Outsourcing in Western Australian hospitals: Management considerations

This thesis examines Health Care Managers\u27 considerations with and experiences of outsourcing services in Western Australian hospitals. Support services such as cleaning and maintenance are some of the areas which have been targeted for outsourcing (contracting out) by the state government. These services have traditionally been delivered by permanently employed staff either on a full or part- time basis, usually with active union involvement. Core services such as nursing and medical care which involve direct patient care delivery are not included in the outsourcing debate. Firstly, this thesis reviews the literature on outsourcing and its application to the health care industry. Performance indicators and benchmarking are also explored within the context of contracted out services in a variety of settings. The implicit economic, social and legal implications are discussed. This study involved Health Care Managers in Western Australian hospitals and was conducted between June 1995 and May 1996. Their experiences with outsourcing of services together with the hospitals and the communities they served were key considerations in the final analysis. The research findings support the views of more recent studies which emphasize the importance of the context within which outsourcing is implemented, such as rural versus metropolitan hospitals. Hospital size, location, accessibility to contractors, human resource issues and funding arrangements such as those which affect teaching and non- teaching facilities were identified as major determinants affecting the degree to which outsourcing had been embraced. Finally, the implications of this research for future studies are discussed

Personal development planning in the first year

The approach to quality and standards in higher education (HE) in Scotland is enhancement led and learner centred. It was developed through a partnership of the Scottish Funding Council (SFC), Universities Scotland, the National Union of Students in Scotland (NUS Scotland) and the Quality Assurance Agency for Higher Education (QAA) Scotland. The Higher Education Academy has also joined that partnership. The Enhancement Themes are a key element of a five-part framework, which has been designed to provide an integrated approach to quality assurance and enhancement. The Enhancement Themes support learners and staff at all levels in further improving higher education in Scotland; they draw on developing innovative practice within the UK and internationally The five elements of the framework are: z a comprehensive programme of subject-level reviews undertaken by higher education institutions (HEIs) themselves; guidance is published by the SFC (www.sfc.ac.uk) z enhancement-led institutional review (ELIR), run by QAA Scotland (www.qaa.ac.uk/reviews/ELIR) z improved forms of public information about quality; guidance is provided by the SFC (www.sfc.ac.uk) z a greater voice for students in institutional quality systems, supported by a national development service - student participation in quality scotland (sparqs) (www.sparqs.org.uk) z a national programme of Enhancement Themes aimed at developing and sharing good practice to enhance the student learning experience, facilitated by QAA Scotland (www.enhancementthemes.ac.uk). The topics for the Enhancement Themes are identified through consultation with the sector and implemented by steering committees whose members are drawn from the sector and the student body. The steering committees have the task of establishing a programme of development activities, which draw on national and international good practice. Publications emerging from each Theme are intended to provide important reference points for HEIs in the ongoing strategic enhancement of their teaching and learning provision. Full details of each Theme, its steering committee, the range of research and development activities as well as the outcomes are published on the Enhancement Themes website (www.enhancementthemes.ac.uk). To further support the implementation and embedding of a quality enhancement culture within the sector - including taking forward the outcomes of the Enhancement Themes - an overarching committee, the Scottish Higher Education Enhancement Committee (SHEEC), chaired by Professor Kenneth Miller, Vice-Principal, University of Strathclyde, has the important dual role of supporting the overall approach of the Enhancement Themes, including the five-year rolling plan, as well as institutional enhancement strategies and management of quality. SHEEC, working with the individual topic-based Enhancement Themes' steering committees, will continue to provide a powerful vehicle for progressing the enhancement-led approach to quality and standards in Scottish higher education

Identification of Mental States and Interpersonal Functioning in Borderline Personality Disorder

Atypical identification of mental states in the self and others has been proposed to underlie interpersonal difficulties in borderline personality disorder (BPD), yet no previous empirical research has directly examined associations between these constructs. We examine 3 mental state identification measures and their associations with experience-sampling measures of interpersonal functioning in participants with BPD relative to a healthy comparison (HC) group. We also included a clinical comparison group diagnosed with avoidant personality disorder (APD) to test the specificity of this constellation of difficulties to BPD. When categorizing blended emotional expressions, the BPD group identified anger at a lower threshold than did the HC and APD groups, but no group differences emerged in the threshold for identifying happiness. These results are consistent with enhanced social threat identification and not general negativity biases in BPD. The Reading the Mind in the Eyes Test (RMET) showed no group differences in general mental state identification abilities. Alexithymia scores were higher in both BPD and APD relative to the HC group, and difficulty identifying one’s own emotions was higher in BPD compared to APD and HC. Within the BPD group, lower RMET scores were associated with lower anger identification thresholds and higher alexithymia scores. Moreover, lower anger identification thresholds, lower RMET scores, and higher alexithymia scores were all associated with greater levels of interpersonal difficulties in daily life. Research linking measures of mental state identification with experience-sampling measures of interpersonal functioning can help clarify the role of mental state identification in BPD symptoms

Annotated Bibliography of Films in Automation, Data Processing, and Computer Science

With the rapid development of computer science and the expanding use of computers in all facets of American life, there has been made available a wide range of instructional and informational films on automation, data processing, and computer science. Here is the first annotated bibliography of these and related films, gathered from industrial, institutional, and other sources. This bibliography annotates 244 films, alphabetically arranged by title, with a detailed subject index. Information is also provided concerning the intended audience, rental-purchase data, ordering procedures, and such specifications as running time and film size.https://uknowledge.uky.edu/upk_computer_science/1000/thumbnail.jp

The reproduction of racism in the private recruitment industry.

Thesis (M.A.)-University of Natal, Pietermaritzburg, 2002."But you've got to make sure you communicate in the right way [laughs] so that no one else knows what you're talking about. [Laughing]" (Interview I) The study examines the rhetoric of 'racial' exclusion used by South African private recruitment consultants to justify racist practice, criticise employment equity and deny racism. The dilemmatic nature of clients racially based requests is understood in a context that socially and legally forbids "unfair discrimination" and racist practice. The reader is provided with an overview of the legislation as it pertains to recruitment and the psychological study of 'race' in order to locate this study within its historical context. An historical context of segregation and resistance to changes in employment practices. We examine how South African psychology has investigated 'race' and racism - past and present. Psychology has traditionally explained 'white' resistance to transformation in terms of 'racial' prejudice. These attitudinal approaches fail to explicate the role of language in the reproduction and conservation of these historical patterns. By providing the reader with an historical overview "interpretative connections" (Wetherell and Potter, 1992) will be established that assist in the analysis of the text. Transcribed interviews with nine private recruitment consultants in two urban centres in South Africa serve as textual evidence. The analysis demonstrates the rhetorical strategies employed by consultants in their conversations, discussions, negotiations, criticism and justification of the conservation of historical employment patterns. Private recruitment consultants engage in a number of rhetorical manoeuvres that appeal to 'white' norms and construct' black' as a requirement and deficient. The construction of' white' and' black' serves as a platform for justifying the historically established 'racial' hierarchy and conserving 'racial' privilege. Consultants construct their practice as a 'reasonable' response to clients' blatant 'racially' based requests for candidates. This is done by splitting racism into 'reasonable' and 'unreasonable' racism. 'Unreasonable' racism is defined as explicit I blatant acts that are located externally and in the past. This splitting functions to distance recruitment consultants from the racist practices of their clients and to counter potential accusations of racism. Their arguments function ideologically to defend the historical status quo in employment and criticise social transformation in South Africa. The study concludes with recommendations for the private recruitment industry in South Africa and suggests future areas of study using a discursive approach. The analysis highlights the need for external auditing of the private recruitment agencies to ensure the enactment and successful implementation of the Employment Equity Act of 1998 and the Promotion of Equality and Prevention of Unfair Discrimination Act of 2000. Furthermore, more detailed analysis of the object of racism, namely the construction of 'whiteness', could be useful in understanding resistance to transformation in the private sector and the (re)production of racism

On Top of the Alveolar Epithelium: Surfactant and the Glycocalyx

Gas exchange in the lung takes place via the air-blood barrier in the septal walls of alveoli. The tissue elements that oxygen molecules have to cross are the alveolar epithelium, the interstitium and the capillary endothelium. The epithelium that lines the alveolar surface is covered by a thin and continuous liquid lining layer. Pulmonary surfactant acts at this air-liquid interface. By virtue of its biophysical and immunomodulatory functions, surfactant keeps alveoli open, dry and clean. What needs to be added to this picture is the glycocalyx of the alveolar epithelium. Here, we briefly review what is known about this glycocalyx and how it can be visualized using electron microscopy. The application of colloidal thorium dioxide as a staining agent reveals differences in the staining pattern between type I and type II alveolar epithelial cells and shows close associations of the glycocalyx with intraalveolar surfactant subtypes such as tubular myelin. These morphological findings indicate that specific spatial interactions between components of the surfactant system and those of the alveolar epithelial glycocalyx exist which may contribute to the maintenance of alveolar homeostasis, in particular to alveolar micromechanics, to the functional integrity of the air-blood barrier, to the regulation of the thickness and viscosity of the alveolar lining layer, and to the defence against inhaled pathogens. Exploring the alveolar epithelial glycocalyx in conjunction with the surfactant system opens novel physiological perspectives of potential clinical relevance for future research

Integrating Information Technology into Curricula Activities: Participant Observation of Laptop Use

This paper presents descriptive use of laptops as a lecturer and students engage in curricula activities over one hour of instruction. Lave and Wenger\u27s (1991) theory of situated learning (SL) is used to contextualise laptop use in teaching and learning, inside the undergraduate business classroom. We examine how laptops are used to support teaching and learning practice and influence the curricula process, as laptops are introduced into instruction. Interpretive ethnography and participant observation capture lecturer and student descriptive narrative as they use laptops. Analysis is presented in time order and documents lecturer / student laptop use inside the undergraduate classroom

Nights at the Roundtable: Discourses of Public Good and Private Rights

In 2005, the state of Colorado mandated the creation of water roundtables in HB05-1177. The purpose of the water roundtables was to provide a public forum for collaboration, discussion, and local decision-making in river basins. Understanding the practice of public deliberation that combines the external trappings of democracy with the substance of legal rule is a puzzle facing communication scholars. Thus far, there are few studies at the intersection of communication, environmental governance, and water. Past research has focused on the importance of public involvement and deliberation, while neglecting variations in the underlying practices of meetings. This dissertation moves beyond a focus on publics to explore processes of institutional change and renewal within a particular type of hybrid meeting: those with competing discourses of public good and private rights. The study inductively reconstructs the communicative practice of roundtables and provides analytical insights that inform communicative practices of deliberation about a critical, non-substitutable resource. First, it suggests that not all public meetings are created equal. Scholars wishing to understand the discourse of public deliberation must look beyond a public/private dichotomy to include distinctions in both the aim and criteria for deliberation. Secondly, the project offers a cautionary tale for policymakers and researchers who view public involvement as a source of democratic change. This case study develops our knowledge of the relationship between discourse and institutional forms of public deliberation and suggests that relational ways of decision-making offer strengths that have been previously overlooked

Role of subtyping in detecting Salmonella cross contamination in the laboratory

<p>Abstract</p> <p>Background</p> <p>With the exception of <it>M. tuberculosis</it>, little has been published on the problems of cross-contamination in bacteriology laboratories. We performed a retrospective analysis of subtyping data from the National <it>Salmonella </it>Reference Laboratory (Ireland) from 2000–2007 to identify likely incidents of laboratory cross contamination.</p> <p>Methods</p> <p>Serotyping and antimicrobial susceptibility testing was performed on all <it>Salmonella </it>isolates received in the NSRL. Phage typing was performed on all <it>S</it>. Typhimurium and <it>S</it>. Enteritidis isolates while multi-locus variance analysis (MLVA) was performed on selected <it>S</it>. Typhimurium isolates. Pulsed field gel electrophoresis (PFGE) using the PulseNet standard protocol was performed on selected isolates of various serovars.</p> <p>Results</p> <p>Twenty-three incidents involving fifty-six isolates were identified as likely to represent cross contamination. The probable sources of contamination identified were the laboratory positive control isolate (n = 13), other test isolates (n = 9) or proficiency test samples (n = 1).</p> <p>Conclusion</p> <p>The scale of laboratory cross-contamination in bacteriology is most likely under recognized. Testing laboratories should be aware of the potential for cross-contamination, regularly review protocols to minimize its occurrence and consider it as a possibility when unexpected results are obtained.</p

Assessing Vancomycin Dosing Per Pharmacy in Elderly Patients Over the Age of 74 Years

Vancomycin has a complex pharmacokinetic profile and carries potential risks for nephrotoxicity and ototoxicity. The pharmacokinetic profile in elderly patients significantly differs from that of younger patients. It is common practice in many institutions for pharmacists to intentionally round serum creatinine levels to 1 mg/dl in elderly patients with levels \u3c1 mg/ dl to avoid overestimating clearance and toxicities. This can potentially lead to underestimation of creatinine clearance, and subsequently lead to vancomycin under dosing. The aim of this study was to evaluate vancomycin target trough attainment and the time to trough attainment with vancomycin dosing per pharmacy in elderly patients