Ramadan Fasting and Diabetes Management among Muslims in the United States: An Exploratory Study

There is a lack of knowledge and awareness among health care providers (HCPs) about how a member of the Islamic faith manages diabetes while fasting during Ramadan, which often leads to inadequate health advice and guidance, especially in Muslim-minority countries. The purpose of this study was to explore diabetes management practices among Muslims who chose to fast during Ramadan in the United States. Data were collected from 47 participants using a self-administered questionnaire that included measures on participants’ characteristics and diabetes management practices. The majority of the participants were males (61%), had type 2 diabetes (90%), and reported they fast during Ramadan (76%). Approximately, 26% of fasting participants reported they decreased the number of finger-stick glucose monitoring performed. Compared to non-fasting participants, fasting participants were more likely to change the dose and/or timing of their medications, but also more likely to include their HCPs in their health decisions. Almost 90% of fasting participants reported no increase in the amount of food consumed and no change in the consumption of concentrated sweets, greasy foods, and sugary drinks. This study supports the need to develop educational programs that involve religious leaders as well as HCPs to ensure patients receive health advice combining religious and medical directives.     

Ambiguous Loss Research,Theory, and Practice: Reflections After 9/11

This article contains an overview of three decades of research, theory development, and clinical application about ambiguous loss. Although the work includes both physical and psychological types of ambiguous loss, the focus is the aftermath of 9/11 (September 11, 2001), when the World Trade Center collapsed following terrorist attacks. On the basis of her previous work, the author was asked to design an intervention for families of the missing. She reflects on what she learned from this unexpected test and presents new propositions and hypotheses to stimulate further research and theory that is more inclusive of diversity. She suggests that scholars should focus more on universal family experience. Ambiguous loss is just one example. Encouraging researchers and practitioners to collaborate in theory development, she concludes that research‐based theory is essential to inform interventions in unexpected times of terror, and in everyday life.     

Escaping into the world of make‐up routines in Iran

Traditionally, Iranian women's use of dress and make‐up has been an arena – sometimes a battleground – for identity negotiation. The present study questions the current over‐emphasis on identity and the prevalent tendency to look for identity meanings in the use of hejab (veiling) and cosmetics. The results of fifteen interpretive in‐depth interviews with young adult women in Iran reveal that these individuals' make‐up practices are largely associated with a total immersion in the experiential, creative aspects of make‐up use and with ways to uplift their tired spirits in a monotonous environment. Make‐up routines provide these women with opportunities to escape from boredom and immerse themselves in the playful fantasies of the world of cosmetics. Despite facing various challenges, including frequent stigmatization on account of their use of make‐up, the informants in the study derive high levels of satisfaction from their make‐up practices. The study establishes that changing socio‐cultural dynamics give rise to new forms of consumption experiences in contemporary society and calls for further investigation of such experiences in women's everyday lives.     

Task analysis of healthcare delivery: A case study

Human error and medical error are highly known as contributors to patient safety [Institute of Medicine (IOM), November 1999. To err is human: building a safer health system. Available at: http://www.nap.edu/openbook/0309068371/html/11.html (accessed 05.03.07); Institute of Medicine (IOM), March 2001. Crossing the quality chasm: a new health system for the 21st century. Available at: http://www.nap.edu/openbook/0309072808/html (accessed 05.03.07); Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 2007. Failure mode, effect, and criticality analysis (FMECA) worksheet. Available at: http://www.jcaho.org (accessed 24.06.07)]. A study was performed to identify the process flow affiliated with elder patients transitioning through different continuums of emergency and non-emergency care. This research is part of a larger research effort to develop and implement a web-based healthcare system that enables hospitals and nursing homes to share patient information resulting in increased knowledge of a patient's medical history, decreased errors and enhanced patient safety. Future research efforts for this study are also presented.     

Nonparametric predictive comparison of lifetime data under progressive censoring

In reliability and lifetime testing, comparison of two groups of data is a common problem. It is often attractive, or even necessary, to make a quick and efficient decision in order to save time and costs. This paper presents a nonparametric predictive inference (NPI) approach to compare two groups, say X and Y, when one (or both) is (are) progressively censored. NPI can easily be applied to different types of progressive censoring schemes. NPI is a statistical approach based on few assumptions, with inferences strongly based on data and with uncertainty quantified via lower and upper probabilities. These inferences consider the event that the lifetime of a future unit from Y is greater than the lifetime of a future unit from X.     

The wages of sweat: A social history perspective on the fight against sweatshops

The social history of the fight against sweatshops casts light on the current movement in favor of corporate social responsibility. But making the head of a chain of subcontractors responsible for seeing to the well-being of those at the end of the chain is not contemporaneous with present-day globalization and North/South relations. Since the 19th century, when the sweatshop system appeared, those who champion the workers have pointed a finger at those who, though they only exercise indirect control, profit from their exploitation. As our historical analysis emphasizes, though in other contexts the issue of poor working conditions sometimes found solutions that (partially) avoided holding the principal liable, what characterizes the anti-sweatshop movement in the context of globalization is its nearly exclusive focus on bringing pressure to bear on the contractor at the head of the chain.     

Design and implementation of a Drum-Buffer-Rope pull-system

Purpose: This paper investigates the selection, design and implementation of a Drum-Buffer-Rope (DBR) type of production pull-system in a panel fabrication plant characterised by extensive shared, batch resource resources within a low volume UK manufacturer of large vehicles. This was the second of a series of two related research projects conducted under the aegis of a Lean initiative at this case firm.

Design/methodology/approach: A purposively selected longitudinal case study conducted over 24?months and organised around a two phase research design. The initial body of evidence included a detailed map constructed by a project team of eight managers and accountants during a two day structured workshop; numerous unstructured interviews and observation of shop floor practices; document and archival analysis, and 140 photographs of the focal operation. Supplemented by extensive financial and operational data extracted from the firm’s accounting and MRP systems, including all data necessary to construct and implement bespoke capacity planning, work in progress (WIP) monitoring and simulation modelling tools. The case firm is anonymised.

Findings: The Lean manufacturing literature ignores the real-world issue of shared resources, and this gap is attributable to the concept of ‘rightsizing’ tools and equipment that is widely promoted within the Lean community. The case panel plant is characterised by extensive shared resources; many of which are also batch processes. The most appropriate pull-system method for this production environment is DBR. The detailed design of the DBR mechanism required a controlled transfer buffer of overhead conveyance capacity after the Drum because the extent of downstream process variability risked it being unable to offload panels, hence compromising throughput.

Research limitations/implications: The study is based upon a single case. This consequently has implications for the ability to generalise from the results.

Practical Implications: When the DBR pull-system design was implemented it reduced the number of panels in WIP by 60%. This equated to a 56% (18?days worth) reduction of manufacturing lead time and more than doubled the plant’s inventory turns (from 9.1 to 21.2). It also significantly improved delivery schedule adherence, with downstream jig stoppages in the Final Assembly falling from an average of six to less than one per week. The financial benefit was independently audited to equate to an annualised value of $850?K. Consequently, this project was awarded the first prize at its parent enterprise’s annual worldwide process improvement competition.

Originality/value: This paper details a novel technique that permits the routings of multiple value streams to be mapped and is useful for highlighting the identity and location of shared resources. It also contributes significantly to the literature that is available on the relationship between the Lean paradigm and the management of shared production resources, and adds to the literature on the detailed design and implementation of a DBR pull-system in a jobbing-type of environment.     

Comparative Capitalism without Capitalism,and Production without Workers: The Limits and Possibilities of Contemporary Institutional Analysis

The aim of this paper is to consider the extent to which the comparative capitalism literature fully reflects the available empirical evidence in its attempts to model different versions of capitalism and, in particular, whether it adequately captures the roles of diverse stakeholders within the capitalist system. In doing so, particular attention is accorded to the varieties of capitalism literature, business systems theory and regulation theory. In addition, there is reflection in the paper on whether any strand of the literature is able to deal effectively with the recent economic crisis and systemic change. It is argued that more attention needs to be devoted to exploring the structural causes of change and the marginalization of the interests of key social groupings, most notably workers, from the process of institutional redesign.     

Using an Objective Structured Clinical Examination for Bachelor of Midwifery students’ preparation for practice

BackgroundContemporary midwifery practice needs a rigorous and standardised assessment of practical skills, and knowledge to ensure that safety is maintained for both women and neonates before, during and after childbirth.AimTo evaluate the use of Best Practice Guidelines (BPG) for Objective Structured Clinical Examinations (OSCE) as a standardised tool to develop clinical competence of Bachelor of Midwifery students.MethodA pragmatic mixed method approach with surveys, focus groups and interviews was used to evaluate the OSCEs for first year students. Quantitative and qualitative data were combined to understand student and academic perceptions of students’ confidence for clinical practice following the OSCE.FindingsThirty-four students responded to surveys (response rate 94%); and 13 participated in focus groups. Two academic lecturers participated in an interview (100%). Two main themes emerged (1) the OSCEs improved student confidence (2) the OSCEs were relevant and prepared students for practice. Most students indicated that they practised for the OSCE using an integrated approach (70%), and that this assisted them in their approach to the assessment of the neonate or post-partum mother.ConclusionThe use of BPGs to ensure that OSCEs focus on important aspects of knowledge and practice helped students to learn and to perform well. Students’ confidence in their ability for the imminent professional experience placement was high. OSCEs designed with the BPGs should be implemented broadly across midwifery education to enhance students’ competence and provide rigorous meaningful assessment.