Upon Russia’s invasion of Ukraine and the outbreak of war in early 2022, brands around the world took a stand to mark their position against Russia and in support of Ukraine. Even brands that did not have any direct ties to Russia or any involvement in the conflict distanced themselves from being associated with Russia by ceasing operations, stopping sales, or changing brand names. Brands engaging in sociopolitical issues, i.e., brand activism, has become more prevalent in recent years and thus become a topic of research. Previous research on brand activism focuses heavily on the corporate perspective, and only recently have scholars studied the effects on consumers. Guided by the research question “How do consumers perceive brand activism and what role does brand authenticity play in their evaluation of genuine brand activism?”, this study aims to offer a deeper understanding of consumers’ views on brand activism and how they evaluate its genuineness using qualitative methods. With a starting point in a recent event that brands have engaged in, namely the war in Ukraine, the study reveals that consumers' views on brand activism vary greatly, and for the majority, brand activism is not a decisive factor in their choice of brand. However, consumers still have a positive attitude towards brands engaging in brand activism and some find it somewhat important that brands do it. Despite this, consumers do not find it necessary for brands to engage in sociopolitical issues. Further, the study found that, in evaluating the genuineness of brand activism, consumers tend to refer to the existing associations with a brand, how authentic they perceive the brand prior to the brand taking a stand, and how well the brand associations align with the sociopolitical issue the at hand.

Background: Patients with left ventricular ejection fractions between 40% and 49% either discovered de novo, having declined from ≥50%, or improved from <40% have been described as heart failure (HF) with mid-range ejection fraction (HFmrEF). Though clinical signs and symptoms are similar to other phenotypes, possible prognostic differences and therapeutic responses reinforce the need for further understanding of patients’ characteristics especially in a rural community based population. The purpose of this study is to evaluate the clinical characteristics, comorbidities and prognosis of a rural patient population with HFmrEF. Materials and Methods: We queried the electronic medical record from a community based university practice for all patients with a HF diagnosis. We included only those patients with >3 months follow-up and interpretable Doppler echocardiograms. We recorded demographic, Doppler-echo, and outcome variables (up to 2,083 days). Results: There were 633 HF patients: 42.4% with preserved ejection fraction (HFpEF, EF ≥50%), 36.4% with HFmrEF, and 21.0% with reduced ejection fraction (HFrEF, EF <40%). HFmrEF patients were older, had greater coronary disease prevalence, lower systolic blood pressure, elevated brain natriuretic peptide, lower hemoglobin, and higher creatinine than HFpEF. All-cause mortality was intermediate between HFrEF and HFpEF but was not significantly different. Landmark analysis revealed a trend toward greater second readmission in HFmrEF as compared to HFpEF (hazard ratio: 1.43 [0.96-2.14],P = 0.0767). Conclusions: Rural patients with HFmrEF without an ambulatory HF clinic represent a higher percentage of HF patients than previously reported with greater coronary disease prevalence with comparable readmission rates and nonsignificantly different all-cause mortality.

No description available.

Aim: The aim of this study was to examine if student nurse participation in root cause analysis has the potential to reduce harm to patients from medication errors by increasing student nurse sensitivity to signal and responder bias. Background: Schools of nursing have traditionally relied on strategies that focus on individual characteristics and responsibility to prevent harm to patients. The modern patient safety movement encourages utilization of systems theory strategies like Root Cause Analysis (RCA). The Patient Risk Detection Theory (Despins, Scott-Cawiezell, & Rouder, 2010) supports the use of nurse training to reduce harm to patients. Method. Descriptive and inferential analyses of the demographic and major study variables were conducted. Validity and reliability assessments for the instruments were performed. The Safe Administration of Medications-Revised Scale (Bravo, 2014) was used to measure sensitivity to signal. The Safety Attitudes Questionnaire (SAQ; Sexton et al., 2006) was used to assess responder bias; this was the first use of this instrument with nursing students. Results: The sample consisted of 125 senior-level nursing students from three universities in the southeastern United States. The SAQ was found to be a valid and reliable test of safety attitudes in nursing students. Further support for the validity and reliability of the SAM-R was provided. A significant difference in safety climate between schools was observed. There were no differences detected between the variables. Conclusion: The results of this study provide support for the use of the SAQ and the SAM-R to further test the PRDT, and to explore methods to improve nursing student ability to administer medications safely.

Kling Glass AB är ett glassföretag som ligger i Mariestad. Företaget är lokalt välkänt och grundades 1950. Det finns en stor del av produktionsprocesserna som ser likadana ut nu som de gjorde då företaget grundades, där det största problemet är processen då företaget producerar sin Dinétårta. I dagsläget är nästan hela tårtan handgjord, vilket skapar kvalitetskrav, krav på operatörer och leder till mycket svinn. Sedan ett ägarbyte 2019 så har viljan att öka omsättningen vuxit på företaget, vilket har lett till många nya kunder. Dock så har inte ledningen på Kling Glass tidigare undersökt vilka interna förbättringsarbeten som kan ge ett ökat resultat. Därmed har företagets omsättning vuxit stadigt för varje år, men företaget har ett bristande kapital. I och med detta så har ledningen på Kling Glass bett om en undersökning av problem i produktionen, specifikt Dinétårtans process, och hur de kan lösa problemen med en lösning som även medför ekonomiska fördelar. Utöver detta så har ledningen även nämnt viljan att förbättra arbetsmiljön för de operatörer som producerar tårtan. Examenarbetets uppgift har därför varit att identifiera problem i processen och presentera realistiska och ekonomiskt gynnsamma lösningsförslag. För att kartlägga nuläget och identifiera problem så användes primärt Värdeflödesanalys, Leans 7+1 slöserier och Ishikawadiagram. Därefter så valdes två specifika problem, i och med att företaget hade fått reklamationer på dessa, vilka var plastbitar under chokladöverdraget och för lite nötter på tårtan. För att djupare undersöka dessa och finna en rotorsak så användes verktyget 5 varför. Verktyget visade att i det första fallet, då plastbitar hade hittats under chokladöverdraget, så uppkom detta på grund av för hög tempo i produktionsprocessen, och att operatören som skar av plastformen inte hann identifiera möjliga defekta produkter. I det andra fallet, då det var för lite nötter på tårtan, så visade rotorsaken vara att plastförseglingsmaskinen i paketeringsfasen hade haft problem, något som skapade stopp i produktion och ett ökat tempo när det återupptogs. Därför hann inte operatören identifiera en tårta som borde varit andrasortering.  De resultat som presenterades för företaget var att standardisera kontroll av temperatur i frystunneln, samt en handhållen doserare med feeder, för att standardisera mängden nötter som läggs på varje tårta. Därefter har det rekommenderats att företaget fortsätter med förbättringsarbete, antingen med andra problem som identifierades i detta arbete, eller använda arbetet som mall för att undersöka och förbättra andra processer. / Kling Glass AB is an ice cream company based in Mariestad. The company is well-known locally and was founded in 1950. A big part of the production process looks identical to the one used when the company was founded, where the biggest problem is the process when the company produces their Diné ice cream cakes. Today a big part of the cake handmade, which creates high quality demands, a need for many operators and creates a lot of waste. Since a new ownership in 2019 the desire to increase revenue increased at the company, which has been realized by growing the amount of customers. Although the management has not investigated how improvement of internal process efficiency can increase the economical result. Due to this, the company’s revenue has continued to increase, although they do not have a lot of funds, and the management of Kling Glass has asked for an investigation of problems in the production, specifically the process where the Diné ice cream cake is produced, and how these problems can be solved with a solution that gives economical benefits. The management has also made aware of their desire for the improvement of the ergonomics in the production. This projects assignment has therefore been to identify problems in the process and present realistic and economical beneficial solutions. To map the current situation and identify the problems the tools Value Stream Mapping, Leans 7+1 wastes and Ishikawadiagram were primarily used. Thereafter two specific problems were chosen, due to complaints caused by these, which were plastic splitter beneath the chocolate coating and the lack of nuts on the cake. To be able to investigate these further and find the causes the tool 5 Whys was used. The tool showed, in the first case, where small plastic pieces were found beneath the chocolate coating, that this was caused due to the high tempo in the process, and that the operator who cut the plastic form didn’t have the time to identify possible defective products. In the second case, where there was a lack of nuts on the cake, the cause showed to be because the plastic sealing machine in the packaging phase had malfunctioned, which caused a stop in the process and an increase in tempo once resumed. This caused the operator to not be able to identify a cake that should have been set aside as sub-standard. The results that were presented to the company was to standardize a control of the temperature in the freeze tunnel, and a handheld dispenser with a feeder, to standardize the amount of nuts that are placed on the cake. Thereafter it has been recommended that the company continue with improvement work, either with other problems that were identified in this project, or to use this project as a template to investigate and improve other processes within the production.

Thesis advisor: Eileen C. Sweeney / Francis Mayronis was a Franciscan friar and one of John Duns Scotus’s primary students; he became a master of theology in 1323. His Commentary on the Sentences is preserved in more than 100 medieval manuscripts. In recent literature, Mayronis’s work has received considerable attention, especially in his cognitive theory and metaphysics. However, his ethical work has generally received very little attention. Mayronis occupies an important place in the early fourteenth century’s Franciscan intellectual tradition, particularly in the onset of the Scotist tradition. Mayronis not only creatively explicated and developed Scotus’s thoughts in his writings but also actively engaged in conversation with Peter Auriol and William Ockham as the “first” Scotist.My dissertation is organized to present Mayronis’s relational teleology in his notion of beatitude as the enjoyment of God. While generally maintaining a volitional agent-centered perspective that an agent or efficient cause is not determined to seek the good, Mayronis argues for the certitude of the ultimate end of the blessed and sees God, i.e., the final cause, as the total cause of the end. Mayronis harmonizes these seemingly contradictory causal powers of the final and efficient causes with the notion of habitus. First, Mayronis affirms the traditional view of habitus as an active power. In the present life, the free will gradually acquires a habitus toward the good through its own actions, and in heaven, grace or charity, i.e., supernatural habitus, is infused in the will of the blessed so that the will is eventually necessitated by the good. However, he could not maintain this position, i.e., the will’s habitus determines the will’s character, without abandoning Scotus’s emphasis on the will’s free aspect over its natural aspect since habitus is natural, though it is second nature. Hence, he develops a novel story of relation that completely replaces the role of habitus: God freely accepts someone due to a relational change to the person, rather than because the person has a supernatural habitus that is ‘acceptable’ to God. I begin by presenting Mayronis’s metaphysics of final causality in its historical context. For Plato and Aristotle, the end is formal. Plato considers the end as the form externally given by the divine craftsman, and Aristotle depicts nature’s motion toward the end as matter’s internal desire for its form. Then, Avicenna, while defining the final cause as the cause of causes, develops two ways the efficient cause can be central: the intellect can see something other than the good as its end, and the will can seek something not as determined by its goodness. I treat Averroes, Aquinas, Scotus, Ockham, and Mayronis in developing Avicenna’s notion of the final cause and the relationship between the final and efficient causes. In medieval teleology, we see fully developed agent-centered perspectives. In his unique rendering of Avicennian final causality, Mayronis shows that, although the final cause is the primary and necessary cause, it potentially causes our relations with God; then, we, as the efficient cause, contingently actualize the relations. Then, to situate Mayronis’s ethical teleology as a continuation of Scotus’s voluntarism, I argue for Duns Scotus’s ethical teleology against Thomas Williams’s view that sees Scotus’s ethics as proto-Kantian. I then present Mayronis’s notion of our intellect’s vision of God and our will’s enjoyment of God according to his metaphysics of final causality. First, I examine Mayronis’s cognitive theory that holds the vision of God, i.e., intuitive cognition, as a relation. I then argue for his relational teleology based on the premise that Mayronis views our enjoyment of God as a relation. For Mayronis, our ultimate end is our beatific enjoyment of God; it is neither our beatific act nor the object of the act, i.e., God, but the relation between the act and the object. Happiness is the relation to the Supreme Good, and misery is the lack of the relation. The purpose or goal of our life is neither merely internal nor external but relational. Finally, I present how Mayronis translates the role of habitus that grants the certitude of the enjoyment of the blessed into divine acceptance. For Mayronis, our moral life is not a long journey of accumulating habitus or virtues until we finally reach our destination; it is an everyday journey of love where we actualize the final cause, which potentially orders us to the Supreme Good. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Philosophy.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Introduction: Medication errors are a major cause of illness and hospitalization of patients throughout the world. This study examines the situation regarding medication errors in the Armed Forces Hospital, Kuwait since no literature exists of any such studies for this country. Several types of potential errors were studied by physicians, nurses and pharmacists. Their attitudes to the commission of errors and possible consequences were surveyed using questionnaires. Additionally, patient medical records were reviewed for possible errors arising from such actions such as the co-administration of interacting drugs. Methods: This study included direct observations of physicians during the prescribing process, pharmacists while they dispensed medications and nurses as they distributed and administered drugs to patients. Data were collected and compiled on Microsoft Excel spreadsheet and analyses were performed using SPSS. Where applicable, results were reported as counts and/ or percentages of error rates. Nurses, pharmacists and physicians survey questionnaires: From the 200 staff sent questionnaires a total of 149 respondents comprising nurses (52.3%), physicians (32.2%) and pharmacists (16.1%) returned the questionnaires a total response rate of 74.5%. All responses were analyzed and compared item-by-item to see if there were any significant differences between the three groups for each questionnaire item. All three groups were most in agreement about their perception of hospital administration as making patient safety a top priority with regard to communicating with staff and taking action when medication errors were reported (all means 3.0 and p > 0.05). Pharmacists were most assured of administration support when an error was reported whereas nurses were least likely to see the administration as being supportive ( p < 0.001), and were more afraid of the negative consequences associated with reporting of medication errors (p = 0.026). Although nurses were generally less likely to perceive themselves as being able to communicate freely regarding reporting of errors compared to pharmacists there was no significant difference between the two groups. Both however were significantly different from physicians (p< 0.001). Physicians had the most favorable response to perceiving new technology as helping to create a safer environment for patients and to the full utilization of such technologies within the institution in order to help prevent medical errors. Scenario response - Responses to two scenarios outlining possible consequences, should a staff member commit a medication error, tended to be very similar among the three groups and followed the same general trend in which the later the error was discovered and the more grievous the patient harm, the more severe would be the consequences to the staff member. Interestingly, physicians saw themselves as less likely to suffer consequences and nurses saw themselves as more likely to suffer consequences should they have committed a medication error. All three groups were more likely to see themselves as facing dismissal from their job if the patient were to die. RESULTS OF ALL THREE OBSERVATIONS: Result of Nursing observations: For 1124 doses studied, 194 resulted in some form of error. The error rate was 17.2% and the accuracy was 82.8%. The commonest errors in a descending order were: wrong time, wrong drug, omission, wrong strength/ dose, wrong route, wrong instruction and wrong technique. No wrong drug form was actually administered in the observational period. These were the total number of errors observed for the entire month period of the study. IV Result of Pharmacist observations: A total of 2472 doses were observed during the one month period. Observations were done for 3 hours per day each day that the study was carried out. The study showed that there were 118 errors detected which were in the following categories respectively: 52 no instructions, 28 wrong drug/unordered, 21 wrong strength/dose, ignored/omission 13, shortage of medication 3 and expired date 1. Result of Prescribers in Chart review for drug-drug interactions: The analysis of the drug-drug interactions showed that out of a total of 1000 prescriptions, 124 had drug-drug interactions. None were found to fall into the highest severity rating i.e. 4 (contraindicated). Only twenty-one interactions were rated 3 (major), 87 interactions were rated moderate and 15 interactions were rated minor according the modified Micromedex scale. Patient education: All health care such as physician, pharmacist, and nurses have a responsibility to educate patient about their medication use and their health conditions to protecting them from any error can occur by wrong using drugs. Conclusion This study has contributed to the field of medication errors by providing data for a Middle Eastern country for the very first time. The views and opinions of the nurses, pharmacists and physicians should be considered to enhance the systems to minimize any errors in the future.

No description available.

No description available.