A QUANTITATIVE ASSESSMENT OF E-GROCERS

Agribusiness,

Medicine needs to swallow a bitter pill for a healthier future

Many doctors will recall as a student or trainee hanging nervously off the end of a Deaver – a large retractor used in pre-keyhole gall bladder surgery – while simultaneously trying to answer the surgeon’s barked questions about the anatomy in the cavity. The problem is you can’t actually see into the cavity without loosening your grip. A looser grip means less vision for the surgeon and usually a torrent of abuse for the trainee. Such moments of “teaching by humiliation” during medical training underscore the nature of medical culture: a totem pole that places surgeons very much at the top. Indeed, doctors have long enjoyed both enormous autonomy and deference to their apparent god-like power to stave off death. Within this mythology, medicine has built a hierarchical and autocratic workplace culture in which incivility, and even frank bullying, towards subordinates is commonplace. Medical students gradually acculturate to this during their training, often at the cost of their empathy and compassion. A recent meta-analysis of 51 studies on harassment and discrimination in medical training showed 59.4% of medical trainees had experienced at least one form of these. “Teaching by humiliation” – regarded by some as a kind of necessary hardening experience – was experienced by 74% of students and witnessed by 84%. Many still felt the sting decades later. Such power-oriented, stratified workplaces are good for no one. And, in medicine, many of the worst consequences fall on patients

TRACKING THE EVOLUTION OF E-GROCERS: A QUANTITATIVE ASSESSMENT

Forecasts of the proportion of food retailing likely to be conducted over the Internet remain small, perhaps only contributing 2 percent of sales. One reason for this low market share is the challenge E-Grocers face in developing strategies which respond to four key areas of interest to consumers: signals of firm quality; signals of product quality; the range of products offered; and service, or customer-relationship management (CRM). Careful attention to these consumer concerns is important in all retail relationships–-online or offline. This paper compares indicators of these factors across U.S. E-Grocers. A quantitative four-period ranking of online food-retailing strategies is presented for the nascent industry. Data from the third and fourth quarters of 2001, the fourth quarter of 2002, and the first quarter of 2004 provide the basis of this discussion. After initial setbacks, data show traditional ("“bricks”") grocery retailers successfully developing online strategies. Firms not primarily focused on groceries exited the E-Grocery sector, while the development of specialty food suppliers blurred the concept of online food retailing. Gaps in current strategies are indicated using content analyses of E-Grocery web sites.Agribusiness,

Equity and career-life balance in marine mammal science?

It is widely acknowledged that family and care-giving responsibilities are driving women away from Science, Technology, Engineering, and Mathematics (STEM) fields. Marine mammal science often incurs heavy fieldwork and travel obligations, which make it a challenging career in which to find work-life balance. This opinion piece explores gender equality, equity (the principles of fairness that lead to equality), and work-life balance in science generally and in this field in particular. We aim to (1) raise awareness of these issues among members of the Society for Marine Mammalogy; (2) explore members’ attitudes and viewpoints collected from an online survey and further discussion at a biennial conference workshop in 2015; and (3) make suggestions for members to consider for action, or for the Board of Governors to consider in terms of changes to policy or procedures. Leaks in our pipeline—the attrition of women, and others with additional caring responsibilities—represent an intellectual and economic loss. By striving for equity and promoting work-life balance, we will help to ensure a healthy and productive Society better able to succeed in its aims promoting education, high quality research, conservation, and management of marine mammals.Publisher PDFPeer reviewe

Zoonotic disease risk perceptions and infection control practices of Australian veterinarians: Call for change in work culture

This study was conducted to determine the perceptions of zoonotic disease risk among Australian veterinarians, the infection control practices they use to protect themselves from zoonotic diseases, and the factors influencing their use of these protective practices. A questionnaire was designed and piloted prior to its administration to veterinarians at the annual Australian Veterinary Association Conference in May 2011. The questionnaire comprised 21 closed, semi-closed and open questions. Data from the questionnaire were analyzed using ordinal logistic regression analyses to determine significant factors for veterinarians’ use of personal protective equipment (PPE). A total of 344 veterinarians completed the questionnaire of which 63.7% were women, 63.2% worked in small/companion animal practice, and 79.9% worked in private veterinary practice. Of the respondents, 44.9% reported contracting a zoonosis during their careers with 19.7% reporting a suspected case and 25.2% reporting a confirmed incidence. Around 40–60% of veterinarians perceived exposure to zoonosis likely or very likely in a variety of situations. With reference to current national industry guidelines, the reported use of PPE was less than “adequate” for most scenarios except for performing postmortems, surgery or dental procedures. No PPE was used by 60–70% of veterinarians for treating respiratory and neurological cases and by 40–50% when treating gastrointestinal and dermatological cases. Workplace conditions need improvement as 34.8% of workplaces did not have isolation units for infected animals, 21.1% did not have separate eating areas for staff, and 57.1% did not have complete PPE kits for use. Veterinarians were more likely to use PPE if they had undertaken postgraduate education, perceived that zoonosis exposure from animals and procedures was likely, consciously considered PPE use for every case they dealt with and believed that liability issues and risks encouraged use of PPE. In contrast, those working in private practices, those who tended to ‘just hope for the best’ when trying to avoid zoonotic diseases, and those who were not aware of industry guidelines were less likely to use PPE. The results suggest that veterinarians’ perceptions and workplace policies and culture substantially influence their use of PPE. Efforts should be made to encourage veterinarians and their workplaces to use infection control practices to protect themselves and their staff from zoonotic diseases

Mistreatment in Australian medical education: a student-led scoping of experiences

Background: Evidence of bullying and harassment of medical students and junior doctors has existed for over 30 years. However, there has been little attempt to explore the dimensions of this issue in Australia to date. Given the evidence which indicates that experiencing abusive behaviour has a detrimental effect on professional identity formation and on mental health, the Australian Medical Students’ Association (AMSA) undertook a national scoping study to better understand the experiences of Australian medical students. Methods: We conducted a mixed methods survey of the 16,959 students enrolled in a medical degree at an Australian university in 2015. An anonymous, voluntary online questionnaire was distributed through AMSA’s social media, email newsletter and website, and medical students’ societies. Results: We received 519 responses, including 194 (37%) detailing at least one incident of bullying or harassment. 335 (65%) survey respondents were women and 345 (67%) were in the clinical years of their training. 60% of all respondents reported experiencing or witnessing mistreatment during their medical education. The most common theme in the free text was belittlement of the student’s competence and capacity to be a good doctor. Some gave details about how universities failed to prevent or appropriately respond to students’ experiences of bullying and harassment. Conclusion: In line with international data, this study shows that many Australian medical students perceive mistreatment as an important problem that is not always managed well by faculties. Multi-pronged policy and practice responses are needed to instigate cultural change in Australian medical education

Response to Kamath et al 'A syncretic approach can yield dividends'

We welcome the response from Kamath et al. and their insight into the issues and culture within medicine in India, and their thoughts about how to address these issues. We also agree that a drama-based approach is not sufficient on its own to deal with entrenched power issues which affect students adversely. As we have indicated, we believe “a multipronged approach is needed to generate systemic change.” These authors similarly advocate that student mistreatment be dealt with “in a comprehensive manner” including a ‘grievance redressal system’ and other measures to withhold accreditation where there are issues of abuse of power. Nevertheless, we note that Kamath et al. have responded positively to our approach—as a part of that mix—and it would be of great interest to see whether drama-based workshops could support medical students developing embodied acting skills in their institution and whether they may have similar transformative effects. We’d like to refer the authors to an excellent Medical Humanities paper we referenced that outlined drama-based activities in medical education in India: Gupta S, Singh S. Confluence: understanding medical humanities through street theatre. Medical Humanities. 2011;37(2):127-128. Despite the above article, the authors note that medical education in India has not embraced the medical humanities. We would draw a distinction within the medical humanities between activities which are primarily studious (reading literature, studying medical history) and workshops that are based on participative and embodied activity. Our experience has indicated the effectiveness of drama-based workshops in addressing both the cognitive and emotive aspects of harmful practices and we believe that it is the embodied nature of acting skills workshops that is transformative

A Prospective Longitudinal Assessment of Medical Records for Diagnostic Substitution among Subjects Diagnosed with a Pervasive Developmental Disorder in the United States

Background: Previously, investigators suggested that diagnostic substitution from other diagnoses, e.g., mental retardation (MR) and/or cerebral palsy (CP) to pervasive developmental disorder (PDD) is a driving factor behind increases in PDD. This study evaluated potential diagnostic substitution among subjects diagnosed with PDD vs MR or CP by examining birth characteristic overlap.Methods: SAS® and StatsDirect software examined medical records for subjects within the Vaccine Safety Datalink (VSD) database who were Health Maintenance Organization (HMO)-enrolled from birth until diagnosed with an International Classification of Disease, 9th revision (ICD-9) outcome of PDD (299.xx, n=84), CP (343.xx, n=300), or MR (317.xx, 318.xx, or 319.xx, n=51).Results: Subjects with PDD had significantly (p<0.01) increased: male/female ratio (PDD=5.5 vs CP=1.5 or MR=1.3), mean age of initial diagnosis in years (PDD=3.13 vs CP=1.09 or MR=1.62), mean gestational age in weeks at birth (PDD=38.73 vs CP=36.20 or MR=34.84), mean birth weight in grams (PDD=3,368 vs CP=2,767 or MR=2,406), and mean Appearance-Pulse-Grimace-Activity-Respiration (APGAR) scores at 1 minute (PDD=7.82 vs CP=6.37 or MR=6.76) and 5 minutes (PDD=8.77 vs CP=7.92 or MR=8.04), as compared to subjects diagnosed with CP or MR.Conclusion: This study suggests diagnostic substitution cannot fully explain increased PDD prevalence during the 1990s within the United States

Perceptions of Environmental Supports for Physical Activity in African American and White Adults in a Rural County in South Carolina

INTRODUCTION: This study examined the association between perceptions of social and safety-related environmental attributes and physical activity (PA) and walking in African American and white adults. METHODS: In a random-digit–dial telephone survey, 1165 adults in a rural county in South Carolina answered questions about their perceptions of social and safety-related environmental supports for PA and their overall PA and walking behavior. Social perceptions included whether neighbors could be trusted or were perceived to be physically active. Safety-related perceptions included neighborhood safety, the safety of public recreation facilities, problems with unattended dogs, traffic volume, and streetlight quality. Logistic regression models were used to examine the associations between environmental supports and PA and walking stratified by race. RESULTS: No association between perceived neighborhood environmental supports and PA or walking was observed in African Americans. Among whites, individuals who perceived their neighbors as active were twice (95% confidence interval [CI], 1.19–3.25) as likely to report meeting the recommendation for PA compared with individuals who did not report their neighbors as active. Whites who perceived their neighbors as active were 2.5 times (95% CI, 1.54–4.08) as likely to report meeting the recommendations for walking than whites who did not, and whites who perceived their neighborhoods as safe were 1.8 times (95% CI, 1.03–3.12) as likely to report meeting the recommendations for walking than whites who did not. CONCLUSION: These data indicate that perceptions of certain social and safety-related environmental supports were strongly associated with meeting the recommendations for PA and walking among white but not African American adults

Experimental philosophy leading to a small scale digital data base of the conterminous United States for designing experiments with remotely sensed data

Research using satellite remotely sensed data, even within any single scientific discipline, often lacked a unifying principle or strategy with which to plan or integrate studies conducted over an area so large that exhaustive examination is infeasible, e.g., the U.S.A. However, such a series of studies would seem to be at the heart of what makes satellite remote sensing unique, that is the ability to select for study from among remotely sensed data sets distributed widely over the U.S., over time, where the resources do not exist to examine all of them. Using this philosophical underpinning and the concept of a unifying principle, an operational procedure for developing a sampling strategy and formal testable hypotheses was constructed. The procedure is applicable across disciplines, when the investigator restates the research question in symbolic form, i.e., quantifies it. The procedure is set within the statistical framework of general linear models. The dependent variable is any arbitrary function of remotely sensed data and the independent variables are values or levels of factors which represent regional climatic conditions and/or properties of the Earth's surface. These factors are operationally defined as maps from the U.S. National Atlas (U.S.G.S., 1970). Eighty-five maps from the National Atlas, representing climatic and surface attributes, were automated by point counting at an effective resolution of one observation every 17.6 km (11 miles) yielding 22,505 observations per map. The maps were registered to one another in a two step procedure producing a coarse, then fine scale registration. After registration, the maps were iteratively checked for errors using manual and automated procedures. The error free maps were annotated with identification and legend information and then stored as card images, one map to a file. A sampling design will be accomplished through a regionalization analysis of the National Atlas data base (presently being conducted). From this analysis a map of homogeneous regions of the U.S.A. will be created and samples (LANDSAT scenes) assigned by region