14,196 research outputs found

    Interpersonal comparison, status and ambition in organizations

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    This paper shows that introducing status concerns into a tournament model has substantial implications for the provision of incentives. We emphasize the role of reference groups and determine the optimal number of winners and losers in tournaments. To compensate employees for the disutility of low status, a profit-maximizing employer may be reluctant to demote employees and instead reward workers through promotions. This rationalizes the prevalence of compensation systems which reward winners without explicitly identifying losers. Differences in ambition and ability affect contestants’ efforts and may result in inefficient promotion outcomes. We analyze how to mitigate these inefficiencies when managing a diverse workforce by using mixed and segregated tournament

    Delivery of patient education and support using an online digital platform for patients undergoing primary hip and knee replacement: The patient’s perspectives

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    The aim of the present evaluation was to evaluate the use of an online digital platform (ODP) to deliver patient education and support (PES) to patients undergoing total hip replacement (THR) and total knee replacement (TKR) surgery. Six objectives were outlined to assess the following areas: patient engagement; ease of use; understanding of information; quantity of information; aid of recovery; suggestions for improvements. A qualitative service evaluation of the ODP. Participants included patients who were registered to the platform for THR or TKR, were at least 90 days post-surgery and had accessed at least one carepac. Interviews followed a semi-structured schedule and were transcribed and analysed using thematic analysis. A total of 14 participants were interviewed. Three main themes were identified, each with subsequent sub-themes. (1) Health behaviours – internal control of own health, external email prompts, social support. (2) Contribution to recovery – quantity and quality of information available, structured program, suggestions of improvements to better aid recovery. (3) PES delivery – ease of use and accessibility of an ODP, technology advancements, alternative methods of PES. The online PES platform was beneficial for patients undergoing THR and TKR surgery. It aided their understanding of and preparedness for joint replacement surgery, as well as being a supportive tool for rehabilitation and recovery. All patients actively engaged with the ODP and in doing so, developed a greater understanding as a result of the detailed and structured carepacs assigned. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

    An integrated care pathway for menorrhagia across the primary–secondary interface : patients' experience, clinical outcomes, and service utilisation

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    Background: ‘‘Referral’’ characterises a significant area of interaction between primary and secondary care. Despite advantages, it can be inflexible, and may lead to duplication. Objective: To examine the outcomes of an integrated model that lends weight to general practitioner (GP)-led evidence based care. Design: A prospective, non-random comparison of two services: women attending the new (Bridges) pathway compared with those attending a consultant-led one-stop menstrual clinic (OSMC). Patients’ views were examined using patient career diaries, health and clinical outcomes, and resource utilisation. Follow-up was for 8 months. Setting: A large teaching hospital and general practices within one primary care trust (PCT). Results: Between March 2002 and June 2004, 99 women in the Bridges pathway were compared with 94 women referred to the OSMC by GPs from non-participating PCTs. The patient career diary demonstrated a significant improvement in the Bridges group for patient information, fitting in at the point of arrangements made for the patient to attend hospital (ease of access) (p,0.001), choice of doctor (p = 0.020), waiting time for an appointment (p,0.001), and less ‘‘limbo’’ (patient experience of non-coordination between primary and secondary care) (p,0.001). At 8 months there were no significant differences between the two groups in surgical and medical treatment rates or in the use of GP clinic appointments. Significantly fewer (traditional) hospital outpatient appointments were made in the Bridges group than in the OSMC group (p,0.001). Conclusion: A general practice-led model of integrated care can significantly reduce outpatient attendance while improving patient experience, and maintaining the quality of care

    Waste Disposal at Whiting Farm: Recommendations for Current Waste Removal and Future Recycling Systems

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    The goal of this report is to provide Whiting Farm in Auburn, Maine with an analysis of options and resources that will help the farm to make informed decisions for the removal and disposal of both existing and future waste, with a specific focus on recycling. Whiting Farm has never had an on-site waste disposal system. As a result, they have accumulated large amounts of agricultural plastic, which is stored mostly outside in three forested areas around the farm. Dealing with this waste is key in implementing the farm’s goals of environmental and economic sustainability, as well as functioning as an educational model for youth and other farmers. In collaboration with Kim Finnerty, Whiting Farm’s Manager, we have created this resource to inform waste removal and the development of a recycling system in order to mitigate future waste buildup. We first compare different options, given commercial infrastructure, for both the removal and disposal of the existing waste. We considered factors such as cost, environmental effects, and feasibility. We conclude that working with Casella Waste Management will be instrumental towards achieving these goals given Casella’s convenience, dumpster rental and waste disposal rates, and recycling capacity. We also discuss options for generating income by selling the metal, large machinery, and cardboard, which have also accumulated on the farm. The information gathered in determining the best removal and disposal methods for existing waste informed our recommendations for a system to recycle future waste, both compostable and non-compostable. Given a lack of local commercial options and innovative technology in the field of agricultural recycling, recommendations for a future system were limited to suggestions regarding commercial partners, dumpster locations, and a list of Whiting Farm’s recyclable waste. Additionally, options are given for compostable waste recycling, keeping in mind the specific practices of Whiting Farm. Our report presents these practical recommendations in the main body, but much of this research was informed and influenced by additional information compiled in Appendices. Among topics considered are rationale for removal of existing waste, barriers to recycling agricultural waste, and case studies referring to other farms’ disposal practices. Additionally, contacts for waste removal and disposal, model farms, as well as academics in the field of agricultural recycling are provided for future reference. This report aims to provide helpful and succinct recommendations for the implementation of a waste disposal system that is in line with Whiting Farm’s practical needs, vision of environmental sustainability, and educational goals

    The Design and Construction of High-Resolution Spectrometers for Exoplanet Discovery and Characterisation.

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    PhD ThesisIn this thesis, we discuss the design and construction of high-resolution spectrometers for exoplanet discovery and characterisation across the entire scope of project budgetary regimes. As with all aspects of astronomy, light and more specifically electromagnetic waves are our greatest key to unlocking the secrets of exoplanetary systems. The radial velocity method, in which analysis of the Doppler shift of star light can infer the existence and minimum mass of an exoplanetary system, relies wholly on the application of high-resolution, stable spectrometer systems. Alongside this, powerful spectroscopic techniques such as: transit and cross-correlation spectroscopy (used to probe the atmospheric characteristics of planets), the Rossiter-McLaughlin effect (which can infer spin-orbit characteristics of the planetary system) and reflected light analysis of a planet (that allow us to discover orbital characteristics and true mass of a planet) require field leading spectrometer design. These investigative techniques alone more than warrant the existence of large, high-cost, ultra-stable, high-resolution spectrograph systems, such as HARPS, PFS, ESPRESSO e.t.c. However, with ever changing science goals, there is scope for a new kind of instrument. With growing discussion amongst the exoplanet community on the application of combined high contrast imaging and high dispersion spectroscopy in exoplanet science, there is a need for replicable, low-cost, stable, high-resolution spectrometer systems for integral field applications; which can be efficiently coupled to high contrast imagers. This thesis presents the design and construction of such an instrument, with a proof of concept prototype spectrometer produced which is compact (comparable in size to a 3U CubeSat chassis), low-cost (<ÂŁ10; 000), highly-replicable (utilising mostly commercially-o -the-shelf components), stable (demonstrated RV precision of approximately 20m/s) and high-resolution (resolving power > 60; 000). Sub-systems for this instrument, a fibre coupling system and a data-reduction pipeline, are designed and constructed with the complete instrument successfully tested on-sky at the QMUL Astronomy Unit Observatory. The design aspects of this system are further employed in the design study of a large-scale, high-budget, ultra-stable, red-NIR, high-resolution spectrometer concept: NEREA (Near Earths and high-Res Exoplanet Atmospheres). If funded, this instrument is to be efficiently coupled to The Gran Telescopio Canarias (GTC). The combination of the 10m aperture of the GTC and the high-resolution, stable spectroscopy of NEREA will open up opportunities to investigate exoplanetary systems which are currently unobtainable with contemporary instrumentation. Finally, all of the experience gained through the completion of these projects is channelled into the construction of a `Spectrometer Design Toolkit' software which aids in the rapid design of spectrograph concepts. This system is tested in the re-design of the collimating/re-focussing lens for EXOhSPEC (EXOplanet high resolution SPECtrograph), a compact, high-resolution spectrograph in development at the University of Hertfordshire for the Thai National Observatory (TNO)

    Mechanisms of common ground in case-based web discussions in teacher education

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    Previous studies suggest that before the participants in Web-based conferencing can reach deeper level interaction and learning, they have to gain an adequate level of common ground in terms of shared mutual understanding, knowledge, beliefs, assumptions, and pre-suppositions (Clark & Schaefer, 1989; Dillenbourg, 1999). In this paper, the main purpose is to explore how participants establish and maintain common ground in order to reach deeper level interaction in case-based Web-discussions. The subjects in this study consisted of 68 pre-service teachers and 7 mentors from three universities, who participated in the Web-based conferencing course for eight weeks. The written discussion data were analyzed by means of a combination of quantitative and qualitative methods. The results suggest that in order to establish common ground it is essential that the participants, especially as fellow students, not only show evidence of their understandings through written feedback, but also provide support to their peers in their replies. Presenting questions also signals the participant’s willingness to continue the discussion, which is essential for maintaining common ground
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