bluuebunny/crossref_metadata_2025 huggingface dataset:
Comolia paraensis (Melastomataceae), a striking new species of Marcetieae endemic to Pará, Brazil
Authors: DA SILVA DIEGO NUNES , DA ROCHA MARIA JOSÉ REIS , GUIMARÃES ELSIE FRANKLIN , GUIMARÃES PAULO JOSÉ FERNANDES
Published: May 2024

During the preparation of the taxonomic review of Comolia, some taxonomic novelties were found. Here we describe Comolia paraensis, a new species endemic to the Brazilian state of Pará, preliminary categorized as Endangered. This species occurs in the campinas around Oriximiná and in the stony Amazonian savannas of Monte Alegre and Óbidos. Comolia paraensis is morphologically similar to C. kuhlmannii and C. veronicifolia, two taxonomic entities that here were considered distinct from C. villosa. Comolia paraensis is illustrated, compared with similar species, and notes on its geographic distribution and preliminary conservation status are provided. We also discuss the succulence found in the branches of the population from Monte Alegre, something unprecedented within Marcetieae, but commonly reported in Pyramieae and Sonerileae.
Lectotypification of Macromia pyramidalis Martin, 1907 (Odonata: Macromiidae) and its nomenclatural consequences
Authors: KOSTERIN OLEG E. , DELFOSSE EMMANUEL
Published: May 2024

The type series of Macromia pyramidalis Martin, 1907 was for a long time suspected to be heterogeneous. The photographs of the three syntypes preserved in Muséum National d’Histoire naturelle, Paris, France (MNHN) revealed the male syntype to be consubspecific to the current Macromia pinratani vietnamica Asahina, 1996 and the two female syntypes conspecific to the current Macromia berlandi Lieftinck, 1941. The name M. pyramidalis is the oldest among those mentioned. The male syntype is designated as the lectotype of M. pyramidalis to result in somewhat less inconvenient nomenclatural consequences, which are as follows: Macromia pyramidalis pyramidalis, valid name = Macromia pinratani vietnamica, syn. nov.; Macromia pyramidalis pinratani Asahina, 1983, comb. nov.; Macromia pyramidalis, valid name = Macromia pinratani, syn. nov.
Redescription of Rhyacophila clemens Tsuda 1940 (Trichoptera, Rhyacophilidae), with descriptions of five new, allied species from Japan
Authors: KAWASE NAOKI
Published: May 2024

Japanese species of the Rhyacophila clemens Species Group Ross 1956 are revised, and six species including five new allied species are recognized: R. clemens Tsuda 1940, R. vesperalis sp. nov., R. inazui sp. nov., R. angulicauda sp. nov., R. parvicauda sp. nov., and R. furcicauda sp. nov. Adult males and females of all species are described or redescribed, and the male genitalia of a Korean species, R. kumgangsanica Kumanski 1990, also belonging to this species group, are illustrated for comparison. The lectotype of R. clemens is designated for nomenclatural stability. The main diagnostic characters for the R. clemens Species Group are provided as follows: (1) Segment X bears an apical hinged process posteroventrally; (2) two pairs of anal sclerites have a common internal root; (3) a pair of large apical bands surrounds the anus and the root of the anal sclerites; (4) the aedeagus bears a large sclerotized ventral plate.
Experimental Approaches to Iron Determination in Potentiometric Sensors Using (2-2-(4-Dinitrophenyl) Hydrazono) Methylphenol
Authors: Abdullah M. M. , Albargi Hasan B. , Algethami Jari S. , Sharma Shashank , Mohammad Luqman  , Mustafa Jawed
Published: May 2024

The study presents a PVC membrane-based potentiometric sensor for iron (III) detection, demonstrating impressive selectivity in Fe(III) ion-selective electrodes (ISE). The sensor achieves a detection limit of 4.0×10−7 M and a Nernstian response slope of 19.4 mV
per decade change within a concentration range of 7.4×10−7 to 1×10−1 M. Operating efficiently within the pH range of 3.6–10, the sensor maintains its potential divergence-free utility for at least eight weeks and has a rapid response time
of approximately twenty seconds. The sensor’s selectivity for Fe3+ ions makes it a robust tool for specific Fe(III) ion detection. The sensor’s reliability and longevity make it a valuable tool for continuous monitoring applications, providing accurate and timely information
on the presence of iron ions in diverse settings.
Formation Mechanism and Morphology Evolution of β-NaYF4 Single Microcrystals in Hydrothermal Process
Authors: Wang Bin-yu , Yang Kai-xin , Hu Jiang-liang , Chang Li-ping , Wang Jian-cheng , Wang Bing
Published: May 2024

Lanthanide-doped upconversion (Ln-doped UC) materials with predicable phase and geometry are attractive for their promising application in optics and biological. Herein, we report a facile strategy for deterministic synthesis of β-NaYF4 microcrystals by an ethylenediaminetetraacetic
acid (EDTA) assisted hydrothermal process. The nucleation and growth process of the β-NaYF4 microcrystals have been experimentally revealed with different hydrothermal times. The phase and geometry of as-obtained crystals can be well manipulated by the experimental parameters
such as pH values, precursors’ ratio, and reactant concentrations. The formation and morphology evolution mechanism of β-NaYF4 single microcrystals can be qualitatively analyzed using energy minimization principles under the thermodynamic and kinetic control. In
addition, we presented the colour-changing up-conversion of Tm3+ and Yb3+ doped single β-NaYF4 microrod. Our work could help the understanding on crystal growth and design of rare earth fluoride mateirals at micro and nanoscale.
Two Characteristic Patterns of the Summer Indian Ocean Dipole
Authors: Fan Lei , Fu Hui-Huang , Liang Yu
Published: May 2024

This study identifies two distinct patterns of the summer Indian Ocean dipole (IOD)—the coastal IOD and the offshore IOD—named based on the proximity of their eastern pole to Sumatra. Their spatial characteristics, evolutionary mechanisms, relationships with ENSO, impacts on precipitation, and the factors controlling the simulation performances of climate models are discussed. The coastal IOD has the same eastern pole as the conventional IOD, which is located off the coast of Sumatra, but its western pole is situated in the central region of the tropical Indian Ocean (TIO). In contrast, the offshore IOD shares the same western pole as the conventional IOD, which is located off the coast of Somalia, whereas its eastern pole is positioned in the central TIO. Regarding their evolutions, while they initially develop similarly, their later evolutions differ due to their distinct pole locations: The offshore IOD peaks in summer, while the coastal IOD can be sustained into autumn. The coastal IOD correlates to preceding and late ENSO states, but the offshore IOD does not, making it an independent internal mode of TIO. The two IODs affect climate differently, with only the coastal IOD affecting Australian rainfall. Climate models exhibit varied levels of performance in simulating the two IODs. Specifically, a stronger link between spring TIO rainfall and ENSO, as well as stronger southeasterly monsoon winds in the southern TIO, can enhance the coastal IOD modeling, while a stronger summer Somali jet benefits the simulation of the offshore IOD. Distinguishing these two IODs has implications for accurate diagnosis and prediction of the summer climate surrounding the TIO.

Significance Statement

The Indian Ocean dipole (IOD) significantly influences the monsoon climate. Previous studies use a unified IOD index based on all-season sea surface temperature (SST) data of tropical Indian Ocean (TIO), resulting in a representation biased toward the autumn peak season. However, understanding SST patterns during summer is crucial for Asian summer monsoon precipitation, and what are the characteristic patterns of summer IOD remains unclear. This study fundamentally advances the understanding of the IOD’s seasonal diversity by identifying two distinct dipole patterns in the summer TIO. These patterns differ from the conventional IOD in terms of spatial characteristics, evolutions, ENSO relationships, and precipitation impacts. Distinguishing between these two IODs is anticipated to improve the diagnosis and prediction of summer monsoon rainfall.
High stiffness 3D-printed continuous pitch carbon fiber reinforced polymer composites
Authors: Saleh Menna A , Olcun Sinan , Karam Mohamed , Kempers Roger , Melenka Garrett W
Published: May 2024

This study presents a method for 3D printing very high stiffness pitch-based carbon fiber (CF) reinforced polylactic acid (PLA) composites using a modified open-source 3D printer. The fused filament fabrication (FFF) technique was used to fabricate the samples with alternating layers of PLA and PLA-coated pitch CF. The tensile Young’s modulus of the 3D-printed composite samples was measured to characterize the effect of different grades and volume fractions of pitch CF on the behaviour of the printed composites. Three grades of pitch CF which have different Young’s modulus were used with volume fractions ranging from 2.4 to 8.4%. Tensile tests showed that the K1392U CF reinforced composite with a 7.3% volume fraction demonstrated the highest improvement in Young’s modulus of 850% compared to neat 3D-printed PLA. This improvement is notably higher than any previous 3D-printed carbon-based composites at a relatively low volume fraction of CF. Statistical analysis showed increased Young’s modulus in all of 3D-printed composite samples tested. The experimental values were compared to the Halpin-Tsai model and suggest that some degree of fibre breakage occurred during the 3D printing process owing to the relative stiffness of the pitch-based fibers. Future directions and suggestions for process improvements are discussed.
Impact of Japanese L1 Rhythm on English L2 Speech
Authors: Kawase Saya , Davis Chris , Kim Jeesun
Published: May 2024

The study aimed to examine whether L1 speech rhythm affects L2 speech by assessing how the speech rhythm of Japanese L2 English speakers differed from native speakers. We chose Japanese and English because they differ markedly in the phonological properties that likely contribute to speech rhythm. Speech rhythm was measured by the variability of vowel and consonant intervals using rate-normalized rhythm metrics (VarcoV and VarcoC; nPVI-V and nPVI-C) and %V. The study utilized recordings of spoken sentences in English by 10 native Australian English speakers; and in English and also in Japanese by 10 native Japanese speakers (who had limited experience in speaking English). Experiment 1 compared the rhythm of L1 English (by measuring 1,750 vowels and 3,093 consonants from 20 sentences) and L1 Japanese (1,923 vowels and 2,097 consonants from 10 sentences). The results showed that for all measures, Japanese had reduced durational variability in both consonant and vowel intervals compared with English. In Experiment 2, we examined the rhythm characteristics of L1 and L2 English using 40 sentences (including the 20 in Experiment 1). The results showed that vowel and consonant intervals were less variable in L2 (Japanese English) than in L1 (Australian English) speech, mirroring the results of Experiment 1. Overall, the results are consistent with the proposal that L1 (Japanese) speech rhythm influenced L2 (English) speech.
Application of Greenroads Rating System and Life Cycle Assessment in Informing the State of the Practice in Sustainable Roadway Construction
Authors: Zokaei Ashtiani Milad , Muench Stephen
Published: May 2024

This paper highlights the application of the Greenroads Rating System in collecting, measuring, and communicating sustainable best practice data in the context of roadway infrastructure construction. Once measured, meaningful comparisons between common practice and what goes above and beyond routine can be recognized, educated, advertised, spread, and finally, implemented. This study collected, organized, and analyzed data from 33 Greenroads-certified roadway construction projects completed between 2011 and 2018 with a total value of over 2 billion USD. We believe such a database is scarce within the literature and is worth exploring. Greenroads scorecards, which indicate the level of achievement in sustainable construction practices, were analyzed to show the frequency with which best practices are pursued. Findings show that projects typically perform activities that can be considered common practice and avoid activities that fall outside of their prior experience realm. Realizing that roadway surfaces including pavement structures often contribute to a high proportion of a roadway project’s sustainability efforts, the last piece of this study is dedicated to the life cycle assessment (LCA) of paving materials as conducted and reported by project teams. Integrating LCA results with financial information from pay item lists, correlation analyses between carbon and energy footprints and the price of major paving materials such as asphalt mixtures and portland cement concrete were carried out. Results show that the quantified environmental footprints of projects and the materials used to build them strongly correlate with the total price of projects and the price of constituent materials, respectively.
Worms and Coffee: Municipal Consolidation in the South
Authors: Giannatasio Nicholas A.
Published: May 2024

This article explores the tax/service equation and progresses through variations in this equation that include productivity and privatization initiatives. Ultimately, as local governments utilize economy and efficiency techniques, they may minimize these techniques and look for other alternatives to tax increases or decreases in service. The author believes that the next progression in the tax/service equation is consolidation of governments. This article repudiates the conventional understanding that consolidation is only a solution for fragmented governments.
Implications of Organizational Climate and Ethical Leadership on Reengineering in Municipal Government
Authors: Daly John L.
Published: May 2024

For the past two decades, increasing demands have been placed on government to "do more with less." These pressures have resulted in innovative searches by officials to "find" practical solutions that enhance organizational productivity within stable to declining operational resource environments. Business Process Reengineering has been touted recently by organizational theorists as an innovative method for improving organizational cost-effectiveness, increasing responsiveness to clients, and enhancing service delivery (Hammer and Champy, 1993' Manganelli and Klein, 1994; Linden, 1994; Hyde, 1995).

The advent and application of reengineering in government, however, has not been without fierce debate. Offsetting the positive aspects of its utilization, reengineering has been criticized as resulting in dehumanizing workforce reductions and increasing workloads for downsizing survivors. In environments of substantial dynamic change, concern exists for damaging cooperative relationships of management and labor.

This study examines survey responses obtained from managers and supervisors in four Florida smaller sized municipal governments. It assesses the influence that organizational climate and ethical leadership have on instituting governmental process changes. The research results indicate a strong relationship between positive organizational climate and successful process reengineering. Less evidence exists to support a similar impact of ethical practices on reengineering outcomes.
Bureaucratic Interests and Institutions in the Making of China'S Socialy Policy
Authors: Duckett Jane
Published: May 2024

Explanations of China's post-Mao social policy have concentrated on the political, social, fiscal, and economic goals of the state and its governing elite. In a study of urban health insurance policy, this article argues that bureaucratic interests and institutions within the Chinese state are also influenced. This article first shows how bureaucratic interests within the central government have influenced the adoption of a new national social health insurance framework. It then shows how that framework has been modified following local implementation experiences that have allowed other bureaucratic and non-bureaucratic interests to be expressed. This examination of both central and local interests helps explain the adoption of a basic social health insurance system that provides for only the urban working population, subsidizes civil servants, and is administered locally. The article also shows the policy process in this sector to have been particularly protracted and incremental and argues that further incremental policy changes are likely.
Street-Level Discretion: Is There A Need for Control?
Authors: Carrington Keith
Published: May 2024

This article examines the exercise of discretion by street-level bureaucrats. The article first examines some of the arguments for and against the uses of discretion by street-level workers. It then looks at the impact of the professional bureaucracy on the exercise of discretion. Finally, the article suggests the need for further research on street-level discretion.
Not as Easy as it Sounds? Delivering the National Integrity System Approach in Practice – the Case Study of the National Anti-Corruption Programme in Lithuania
Authors: Doig Alan
Published: May 2024

The article takes forward some of the issues deriving from the Transparency International concept of the National Integrity System [NIS]. The NIS is a framework approach developed by Jeremy Pope when he was with TI that proposes assessing corruption and reform holistically. The NIS not only looks at separate institutions, or separate areas of activity, or separate rules and practices, but also bases its perspective on institutional and other inter-relationships, inter-dependence and combined effectiveness. It provides a framework for the development of comprehensive country-wide anti-corruption plans.

This article assesses the NIS approach in the light of the main themes raised by two research studies into the NIS in practice – one funded by the Dutch Government and the other by the UK Department for International Development – in some 40 countries, involving 18 countries, including transitional countries.

One such country – Lithuania – is used to illustrate the NIS in practice and, in particular, issues concerning the delivery of an NIS in practice. The implementation of the Lithuanian anticorruption programme is used to assess how easy or difficult it is both to deliver a comprehensive reform process that reflects the purpose of an NIS in practice and to implement its core components. Such issues should inform the nature of the support provided by donor agencies and also what expectations other transnational agencies may have of transitional countries as they seek to implement an appropriate and integrated framework to address corruption. Overall, the use of the NIS is seen as a useful framework within which to assess corruption and deliver reform. Seeking to implement a comprehensive programme without the use of such a methodology or framework does create issues of effective implementation.
Accountability in the Netherlands: Exemplary in its Complexity
Authors: de Vries Michiel
Published: May 2024

This article addresses the accountability practices in the Netherlands. It is argued that during the past few decades, nearly all constituting elements of classic accountability have been abandoned. The new practices involve audits, monitoring, performance measurement, evaluation, etc. It is argued that these practices have some serious side-effects, namely that accountability procedures have deteriorated in standard operations, resulting in an increase of administrative cost, insignificance, biased accounts, and ambiguous responsibility. The article concludes by a plea to reconsider the merits of modern managerial accountability.
Limits of Public Accountability under the Reinvented State in Developing Nations
Authors: Haque M. Shamsul
Published: May 2024

In recent decades, there has emerged a worldwide movement for reinventing the state and government in favor of market forces, promarket policies and roles, and businesslike structures and standards. Under such a reinvented state, there are corresponding changes in terms of how, for what, and to whom public officials are held accountable. These new trends have some major critical implications for the realizations of public accountability. This article explores these concerns with special reference to developing nations.
Contracting for Underwriters: Are All Underwriters Equal?
Authors: Robbins Mark D. , Simonsen Bill
Published: May 2024

Municipal bond sales require access to investors who ultimately buy the bonds. In most cases, this function is outsourced to an underwriter that acts as the financial intermediary between the bond issuer and the investor. We ask the question: how interchangeable are different underwriters? There is no organized market where municipal bonds are bought and sold. The interest rates on any particular issue can be affected by factors such as how much risk the underwriter is willing to take and underwriter reputation/certification. In this paper, we use data on Missouri local government bond sales from 2008–2011 to test whether the choice of a specific underwriter influences bond interest rates. We find that governments receive different pricing when selecting one firm versus another. This suggests that public managers should use contract management techniques to select underwriters and then evaluate the bond sale results.
Organizational Culture and Change: What Impact will the United States Marine Corps’ Culture have on the Implementation of the Don't Ask Don't Tell Repeal?
Authors: Moran David , Lynch Cynthia E.
Published: May 2024

In its over two hundred year existence, the U.S. Marine Corps has undergone many serious changes such as the admission of women and Blanks into its ranks. The most current change is open acceptance of lesbians, gays and bisexuals (LGB) as U.S. Marines and is referred to as the repeal of Don't Ask Don't Tell (DADT). This article examines the way in which a large organization, such as the U.S. Marine Corps, implements an enormous change and the role that organization culture plays in the success or failure of the implementation. Cameron and Quinn's Competing Values framework is used to explain the theory behind implementing this major change and how this moment in the Marine Corps’ process can afford researcher great insight into the power and influence of organization culture
Interstate Disparity in Combating COVID-19 in India: Efficiency Estimate Across States
Authors: Maity Shrabanti , Sinha Anup
Published: May 2024

Currently, COVID-19 is the most lethal menace in the world. Due to its health and economic consequences, it becomes a serious challenge for the economy. The present article aims to explore India’s interstate disparities of efficiency in combating COVID-19 based on secondary data. Besides, an attempt has been made to pinpoint the factors responsible for the inefficiency of resisting this deadly virus. The interstate efficiency measurement is facilitated by applying stochastic production frontier analysis. The empirical result divulges that among the Indian states, Bihar is the most efficient in combating COVID-19. The empirical estimation of the frontier model discloses that the number of doctors, nurses, police force, isolation beds and hotspots positively and significantly influence the recovery rate from COVID-19 in Indian states. The empirical results of the inefficiency effects model suggest that the share of elderly and urbanisation reversely influence the efficiency in combating the virus, while favourable sex ratio, literacy rate, regular salaried employment, digitalisation and ruralisation stimulate the efficiency of the concerned state. The study concludes that efficient utilisation, coupled with the advancement of the existing health infrastructure, is imperative for the acceleration of the recovery rate from this pandemic.
The Demographic, Economic, and Health Profile of Older Latinos: Implications for Health and Long-Term Care Policy and the Latino Family
Authors: Villa Valentine M. , Aranda Maria P.
Published: May 2024

The number of older Latinos is increasing rapidly and many of its members are in poor health, economically disadvantaged, and reliant on publicly-funded programs that are at risk of continuing cutbacks and restructuring. Such changes limit this population's access to health and long-term care services and shift an increasing amount of responsibility to the Latino family. This article reviews the demographic, economic, and health data of the Latino population and also discusses current and proposed changes under Medicare and Medicaid and the potential impact of these revisions on the Latino population. The authors argue that the needs of younger and older Latinos are linked and any program and policy to improve the situation of the elderly must confront the vulnerabilities of all family members.
Medicine, Government and the Human Genome
Authors: Larson James S.
Published: May 2024

The sequencing of the human genome represents the most important scientific discovery of our age. What can the medical community expect from government in applying this new technology? The major government initiative, the Human Genome Project, is due to be completed in 2005, but a number of important issues remain. Genetic therapy promises to be the most significant use of the new technology, developing new drugs and treatments for the genetic components of disease. But, genetic enhancement is a controversial area involving moral, legal and ethical issues. Government policy will have to respond to this issues, as well as important developments in the private sector. Ultimately, the public good will have to be protected, as scientific discoveries advance the frontiers of medicine.
Nonprofit Ownership and Quality in Mddicaid's Long-Term Care Program for Persons with Developmental Disabilities
Authors: Brown Samuel L.
Published: May 2024

To assess ownership-related differences in the Intermediate Care Facility Program for persons with Mental Retardation (ICF/MR) Industry, this article analyzes a nationally representative sample of data on Medicaid certified facilities from the Health Care Financing Administration On-line Survey and Certification Reporting System. This study found that nonprofit providers provided a higher level of quality than for-profit facilities when organizational size and facility-mix were controlled. The size and case-mix composition of these facilities were also influenced by nonprofit ownership type. Nonprofit providers offered smaller facilities, on average, and were more likely to enroll heavy case-mix residents than their for-profit counterparts.
Sole Hospital Commitment to Health Promotion and Disease Prevention (HPDP) Services: Does Ownership Matter?
Authors: Zhao Mei , Carretta Henry J. , Hurley Robert E.
Published: May 2024

Hospitals have been increasingly involved in health promotion and disease prevention (HPDP) in the last two decades. Concurrent with this trend, environmental changes and market pressures have resulted in more hospital consolidations and conversions from not-for-profit (NFP) to for-profit (FP) organizations. The emergence of a large number of sole community hospitals has attracted the attention of policy-makers and community stakeholders because sole community hospitals have more power in the local market and may discontinue unprofitable services to pursue profit maximization. This may be especially true when the sole hospital is a FP organization. On the other hand, sole community hospitals are confronted with a variety of expectations to offer community-oriented services that promote community population health, regardless of ownership.

There is relatively little literature that has attempted to examine the behavior of sole community hospitals. This study depicts the profile of sole hospitals’ involvement in HPDP services and estimates the possible influence of community constituencies on hospitals with respect to their providing community-oriented services. The results indicate that typically, when there is only one hospital in the community, hospital ownership has no significant influence on hospital HPDP services than their NPD counterparts. Implications for policy-makers and health care leaders are also discussed.
Understanding Differences in Influenza Immunization Rates: A Survey of African-American and Caucasian Medicare Beneficiaries in Texas
Authors: Abel Robert L. , McGaha Paul , Young Robert , Bing Mark , Foran Terese , Oaks Brian
Published: May 2024

A goal of Healthy People 2010 is to increase the influenza immunization rate among high-risk populations to at least 90 percent. This article presents the results of a survey on influenza immunizations among African-Americans and Caucasian Medicare beneficiaries in a 25-county project intervention area in Texas. Information on the burden of suffering from pneumonia and influenza, the benefits of influenza immunization, and recommendations are included. Data are presented on the characteristics of the African-American and Caucasian Medicare beneficiary survey respondents, their influenza immunization rates, health status and sources of health care, and factors that influence them to obtain an annual influenza immunization.
State, Healthy Physicians: An Assessment of the Louisiana Natural Death Act
Authors: Frank Pamela , Cruise Peter L. , Parsons Sharon K. , Stutes Ronald , Fruchter Scott
Published: May 2024

In our society, state governments have the major role in regulating physician behavior and actions related to end-of-life decision making. However, in the current confusing and conflicted legal environment, how well are state governments doing with this serious responsibility? The authors of this article report the results of the first statewide survey of Louisiana physicians regarding their knowledge of and compliance with specific parts of one state government's attempt to regulate end-of-life decision making: the Louisiana Natural Death Act (LNDA). Physician respondents were asked to indicate their level of familiarity with the LNDA and several questions examined physician compliance with specific sections contained in the statute. Among many things, the survey revealed most physicians (74%) were not familiar with even the basic provisions of the LNDA, and had not received either medical school or subsequent post graduate training in this area. Based on the results of this survey, the authors offer several policy recommendations that could enhance physician knowledge and subsequent compliance with the LNDA.
An Ethnographic Study of Nursing Home Culture to Define Organizational Realities of Culture Change
Authors: Deutschman Marian T.
Published: May 2024

The current system of delivery of nursing home care is costly both in dollars and in human terms. Culture change may provide solutions to both issues. Culture change has a different meaning for different organizations depending on where they are in the continuum of change. Detailed observation of staff members “in action” in three long-term care facilities over a period of several months was supplemented by formal and informal interviews of organization members to gain an understanding of the culture of the nursing home organization.

Four three-hour observations in each of three facilities, representing privately-held and not-for-profit organizations in urban, suburban, and rural locations yielded insights into the routine, recruitment, training, teamwork, activities, leadership, role-modeling, mentoring, staff and resident satisfaction, weekend staffing and activities, bureaucratic structure, and sharing of best practices. Discussion of each of these issues may provide a starting point for all those facilities that are contemplating significant culture change.

If the objective is to have facilities truly embrace a new set of values, then the change begins with the owners and administrators of nursing homes who need to focus on building new relationships with all the stakeholders. In-depth interviews of organization members and six chief executive officers in long-term care in the Western New York area culminated the study with the development of a fifty-question survey for decision makers.
Racial Differences in Health Care Use among Medicare Only and Dual Eligibles
Authors: Moon Sangho , Shin Jaeun
Published: May 2024

It has been an important financial issue in the U.S. Medicare expenditures that health care expenses of Medicaid-Medicare dual eligibles (MMDE) are much higher than those of Medicare only beneficiaries (MOB). This paper compares health care use and health status of MMDEs and MOBs who are either Afro-American or white recipients.

Using total health care use information from the Medical Expenditure Panel Survey (MEPS) 2000, we find that the proportion of dual eligibles with chronic health conditions is higher by 4% than that of the Medicare only beneficiaries and that dual eligibles make more frequent uses of various health care services. The number of office-based physician visits and outpatient physician visits are higher for Afro-American dual eligibles than white dual eligibles. This finding seems to be contributed to by relatively high medical needs among dual eligibles. Higher utilization of agency-related home health services among Afro-American dual eligibles than among white dual eligibles is considered as a consequence of different ethnicity-specific responses to insurance coverage.
Entrepreneurial Organizations: The Driving Force for Improving Quality in the Healthcare Industry
Authors: Borkowski Nancy , Gordon Jean
Published: May 2024

Using DiMaggio and Powell's concept of institutional isomorphism, the authors explain why healthcare lags behind other industries in innovating new production functions that address quality. Healthcare firms can “learn” to be entrepreneurial organizations within Stevenson's ‘entrepreneurial versus administrative behavior’ framework and Covin and Slevin's model of an entrepreneurial organization's required culture and behavioral support structure.
HIV/AIDS in Bangladesh: The Role of Government in Health and Human Services Administration
Authors: Mahmood Shakeel Ahmed Ibne
Published: May 2024

Explore the susceptibility of the People of Bangladesh to HIV/AIDS. The prevalence of HIV/AIDS in the neighboring countries may have reasonable proportions of impact in our country. According to the data provided by a Bangladesh University, the number of detected People living with HIV/AIDS reached 567 as of Dec 2005. Importance of appropriate education on safe sex, violence, HIV/AIDS at all levels of our society, including counseling and advocacy, is emphasized and recommends governmental policy and research for prevention of HIV/AIDS.
Ten Approaches for Enhancing Empathy in Health and Human Services Cultures
Authors: Hojat Mohammadreza
Published: May 2024

Empathy is defined as a predominantly cognitive attribute that involves an understanding of experiences, concerns and perspectives of another person, combined with a capacity to communicate this understanding. Empathy in the context of clinical care can lead to positive patient outcomes including greater patient satisfaction and compliance, lower rates of malpractice litigation, lower cost of medical care, and lower rate of medical errors. Also, health professionals’ well-being is associated with higher empathy. Enhancing empathic engagement in patient care is one of the important tasks of medical education. In this article, I briefly describe 10 approaches for enhancing empathy in the health care environment: improving interpersonal skills, audio- or video-taping of encounters with patients, exposure to role models, role playing (aging game), shadowing a patient (patient navigator), hospitalization experiences, studying literature and the arts, improving narrative skills, theatrical performances, and the Balint method. I conclude that empathic engagement in the health care and human services is beneficial not only to the patients, but also to physicians, other health care providers, administrators, managers, health care institutions, and the public at large.
Structural Relationships between Work Environment and Service Quality Perceptions as A Function of Customer Contact Intensity: Implications for Human Service Strategy
Authors: Scotti Dennis J. , Harmon Joel , Behson Scott J.
Published: May 2024

This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.
Diabetes Self Management: Are Cuban Americans Receiving Quality Health Care?
Authors: Huffman Fatma G. , Vaccaro Joan A. , Nath Subrata , Zarini Gustavo G.
Published: May 2024

Objectives

We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA).

Study Design

Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida.

Methods

Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age ≥ 35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%.

Results

Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001).

Conclusions

The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample's diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions.
Supply Chain Management with Cost-Containment & Financial-Sustainability in a Tertiary Care Hospital
Authors: Chandra Hem , Rinkoo Arvind Vashishta , Verma Jitendra Kumar , Verma Shuchita , Kapoor Rakesh , Sharma R K
Published: May 2024

Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. the main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. the model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8–25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. in 2009–10, total annual purchases of 14 Million USD were made. the balance sheet reflected 1.4 Million USD as fixed deposit investment. the minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009–10. In-depth analysis of ‘balance sheet’ and ‘Income and Expenditure’ statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain mechanism to ensure availability of the right materials at the right time at a reasonable cost. Thus innovations like HRF will prove robust in rendering quality healthcare at an affordable cost.
A Longitudinal Model of the Dynamics between Hmos’ Consumer-Friendliness and Preventive Health Care Utilization
Authors: Xiao Qian , Savage Grant T. , Zhuang Weiling
Published: May 2024

This study aims at replicating and extending Xiao and Savage's (2008) research to understand the multidimensional aspect of HMOs distinguished by HMOs’ consumer-friendliness, and their relationship to consumers’ preventive care utilization. This study develops a dynamic model to consider both concurrent and time lagging effects of HMOs’ consumer-friendliness. Our data analysis discloses similar relationship patterns as revealed by Xiao and Savage. Additionally, our findings reveal the time-series changes of the influence of HMOs’ consumer-friendliness that either the effects of early experienced HMOs’ consumer-friendliness wear out totally or HMOs’ consumer-friendly characteristics on the concurrent term contain most of the explanatory power.
Arabic Translation and Adaptation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Patient Satisfaction Survey Instrument
Authors: Dockins James , Abuzahrieh Ramzi , Stack Martin
Published: May 2024

Objective.

To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population.

Design.

Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking Setting. Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia.

Participants.

645 patients discharged during 2011 from the hospital's inpatient care units. Interventions. the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives. Main outcome measures. Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items. Results. Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 – 0.750, P<0.01; Cronbach's alpha = 0.516 – 0.851) All ten HCAHPS measures were compared quarterly to US national averages with results that closely paralleled the US benchmarks.

Conclusion.

The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.
Impact of A Serious Game for Health on Chronic Disease Self-Management: Preliminary Efficacy among Community Dwelling Adults with Hypertension
Authors: Hickman Ronald L. , Clochesy John M. , Pinto Melissa D. , Burant Christopher , Pignatiello Grant
Published: May 2024

Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control. Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN.
Perspectives on Multidisciplinary Team Processes among Healthcare Executives: Processes that Facilitate Team Effectiveness
Authors: Landry Amy , Erwin Cathleen
Published: May 2024

Background

Multidisciplinary teams (MDTs) are used in healthcare organizations to address both clinical and managerial functions. Despite their prevalence, little is known about how team processes work to facilitate effectiveness among MDT leadership teams.

Purpose

This study explores perceptions of MDT participation experienced by organizational leaders in healthcare organizations in the United States.

Methodology/Approach

A survey of American College of Healthcare Executives members was conducted to assess involvement and perceptions of MDTs among health care management professionals. Descriptive statistics, independent T-Tests and Chi-square analyses were used to examine participation in MDTs, perception of MDT processes, and the association of participation and perceived processes with employee and organizational characteristics.

Findings

The survey yielded a sample comprised of 492 healthcare executive or executive-track employees. An overwhelming majority indicated participation in MDTs. The study identified team processes that could use improvement including communication, cooperation, and conflict resolution.

Practice Implications

The study provides evidence that can help guide the development of training programs that focus on providing managerial leaders with strategies aimed at improving communication, coordination, and conflict resolution that will improve the effectiveness of MDT functioning in healthcare organizations.