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ANALYZING THE ASSOCIATION OF CERTIFICATE OF NEED REGULATIONSON VOLUME AND QUALITY INDICATORS FOR HEART AND KIDNEY TRANSPLANTATIONCosby, Courtney 09 February 2011 (has links)
States have historically used Certificate of Need (CON) regulations to regulate cost, quality, and access to healthcare services. Federally mandated in 1974, the regulation required the states to review requests for new healthcare construction and services. In theory, community-level planning backed by the state-level CON review and health planning process would prevent unnecessary duplication of services and the accompanying costs (Smith-Mellot, 2004). However, none of the published studies have examined the association of CON regulation on volume and outcomes of solid organ transplants. In 1984, the federal mandate ended, and each state was allowed to determine whether or not to maintain its CON programs; more than one-third of the states eliminated them (Altman & Ostby, 1991). Currently, 37 states including the District of Columbia have CON programs (American Health Planning, 2010). Of those states, 21 include organ transplant as a reviewable, regulated service. Although several studies have investigated whether CON regulation has affected healthcare cost, to date very little has been written about the impact of CON on volume and quality of care; the data that does exist is contradictory. In 1988, investigators studied the effects of CON regulation on mortality and observed that greater regulatory stringency was a positive and significant predictor of hospital mortality rates (Shortell & Hughes, 1988). In contrast, DiSesa et al (2006) found no significant difference in risk-adjusted mortality for cardiac surgery patients in states with and without CON regulations. The gap between evidence and decision-making and the large number of states that use CON to regulate healthcare services indicate a need for a study on the quality of healthcare services. Solid organ transplantation is a complex, high-cost treatment that was performed over 27,000 times in 2008. The purpose of this study is to assess the association of solid organ transplant CON regulations using clinically rich data available from the Scientific Registry of Transplant Recipients (SRTR). This study tests the hypotheses that states with solid organ transplant CON regulations have fewer transplant centers, higher volumes of heart and kidney transplants per center, lower graft failure rates and lower patient mortality rates per center. In addition, this study assesses these hypotheses using two different transplant procedures (heart and kidney). This study provides additional information for transplant centers to use in their strategic decision making. Moreover, with the presence of minimum volume standards for transplant procedures mandated by the Centers for Medicare and Medicaid (CMS) now, the policy implications of continuing or repealing CON regulations should be examined.
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A Multiple-Site Case Study of Two University Teacher Induction Programs Using Different Methods of DeliveryHenschel, Molly M 01 January 2016 (has links)
The literature shows that up to 50% of teachers will leave the profession within their first 5 years of teaching (Saka, Southerland, Kittleson, & Hutner, 2013). Although reasons for departure vary, Johnson and Kardos (2005) found schools with high-poverty and high-minority students display excessive rates of teacher turnover. Teacher induction programs were established to assist beginning teachers as they transition into their new professional career in an attempt to increase retention rates. This research aimed to explore beginning teachers from high need schools’ experiences with university-based PLC induction. A total of 23 teachers participated in the induction programs during the 2015 - 2016 academic year. This research provides findings from three different data sources: interview transcripts, surveys, and focus group transcripts. Data was collected to understand beginning teachers’ experience with induction, the types of support offered by the programs, their intentions to remain at their school, and their attitudes towards the method of program delivery.
Findings indicate that the majority of the teachers had positive experiences with the two induction programs. Mostly, the teachers felt that induction provided emotional and personal support. According to the novice teachers, administrative support had the largest influence on their intentions to stay or leave their high need schools. As a result, the teachers provided mixed results as to induction’s impact on their decision to stay or leave their current school. Finally, the majority of teachers prefer in-person models to virtual models although there were advantages and disadvantages to both types of programs.
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Porovnání pitného režimu u žáků 2. stupně ZŠ a u žáků střední školy / Comparison of the drinking regime for second primary school students and high school studentsPlachá, Barbora January 2015 (has links)
This thesis deals with the study of the drinking regime for second primary school students and high school students with a focus on drinking schedule at school. The work is divided into theoretical and practical part. In the introduction to the theoretical part there has been characterized the target group. Furthermore, there's given the importance of water for the human body, water balance, principles of drinking regime and specific recommendations for the target group. Furthermore, there's been made a recherche out of several different sources regarding particular nonalcoholic drinks. In the conclusion, the attention is paid to the risks that may be occured due to improper intake of liquids and also to providing the drinking regime in school. The practical part of the thesis describes the research which was done among students and teachers. The way to data collection were questionnaires. Particular results are presented and discussed in the conclusion of the thesis. The results of the survey determine that, although some awareness of the monitored group of students is apparent, keeping the drinking regime principles is unsatisfactory. Based on the research and information from available literature, there've been formulated recommendations for teaching practice.
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Dining at continuing care retirement communities: a social interaction viewAbu Bakar, Ainul Zakiah January 1900 (has links)
Doctor of Philosophy / Department of Hospitality Management and Dietetics / Deborah Canter / Chihyung Ok / As the number of older adults increases so does the demand for housing and personal care needs. The continuing care retirement community is unique from other senior care facilities as it provides a continuum of housing and care that caters towards an individual’s need. Foodservice is often utilized to attract older adults into retirement facilities. Such service would give residents additional opportunities to socialize with service workers as well as other patrons of the restaurant. Yet, few studies have focused on the roles of food and dining service on resident’s satisfaction with foodservice and their quality of life. Study 1 examined the relationships between residents’ perception of individual customer orientation of service employee dimensions: technical skills, social skills, motivation, and decision-making authority, with relational benefits, satisfaction and subsequent behavioral outcomes: repurchase intention and word-of-mouth. Study 2 explored the moderating effects of resident’s activity involvement and food involvement on the relationships between rapport, dining-need satisfaction and resident’s quality of life. To achieve the objectives of these studies, 412 continuing care retirement community residents from five facilities completed a self-report questionnaire. Of these, 354 were used in study 1 and study 2. Findings of the structural equation modeling (Study 1) suggested that resident’s perception of foodservice employee’s technical skills, social skills and motivation were important determinants of confidence and social benefits that led to residents’ overall satisfaction with foodservice. Satisfied resident-consumer is likely to engage in word-of-mouth and repurchase intention. Results of hierarchical multiple regressions (Study 2) revealed that perceived rapport and resident’s dining-need satisfaction are positively related to resident’s quality of life. This study also found that activity involvement and food involvement moderated the relationships between rapport and dining-need satisfaction with quality of life respectively. That is, the more involved resident has an improved quality of life.
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Enhancing User Engagement in Electronic Commerce Through the Transition to a Digital EcosystemYang, Binbin January 2016 (has links)
Electronic Commerce (EC) companies are faced with a highly competitive environment today. Strengthening user engagement in digital ecosystems is a promising approach to increasing value co-creation. However, enterprise-oriented user engagement strategies examined in previous studies are relatively inadequate to meet today’s expectations. This paper looks to answer the question, “how to effectively strengthen user engagement to acquire a sustainable value co-creation system in EC.” A plausible user engagement strategy was revealed by analyzing a single case study in the music sector based on details of a digital ecosystem. Semi-structured interviews performed with company Xiami along with their users, show that the recognition of user-oriented needs and the expansion of user-driven demands are two key aspects for EC companies to maintain a sustainable growth of value co-creation.
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Motivation Through the Lens of SensemakingMarr, Adam, Patharai, Diana January 2019 (has links)
Early research on motivation draws connections to what are now understood as aspects of sensemaking, however research does not explicitly draw a connection to the theory of sensemaking itself. Therefore, the sensemaking perspective is applied to the motivational theory of self determination in order to gain a deeper understanding of how and why motivation develops through sensemaking. This is accomplished through a qualitative approach using semi-structured interviews for empirical data collection, followed by thematic analysis. The research concludes with a representation of the sequential process that demonstrates the interconnectedness of sensemaking and motivation, demonstrating the connection between environmental change, meaning creation and internalization, need satisfaction, motivation and action. Consequently, this research provides insight to the co-existence of sensemaking and motivation, facilitating opportunities to reach a more complete understanding of how individual motivation actually exists and develops.
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Vers une meilleure compréhension des réponses des consommateurs face à la contamination perçue : le rôle de l'imagerie mentaleGerard, Jessica 04 December 2012 (has links)
Dans la plupart des environnements de vente, le consommateur peut facilement manipuler les produits et ainsi vivre des expériences tactiles. Cependant, cette liberté de toucher les produits n’est pas sans conséquences. En effet, si le consommateur aime toucher les produits, il est réticent à ce le produit qu’il touche ait été manipulé au préalable par d’autres personnes. Ce paradoxe est un enjeu pour les praticiens. Comment permettre aux clients de toucher les produits tout en garantissant qu’ils soient dépourvus de contacts antérieurs avec autrui ? Cette thèse s’intéresse au phénomène de contamination perçue des produits. Elle a pour objectif de mettre en évidence les variables agissant sur la contamination perçue et sur les réponses à l’égard des produits perçus comme contaminés. Une étude première qualitative explore la vision que les consommateurs ont de la contamination perçue des produits ; une seconde étude qualitative s’intéresse au point de vue des manageurs. Cette phase qualitative sert de base au développement d’une échelle de contamination perçue. Puis, trois collectes de données quantitatives sont menées afin de comparer l’impact de deux facteurs de contamination. Les résultats montrent que le consommateur est plus sensible lorsqu’un produit présente un résidu suggérant qu’il a été touché que lorsqu’il voit un contaminateur manipuler ce produit. Ils mettent également en évidence que l’imagerie mentale est un mécanisme sous-jacent explicatif de la contamination perçue mais que le besoin de toucher n’a pas d’effet sur le phénomène. / In most retail environments the customer is able to handle products, feel their weight and try them, in other words the customer has a tactile experience. However, this freedom to touch products has a downside. Indeed, even if the consumer likes to touch products, he refuses the same product if it has been handled by other customers. This ambivalence concerning touch is a major problem for managers in retail outlets. How is it possible to allow consumers to touch products while guaranteeing that they are devoid of previous contact with others? This dissertation focuses on the concept of product contamination. It aims to understand the variables that reflect the impact of perceived contamination on consumer responses. A first qualitative study examines the vision of consumers on product contamination. A second qualitative study focuses on managers’ point of view. These studies are then used as a basis for the development of a perceived contamination scale. Lastly, three quantitative studies compare the impact of two contamination’s cues. The results suggest that the consumer is more sensitive when a product contains a cue that it has been touched, as compared to their reaction to seeing someone touch a product. These findings show that mental imagery is an underlying mechanism contrary to need for touch.
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Comunidades carentes, lugares da não-informação / Comunidades carentes, lugares da não-informaçãoLima, Justino Alves 14 February 2007 (has links)
Este trabalho analisa as necessidades de informação em comunidades carentes. Conduziu-se a investigação junto a 11 comunidades que integram a região denominada de Grande Rosa Elze, situada no município de São Cristóvão, em Sergipe. Os dados analisados foram obtidos tomando-se a opinião de 75 informantes, destes 68 responderam questionários e sete foram entrevistados. A pesquisa teve como objeto de estudo a análise de como comunidades carentes, sem a presença de órgãos públicos de informação, obtém informações que respondam as suas necessidades. Nesse sentido, observou-se o atendimento das necessidades de informação, verificaram-se as práticas de obtenção, avaliaram-se as demandas criadas e as buscas realizadas e identificaram-se as necessidades de informação. Os resultados mostram que: as comunidades carentes do Grande Rosa Elze têm carências de informação; os residentes das comunidades não têm um órgão público a que possam recorrer quando necessitam de informação; a circulação da informação é frágil, pois depende, exclusivamente, de fontes midiáticas; a região é tecnologicamente atrasada, portanto distante da inclusão digital. Conclui-se que a região do Grande Rosa Elze é um lugar onde a informação não acontece, situação resultante da ausência de uma política pública de informação; e que é necessário à existência de um órgão público, para o atendimento da necessidade de informação da comunidade, integrando os processos tradicionais da informação impressa, e os modernos da informação virtual. / This work analyzes the need for information in poor communities.The investigation was conducted in the eleven communities that integrate Rosa Elze region, located at São Cristóvão municipality, in Sergipe state. The analyzed data was based on the opinion of seventy-five people, from which, 68 answered questionnaires and 7 were interviewed. The research aimed at showing how poor communities obtain information they need without having public facilities that provide information located near them. Having this in mind, not only was the fulfilment of the information´need observed but the way they were obtained was also verified.After that, the created demands were evaluated and the need for information was identified.The results of this research showed that: the poor communities at Grande Rosa Elze region are in need of information; the communities dwellers don´t have a public facility where they can require information when they need; The flow of information is poor as it only depends on social communication means and the region is technologically out-of-date, far from the digital era.In conlusion, we notice that Grande Rosa Elze region is a place where there is no flow of information due to the abscense of an information public policy.Therefore, it is imperative to set a public facility that provides not only some traditional printed information as well as some modern virtual one
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Therapeutic Camps and their Impact on the Family of Children with Special Health Care Needs: A Mixed Method StudyLindsey, Brandi 01 December 2014 (has links)
Children with a chronic illness or disability can encounter many difficulties throughout their lifetimes. Respite care through therapeutic summer day camps is a service used to relieve the physical and mental strains placed on caregivers while also creating unique opportunities to benefit the child. There are gaps in the literature surrounding therapeutic camps and their benefit for the family and their ability to manage the child’s special health care need. The purpose of this study is to determine how respite care in the form of a therapeutic summer day camp for children with special needs impacts a family’s ability to manage their child’s special health care needs within their family. This research study used mixed methodology combining quantitative data collection through pre- and postsurveys and qualitative data collection through interviews that work to answer questions relating to the effects of a therapeutic summer day camp on parents’ perspective and management of their child’s condition. The theoretical framework used to guide the study is the Family Management Style Framework. Twenty-two parents completed The Family Management Measure that was administered prior to and at the conclusion of an 8-week therapeutic summer day camp program. Qualitative interviews with 11 parents helped to better understand specific interventions and experiences of the therapeutic camp that benefitted their child and family. Although the quantitative analysis did not yield statistically significant changes in the family’s ability to manage their child’s condition as a result of attendance at the camp, the qualitative interviews demonstrated robust evidence that the camp provided meaningful experiences for the campers and parents while alleviating stress within the family. Themes that emerged from the interviews include: (1) Family-Child themes of loss of normalcy, relationships affected, increased stress, family adaptations, and love for the child; (2) Camp-Child themes of meets individual needs, creates happiness, and behavior changes; and (3) Camp-Parent themes of improved perception of the child, decreased stress, parent involvement with staff, and need for specific environment at camp. Implications of the results are discussed, along with recommendations for future research.
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Emotional Responses to Varying Sources of Interpersonal RejectionCleek, Molly K. 01 May 2015 (has links)
Baumeister and Leary (1995) propose with their Need to Belong Theory that negative affect would occur upon the disruption of an existing or even potential social connection. The present paper presents two studies that sought to resolve past contradictory research by examining how rejection by various sources (romantic partners, family members, close friends, or strangers) impact the rejectee’s emotional responses. The first study, which used a recalled memory of rejection, yielded no significant differences in mood, need to belong, threat to the four fundamental needs, or state self-esteem for the different sources. However, the second study, which used imagined scenarios, found that the source of rejection had a significant effect on the rejectee’s levels of hurt feelings, sadness, and perceived level of rejection, indicating that the effects of rejection are influenced by the relationship people have with their rejecters. This has many implications on how we understand relational dynamics and rejection.
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