Palliative and curative care nurses' attitudes toward dying and death in the hospital setting

This paper explores the errors involved in the approximation of both the maximum and sum of two independent Beta random variables, each by another Beta random variable. The principal area of application is the time analysis of PERT networks, and the results are interpreted and discussed in terms of this application. The error was found to be acceptable for the greater part of the range of the parameters involved. The results will help practitioners estimate the mean and standard deviation of the completion time of PERT networks.     

Dialectical contradictions experienced when a loved one is dying in a hospital setting

A family member who is present when a loved one is dying in a hospital setting may be profoundly affected by interactions with others in that setting, including the dying person. Interaction shapes how one experiences a loved one's death and dying. Framed in relational dialectics theory, this qualitative case study describes dialectical contradictions I experienced in the context of my grandmother dying in a hospital setting. Personal journals were analyzed, with three primary dialectics being identified: certainty-uncertainty, control-lack of control, and autonomy-connection. Understanding dialectical contradictions experienced by a family member when a loved one is dying in a hospital setting could lead to enhanced support services for family members.     

Quality insights of university students on dying, death, and death education--a preliminary study in Hong Kong

Death is a subject seldom studied in school and often misunderstood and feared by many people. Children often learn about death from their family and mass media. From the literature review on dying, death, and death education, it may be concluded that people are generally ignorant about the issues of death and dying. There is a need to investigate what young people, such as university students, know about death and dying, and their attitudes toward them. Eight university students were recruited for this study. Most participants have had death experiences. They seldom talked about death and loss. Some of these experiences were quite pleasant but some of them were not. Most participants addressed the need to have "life and death" education in schools at their young age. Such a need is further supported by the incidents of two participants who attempted suicide unsuccessfully when they encountered a life problem which they could not solve.     

Images of heaven and the spiritual afterlife: Qualitative analysis of children's storybooks about death, dying, grief, and bereavement

Many parents turn to picture books and storybooks to help explain issues surrounding death and dying to their young children. In addition to dealing with topics such as death, funerals, memories, and grief, a number of the books also mention the concept of heaven and what our loved ones might experience after they die. This article uses qualitative research methods to analyze 49 children's storybooks that touch on the existence of heaven or a spiritual afterlife. Results show that heaven is portrayed in a simplistic fashion, as a place high in the sky with bright lights, angels, and clouds. Even as heaven is presented in a relatively simple way, there are also patterned differences in depictions of the spiritual afterlife depending upon whether the decedent in the book was a family pet, a child, a parent, or a grandparent. The article concludes with a discussion of how these depictions of heaven and the afterlife might help young children cope with death-related grief.     

I can,I am: Differential predictors of leader efficacy and identity trajectories in leader development

Despite significant attention devoted to outcomes of formal leadership training, little is known about how individuals develop during these programs. The current study examined developmental trajectories of leader efficacy and identity, two proximal outcomes supporting leadership effectiveness, in a six-week leadership training course (N = 240). Testing competing predictions between developmental readiness and developmental need perspectives, we examined whether learning goal orientation (LGO) and motivation to lead (MTL) predicted development of trainees' leader self-views. Latent growth modeling results revealed leader efficacy developed linearly, whereas leader identity developed quadratically (i.e., positive change with slowing growth over time). Results for leader efficacy supported the developmental need perspective, as individuals lower on affective MTL exhibited greater changes to their leader efficacy, which was further moderated by LGO. In contrast, individuals higher and lower on LGO developed equally on leader identity, albeit via different trajectories. Implications for leadership theory and practice are discussed.     

Public Day Care Centres,Company Day Care Centres,and Segregation Between Men and Women in the Labour Market: the Case of the Netherlands*

Abstract. What is needed to diminish segregation between men and women in the labour market is a program of affirmative action for the Netherlands as a whole. Specific measures aimed at the removal of barriers between occupations cannot be successful unless they are imbedded in such an overall program. A necessary part of such a plan are facilities that enable women and men to combine unpaid parental tasks and paid labour. In contrast with public day care centres, company day care centres do not fit into such a plan, because they even enlarge existing segregation. Company day care centres and other measures to facilitate parental care and paid labour are more often found in industries with a larger share of female workers. This relationship is found for both the Netherlands and the United States. It is concluded that it is in the interest of employers as well as women's emancipation to increase the number of public day care centres instead of the number of company day care centres.     

Shared leadership performance relationship trajectories as a function of team interventions and members' collective personalities

We used longitudinal data from 205 members of 53 student teams who competed in a complex business simulation over 10 weeks to test: (1) whether shared leadership and performance were related reciprocally over time; (2) the relative magnitude of those relationships; and (3) whether a shared leadership intervention changes those relationships. We also considered the influence of team members' mean level personality to account for compositional effects. As anticipated, shared leadership and performance were related positively and reciprocally over time. Moreover, the shared leadership to performance relationship grew stronger and positive whereas the performance to shared leadership relationship remained fairly consistent over time. As expected, the intervention positively related to the trajectory of shared leadership. Finally, we did not find evidence for the hypothesized relationships of personality on shared leadership nor the strength of the intervention.     

Health Care Supply Chain Design: Toward Linking the Development and Delivery of Care Globally*

This article is motivated by the gap between the growing demand and available supply of high‐quality, cost‐effective, and timely health care, a problem faced not only by developing and underdeveloped countries but also by developed countries. The significance of this problem is heightened when the economy is in recession. In an attempt to address the problem, in this article, first, we conceptualize care as a bundle of goods, services, and experiences—including diet and exercise, drugs, devices, invasive procedures, new biologics, travel and lodging, and payment and reimbursement. We then adopt a macro, end‐to‐end, supply chain–centric view of the health care sector to link the development of care with the delivery of care. This macro, supply chain–centric view sheds light on the interdependencies between key industries from the upstream to the downstream of the health care supply chain. We propose a framework, the 3A‐framework, that is founded on three constructs—affordability, access, and awareness—to inform the design of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device–based care for cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innovation initiatives relevant to bridging the gap between the demand and supply for high‐quality, cost‐effective, and timely care. Finally, we delineate directions of future research that are anchored in and follow from the developments documented in the article.     

Political Exhortation, Patient Expectation and Professional Execution: Perspectives on the Consumerization of Health Care

A central theme underpinning the reform of public-sector services in western economies since the 1980s has been the emphasis on reorienting service provision around the user. Public-sector organizations have been forced to reappraise the design of the service delivery process, in particular the service encounter, to take account of the resultant changes in service users' expectations. Such focus on the service user has fundamental implications for public-sector professionals, specifically challenging the dominance of service professionals in the design and delivery of services. Based on a survey of patient attitudes towards service provision in the National Health Service in Scotland (NHSiS) and in-depth interviews with senior hospital clinicians and managers, the paper critically examines the reaction of both patients and professionals to politically driven initiatives to reorientate the delivery of health-care services. Specifically the paper explores the emerging perspectives of both patients and professionals towards the consumerization of health care and the changing nature of the relationship between patients and professionals within a publicly funded health-care system.     

A joint optimization of data ferry trajectories and communication powers of ground sensors for long-term environmental monitoring

Recently, various hybrid wireless sensor networks which consist of several robotic vehicles and a number of static ground sensors have been investigated. In this kind of system, the main role of the mobile nodes is to deliver the messages produced by the sensor nodes, and naturally their trajectory control becomes a significant issue closely related to the performance of the entire system. Previously, several communication power control strategies such as topology control are investigated to improve energy-efficiency of wireless sensor networks. However, to the best of our knowledge, no communication power control strategy has been investigated in the context of the hybrid wireless sensor networks. This paper introduces a new strategy to utilize the communication power control in multiple data ferry assisted wireless sensor network for long-term environmental monitoring such that the lifetime of the sensor network is maximized. We formally define the problem of our interest and show it is NP-hard. We further prove there exists no approximation algorithm for the problem which can produce a feasible solution for every possible problem instance even though there is a feasible solution. Then, we propose heuristic algorithms along with rigorous theoretical performance analysis for both the single data ferry case and the multiple data ferry case under certain condition.     

Taiwan quality indicator project and hospital productivity growth

The Taiwan Quality Indicator Project (TQIP) is a quality management program that measures and monitors the healthcare quality of hospitals in Taiwan. This paper examines the impact of TQIP participation on hospital productivity growth with the application of the Malmquist productivity change index based on data envelopment analysis (DEA). Analyzing operations data from 31 TQIP regional hospitals over the period 1998–2004, we find that TQIP hospitals improved their productivity in the post-TQIP period. This improvement is attributable to quality change and relative efficiency progress. The simultaneous enhancement in both quality and relative efficiency coincides with the philosophy of total quality management (TQM) spirit, and confirms the efficiency improvement and quality assurance functions of TQIP.     

The recruitment and selection of hospital medical consultants

Abstract

The literature on selection has been dominated in recent decades by the ‘prediction’ paradigm. Such an approach requires a substantial number of positions to be filled in order to compute validity coefficients. There are other approaches, using a different paradigm, when concentrated on adjusting the organization and the employee. Here careful analysis of job demands is essential. This article describes such an analysis, taking the medical consultant as an example. The method can be used in an iterative way. It is useful when one has to work with small numbers of positions.     

The Chinese version of the multidimensional orientation toward dying and death inventory (MODDI-F/chin): an introduction

Preliminary data on the test criteria of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/chin) are presented. Data from a sample of Hong Kong college students (N = 256) revealed internal consistencies of the eight subtests between .68 and .91, on the whole favorable shape of frequency distributions, and evidence of construct as well as differential validity of the instrument. The use of the full set of 47 items is recommended for the time being.     

The medical examiner and deaths in the hospital setting

There has been a perceived increase in the number of medical negligence claims in recent years. The modern metropolitan medical examiner is increasingly called upon to deal with numerous medical, legal, social, and ethical issues. Nowhere is the role of the medical examiner more important than in the investigation of deaths related to surgical, diagnostic, anesthetic, or therapeutic procedures. Medical examiners have an important role in the investigative process. Through utilization of the offices and services of the medical examiner, questions raised by families, physicians, and other hospital employees may be satisfactorily answered a priori, and litigation may therefore be averted.