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Objective: The objective of the study was to examine the impact of decentralization on operational efficiency, staff well-being, and teamwork on three inpatient units. Background: Decentralized unit operations and the corresponding physical design solution were hypothesized to positively affect several concerns-productive use of nursing time, staff stress, walking distances, and teamwork, among others. With a wide adoption of the concept, empirical evidence on the impact of decentralization was warranted. Methods: A multimethod, before-and-after, quasi-experimental design was adopted for the study, focusing on five issues, namely, (1) how nurses spend their time, (2) walking distance, (3) acute stress, (4) productivity, and (5) teamwork. Data on all five issues were collected on three older units with centralized operational model (before move). The same set of data, with identical tools and measures, were collected on the same units after move in to new physical units with decentralized operational model. Data were collected during spring and fall of 2011. Results: Documentation, nurse station use, medication room use, and supplies room use showed consistent change across the three units. Walking distance increased (statistically significant) on two of the three units. Self-reported level of collaboration decreased, although assessment of the physical facility for collaboration increased. Conclusions: Decentralized nursing and physical design models potentially result in quality of work improvements associated with documentation, medication, and supplies. However, there are unexpected consequences associated with walking, and staff collaboration and teamwork. The solution to the unexpected consequences may lie in operational interventions and greater emphasis on culture change. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multi-measure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency. [ABSTRACT FROM AUTHOR]

At the beginning of the 17th century Rene Descartes proposed the first plausible neural theory of vision and visual perception and thus began a scientific enterprise that has continued unabated [...]

The article discusses a study examining the impact of decentralization of support spaces on reduction of the time wasted by registered nurses (RNs) in walking, using a simulation-based experimental method. Results showed that the total walking time can be reduced up to 67.9 percent, depending on the decentralization level used. It suggests that appropriate levels of decentralization may contribute to care quality and efficacy, although extreme levels may reduce the opportunities for several activities in areas of peer support, socialization and mentoring that contribute to care quality.

Since the last ATAX conference in April 2010, the US has unilaterally adopted two, very controversial transparency initiatives: * FATCA - Imposes a 30% withholding tax on a foreign financial institution (FFI) that desires to access the US financial market unless the FFI agrees to report information about its US customers. * Schedule UTP - Requires large corporations to disclose uncertain tax positions (UTPs) for which a tax reserve has been recorded in audited financial statements. While a senior US government tax official, the author was heavily involved in developing both FATCA and Schedule UTP. The primary purpose of this article is to discuss certain of the global considerations of these two ground-breaking initiatives. For example: Does the US need multilateral action to accomplish its goals with respect to either FATCA or Schedule UTP, and if so, what form might such action take? The paper concludes the following: * The US likely needs multilateral action to successfully implement FATCA, but it does not for Schedule UTP. * Foreign countries would benefit greatly from using the US's leverage to effectively force financial institutions to join a multilateral FATCA system. The US would benefit from reducing the number of viable investment options available to US tax cheats. * A successful multilateral FATCA system could incorporate multiple design features. For example, it could accommodate both a reporting and withholding model. However, if this option is selected, a "punitive withholding model" should be adopted that has a relatively high tax rate and applies to both investment income and new money. The failure to apply withholding tax to new money is a major deficiency of the recent withholding agreements between Switzerland and the UK/Germany. * Schedule UTP requires a corporation to link a tax reserve with a specific tax issue. If tax reserves are recorded on an aggregate basis, the link between a tax reserve and a specific tax issue may be more difficult to establish. This issue had been resolved by FIN 48 in US GAAP, but it still exists for IFRS. Fortunately, there is a solution. [ABSTRACT FROM AUTHOR]

The article presents information on the Foreign Account Tax Compliance Act (FATCA) that has been criticized by many persons of the financial community in the U.S. It informs that the act was signed by U.S. President Barack Obama and is a bold, unilateral action by the U.S. government to increase transparency. It further informs that time is required to implement the act successfully.

Background: The prevailing focus on cognitive load reduction in healthcare environment standardization excludes a domain of healthcare delivery that could contribute significantly to safety and efficiency through standardization, but it has escaped discussion in the context of the biomechanics of care delivery. Inappropriate biomechanics not only can harm caregivers but compromise care delivery. Little, however, is known regarding the biomechanics of patient care and the way it interacts with the configurational issues typically targeted in healthcare environment standardization. Objectives: Examine the types of potentially harmful or stressful actions exhibited by nurses during patient care delivery in an acute medical/surgical setting. Examine the sources influencing unsafe actions. Method: Twenty nurses provided three types of simulated care in an experimental setting involving nine care configurations that were systematically manipulated. A kinesiology expert coded 80 simulation segments representing two types of task and two levels of environmental challenge to identify potentially stressful and harmful actions. Exploratory and regression analyses were conducted on the data. Results: Analysis suggests that a considerable proportion of potentially harmful and stressful actions are associated with the design of the physical elements as opposed to the configurational factors typically addressed in standardization. Both of these factors interact to produce work-arounds that result in unsafe actions. Conclusion: The standardization of healthcare environments needs a larger framework to address both cognitive lapses and the biomechanics of care delivery [ABSTRACT FROM AUTHOR]

Objective: The study objective was to examine whether standardized same-handed room configurations contribute more to operational performance in comparison to standardized mirror-image room configurations. Based on a framework that physical environment standardization supports process and workflow standardization, thus contributing to safety and efficiency, the study examined the comparative effectiveness of the standardized same-handed configuration and the standardized mirror-image configuration. Background: Patient room handedness has emerged as an important issue in inpatient unit design, with many hospitals adopting the standardized same-handed room concept at all levels of patient acuity. Although it is argued that standardized same-handed rooms offer greater levels of safety and efficiency in comparison to standardized mirror-image rooms, there is little empirical evidence either to support or refute these contentions. Method: An experimental setting was developed where elements of the physical environment and approach to the caregiver zone were systematically manipulated. Twenty registered nurses (10 left-handed and 10 right-handed) provided three types of care to a patient-actor across nine physical design configurations, which were videotaped in 540 separate segments. Structured interviews of the subjects were conducted at the end of each individual set of simulation runs to obtain triangulation data. Video segments were coded by nursing experts. Statistical and content analyses of the data were conducted. Results: Study data show that standardized same-handed configurations may not contribute to process and workflow standardization—hence, to safety and efficiency—any more than standardized mirror-image configurations in acute medical-surgical settings. Data suggest that a global view of the patient care environment upon entry is the most sought-after familiarization factor to reduce cognitive load. [ABSTRACT FROM AUTHOR]

The article focuses on various nondestructive testing tools for evaluation of masonry in building structures. It states that masonry-evaluation methods could involve unstable damage levels or deconstruction such as cracks, efflorescence, and spalls, but nondestructive testing tools can reduce these damages induced by the testing. It notes that Ultrasonic wave techniques could also provide estimates of masonry's strength properties such as ultrasonic pulse velocity (UPV) and impact echo (IE).

Purpose: A framework for multidimensional assessment of patient room configurations is presented. Twenty-three issues are considered and categorized under six domains of assessment: (1) patient safety, (2) staff efficiency, (3) circulation, (4) infection control, (5) patient considerations, and (6) family amenities. Use of the framework to rank issues by importance and assess six alternative patient room configurations by a diverse group of experts in a symposium is described. Background: One of the key questions posed during inpatient room design is the location of the bathroom. What issues are affected by the variations in room configuration that arise from bathroom location? A complete articulation of the issues that potentially are affected by room configuration is not available in the literature. Framework: The list of issues was developed by the authors in preparation for a symposium. The symposium was organized in May 2007 and attended by 14 experts from four institutions. Six alternative room configurations were used. Variations the configurations included: (1) three same-handed and three mirror-image rooms; (2) three outboard, two inboard, and one nested bathroom; and (3) three rooms with footwall bathrooms and three with headwall bathrooms. In a four-step process, the attendees ranked the issues, discussed them in detail, rated each room configuration against each issue on a seven-point suitability scale, and conducted an overall assessment of the six configurations. Conclusions: Based on the ratings and rankings provided by the symposium participants, outboard bathroom locations were found to be most suitable, followed by nested and inboard configurations. Furthermore, configurations with patient bathrooms located on the footwall were rated as more suitable than headwall locations. The authors recommend, however, that the framework be used to determine a suitable room configuration in a specific context, rather than to identity configurations that will perform well universally. [ABSTRACT FROM AUTHOR]

Noise and distortion reduce speech intelligibility and quality in audio devices such as hearing aids. This study investigates the perception and prediction of sound quality by both normal-hearing and hearing-impaired subjects for conditions of noise and distortion related to those found in hearing aids. Stimuli were sentences subjected to three kinds of distortion (additive noise, peak clipping, and center clipping), with eight levels of degradation for each distortion type. The subjects performed paired comparisons for all possible pairs of 24 conditions. A one-dimensional coherence-based metric was used to analyze the quality judgments. This metric was an extension of a speech intelligibility metric presented in Kates and Arehart (2005) [J. Acoust. Soc. Am. 117, 2224–2237] and is based on dividing the speech signal into three amplitude regions, computing the coherence for each region, and then combining the three coherence values across frequency in a calculation based on the speech intelligibility index. The one-dimensional metric accurately predicted the quality judgments of normal-hearing listeners and listeners with mild-to-moderate hearing loss, although some systematic errors were present. A multidimensional analysis indicates that several dimensions are needed to describe the factors used by subjects to judge the effects of the three distortion types. [ABSTRACT FROM AUTHOR]

A method for simulating the effects of visual adaptation using image processing techniques was developed, and then tested for accuracy in predicting the reductions in visual performance that occur with adaptation. The simulation process entailed transforming digital photographs of realistic exterior scenes into the spatial frequency domain, filtering the transformed data using contrast sensitivity functions for different adaptation levels, transforming the filtered data back into the luminance domain, and producing a new digital image of the scene. Two experiments were conducted that compared performance on a realistic visual detection task when the subjects were adapted to different luminances, to performance on the same task when subjects' adaptation level was held constant while they viewed the simulated adaptation effects. Results showed that the simulations produced decreases in performance in the same direction as actual adaptation effects, but the effects were of smaller magnitude. A third experiment was conducted to better quantify the differences between the simulated and actual adaptation conditions; this experiment utilized a standardized visual test target, the United States Air Force (USAF) 1951 test pattern. [ABSTRACT FROM AUTHOR]

Jerome's three exercises in hagiography, his Paul, Malchus, and Hilarion, as printed in our standard editions, lack dedications. The manuscript tradition, however, reveals a special (possibly first) edition of the Hilarion explicitly dedicated to the ascetic Roman woman Asella. The present study reviews the nature of the pertinent manuscript evidence, identifies the discovery of the dedication in the early seventeenth century, and then discusses the dedication's loss from scholarly sight (and why it was lost), until its rediscovery by a graduate student at the University of Illinois in the 1930s. Finally, the literary and social contexts prompting Jerome's dedication of this particular vita to Asella are discussed. [ABSTRACT FROM AUTHOR]

In Shakespeare's Troilus and Cressida, an obvious, but curious, Italian word – chipochia – appears in an exchange between Cressida and Pandarus (4.2.31). All modern editions print this word as capocchia, following the emendation of Lewis Theobald in 1733. Theobald posited that this word meant "simpleton" or "blockhead," and editors since then have accepted this meaning, while many have argued for a sexual connotation here, a pun on Troilus' penis. This study offers evidence to support the original spelling of chipochia in both the Quarto and Folio versions and proposes a new definition for chipochia, sensible to dramatic context and founded on established philological evidence. [ABSTRACT FROM AUTHOR]

The article analyzes the inscribed bowl excavated at Garigliano (Minturnae) in Italy. The artifact is a small impasto bowl with bucchero glaze, similar to bowls found at Satricum, Frusinone, and Alfidena. It is inscribed externally and on the internal rim. According to the author, it should not be assumed that the letter were mechanically transferred and imitated from Chalcidic orthography. The author concluded that the bowl may point to an Oscan from the Apennine hills or from the Campanian plain or shore who journeyed to Minturnae to dedicate to a deity.

Previous studies have shown that the baboon and squirrel monkey are resistant to certain herpesviruses that cause serious infection or induce tumours in the cebus monkey and marmoset. This study was undertaken to evaluate the immunological competence of the four species of nonhuman primates. A variety of clinical immunological techniques were employed to evaluate the bursal, thymic-dependent and phagocytic systems of immunity in these species. No primate was found to demonstrate immune competence of the same magnitude observed in normal humans The baboon manifested immune responsiveness most closely resembling that of man. These animals displayed no abnormalities in circulating white blood cell populations, ability to form antibody. delayed skin response to mitogens or lymphocyte transformation in vitro. Rebuck skin window (RSW) findings closely resembled those observed in humans. While the squirrel monkey also appeared to be relatively competent. antibody formation, skin test reactivity and RSW responses were slightly less than those observed in the baboon. Cebus monkeys showed several abnormalities which included significant leukopenia, very low serum alpha-1 globulin levels, cutaneous anergy and a poor RSW response. The most marked abnormalities were found in the marmosets that had persistent leucocytosis, absent to poor antibody responses to immunogens, weak responses to phytohaemagglutin- in in vivo and in vitro, with a uniquely greater response to pokeweed mitogen in vitro. The poor RSW response was similar to that observed in the squirrel monkey and cebus. While these studies suggest that baboons and squirrel monkeys are relatively intact immunologically, the marmoset and cebus monkey species appear to have significant manifestations of immunological incompetence in association with susceptibility to a variety of infectious and oncogenic agents. [ABSTRACT FROM AUTHOR]

Focuses on the ways of using scientific knowledge in the formation of social policy. Reflection on the state of funding for research; Accounts on the cognitive process of integrating current scientific information and social values; Emphasis on the moral justification of lobbying special interests.

Elaborates various aspects of visual perception. Feasibility of the correlation between phenomenal and behavioral measures of perception; Development of innovative measurement techniques of sensory and perceptual processes; Analysis of pattern perception.

The article discusses efforts of the U.S. Navy (USN) and the French Navy who were involved in the 2012 search for the Bonhomme Richard (BHR), a sailing warship in the Continental Navy. It mentions that a French hydrographie ship, equipped with side-scan sonar and a magnetometer, was involved in the search to scan the seabed. It adds that the P-3 Orion aircraft from the USN, equipped with a magnetic anomaly detector, flew over the search area to detect a debris field of iron ballast.