recruit and retain talented major gift officers and foster a positive and flourishing culture that will not experience high rates of voluntary turnover within the development profession and will also increase fundraising success with alumni, donors, and friends of the university