Does Governance Affect Organizational Performance? Governance Structure and Hospital Performance in Tennessee

It is critical for a hospital to perform efficiently, to provide quality healthcare, and to maintain a high reputation in the community which the hospital serves. Since hospital governing boards are charged with ensuring high performance on the part of the hospital, it is important to understand the features of governing boards that contribute positively to hospital performance. This study investigates the relationship between hospital governance and hospital performance in Tennessee. It measures the performance of 125 community hospitals during the years 2008-2012 using data envelopment analysis (DEA). This study found that hospitals with a corporate governance model had higher performance than hospitals with a philanthropic governance one

HUBUNGAN ANTARA PENGETAHUAN DAN SIKAP IBU TENTANG ASI EKSKLUSIF DENGAN PEMBERIAN ASI EKSKLUSIF PADA BAYI DI GAMPONG LAMGUGOB KECAMATAN SYIAH KUALA BANDA ACEH TAHUN 2012

KEMENTRIAN PENDIDIKAN NASIONALUNIVERSITAS SYIAH KUALAFAKULTAS KEDOKTERANPROGRAM STUDI ILMU KEPERAWATANSKRIPSIxiv Halaman + VI Bab + 67 Halaman + 8 Tabel + 1 Skema + 16 LampiranERI MAULIDAR1007101190027HUBUNGAN ANTARA PENGETAHUAN DAN SIKAP IBU TENTANG ASI EKSKLUSIF DENGAN PEMBERIAN ASI EKSKLUSIF PADA BAYI DI GAMPONG LAMGUGOB KECAMATAN SYIAH KUALA BANDA ACEH TAHUN 2012ABSTRAKPemberian air susu ibu (ASI) eksklusif, belum begitu populer di masyarakat Banda Aceh. Bahkan, banyak ibu melahirkan belum mengetahui pentingnya pemberian ASI eksklusif kepada bayi yang baru dilahirkan. Rendahnya pemahaman masyarakat terkait ASI eksklusif, karena pengaruh mitos yang sudah berkembang secara turun-temurun, menyebabkan tidak berhasilnya pemberian ASI eksklusif. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan ibu tentang ASI eksklusif dengan pemberian ASI eksklusif pada bayi, dan hubungan antara sikap ibu tentang ASI eksklusif dengan pemberian ASI ekeklusif pada bayi di Gampong Lamgugob Kecamatan Syiah Kuala Banda Aceh Tahun 2012. Desain penelitian bersifat deskriptif korelatif dan teknik pengambilan sampel menggunakan total sampling yaitu 52 responden. Instrumen penelitian berupa kuesioner dengan teknik wawancara terpimpin, waktu penelitian dilakukan 10-14 Oktober 2012, metode analisis data menggunakan uji chi-square. Hasil univariat menunjukkan (50%) responden, berada pada katagori pengetahuan tinggi, (52%) responden menunjukkan sikap baik, (29%) responden berada pada katagori eksklusif dalam memberikan ASI eksklusif pada bayi di Gampong Lamgugob Kecamatan Syiah Kuala Banda Aceh. Hasil analisis bivariat di dapatkan tidak ada hubungan antara pengetahuan ibu tentang ASI eksklusif dengan pemberian ASI eksklusif pada bayi (p-value 0,066), ada hubungan antara sikap ibu tentang ASI eksklusif dengan pemberian ASI eksklusif pada bayi (p-value 0,004) di Gampong Lamgugob Kecamatan Syiah Kuala Banda Aceh. Diharapkan kepada ibu untuk lebih dapat meningkatkan pengetahuan mengenai pemberian ASI eksklusif dan sikap yang positif terhadap ASI eksklusif sehingga program pemberian ASI eksklusif pada bayi berhasil dilakukan.Kata Kunci : pengetahuan, sikap, ASI eksklusifDaftar bacaan : 23 buku, 10 internet (2002-2012)Banda Ace

Korea’s technical assistance for better governance

노트 : - Paper for International Conference on U.S.-Korea Dialogue on Strategies for Effective Development Cooperation - Organized by Asia Foundation October 17-18, 2011 Seoul, Korea 행사명 : International Conference on U.S.-Korea Dialogue on Strategies for Effective Development Cooperatio

Decomposing Organizational Productivity Changes in Acute Care Hospitals in Tennessee, 2002-2006: A Malmquist Approach

After the passage of the Patient Protection and Affordable Care Act, the survival and the productivity of hospitals are a critical topic in health care management. This study measured the productivity of acute care hospitals in Tennessee, applying the DEA-Malmquist index, which can be decomposed into a technical efficiency and technological change index in relation to factors such as size, ownership, location, and network. This draws on utilization data and financial statements from 144 acute care hospitals in Tennessee from 2002 through 2006. The analysis indicates that community hospitals in Tennessee were generally inefficient. The community hospitals in Tennessee suffered both with respect to technological change and technical efficiency, with the latter playing a relatively more important role. This study finds the bigger-sized, urban, public or nonprofit, strategically allied hospitals to be more productive relatively speaking and suggests that community hospitals in Tennessee need to upsize their facilities or make other adjustments, such as changing their cost structure and the way they operate their facility or bringing in new management to increase productivity. Government and health policy makers also need to develop and enact health policies to ensure that hospitals are both able to make technical progress and improve efficiency and thereby increase productivity.This paper was supported by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2010-330-B00031 and NRF-2012-330-B00194)

Three-Dimensional Structure and Evolution of Extreme-Ultraviolet Bright Points Observed by STEREO/SECCHI/EUVI

We unveil the three-dimensional structure of quiet-Sun EUV bright points and their temporal evolution by applying a triangulation method to time series of images taken by SECCHI/EUVI on board the STEREO twin spacecraft. For this study we examine the heights and lengths as the components of the three-dimensional structure of EUV bright points and their temporal evolutions. Among them we present three bright points which show three distinct changes in the height and length: decreasing, increasing, and steady. We show that the three distinct changes are consistent with the motions (converging, diverging, and shearing, respectively) of their photospheric magnetic flux concentrations. Both growth and shrinkage of the magnetic fluxes occur during their lifetimes and they are dominant in the initial and later phases, respectively. They are all multi-temperature loop systems which have hot loops (approx. 10(exp 6.2) K) overlying cooler ones (approx 10(exp 6.0) K) with cool legs (approx 10(exp 4.9) K) during their whole evolutionary histories. Our results imply that the multi-thermal loop system is a general character of EUV bright points. We conclude that EUV bright points are flaring loops formed by magnetic reconnection and their geometry may represent the reconnected magnetic field lines rather than the separator field lines

[Fe II] and H2 filaments in the Supernova Remnant G11.2-0.3: Supernova Ejecta and Presupernova Circumstellar Wind

We present the results of near-infrared imaging and spectroscopic observations of the young, core-collapse supernova remnant (SNR) G11.2-0.3. In the [Fe II] 1.644 um image, we first discover long, clumpy [Fe II] filaments within the radio shell of the SNR, together with some faint, knotty features in the interior of the remnant. We have detected several [Fe II] lines and HI Br-G line toward the peak position of the bright southeastern [Fe II] filament. The derived extinction is large (Av=13 mag) and it is the brightest [Fe II] filament detected toward SNRs to date. By analyzing two [Fe II] 1.644 um images obtained in 2.2 yrs apart, we detect a proper motion corresponding to an expansion rate of 0.''035 (0.''013) /yr [or 830 (310) km/s]. We also discover two small H2 filaments. One is bright and along the SE boundary of the radio shell, while the other is faint and just outside of its NE boundary. We have detected H2 (2-1) S(3) line toward the former filament and derive an excitation temperature of 2,100 K. We suggest that the H2 filaments are dense clumps in a presupernova circumstellar wind swept up by the SNR shock while the [Fe II] filaments are probably composed of both shocked wind material and shocked supernova (SN) ejecta. The distribution of [Fe II] filaments may indicate that the SN explosion in G11.2-0.3 was asymmetric as in Cassiopeia A. Our results support the suggestion that G11.2-0.3 is a remnant of a SN IIL/b interacting with a dense red supergiant wind.Comment: 30 pages with 10 figures, To appear in the Astrophysical Journa

2D solar wind speeds from 6 to 26 solar radii in solar cycle 24 by using Fourier filtering

Measurement of the solar wind speed near the Sun is important for understanding the acceleration mechanism of the solar wind. In this study, we determine 2D solar wind speeds from 6 to 26 solar radii by applying Fourier motion filters to \textit{SOHO}/LASCO C3 movies observed from 1999 to 2010. Our method successfully reproduces the original flow speeds in the artificially generated data as well as streamer blobs. We measure 2D solar wind speeds from 1-day to 1-year timescales and their variation in solar cycle 24. We find that the solar wind speeds at timescales longer than a month in the solar maximum period are relatively uniform in the azimuthal direction, while they are clearly bimodal in the minimum period, as expected from the \textit{Ulysses} observations and IPS reconstruction. The bimodal structure appears at around 2006, becomes most distinctive in 2009, and abruptly disappears in 2010. The radial evolution of the solar wind speeds resembles the Parker's solar wind solution.Comment: 7 pages, 5 figures; accepted by PR

Accelerating and Supersonic Density Fluctuations in Coronal Hole Plumes: Signature of Nascent Solar Winds

Slow magnetoacoustic waves in a static background provide a seismological tool to probe the solar atmosphere in the analytic frame. By analyzing the spatiotemporal variation of the electron number density of plume structure in coronal holes above the limb for a given temperature, we find that the density perturbations accelerate with supersonic speeds in the distance range from 1.02 to 1.23 solar radii. We interpret them as slow magnetoacoustic waves propagating at about the sound speed with accelerating subsonic flows. The average sonic height of the subsonic flows is calculated to be 1.27 solar radii. The mass flux of the subsonic flows is estimated to be 44.1$\%$ relative to the global solar wind. Hence, the subsonic flow is likely to be the nascent solar wind. In other words, the evolution of the nascent solar wind in plumes at the low corona is quantified for the first time from imaging observations. Based on the interpretation, propagating density perturbations present in plumes could be used as a seismological probe of the gradually accelerating solar wind.Comment: Accepted for publication in ApJL, 11 pages, 5 figure

Tide-related changes in mRNA abundance of aromatases and estrogen receptors in the ovary and brain of the threespot wrasse Halichoeres trimaculatus

Author Posting. © The Author(s), 2018. This is the author's version of the work. It is posted here under a nonexclusive, irrevocable, paid-up, worldwide license granted to WHOI. It is made available for personal use, not for redistribution. The definitive version was published in Ocean Science Journal 53 (2018): 239-249, doi:10.1007/s12601-018-0016-0.The threespot wrasse (Halichoeres trimaculatus; Family Labridae) is a common coral reef species of the Indo-Pacific Ocean. Given that this species spawns daily at high tide (HT), we hypothesized that endocrine changes in relation to gonadal development are synchronized with the tidal cycle. To test this, we examined the transcript abundance of two cytochrome P450 aromatases (cyp19a and cyp19b) and two estrogen receptors (er and er) in the ovary and brain of this species in response to tidal change. When fish were collected around four tidal points [low tide (LT), flood tide (FT), high tide (HT), and ebb tide (ET)], gonadosomatic index and oocyte diameter increased around HT and FT, respectively. Ovulatory follicles were observed in ovaries around HT. Real-time quantitative polymerase-chain reaction revealed that mRNA abundance of cyp19a and er, but not er, in the ovary increased around ET and HT, respectively. On the other hand, mRNA levels of cyp19b in the forebrain were significantly higher around FT. Increases of er and er mRNA abundance around FT were observed in all areas of the brain and the midbrain, respectively. The changes in mRNA abundance of key genes involved in reproduction at specific tidal cycles, along with the development of the vitellogenic oocytes in the ovary, support our hypothesis that synchronization of endocrine changes to the tidal periodicity plays a role in the gonadal development of this species. We hypothesize that conversion of testosterone to E2 in the brain may be associated with the spawning behavior given that the wrasse exhibits group spawning with a territory-holding male around HT.This study was supported partially by the 21st Century COE program “The Comprehensive Analyses on Biodiversity in Coral Reef and Island Ecosystems in Asian and Pacific Regions” from the Ministry of Education, Culture, Sports, Science and Technology, Japan, JSPS KAKENHI Grant number 16H05796, and the Natural Sciences and Engineering Research Council (NSERC, Canada) Discovery Grant program