The assessment of caregiver burden among participants in the Home-Based Primary Care program

With the increase in the elderly, American\u27s caregiver roles and responsibilities are also on the rise. Developing with this increase is the growing problem of caregiver burden. The Loma Linda V. A. Hospital has developed a service known as the Home-Based Primary Care program designed to combat caregiver burden. Studies were conducted among caregiver participants in this program in an effort to evaluate overall levels of burden and the program\u27s efficiency at meeting caregiver needs. Overall this program provides a useful model for future programs aimed at reducing caregiver burden. Limitations that can be improved, however, include consistency in scheduling, reliable staffing, and continuity in care

Torts—Libel—Absolute Privilege of Municipal Officials

Lombardo v. Stoke, 18 N.Y.2d 394, 222 N.E.2d 721, 276 N.Y.S.2d 97 (1966)

Continuous consent and dignity in dentistry

Despite the heavy emphasis on consent in the ethical code of the General Dental Council (GDC), it is often overlooked that communication difficulties between patient and dentist can cause problems in maintaining genuine consent during interventions. Inconsistencies in the GDC's Standards for dental professionals and Principles of patient consent guidelines are examined in this article, and it is concluded that more emphasis must be placed on continuous consent as an ongoing process essential to maintaining patients' dignity in dentistry

ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI KEPUTUSAN PEMBELIAN BROKOLI ORGANIK DI PASAR MODERN GELAEL SEMARANG

ABSTRACT Di era modern ini masyarakat cenderung menyukai makanan-makanan organik dibandingkan makanan anorgnaik. Masyarakat memenuhi kebutuhan gizi dan nutrisinya dengan membeli sayuran organik. Brokoli menjadi salah satu pilihan sayur masyarakat untuk memenuhi kebutuhan vitamin dan gizi. Berkaitan dengan itu maka penelitian ini dilakukan untuk mengetahui keputusan pembelian konsumen dan faktor-faktor yang mempengaruhi keputusan pembelian konsumen terhadap brokoli organik. Penelitian dilaksanakan di pasar modern Gelael kota Semarang yaitu Gelael Akpol dan Gelael Mall Citraland. Pengambilan sampel dilakukan menggunakan metode accidental sampling pada 100 responden yang membeli produk brokoli organik. Data dianalisis menggunakan analisis logistik biner untuk mengetahui faktor-faktor yang secara signifikan mempengaruhi keputusan pembelian konsumen. Hasil penelitian menunjukkan bahwa karakteristik responden di Gelael Semarang yaitu responden didominasi oleh konsumen perempuan, berstatus menikah kelompok usia 31-40 tahun, latar belakang pendidikan Strata 1, pekerjaan sebagai ibu rumah tangga, memiliki jumlah anggota keluarga 4 – 6 orang, memiliki pendapatan antara Rp 4.500.000 - Rp 8.000.000,- per bulan dengan frekuensi pembelian brokoli organik sebanyak 2 kali dalam 1 bulan dengan pengeluaran untuk membeli brokoli organik sebesar Rp 30.000 – Rp 50.000. Adapun variabel lainnya berupa harga, lokasi, kualitas, gaya hidup, sikap dan promosi diolah dengan analisis deskriptif. Hasil penelitian menunjukkan bahwa harga, lokasi, kualitas, dan sikap memiliki pengaruh yang signifikan terhadap keputusan pembelian brokoli organik di Gelael Semarang. Kata Kunci: analisis deskriptif, brokoli organik, keputusan pembelian, regresi logisti

Mesh Adaption for Tracking Vortex Structures in OVERTURNS Simulation of the S-76 Rotor in Hover

The constant need to improve helicopter performance requires the optimization of existing and future rotor designs. A crucial indicator of rotor capability is hover performance, which depends on the near-body flow as well as the structure and strength of the tip vortices formed at the trailing edge of the blades. Computational Fluid Dynamics (CFD) solvers must balance computational expenses with preservation of the flow, and to limit computational expenses the mesh is often coarsened in the outer regions of the computational domain. This can lead to degradation of the vortex structures which compose the rotor wake. The current work conducts three-dimensional simulations using OVERTURNS, a three-dimensional structured grid solver that models the flow field using the Reynolds-Averaged Navier-Stokes equations. The S-76 rotor in hover was chosen as the test case for evaluating the OVERTURNS solver, focusing on methods to better preserve the rotor wake. Using the hover condition, various computational domains, spatial schemes, and boundary conditions were tested. Furthermore, a mesh adaption routine was implemented, allowing for the increased refinement of the mesh in areas of turbulent flow without the need to add points to the mesh. The adapted mesh was employed to conduct a sweep of collective pitch angles, comparing the resolved wake and integrated forces to existing computational and experimental results. The integrated thrust values saw very close agreement across all tested pitch angles, while the power was slightly over predicted, resulting in under prediction of the Figure of Merit. Meanwhile, the tip vortices have been preserved for multiple blade passages, indicating an improvement in vortex preservation when compared with previous work. Finally, further results from a single collective pitch case were presented to provide a more complete picture of the solver results

Virtual Physician Care: How can its use be Accelerated?

Although the provision of virtual care, often referred to as telemedicine, has been around for over fifty years, its use by physicians to care for patients has not been widely adopted. This dissertation examines how to accelerate the use of virtual physician care in three aims. Systematic literature reviews were used to understand more about the quality of virtual physician care (Aim 1) and barriers to its use (Aim 2). Aim 3 engaged physician leaders from Carolinas HealthCare System (CHS); the second largest public healthcare system in America, in key informant interviews to better understand what factors could accelerate the use of virtual physician care. Results from the literature review on quality (Aim 1) concluded that virtual physician care results in at least comparable or better quality care. Aim 2, exploring the barriers to virtual physician care, identified nine (9) general themes as contributors to the lack of its adoption including physician attitude, system support, training, patient acceptance, legal/ regulatory issues, quality, reimbursement, liability and technology. Aim 3, focused on the acceleration of virtual physician care, revealed five (5) themes critical from the physician perspective to increase its use and more widespread adoption to care for patients. These themes included: 1. Effective technology to provide virtual physician care must be available in a consistent, reliable format. 2. Providing physician care virtually must meet the same quality standards as the current model of care. 3. Institutional support to provide virtual physician care must be clearly articulated and recognized throughout the organization as an acceptable model of care. 4. The provision of virtual physician care must be efficiently integrated into the current workflow of the physicians in all care settings. 5. The healthcare environment must create a demand for virtual physician care. Strategic recommendations to support the implementation of virtual physician care at Carolinas HealthCare System include: aligning the system strategy to support its use, identifying both physician and administrative champions, and pilot-testing virtual care programs to demonstrate its efficiency and confirm high-quality outcomes. As the adoption of virtual physician care increases at CHS, the plan also accounts for sharing knowledge through purposeful research to add to the literature on virtual physician care and taking an active role in national policy development. It is anticipated this model of care will continue to received increased attention and its use can be positioned to help advance the work of public health and healthcare to improve the health of populations and individuals.Doctor of Public Healt

ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI KEPUTUSAN PEMBELIAN BROKOLI ORGANIK DI PASAR MODERN GELAEL SEMARANG

Di era modern ini masyarakat cenderung menyukai makanan-makanan organik dibandingkan makanan anorgnaik. Masyarakat memenuhi kebutuhan gizi dan nutrisinya dengan membeli sayuran organik. Brokoli menjadi salah satu pilihan sayur masyarakat untuk memenuhi kebutuhan vitamin dan gizi. Berkaitan dengan itu maka penelitian ini dilakukan untuk mengetahui keputusan pembelian konsumen dan faktor-faktor yang mempengaruhi keputusan pembelian konsumen terhadap brokoli organik. Penelitian dilaksanakan di pasar modern Gelael kota Semarang yaitu Gelael Akpol dan Gelael Mall Citraland. Pengambilan sampel dilakukan menggunakan metode accidental sampling pada 100 responden yang membeli produk brokoli organik. Data dianalisis menggunakan analisis logistik biner untuk mengetahui faktor-faktor yang secara signifikan mempengaruhi keputusan pembelian konsumen. Hasil penelitian menunjukkan bahwa karakteristik responden di Gelael Semarang yaitu responden didominasi oleh konsumen perempuan, berstatus menikah kelompok usia 31-40 tahun, latar belakang pendidikan Strata 1, pekerjaan sebagai ibu rumah tangga, memiliki jumlah anggota keluarga 4 – 6 orang, memiliki pendapatan antara Rp 4.500.000 - Rp 8.000.000,- per bulan dengan frekuensi pembelian brokoli organik sebanyak 2 kali dalam 1 bulan dengan pengeluaran untuk membeli brokoli organik sebesar Rp 30.000 – Rp 50.000. Adapun variabel lainnya berupa harga, lokasi, kualitas, gaya hidup, sikap dan promosi diolah dengan analisis deskriptif. Hasil penelitian menunjukkan bahwa harga, lokasi, kualitas, dan sikap memiliki pengaruh yang signifikan terhadap keputusan pembelian brokoli organik di Gelael Semarang.     Kata Kunci: analisis deskriptif, brokoli organik, keputusan pembelian, regresi logistik &nbsp

The Ethics of Delusional Belief

In this paper we address the ethics of adopting delusional beliefs and we apply consequentialist and deontological considerations to the epistemic evaluation of delusions. Delusions are characterised by their epistemic shortcomings and they are often defined as false and irrational beliefs. Despite this, when agents are overwhelmed by negative emotions due to the effects of trauma or previous adversities, or when they are subject to anxiety and stress as a result of hypersalient experience, the adoption of a delusional belief can prevent a serious epistemic harm from occurring. For instance, delusions can allow agents to remain in touch with their environment overcoming the disruptive effect of negative emotions and anxiety. Moreover, agents are not blameworthy for adopting their delusions if their ability to believe otherwise is compromised. There is evidence suggesting that no evidence-related action that would counterfactually lead them to believe otherwise is typically available to them. The lack of ability to believe otherwise, together with some other conditions, implies that the agents are not blameworthy for their delusions. The examination of the epistemic status of delusions prompts us to acknowledge the complexity and contextual nature of epistemic evaluation, establish connections between consequentialist and deontological frameworks in epistemology, and introduce the notion of epistemic innocence into the vocabulary of epistemic evaluatio