A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital

This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. Conclusions: (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.     

A usability gap between older adults and younger adults on interface design of an Internet-based telemedicine system

Internet-based telemedicine is becoming an effective tool to deliver home-healthcare services and health information on demand, especially in rural areas, where there is often a large elderly population with greater rates of preventable chronic diseases. However, the designs of current interfaces for these internet-based telemedicine systems do not take elderly user characteristics into consideration. This study conducted usability testing on the interface of an internet-based telemedicine system using two different age groups, young adults and older adults. Differences in overall performance and satisfaction between the two groups were identified. Based on these results, a future direction is suggested for the interfaces of Internet-based telemedicine systems.     

Contributions from the activity analysis to the products development project: case study based on a project of innovation and comfort in aircraft's cabins

Comfort is an issue that has gained relevance within the aeronautical industry due to the necessity of manufacturers and airline companies of differentiating themselves in a market that has become more and more competitive each day. This study's aim is to analyze the comfort/discomfort of passengers, based on the analysis of the activities performed in the aircrafts' cabin during real flights, in order to create ergonomics requirements and a methodology of comfort analysis. The study has been performed during domestic commercial flights, and the adopted data collection techniques have been: the application of 219 questionnaires to passengers, 44 registrations of postures and actions through filmings and 12 semistructured interviews. The method has made possible the reconstruction of the user's action course in performing activities in real flight situations, and the calculation of the area occupied by the passenger during his or her actions. The integrated analysis of the results corroborates data from previous studies in which both the space made available to each passenger and the activity performed interfere in their perception of comfort. From this study it has been concluded that the method constitutes itself as an innovative tool within the process of aircrafts' cabins project enabling the calculation of the action space based on the reconstructed course.     

Child sexual abuse and psychological impairment in victims: results of an online study initiated by victims

Sexual abuse of children has been a topic of scientific investigation for the past few decades. Research in this area, however, is rarely initiated, conceptualized, and conducted by victims themselves. Apart from possibly having painted a one-sided picture of sexual abuse, this presumed dominance of nonvictims might also have marginalized victims in a research area central to their lives. This study was conducted by a victims interest group as an effort to meet the need to add victims' perspectives to our current understanding of this topic. The online survey focused on investigating victims' psychosocial impairment, which was found to be extensive. Results indicated that an intact social support system facilitates better health, especially when offered early on.     

Work hours,social value of leisure and globalisation

We examine how openness interacts with the coordination of consumption–leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure to be increasing in the leisure time taken by other workers. Coordination takes the form of internalising the leisure externality and other relevant constraints (e.g., labour demand). The extent of openness is measured by the degree of capital mobility. We find that: coordination lowers equilibrium work hours and raises the wage rate; there is a U-shaped (inverse-U-shaped) relationship between work hours (wages) and the degree of coordination; coordination is welfare improving; and, the gap between the coordinated and uncoordinated work hours (and the corresponding wage rates) is affected by the extent and nature of openness.     

Walking in the shoes of others: Experimental testing of dual-interest and empathy in environmental choice

This paper further tests dual interest theory and the metaeconomics approach to environmental choice, recognizing a possible role for empathy–sympathy (the basis for an internalized, shared other-interest) in tempering and conditioning the more fundamental tendency to pursue self-interest. To test, we focus on rivers flowing through agricultural areas carrying sediments, chemicals, and fertilizers which are making their way into downstream rivers and lakes. We conduct a framed laboratory experiment modeling this problem: farmers decide on the usage of conservation technology to lessen impacts on the water quality (i.e. on the commons, the capacity to absorb these wastes) in downstream areas, which is more costly than the alternative intensive technology. The results confirm our hypotheses, demonstrating that Upstream Farmers who practice conservation are tempering profit maximization with empathy-based, environmentally conscious behavior. Such behavior better serves the farmers’ own-interest, and also helps Downstream Water Users. Environmental economics models need to explicitly include empathy–sympathy and the moral–ethical context it produces, providing a more scientific basis for conservation policy and programs.     

Governing the transnational organic cotton network from Benin

In this article, we attempt to conceptualize the historical development and the governance structure of the transnational organic cotton network from Benin. We aim to discover how the organic cotton production‐consumption network is governed locally and internationally. Existing bodies of literature on international agricultural production networks, in particular the Global Value Chains (GVC) perspective, focus on economic dimensions, but find it difficult to incorporate the sustainability dimension. We favour widening the concept of GVCs beyond economics by acknowledging and including environmental rationalities and the representatives of their interests, not as external elements, but rather as co‐governing or co‐structuring factors (or actors) of sustainable value chains. Our findings reveal that beyond the traditional producer versus buyer dualism, intermediate stakeholders, namely transnational and local environmental NGO networks, are instrumental in the construction, maintenance and transformation of the organic cotton network. It is also apparent that farmers' leaders play an important role in mediating and (re)building trust among organic farmers, though they exert insufficient vertical power in the organic cotton network to control it.     

Potential strategies to avoid progestogen-induced premenstrual disorders

Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced - it never will - and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense.     

Exercise self-regulation among older women participating in a heart disease-management intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.