Estimation of energy efficiency of residential buildings

Increasing energy performance of the residential buildings by means of reducing heat consumption on the heating and ventilation is the last segment in the system of energy resources saving. The first segments in the energy saving process are heat producing and transportation over the main lines and outside distribution networks. In the period from 2006 to 2013. by means of the heat-supply schemes optimization and modernization of the heating systems. using expensive (200-30

Nursing Facility Residents’ Cardiopulmonary Resuscitation Decisions

Context As many as one-quarter of all residents in nursing facilities have cardiopulmonary resuscitation (CPR) as a documented choice in the medical record, despite the likelihood of limited medical benefit in this setting. Objectives The aim of this study was to understand the perspectives of healthcare providers and nursing facility residents regarding CPR decisions. Methods We used qualitative interviews to examine the perspectives of residents with a documented decision for CPR in the medical record. We then compared residents’ views with those of healthcare providers who routinely conduct advance care planning (ACP) conversations in the nursing facility setting. Results Five themes emerged from the interviews: (a) Resident versus Provider Concerns, (b) Offering Information versus Avoidance, (c) Lack of Understanding of CPR, (d) Lack of Awareness, and (e) ‘Don't Keep Me on Machines'. Residents held misconceptions about CPR and/or exhibited an overall poor understanding of the relationship between their own health status and the likelihood of a successful CPR attempt. Although healthcare providers offer information and health education in an attempt to address knowledge gaps, these efforts are not always successful or even accepted by residents. Resident viewpoints and priorities differed from healthcare providers in ways that affected communication about CPR. Conclusions Unrecognised differences in perceptions between providers and residents affect key aspects of ACP communication that can impact CPR decision-making. The concerns and priorities of institutionalized older adults may differ from those of healthcare providers, creating challenges for engaging some residents in ACP. Implications for Practice ACP communication models and training should be designed not only to explore nursing facility residents' goals, values, and preferences, but also to elicit any underlying differences in perceptions that may affect communication. Healthcare providers can identifying the primary concerns of residents and assist them with integrating or reframing these issues as a part of ACP discussions

Evaluating beauty care provided by the hospital to women suffering from breast cancer: qualitative aspects

International audienceGOALS OF WORK: Cancer patients are offered more and more access to beauty care during their stay in the hospital. This kind of intervention has not been evaluated yet. Primary objective of our research was to determine what type of evaluation strategy to be implemented (as a supportive care with quality of life and/or medical benefits; as a service providing immediate comfort); intermediate objective was to investigate in scientific terms (psychological, sociological) the experience of beauty care by patients. PATIENTS AND METHODS: Sixty patients (all users of beauty care provided by hospital, 58 female, most of them treated for breast cancer, two male, mean age 53 years) and 11 nurses and physicians, from four French cancer centres were included. We used direct observation and semi-structured interviews, conducted by a sociologist and a psychologist; different types of beauty care were concerned. RESULTS: All the interviewed patients were satisfied. Patients appreciated acquiring savoir-faire on how to use make-up and on personal image enhancement. Psychological and social well-being benefits were mentioned. The beauty care was not alleged to be reducing the side effects of the treatments, but it had helped patients to accept or bear the burden of them. Providing care beyond that which is directly curative was appreciated by the patients as a sign that they were treated as a "whole" person. CONCLUSION: The survey brings valuable clues concerning beauty care experience by cancer patients; it suggests the relevance of quantitative evaluation of the immediate and long-term effects on the quality of life

Anointed or appointed? Father–daughter succession within the family business

With the focus on events and outcomes shaping most of the existing family business research on intra-family succession, the subtleties of the incumbent-successor relationship and the dynamic nature of succession as a process of becoming is somewhat neglected. In particular, we have limited understanding of how successor identities are constructed as legitimate between incumbent and successor during father-daughter succession. This article addresses this gap in understanding by exploring how the daughter successor engages in identity work with the father incumbent during the process of succession and the role of father-daughter gendered relations in shaping her successor identity. Using a two-stage research design strategy, we draw upon empirical evidence derived from 14 individual and joint semi-structured interviews to present a narrative analysis of five father-daughter dyads. In so doing, we unveil how the daughter’s successor identity was co-constructed as legitimate and how father-daughter gendered relations influenced this process. Although daughters rely on certain father-daughter relations (preparation, endorsement and osmotic credibility) for legitimacy, they also need to develop independently from their father in order to heighten their own visibility and establish credibility

COMPUTER-CONTROLLED GAS CHROMATOGRAPH CAPABLE OF ''REAL-TIME'' READOUT OF HIGH-PRECISION DATA.

A gas chromatograph has been assembled which provides computer control of sample injection, column temperature, and flow rate, plus direct computer readout of inlet pressure, mass flow rate, and detector response. Data processing yields, in real-time, a standard deviation of less than 0.05% in retention time, which is comparable to previous results obtained using an off-line computer. However, corrected retention volumes determined in real-time had a standard deviation of about 0.4% which reflected primarily the uncertainty in flow measurement

Performance feedback: An exploratory study to examine the acceptability and impact for interdisciplinary primary care teams

Background - This mixed methods study was designed to explore the acceptability and impact of feedback of team performance data to primary care interdisciplinary teams. // Methods - Seven interdisciplinary teams were offered a one-hour, facilitated performance feedback session presenting data from a comprehensive, previously-conducted evaluation, selecting highlights such as performance on chronic disease management, access, patient satisfaction and team function. // Results - Several recurrent themes emerged from participants' surveys and two rounds of interviews within three months of the feedback session. Team performance measurement and feedback was welcomed across teams and disciplines. This feedback could build the team, the culture, and the capacity for quality improvement. However, existing performance indicators do not equally reflect the role of different disciplines within an interdisciplinary team. Finally, the effect of team performance feedback on intentions to improve performance was hindered by a poor understanding of how the team could use the data. // Conclusions - The findings further our understanding of how performance feedback may engage interdisciplinary team members in improving the quality of primary care and the unique challenges specific to these settings. There is a need to develop a shared sense of responsibility and agenda for quality improvement. Therefore, more efforts to develop flexible and interactive performance-reporting structures (that better reflect contributions from all team members) in which teams could specify the information and audience may assist in promoting quality improvement

Mix of methods is needed to identify adverse events in general practice: A prospective observational study

Contains fulltext : 69425.pdf ( ) (Open Access)BACKGROUND: The validity and usefulness of incident reporting and other methods for identifying adverse events remains unclear. This study aimed to compare five methods in general practice. METHODS: In a prospective observational study, with five general practitioners, five methods were applied and compared. The five methods were physician reported adverse events, pharmacist reported adverse events, patients' experiences of adverse events, assessment of a random sample of medical records, and assessment of all deceased patients. RESULTS: A total of 68 events were identified using these methods. The patient survey accounted for the highest number of events and the pharmacist reports for the lowest number. No overlap between the methods was detected. The patient survey accounted for the highest number of events and the pharmacist reports for the lowest number. CONCLUSION: A mix of methods is needed to identify adverse events in general practice