Improving Intraoperative Parathyroid Hormone Lab Efficiency

Background Intraoperative parathyroid hormone (iPTH) testing is often used to confirm successful removal of hypersecreting parathyroid glands during parathyroidectomy. Unfortunately, the iPTH test can be a time-consuming and highly variable process that occurs while the patient is under anesthesia. We set out to improve iPTH lab efficiency and variability. Methods We performed a retrospective review of 85 patients who underwent parathyroidectomy at our institution from October 2017 to October 2019. Each step of the iPTH lab reporting process was recorded and analyzed. Three simulations were performed of the entire process. We then established interventions to modify inefficiencies in the process and studied 21 patients who underwent parathyroidectomy at our institution from November 2019 to March 2020. Results Twenty-five minutes of time inherent to the process were identified. Four critical steps were identified as modifiable steps in the process: 1. Operating room (OR) blood draw ---> lab receipt. 2. Lab receipt ---> placement on centrifuge. 3. Removal from centrifuge ---> placement on PTH machine. 4. PTH machine result ---> OR verbal report. We improved iPTH lab efficiency by 19%, decreasing the average lab result from 45 to 36 minutes ( P = .001). We improved iPTH lab variability by 62%, decreasing the standard deviation from 21 to 8 minutes ( P = .001). Discussion Utilizing a team-based approach to identify and expedite critical steps in the iPTH lab process can make a significant improvement in iPTH lab efficiency, improving patient care by decreasing total anesthesia time.

Expressing unconscious general knowledge using Chevreul’s pendulum

Can unconscious knowledge be elicited by ideomotor action when the knowledge fails to be elicited by verbal reports? Using a Ouija board, Gauchou et al. (2012), found ideomotor action produced substantial accuracy for general knowledge questions previously rated as pure “guesses”, and for which later verbal reports produced accuracy close to chance. We replicated the procedure substituting Chevreul’s pendulum rather than a Ouija board. We found that questions whose answer was previously rated as a guess, were answered equally well and at about chance levels by ideomotor action and verbal responses. Thus, one cannot presume that ideomotor action rather than verbal report will allow greater knowledge to be expressed in any particular context, including therefore the hypnotherapy one. An ideomotor action may elicit only conscious knowledge. Further research is recommended to clarify this important issue.

Understanding New Zealand Homeowners Apparent Reluctance to Adopt Housing-Sustainability Innovations

<p>This thesis investigates why sustainability innovations are not being adopted at the expected rate when they not only reduce environmental problems but also improve health, comfort, productivity, and economic and social wellbeing. Homeowners' demonstrate an apparent preference for sustainability innovations. However, there are apparent inconsistencies in their decisions as demonstrated by the lack of success of numerous intervention schemes. The aim of this research was to understand the motivations behind New Zealand homeowners' apparent reluctance to adopt sustainability innovations such as solar water heating panels or double glazing. A mixed methods research approach was taken to account for the numerous explanations and to address the research questions and concerns. This included a preliminary study to further establish the need for this research by investigating the implied market value of sustainability through real estate advertisements; a survey to identify homeowners engaging in this behaviour and their reasons for doing so; and a series of verbal report interviews to develop a qualitative insight of the thought processes behind their decisions. Numerous groups of homeowners were identified; the focus of this research however were those who displayed apparently unreasonable behaviour in that despite knowing what the logical answer should be they still said that they were not willing-to-pay full price for the innovation. This group were found to represent the largest proportion of homeowners suggesting that our time and resources need to be focussed primarily on convincing this large group of homeowners. The cause of these homeowners apparently unreasonable behaviour was observed to be due to an exaggerated perception of risk. In addition to the obvious risks that the innovation might not suit their house or that the financial return would not occur, these homeowners seemed averse to being seen to be different from the average homeowner. It is proposed that the findings from this research can be used to plan interventions that either change behaviour or align policy and other marketing responses to the characteristics this group of homeowners displayed.</p>

Understanding New Zealand Homeowners Apparent Reluctance to Adopt Housing-Sustainability Innovations

<p>This thesis investigates why sustainability innovations are not being adopted at the expected rate when they not only reduce environmental problems but also improve health, comfort, productivity, and economic and social wellbeing. Homeowners' demonstrate an apparent preference for sustainability innovations. However, there are apparent inconsistencies in their decisions as demonstrated by the lack of success of numerous intervention schemes. The aim of this research was to understand the motivations behind New Zealand homeowners' apparent reluctance to adopt sustainability innovations such as solar water heating panels or double glazing. A mixed methods research approach was taken to account for the numerous explanations and to address the research questions and concerns. This included a preliminary study to further establish the need for this research by investigating the implied market value of sustainability through real estate advertisements; a survey to identify homeowners engaging in this behaviour and their reasons for doing so; and a series of verbal report interviews to develop a qualitative insight of the thought processes behind their decisions. Numerous groups of homeowners were identified; the focus of this research however were those who displayed apparently unreasonable behaviour in that despite knowing what the logical answer should be they still said that they were not willing-to-pay full price for the innovation. This group were found to represent the largest proportion of homeowners suggesting that our time and resources need to be focussed primarily on convincing this large group of homeowners. The cause of these homeowners apparently unreasonable behaviour was observed to be due to an exaggerated perception of risk. In addition to the obvious risks that the innovation might not suit their house or that the financial return would not occur, these homeowners seemed averse to being seen to be different from the average homeowner. It is proposed that the findings from this research can be used to plan interventions that either change behaviour or align policy and other marketing responses to the characteristics this group of homeowners displayed.</p>

The Challenge of Inferring Unconscious Mental Processes

Studies of unconscious mental processes often compare a performance measure (e.g., some assessment of perception or memory) with a measure of awareness (e.g., a verbal report or forced-choice response) of the critical cue or contingency taken either concurrently or separately. The resulting patterns of bivariate data across participants lend themselves to several analytic approaches for inferring the existence of unconscious mental processes, but it is rare for researchers to consider the underlying generative processes that might cause these patterns. We show that bivariate data are generally insufficient to discriminate single-process models, with a unitary latent process determining both performance and awareness, from dual-process models, comprising distinct latent processes for performance and awareness. Future research attempting to isolate and investigate unconscious processes will need to employ richer types of data and analyses.

CLIL approach in encouraging self-efficacy amongst Malaysian gifted students for Arabic tasks accomplishment

CLIL approach refers to Content and Language Integrated Learning. This paper discusses the self-efficacy of Malaysian Gifted Students (MGS) at GENIUS@Pintar Negara in understanding Arabic tasks in the classroom, for example, understanding the Arabic terms in the lesson of Haji. These terms are; a) dam tertib and takdir, b) dam tertib and ta’dil, c) dam takhyir and takdir, d) dam takhyir and ta’dil. Besides, by employing the CLIL, the MGS can improve themselves because the CLIL approach encourages their self-efficacy to completely deal with the language task. The present study employs; qualitative study by using an interview, verbal report, and observation. This method is an instrument to answer two research questions. a) How the individual of MGS adapts his/ her situation to understand the four Arabic terms of the dam in Haji after undergo the three principles stages of classroom task in CLIL? b) What is the best method to memorize the four Arabic terms of the dam in Haji? In this study, three participants took part in the pilot study, and seven participants took part in the actual study. The present study revealed that the MGS in the Pusat GENIUS@Pintar Negara prefer to be independent learners by using the internet to understand the four Arabic terms and memorize by using keywords related to the four Arabic terms in performing Haji.

MUSIC RADIO RECORDINGS AS OBJECTS OF THE ARCHIVAL STORAGE

The purpose of the article is to characterize the peculiarities of organizing the storage of musical audio recordings in the repositories of radio stations. The methodology is based on the use of general scientific and special methods. The universal nature of music as a special language determines the internationality of music art. From the moment of birth and during the past years verbal report of the unwritten conditions, that are connected to music sound record accumulation in different cultural institutions, has changed not once. The transformations of this relationship were caused by different reasons – social, political, technical, and technological nature. In current high-technology conditions integration properties inherent in the holistic process of creation, circulation, and spread of information, accumulated in music compositions for radio. Today the formation of the new qualitative communication area with the rapid growth of the sound messages streams level occurs. The article is dedicated to the scientific problem of the preservation and use of music audio recordings of radio companies as objects of archival storage. Archived musical radio records are defined as a special cluster of the communication area. The socio-communicative approach is the methodological basis of the publication. The scientific novelty. The main directions of ensuring the preservation, restoration, and restoration of music audio recordings of archival audio recordings are substantiated, as well as the peculiarities of digitization and use of sound documents of this type, are revealed. The specifics of the formation of the respective collections are considered on the example of the BBC Archive Center and The British Library Sound Archive as leading foreign institutions where music records are stored. It is concluded that digital technologies have led to a change in the culture of music consumption and, accordingly, have transformed the processes of storing music archival recordings in the repositories of radio companies, which have acquired specific properties. Examining music radio recordings as archival objects have shown that in the age of the digital revolution, the music industry around the world has undergone significant changes. Both the revenue structure and the cost structure of record labels and music radio companies have fundamentally changed. Conclusions. Digital technologies have led to a change in the culture of music consumption (there has been a change in the ideology of authorship for music products) and the emergence of digital recording technologies that use artificial intelligence, digital workstations, etc. In this regard, the specifics of the organization of storage of music archival recordings were transformed, in particular in the phono repositories of radio companies that have acquired specific properties of the service grade (reprint of archival music recordings that were previously specially recorded for radio stations).

Non-Verbal Pain Assessment: A Literature Review

Pain is influenced by multiple factors including personal experience, psychological, sociocultural and situational factors. Failure to recognise pain will lead to poor patient management and deleterious effect on the patients’ wellbeing. Assessing pain in paediatric and cognitively compromised patients remains a challenge. Pain assessment in these groups of patients depends on the observers’ assessment and studies have shown the discrepancy between the observers’ assessment and patients’ verbal report. A specific and accurate tool is required to assist in the pain assessment. Although there are assessment tools available using behaviour scoring system and physiological indicators, none of the tool demonstrates its superiority than the others. Biochemical indicators such as stress hormones are frequently measured and used in con-junction with verbal reports; however they are non specific to pain and are increased in inflammation, haemodynamic and emotional changes. The association between immunological indicators e.g. IL-1 , IL-6, IL- 8 and clinical pain has been shown, however; the definite correlation of the changes in the indicators and the level of pain is still unclear and may require further investigation.

Faktor Ideasi dalam Proses Kreasi Seniman Lukis Jelekong

Alih keterampilan yang dilakukan secara turun-temurun dalam komunitas pelukis Jelekong yang tidak memiliki latar belakang pendidikan seni formal telah berlangsung selama 50 tahun dan menghasilkan karakter khas dari lukisan Jelekong yang secara konsisten dipraktekkan dalam memproduksi karya lukis. Tujuan penelitian ini adalah untuk mengetahui faktor ideasi seniman lukis Jelekong yang tidak memiliki latar belakang pendidikan seni formal agar membangun pemahaman mengenai proses kreasi pada konteks pewarisan keahlian melukis secara turun-temurun. Penelitian ini menganalisis proses kreasi pada ideasi tahap awal dengan metode verbal report, melalui analisis jaringan konsep asosiatif dari pengalaman subjek saat menggambar sketsa, image analysis dan analisis faktor. Dari hasil analisis, 10 pelukis Jelekong yang diteliti dalam pikirannya saat proses menggambar sketsa mengarah kepada harmoni yang diindikasikan melalui jarak rumah yang berdekatan, penempatan objek yang umumnya berjumlah dua di sisi kanan dan kiri, perbedaan warna objek jauh dan dekat, alam yang ideal dengan adanya awan, bentuk figuratif dan benda alam lainnya, perbedaan garis untuk memberikan tekstur, perbedaan profesi, perbedaan aktifitas, serta komposisi yang seimbang. Ketika menggambar sketsa, pelukis juga mempertimbangkan ketenangan yang diindikasikan melalui suasana yang sepi dengan tidak adanya unsur alam yang rusak, seperti kekeringan namun suasana yang sejuk, ingatan seniman akan suasana alam yang sejuk dan tenang, serta gambar-gambar dengan ruang yang luas, seperti penggambaran satu rumah dan sangat jarang menggambar banyak makhluk hidup. Faktor ideasi dalam proses kreasi seniman lukis Jelekong cenderung mempraktikkan peniruan atau mencontoh karya yang telah dibuat sebelumnya dan sangat jarang ditemukan unsur kebaruan, sehingga seringkali menemukan harmoni dan ketenangan pada setiap karya.

Issues in the assessment of L2 pragmatics

This paper highlights areas of concern in the assessment of pragmatics, with the intent of stimulating fresh thinking about the assessment of pragmatics both for research purposes and as a part of classroom instruction. It starts by considering what aspects of ability in pragmatics to assess, and then contrasts the trade-off between the feasibility of obtaining data and the ultimate importance of the data. Next, the conspicuous lack of assessment of ability in L2 pragmatics in language classes is noted. Then follow sections on topics all relating primarily to the assessment of pragmatics for research purposes – the use of mixed methods, data elicitation procedures, and norms used in determining the appropriateness of any given performance in pragmatics. The last two topics deal, respectively, with the perceived relevance of the given assessment by the learners and with the value of collecting verbal report data from the respondents as a means for validating the assessment measures. Finally, considerations regarding the most prominent of these issues are provided.