Orientation to mission: Assessing the perceptions of effectiveness of an in-house orientation program focussed on mission, vision and values within a large-scale, not-for-profit, private hospital

St John of God Healthcare (SJGHC), as a large Catholic, not-for-profit, healthcare provider, has explicit statements which reflect the Mission, Vision and Values of the organisation. New employees receive a comprehensive induction and orientation program, part of which includes ensuring new recruits are conversant with the Mission, Vision and Values. This program is deemed as formation, rather than training, to reflect a desire for the input to have a direct and personal impact on new employees, to increase their motivation and engagement with the ideals of the organisation. This research attempted to measure the perceived efficacy of the Mission component of Orientation at one particular SJGHC site, the hospital located in Subiaco, Western Australia, through both participant surveys and interviews. The results of 120 surveys were analysed and 16 semi-structured interviews were used to validate and probe information obtained from the participant surveys. Importantly, the research demonstrated that the session was perceived as valuable by participants and showed an increase in knowledge. This research has led to further ongoing research to determine if the perceptions of patients and their visitors align with staff perceptions of the way Mission is integrated in to the life of this hospital. The latter work will provide an important adjunct to this project since the work of hospital staff is ultimately not measured by individual staff members’ knowledge, attitude or intentions, but by how their work impacts on the patients and their visitors

The experiences of medical students and junior doctors with dyslexia: a survey study

Little research exists concerning dyslexia in medical education. A qualitative study highlighted issues such as bullying and a lack of support. This project aimed to quantify those findings. An online survey was sent to junior doctors in parts of the United Kingdom. Seventy-five participated. Most (53%) were diagnosed with dyslexia at university / medical school. Most reported that dyslexia impacted upon their self-image (59%) and self-esteem (73%). Nearly half (46%) felt it influenced their career pathway choices within medicine. Participants reported bullying at medical school-from peers (24%), from academic teachers (14%), and from clinical teachers (27%); and also at work-from peers (25%), from academic teachers (13%), and from clinical teachers (23%). 88% reported that foundation schools provided no support, 92% that NHS Trusts provided none, and 90% that their deaneries provided none. The sorts of supports which seemed to be lacking were "psychological" or "pastoral" supports

Portal vein grafts in hepatic transplantation

Confirmation of patency of the portal vein by either ultrasound or angiography is a routine part of the evaluation of patients being considered for hepatic transplantation. Complete thrombosis of the portal vein usually has been viewed as precluding successful orthotopic hepatic replacement. In addition, some pediatric patients present with extremely small portal veins which, although patent, have proved to be thick walled and sclerotic. Our recent experience has shown that, in both of these situations, successful and complete revascularization of hepatic allografts is quite feasible by using a vein graft to ensure adequate portal venous flow

Formation of porous surface layers in reaction bonded silicon nitride during processing

An effort was undertaken to determine if the formation of the generally observed layer of large porosity adjacent to the as-nitride surfaces of reaction bonded silicon nitrides could be prevented during processing. Isostatically pressed test bars were prepared from wet vibratory milled Si powder. Sintering and nitriding were each done under three different conditions:(1) bars directly exposed to the furnance atmosphere; (2) bars packed in Si powder; (3) bars packed in Si3N4 powder. Packing the bars in either Si of Si3N4 powder during sintering retarded formation of the layer of large porosity. Only packing the bars in Si prevented formation of the layer during nitridation. The strongest bars (316 MPa) were those sintered in Si and nitrided in Si3N4 despite their having a layer of large surface porosity; failure initiated at very large pores and inclusions. The alpha/beta ratio was found to be directly proportional to the oxygen content; a possible explanation for this relationship is discussed

Capturing the scale and pattern of recurrent care proceedings: initial observations from a feasibility study

This article reports the initial findings of a feasibility study that has captured the scale and pattern of recurrent care proceedings. Although frontline professionals have reported long-standing concerns about the repeat clients of public law proceedings, prior to the study we report, the scale of the problem has been unknown. With funding from the Nuffield Foundation and support from the Child and Family Court Advisory Service (CAFCASS) and the President of the Family Division, the research team has arrived at a first estimate of prevalence, confirming that recurrence is a sizeable problem for the English family court. Based on cases that completed during the observational window 2007-2013 (calendar years), 7,143 birth mothers appeared in 15,645 recurrent care applications concerning 22,790 infants and children. Moreover, the study most likely underestimates recurrence, because reliable data concerning completed cases is not available before 2007. Initial observations are that the spacing between recurrent care proceedings is very short, which raises searching questions about prevention. Where episodes of care proceedings follow in swift succession, most likely prompted by the birth of another infant, this affords mothers little opportunity to effect change. Unless, this ‘status quo’ is tackled, it is difficult to envisage how vulnerable birth mothers can exit this cycle. Preliminary recommendations are made in respect of policy and practice change

AGRICULTURAL AND RECREATIONAL IMPACTS FROM SURFACE FLOW CHANGES DUE TO GOLD MINING OPERATIONS

Nevada ranks third in the world in gold production. In order to operate the massive open pit gold mines, the State of Nevada granted mining companies a temporary permit to pump groundwater from near the open pits and dispose of it. Certain instream flows have nearly doubled relative to average historical flows in recent years. Following pit closure, surface flows will likely decline from historical levels. This study measures the impacts of these changing water supplies on downstream agricultural and recreational users. We argue that the creation of temporary changes in water rights for the downstream users would likely mitigate future losses both groups are expected to experience.Resource /Energy Economics and Policy,

Design of experiment for the optimisation of deep reactive ion etching of silicon inserts for micro-fabrication

The following paper describes a design of experiments investigation of the deep reactive of pillar structures on a silicon wafer. The etched wafers would subsequently be used as masters for the fabrication of nickel mould inserts for microinjection moulding. Undercuts occur when the pillar base has a smaller cross-section than the apex of the pillar. They therefore affect tolerances of the subsequent nickel mould, its strength and its de-mouldability from the silicon form. The response measured in these experiments was the degree of undercut of micro-scale (10 μm x 10 μm x 40 μm, 5 μm x 5 μm x 40 μm and 2 μm x 2 μm x 40 μm) The literature suggests that gas pressure, platen power, gas flow rate, phase switching times and mask size can all affect the degree of undercut. After examination of this literature, and of manufacturers guidelines, three parameters were selected for experimental testing: platen power, C 4F 8 gas flow rate during the passivation phase and switching times. Switching times was found to be the only statistically significant parameter for both 10x10 μm and 5x5 μm pillars. The 2x2 μm pillars were not successfully replicated and could therefore not undergo statistical evaluation

Management of RH Services in India and the Need for Health System Reform

For the last ten to fifteen years, a comprehensive agenda of health sector reforms and health systems development has engulfed the health system in many countries in structural and organisational changes. Experience with varying degrees and types of reforms have now been reported from many countries. In our paper, we begin by describing some important issues facing the management of RH programs in India, based on our research done in a few states over the last five years. The failures in the management of RH services are complex and multi-factorial, and cannot all be addressed through health system reform. It is therefore necessary to identify which failures in service are attributable to causes, which could be removed or changed by reform in the health system. In our paper, we identify those failures and causes which could be corrected through health system reforms and propose certain concrete steps to expedite the reforms in the health system to enable the improvement of RH services in India.