3,014 research outputs found

    Monitoring Hospital Safety Climate Using Control Charts of Non-harm Events in Reporting Systems

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    The primary aim of this thesis is to design an approach and demonstrate a methodology to supplement safety culture assessment efforts. The framework affords an enhanced understanding of hospital safety climate, specifically reporting culture, through the use of control charts to monitor non-harm patient safety events documented in reporting systems. Assessing safety culture and climate remains difficult. One of the most common methods to assess safety culture is a self-report survey administered annually. Surveys assess safety climate, because they are a snapshot of the management\u27s and front-line staff\u27s perceptions of safety within their settings. One component of safety culture is reporting culture, which is assessed by survey questions targeting the total number and frequency of events reported by individuals. Surveys use subjective data to measure outcome variables with regard to patient safety event reporting. Relying on subjective data when organizations also collect data on actual reporting rates may not be optimal. Additionally, the time lag limits management\u27s ability to efficiently assess the need for, and the effect of improvements. Strategic interventions may result in effective change, but annual summary data may mask the effects. Additionally, there are advantages to focusing on non-harm events, and capturing non-harm event reporting rates may aid safety climate assessment. Despite the limitations of reporting systems, incorporating actual data may allow organizations to gain a more accurate depiction of the safety climate and reporting culture. With the increased prevalence of reporting systems in healthcare organizations, the data can be used to track and trend reporting rates of the organization. Incorporating control charts can help identify expected non-harm event reporting rates, and can be used to monitor trends in reporting culture. Data in reporting systems are continuously updated allowing quicker assessment and feedback than annual surveys. The methodology is meant to be prescriptive and uses data that hospitals typically collect. Hospitals can easily follow the summarized approach: check for underlying data assumptions, construct control charts, monitor and analyze those charts, and investigate special cause variation as it arises. The methodology is described and demonstrated using simulated data for a hospital and three of its departments

    Herreshoff Marine Museum: Historical Analysis

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    These methods that Herreshoff utilized can be classified as early stages of the LEAN manufacturing concept which is used today in a majority of America’s leading manufacturers. Herreshoff made sure that his entire inventory was used and nothing was wasted. By reducing/eliminating waste, Nat preserved the value of his products and increased the efficiency of operation

    Tragic implications of man\u27s frustration by society in three of Dreiser\u27s novels.

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    The purpose of this paper is to examine three of Dreiser\u27s major novels in order (1) to show that his philosophy of life is exemplified in his fiction and (2) to determine whether or not his ideas undergo any change. The three novels chosen for this study are The Genius , An American Tragedy, and The Bulwark, because they cover a span of American life, as Dreiser saw it, from the time of his greatest productivity until his death--a period of thirty years. The first part of the thesis will contain: (1) a general background of the period of which Dreiser is a product and (2) Dreiser\u27s particular background and his attitude toward life. The second part will comprise an analysis of the novels under study, which are to be considered under three major headings: (1) attitude toward religion, (2) attitude toward sex, and (3) attitude toward economic status

    Enhanced production of a recombinant, thermostable [alpha]-amylase in streptomyces lividans: Effects of plasmid construction and culture condition

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    Members of the genus Streptomyces are well known for their ability to produce a wide range of antibiotics. In addition to this valuable attribute, many of these bacteria also secrete a variety of proteins. This has led to their being considered as alternative host organisms for the production of heterologous gene products. This work examines the potential of Streptomyces lividans as a host for the secretion of recombinant proteins using the production of a thermostable a-amylase as a model system. Two new streptomycete expression vectors were constructed. Incorporation of the sti region from pIJ101, which carries a site for second strand initiation of plasmid replication, was found to increase levels of a-amylase production by over 1000-fold. This was likely due to improvements in plasmid copy number and form. The study confirmed that use of promoter arrays to drive recombinant gene expression can be an effective way to achieve high level protein production. Over one and a half times more a-amylase was produced when Pmel was placed in tandem with Pamy in front of the a- amylase gene. As expected, medium composition also played an important role in determining the behaviour of the system. The most favourable condition for high level enzyme production was found to be minimal medium lacking rapidly metabolisable sugars. Glucose was found to repress production of the a-amylase in the S. lividans system, likely through the action of the Reg1 protein. A statistical experimental approach allowed the identification of other influential medium variables, with succinate, calcium and phosphate levels proving key. Unexpectedly, above optimal growth temperatures were found to significantly boost levels of a-amylase production from the S. lividans host. Possible reasons for this phenomenon are explored and discussed. In summary, this work highlights the strong potential of the Streptomyces system. It demonstrates that S. lividans can provide a viable, and competitive, alternative to E. coli as a host for the production of heterologous proteins

    Sound-symbol matching and blending ability among preschoolers as a function of distinctive feature training and language ability

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    Teaching preschoolers to note the distinctive features of letters has been proposed as an effective prereading activity. The current study investigated whether this method of visual discrimination training facilitates learning two reading-related tasks, mapping sounds to artificial symbols and blending sounds together, among four- and five-year-olds. The relationship between language ability and performance on these tasks was also examined;Previous findings with respect to distinctive feature training were replicated in that the successive mode of presentation of stimuli was more difficult than the simultaneous mode, and children\u27s ability to discriminate was retained over several days. However, no significant difference was found between the trained and untrained groups on the reading-related tasks. It was suggested that although a subset of preschoolers might benefit from such training, most preschoolers may learn to distinguish among highly similar letters while simultaneously learning to match sounds to symbols;Subjects\u27 language ability was unrelated to the ease with which distinctive feature training was mastered. However, the less sophisticated language group unexpectedly learned to match sounds to symbols in a significantly fewer number of trials than the more sophisticated language group. When the groups were compared on blending the more successful (although not to a statistically significant degree) than their less advanced counterparts. It was suggested that a rich linguistic background may have created interference on the matching-sounds-to-symbols task for subjects who were more advanced in language ability
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