Is Higher Nurse Aide Retention Associated with Fewer Nursing Home Allegations and Complaints?

Consumer voices are often left out from assessments of nursing home (NH) quality. For this reason, consumer allegations and complaints against nursing homes were studied in relation to facility rates of nurse aide retention. Analyses involved means and frequencies, correlations, ANOVAs with Tukey correction to examine the independent and dependent variables (N=690). Four quartiles of retention were created. In the final models, medium, high, and extremely high retention facilities are compared to the low retention facilities. Negative binomial regressions were estimated on total, substantiated, and unsubstantiated counts of allegations and complaints. All regressions controlled for the same characteristics, including nurse aide empowerment, consistent assignment, administrator turnover, director of nursing turnover, average age of residents, and percent female. The correlation between retention and the dependent variables was negative and statistically significant (r=-0.11, p<.01). The ANOVAs showed that high retention NHs (61-72%) received significantly fewer allegations than low (0-48%) and medium (49-60%) retention NHs; they also received fewer unsubstantiated allegations, and fewer complaints, both substantiated and unsubstantiated. After controlling for other variables, each retention group was significantly related to having fewer allegations and complaints compared to the low retention NHs. Notably, high retention NHs received between 29 and 35% fewer allegations and complaints of all types. Unexpectedly, extremely high retention NHs had more allegations, complaints, and unsubstantiated allegations than high retention NHs. Policy and practice have a role to promote nurse aide retention, improve job quality, and ensure adequate support for this critical, in-demand workforce.

Creating reverse flow arteriovenous fistulas with a forearm cannulation target

Background: Establishing a forearm arteriovenous fistula (AVF) offers preferred cannulation sites and preserves proximal access opportunities. When a radiocephalic AVF at the wrist is not feasible and the upper arm cephalic and median cubital veins are inadequate, an AV graft or more complex access procedure is often required. Creating a retrograde flow forearm AVF (RF-AVF) is a valuable alternative where the mid-forearm median antebrachial or cephalic vein is adequate, offering forearm cannulation zones with AVF outflow through deep and superficial collaterals. We report our technique and results. Methods: We retrospectively reviewed our vascular access data base of consecutive patients during an 11-year study period where a RF-AVF established the only available cannulation target in the forearm. In addition to physical examination, all patients had ultrasound vessel mapping. Results: A forearm access was established with a RF-AVF as the only opportunity for cannulation in 48 patients. Ages were 14–86 years (median = 62 years). Forty-four percent female, 63% diabetic, 13% obese, and 29% had previous access operations. Inflow was proximal radial artery in 47 individuals and one proximal ulnar. Nine AVFs (19%) failed at 2–66 months (median 14 months). One RF-AVF was ligated due to arm edema. Follow-up was 2–111 months (median = 23.5 months). Primary and cumulative patency rates were 62% and 91% at 12 months, and 46% and 85% at 24 months. Five patients were lost to follow-up with functioning RF-AVFs (mean 41 months). Twenty-three patients (48%) died during F/U of causes unrelated to access procedures (mean 25 months). Conclusions: Establishing a reverse flow forearm AVF offers a successful autogenous access option in the forearm for selected patients with an inadequate distal radial artery and/or cephalic vein at the wrist, avoiding more complex or staged procedures and preserving upper arm sites for future use. A proximal radial artery inflow procedure is recommended.

Opioid overdoses: Emerging clinical challenges

Objective: Analysis of a large consecutive case series of cases brought to an Emergency Department (ED).Design: Retrospective chart review.Setting: Emergency Department in Broward County, Florida.Patients: Medical records of patients with registered diagnoses of opioid overdose in 2016 and 2017.Outcomes: Demographics, toxicology results, mental-health comorbidities, use/response to naloxone, and hospital disposition.Results: Seven hundred and seventy nine opioid-overdose cases were identified (35 percent female, 65 percent male; age 36.2). Heroin intoxication was registered in 77 percent of discharge diagnoses, and 17.7 percent were prescription pain medications. Urine samples were collected in 39 percent and 81.5 percent of patients received naloxone (mean dose 4.0 mg ± 2.2). Sixty-five percent of cases were discharged home, 17.5 percent left the ED against medical advice, and 17.5 percent were admitted to the hospital/intensive care unit/behavioral unit.Conclusion: There is an alarming number of visits to the ED due to opioid overdoses with differences in age and gender. Clinicians are facing diagnostic, treatment and follow-up challenges for the management of these cases.

Indonesian Women in Politics: Critical Analysis of Portrayal in Online News Sites

In 2004 Election, Indonesian government launched a policy mandatory 30 percent female representatives in the legislature. This is an effort to accelerate an increase of women’s representativeness in the parliament. This research describes the imaging of women as politicians in Indonesian online news sites: detikcom, Kompas.com, and Tribunnews.com. Van Dijk’s critical discourse analysis was utilized as method of this research with feminist critical analysis as the corresponding method. The result shows that the imaging of female politicians is in the domestic area. They are pictured as emotional and weak persons.

Employees’ perceptions of their manager’s authentic leadership

Purpose The purpose of this paper is to test whether managers’ political skill is relevant for employees’ authentic leadership perceptions. Political influence theory assumes that political tactics seek to affect others’ interpretations of a person or situation. Thus, what matters for employees’ perceptions of their manager’s authentic leadership may be whether the manager actively seeks to show behavior that can be interpreted as authentic leadership. Combining political influence theory and gender stereotypes research, it is further suggested that manager gender moderates the employees’ interpretation of political influence attempts that are ambiguous. Design/methodology/approach Managers (n=156; 49.5 percent female) completed measures of their political skill. Employees (n=427; 39.1 percent female) completed measures of the manager’s authentic leadership. Findings Managers’ apparent sincerity was positively related to employees’ perceptions of managers’ authentic leadership; managers’ networking ability was negatively related to employees’ perceptions of female managers’ authentic leadership, but not of male managers. Research limitations/implications The methodology does not allow claims about causality. Originality/value Findings add knowledge of authentic leadership, such as difficulties that female managers face, and show the value of a fine-grained approach to political skill. Female managers should be aware that networking might have disadvantageous side effects. Conversely, sincere behavior attempts seem favorable for authentic leadership perceptions.

Development of Reheatable Thermo Jackets

Since the past two decades, there has been a constant increase in upper quadrant body pain among people of different age groups. Taking view of the effectiveness of heat therapy in curing pain, the present study was undertaken to develop reheatable thermo jackets using heating gel packs. A functional design consisting of pockets for insertion of gel packs in thermo jacket was created digitally. The jacket was developed using casement and PVC fabrics. Two jackets, one for male and female respectively were developed with variation in colours. To study the effectiveness of the developed jackets on the basis of functionality and cost, ten respondents suffering from upper quadrant pain were selected purposively and jacket was given to each one of them to use for five days. The results revealed that 60 percent male and 80 percent female respondents found the jacket to be extremely comfortable and relieved them off their pain even while at work. Majority of the respondents did not face any problem in heating and placing gel packs in the jacket and more than 60 percent of them were highly relieved from their pain and found the jackets to be functionally and cost effective. The jacket was highly appreciated by respondents as it proved to be a multi pain relaxer for them while the selected experts opined that jackets retained the heat of gel packs for a longer duration as compared to other commercially available substitutes.

The None in Three Victim Responsiveness Assessment (Ni3: VRA): a new outcome measure for intimate partner violence (IPV) prevention programs

Purpose The purpose of this paper is to develop and validate the None in Three Victim Responsiveness Assessment (Ni3: VRA) examining affective and cognitive responsiveness toward victims of intimate partner violence. Design/methodology/approach Data were collected at two time points in a sample of 359 young people from Barbados and Grenada (56.27 percent female; M age=12.73 years). Findings Confirmatory factor analysis results indicated that the Ni3: VRA scores are best captured by a two-factor solution, including affective and cognitive dimensions. A test-retest correlation confirmed the reliability of the Ni3: VRA over time. Affective responsiveness formed a significant positive association with caring/cooperative behavior. Originality/value The Ni3: VRA can be used for the evaluation of preventive strategies aimed at reducing the rates of IPV.

Enhancing brand equity through emotions and experience: the banking sector

Purpose The banking sector is devoted to attracting Generation Y customers with their particular tastes and interests. The purpose of this paper is to explore for the first time how bank experience influences emotions and perception of brand equity. Using the stimulus–organism–response (S–O–R) framework, the authors consider the perception of brand equity as the outcome. Design/methodology/approach A panel based on the method of Walsh and Beatty (2007) with completed and usable questionnaires was used to test the proposed model. The authors selected a sample of 211 respondents. After eliminating some inconsistencies, a final data sample consisted of 205 usable survey participants (male: 58 percent; female: 42 percent). Findings Executional excellence, staff engagement and value for money are the most relevant indicators in shaping the overall bank experience. Pleasure is the positive emotion that most enhances the perception of brand equity. Originality/value This study extends the S–O–R model by employing dimensions of experience as stimuli and brand equity as response. The study demonstrates the role of emotions (particularly pleasure) in enhancing brand equity among individuals from the Generation Y.

Hurricane knowledge and interpretation of forecasted error cone and wind potential graphics

Objective: The purpose was to examine how participants understand, interpret, and make decisions using hurricane forecast graphics.Design: A four-part online survey was administered.Participants were provided an error cone graphic and one of three experimental potential for damaging winds graphics. Hurricane knowledge was also measured.Subjects: Two hundred eighty-six individuals initially responded to the survey. A subset of the sample was used for analysis (N = 203, with 130 responding to questions in all four parts). The average age was 41.97 (SD 12.97) with a range from 18 to 75. The reduced sample was 56.7 percent female and 43.3 percent male.Results: Responses were significantly different between those receiving the potential for damaging winds graphic and both other graphics. The addition of the error cone did not significantly change decision making. Perceived helpfulness of the forecast graphic increased with the addition of the track, but similarly, the addition of the error cone did not contribute significantly (means = 5.91, 7.78, 8.09). A majority of respondents answered five of the six hurricane knowledge questions correctly (62.1-79 percent). The lowest percentage knew what ingredients hurricanes needed to form (36.3 percent).Conclusions: Track information significantly altered participants’ perceptions of risk from damaging winds, but the error cone did not. Hurricane knowledge was good, with misconceptions existing regarding the effectiveness of taping windows and the meaning of the term “major hurricane.” Understanding of the two forecast graphics was also good.

From sPassion to sWOM: the role of flow

Purpose Social commerce websites entail a completely new scenario for sharing experiences and opinions due to its richness in terms of social interactions. Nowadays, users can interact with the company and with other users; hence, it seems important to study how social stimuli affect users. Drawing on the stimulus-organism-response framework and flow theory, the purpose of this paper is to propose that the social stimulus (named social passion (sPassion)) has a positive effect on the organism (state of flow), which leads to a users’ positive response (via social word of mouth (sWOM)). Design/methodology/approach The data were collected through an online survey in 2015. The sample consists of 771 users of social commerce websites, of which 51 percent are male and 49 percent female, aged between 16 and 80 years old. Structural equation modeling was used to analyze the data with the statistical software SPSS version 22 and EQS 6. Findings The empirical results confirm that passionate users are prone to experience a state of flow and, as a consequence, share positive sWOM. Originality/value This study contributes to the literature on customers’ online participation, and the findings are hoped to help companies in developing social commerce websites that boost users’ exchange of information.