439 research outputs found

    Using patient value statements to develop a culture of patient-centred care: a case study of an Ontario, Canada hospital

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    Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario hospital operationalized their patient value statement in policy and practice. The objectives of this research were to: a) understand what role the patient value statement played in policy and practice within a leading Ontario hospital and b) to examine how a leading Ontario hospital incorporated these values into their overarching organizational structures. This was a qualitative case study, which took place in a leading patient-centred Ontario hospital. The study included 18 interviews with employees and patient/family advisors. The analysis found a five-step process including: 1) setting the stage, 2) inspiring change, 3) organizational capacity, 4) barriers, and 5) reflection and improvement. This study has highlighted the role of a patient value statement within a leading Ontario hospital. The findings provide a five-step process with 12 core strategies for creating change in a healthcare organization; to embed a culture of patient-centred care

    Political Commitment and Sense of Social Responsibility among Social Entrepreneurs in Davao City, Philippines

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    Social entrepreneurs can play a game-changing role in local and national development by introducing social innovation. Strongly committed and mission- driven, they employ entrepreneurial schemes to organize and manage resources through financially sound and economically sustainable entities in order to create social value. This study aimed to determine the levels of political commitment and sense of social responsibility among social entrepreneurs of small and medium-sized social enterprises in Davao City. Using the non-experimental descriptive correlation method to gather survey inputs from 47 respondents, the researchers found that the respondents exhibited high levels of political commitment and sense of social responsibility. Furthermore, a significant relationship existed between political commitment and sense of social responsibility. When analyzed according to sex, no significant difference was observed in the level of political commitment. However, a significant difference appeared when analyzed according to type of business venture. No significant difference was ever observed in the level of sense of social responsibility in both variables

    Policy Implementation in Higher Education: The Dynamics of a Fall Break

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    A case study using mixed methods that critically appraises the implementation of a mental health policy in higher education in the absence of evidence to inform the policy using an exemplar case from one mid-sized post-secondary institution was the motivation for this research. Explanation building was used to iteratively analyse data on rival explanations of the implementation of the fall break policy. Analyses from the surveys revealed that overall, only 36.9 per cent of students perceived an increase in workload before the break and only 29.6 per cent of students perceived an increase in workload after the break. However, the focus groups and professor interviews revealed that the timing of the fall break had an impact on how students and professors experienced the break and their perceptions on its impact on student mental health. If baseline data regarding the implementation of the fall break would have been collected prior to its implementation, we could have possibly avoided the implementation issues that arose. While this research provides an exemplar case of a fall break policy at one post-secondary institution, the policy learning is universal

    Evolutionary history of anglerfishes (Teleostei: Lophiiformes): a mitogenomic perspective

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    <p>Abstract</p> <p>Background</p> <p>The teleost order Lophiiformes, commonly known as the anglerfishes, contains a diverse array of marine fishes, ranging from benthic shallow-water dwellers to highly modified deep-sea midwater species. They comprise 321 living species placed in 68 genera, 18 families and 5 suborders, but approximately half of the species diversity is occupied by deep-sea ceratioids distributed among 11 families. The evolutionary origins of such remarkable habitat and species diversity, however, remain elusive because of the lack of fresh material for a majority of the deep-sea ceratioids and incompleteness of the fossil record across all of the Lophiiformes. To obtain a comprehensive picture of the phylogeny and evolutionary history of the anglerfishes, we assembled whole mitochondrial genome (mitogenome) sequences from 39 lophiiforms (33 newly determined during this study) representing all five suborders and 17 of the 18 families. Sequences of 77 higher teleosts including the 39 lophiiform sequences were unambiguously aligned and subjected to phylogenetic analysis and divergence time estimation.</p> <p>Results</p> <p>Partitioned maximum likelihood analysis confidently recovered monophyly for all of the higher taxa (including the order itself) with the exception of the Thaumatichthyidae (<it>Lasiognathus </it>was deeply nested within the Oneirodidae). The mitogenomic trees strongly support the most basal and an apical position of the Lophioidei and a clade comprising Chaunacoidei + Ceratioidei, respectively, although alternative phylogenetic positions of the remaining two suborders (Antennarioidei and Ogcocephaloidei) with respect to the above two lineages are statistically indistinguishable. While morphology-based intra-subordinal relationships for relatively shallow, benthic dwellers (Lophioidei, Antennarioidei, Ogcocephaloidei, Chaunacoidei) are either congruent with or statistically indistinguishable from the present mitogenomic tree, those of the principally deep-sea midwater dwellers (Ceratioidei) cannot be reconciled with the molecular phylogeny. A relaxed molecular-clock Bayesian analysis of the divergence times suggests that all of the subordinal diversifications have occurred during a relatively short time period between 100 and 130 Myr ago (early to mid Cretaceous).</p> <p>Conclusions</p> <p>The mitogenomic analyses revealed previously unappreciated phylogenetic relationships among the lophiiform suborders and ceratioid familes. Although the latter relationships cannot be reconciled with the earlier hypotheses based on morphology, we found that simple exclusion of the reductive or simplified characters can alleviate some of the conflict. The acquisition of novel features, such as male dwarfism, bioluminescent lures, and unique reproductive modes allowed the deep-sea ceratioids to diversify rapidly in a largely unexploited, food-poor bathypelagic zone (200-2000 m depth) relative to the other lophiiforms occurring in shallow coastal areas.</p

    Eddy-Current Testing For A Thick Sus Plate

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    Immunogenicity of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Ad26.CoV2.S Vaccination in People Living With Human Immunodeficiency Virus (HIV)

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    BACKGROUND: People living with HIV (PLWH) have been reported to have a higher risk of more severe Covid-19 disease and death. We assessed the ability of the Ad26.CoV2.S vaccine to elicit neutralizing activity against the Delta variant in PLWH relative to HIV-negative individuals. We also examined effects of HIV status and suppression on Delta neutralization response in SARS-CoV-2 infected unvaccinated participants. METHODS: We enrolled participants who vaccinated through the SISONKE South African clinical trial of the Ad26.CoV2.S vaccine in health care workers (HCW). PLWH in this group had well controlled HIV infection. We also enrolled unvaccinated participants previously infected with SARS-CoV-2. Neutralization capacity was assessed by a live virus neutralization assay of the Delta variant. RESULTS: Majority of Ad26.CoV2.S vaccinated HCW were previously infected with SARS-CoV-2. In this group, Delta variant neutralization was 9-fold higher compared to the infected only group and 26-fold higher relative to the vaccinated only group. No decrease in Delta variant neutralization was observed in PLWH relative to HIV-negative participants. In contrast, SARS-CoV-2 infected, unvaccinated PLWH showed 7-fold lower neutralization and a higher frequency of non-responders, with the highest frequency of non-responders in people with HIV viremia. Vaccinated only participants showed low neutralization capacity. CONCLUSIONS: The neutralization response of the Delta variant following Ad26.CoV2.S vaccination in PLWH with well controlled HIV was not inferior to HIV-negative participants, irrespective of past SARS-CoV-2 infection. In SARS-CoV-2 infected and non-vaccinated participants, HIV infection reduced the neutralization response to SARS-CoV-2, with the strongest reduction in HIV viremic individuals

    SHARAQ Project: Progress in 2009

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    On March 23, 2009, the first beam was successfullytransported to the final focal plane of the SHARAQspectrometer. We investigated detector responses toheavy-ion beams and the ion optical properties ofthe SHARAQ spectrometer1) and the high-resolutionbeam line2) in the subsequent commissioning runs andfound that the system as a whole worked almost as perits design. The first physics run with the spectrometerwas performed in November 2009. In this article, wereview the progress in the SHARAQ project in 2009
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