Full Service Research Articles

Government Regulation and Percutaneous Coronary Intervention Volume, Access and Outcomes: Insights From the Washington State Cardiac Care Outcomes Assessment Program

BackgroundIt is unclear how to geographically distribute percutaneous coronary intervention (PCI) programs to optimize patient outcomes. The Washington State Certificate of Need program seeks to balance hospital volume and patient access through regulation of elective PCI.Methods and ResultsWe performed a retrospective cohort study of all non‐Veterans Affairs hospitals with PCI programs in Washington State from 2009 to 2018. Hospitals were classified as having (1) full PCI services and surgical backup (legacy hospitals, n=17); (2) full services without surgical backup (new certificate of need [CON] hospitals, n=9); or (3) only nonelective PCI without surgical backup (myocardial infarction [MI] access hospitals, n=9). Annual median hospital‐level volumes were highest at legacy hospitals (605, interquartile range, 466–780), followed by new CON, (243, interquartile range, 146–287) and MI access, (61, interquartile range, 23–145). Compared with MI access hospitals, risk‐adjusted mortality for nonelective patients was lower for legacy (odds ratio [OR], 0.59 [95% CI, 0.48–0.72]) and new‐CON hospitals (OR, 0.55 [95% CI, 0.45–0.65]). Legacy hospitals provided access within 60 minutes for 90% of the population; addition of new CON and MI access hospitals resulted in only an additional 1.5% of the population having access within 60 minutes.ConclusionsMany PCI programs in Washington State do not meet minimum volume standards despite regulation designed to consolidate elective PCI procedures. This CON strategy has resulted in a tiered system that includes low‐volume centers treating high‐risk patients with poor outcomes, without significant increase in geographic access. CON policies should re‐evaluate the number and distribution of PCI programs.

국내 대형항공사 MZ세대 고객의 고객가치, 고객태도 및 고객행동의도의 구조적 관계

The objectives of this study are to investigate the structural relationship among the customer value, customer attitude, and customer behavior intention of MZ generation on the service experiences of the full service carrier in korea, and the mediating effect of customer attitude. The MZ generation is drawing attention as a generation that leads trends not only in the digital industry but also in various industries based on differentiated values from the previous generation. A total of 210 responses were used for analysis in this study. Demographic characteristics were examined through frequency analysis, and exploratory factor analysis, confirmatory factor analysis, and correlation analysis were conducted to verify the validity and reliability of factors using SPSS 20.0 program. After that, the hypothesis were verified by using AMOS 22.0, and also the mediating effect on customer attitude was examined. As a result of this study, first, it was found that among the customer value of the MZ generation for full carrier service, the functional value and emotional value had a significant positive influence on customer attitude. Second, the functional value among the customer value had a significant positive influence on customer behavioral intention. Third, it was found that customer attitude had a significant positive relationship with customer behavior intention. Fourth, it was found that customer attitude plays a mediating role between customer value and customer behavior intention. Based on this study results, it suggested some practical implications that can be used to domestic full service carrier.

Analysis of public transportation system in makkah: Evaluation of efficiency, efficacity and safety operation of Almashaaer Al Mugaddassah Metro (MMMSL)

The pilgrim passenger service was designed to support traffic capacities of 72,000 pphpd (during Hajj), the line length is approximate 18 Km, double track, and standard gauge. This study proposes to evaluate efficiency, efficacity and safety operation of the metro system build in Makkah, Almashaaer Al Mugaddassah Metro (MMMSL). It is a special 18 Km of Metro line dedicated to support pilgrim service, especially during Hajj period. This line connects Arafat, Muzdalifah, Mina and Jamarat in Makkah area. This line was constructed in 2 years, during 2009 to 2011 time period, and entering in full service before Hajj, November 2011. This paper intends to suggest a further development(s) study concerning safety operation, and efficiency of the MMMSL metro line, and suggest potential infrastructure upgrades fit traffic capacities. Therefore, researchers present to the concerned reader(s) a paper structured to cater information for: introduction, line operation, dysfunctionalities, scheme development principles, identification of potential errors in scheme design, and recommendation for improvement. A qualitative research method was used, with both, literature review and five semi-structured interviews with industry experts. Research results indicated that more sample analysis and evaluation should be carried out, with a balance between a four-line metro system and upgrade the existing line to Maglev transport technology, software simulation of traffic capacities with verified software tools, analyse of station accommodation and loading / off-loading capacities, issues caused by signaling systems operating with OOP (Object Orientated Programming), etc. It was clearly outlined that existing metro system capacity cannot cope with 72,000 pphpd, and for existing forecasted figures of 2.5 million Hajj Pilgrims, a system with nearly 100,000 pphpd would satisfy requirements.

Assessment of surgical care capacity at non-tertiary hospitals in Botswana

Background: Most low- and middle-income communities (LMICs) live in rural areas and are served mainly by primary and district hospitals. This study seeks to geographically map these hospitals and measure their surgical care capacity in Botswana. Methods: This 3-month cross-sectional observational study was conducted at the Department of Surgery, University of Botswana. Google Map was used to map hospitals geographically. The PIPES (personnel, infrastructure, procedures, equipment, and supplies) tool was used to assess the surgical care capacity of hospitals. This tool was developed by Surgeons Overseas to quantify surgical capacity in low-resource settings. Consent was obtained. Results: Nine districts and ten primary hospitals were assessed. The distance from settlements to the nearest healthcare facility in sparsely populated areas was relatively larger, making timely healthcare access potentially problematic. Intensive care services were unavailable except at three hospitals. None of the hospitals had full blood bank services. X-ray and ultrasound machines and basic supplies were available at over 90% of the hospitals. Conclusion: There was a general lack of surgical care specialists. Hospitals with a full complement of surgical care specialists had relatively higher PIPES indices. We recommend investing in deploying specialized surgical care providers to primary and district hospitals.

Construction of Heritage Digital Resource Platform Based on Digital Twin Technology

In order to preserve and inherit material cultural heritage, the author proposes a method for digital construction of the Great Wall’s cultural heritage based on digital twin. This method discusses the connotation of the whole life cycle of the Great Wall digital twin, proposes the research path and content of the digital twin construction of the Great Wall cultural heritage, and conducts the application of the Great Wall digital twin to evaluate the application effect. The evaluation results show that users’ overall satisfaction with Great Wall’s digital twin application is relatively high, and the average score of each indicator is above 4, and the functional experience is slightly poor. Conclusion. This method can provide full life cycle visualization services for the digital archiving, application, and decision-making of the Great Wall cultural heritage and provide theoretical and methodological references for the preservation and inheritance of material cultural heritage.

Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India.

Laparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdominal conditions. However, access to laparoscopic surgery in rural North-East India is limited, in part due to limited equipment, unreliable supplies of CO2 gas, lack of surgical expertise and a shortage of anaesthetists. We evaluate the cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery (MIS) for abdominal conditions in rural North-East India. A decision tree model was developed to compare costs, evaluated from a patient perspective, and health outcomes, disability adjusted life years (DALYs), associated with gasless laparoscopy, conventional laparoscopy or open abdominal surgery in rural North-East India. Results indicate that MIS (performed by conventional or gasless laparoscopy) is less costly and produces better outcomes, fewer DALYs, than open surgery. These results were consistent even when gasless laparoscopy was analysed using least favourable data from the literature. Scaling up provision of MIS through increased access to gasless laparoscopy would reduce the cost burden to patients and increase DALYs averted. Based on a sample of 12 facilities in the North-East region, if scale up was achieved so that all essential surgeries amenable to laparoscopic surgery were performed as such (using conventional or gasless laparoscopy), 64% of DALYS related to these surgeries could be averted, equating to an additional 454.8 DALYs averted in these facilities alone. The results indicate that gasless laparoscopy is likely to be a cost-effective alternative to open surgery for abdominal conditions in rural North-East India and provides a possible bridge to the adoption of full laparoscopic services.

Anti‐Corrosion and Reconstruction of Surface Crystal Plane for Zn Anodes by an Advanced Metal Passivation Technique

For the aqueous Zn‐ion battery, dendrite formation, corrosion, and interfacial parasitic reactions are major issues, which greatly inhibits their practical application. How to develop a method of Zn construction or treatment to solve these issues for Zn anodes are still great challenges. Herein, a simple and cheap metal passivation technique is proposed for Zn anodes from a corrosion science perspective. Similar to the metal anti‐corrosion engineering, the formed interfacial protective layer in a chemical way can sufficiently solve the corrosion issues. Furthermore, the proposed passivity approach can reconstruct Zn surface‐preferred crystal planes, exposing more (002) planes and improving surface hydrophilicity, which inhibits the formation of Zn dendrites and hydrogen evolution effectively. As expected, the passivated Zn achieves outstanding cycling life (1914 h) with low voltage polarization (<40 mV). Even at 6 mA cm−2 and 3 mA h cm−2, it can achieve stable Zn deposition over 460 h. The treated Zn anode coupled with MnO2 cathode shows prominently reinforced full batteries service life, making it a potential Zn anode candidate for excellent performance aqueous Zn‐ion batteries. The proposed passivation approach provides a guideline for other metal electrodes preparation in various batteries and establishes the connections between corrosion science and batteries.

Synthetic control methods for policy analysis: Evaluating the effect of the European Emission Trading System on aviation supply

In this paper, we provide a novel application of synthetic control methods by offering two major modifications to the existing methodological framework. We provide the first complete ex-post evaluation of the causal impact of carbon pricing on aviation supply, expressed in terms of airline output (i.e., number of seats supplied at the airline-route level). We investigated the policy change in the European Union Emission Trading System (EU ETS), the first large greenhouse gas emissions trading scheme in the world. We distinguish between low-cost, regional and full service airlines, short and medium/long-haul routes, routes towards (or from) hub airports versus non-hub airports, monopolistic versus non-monopolistic routes. The analysis shows that the EU ETS does not have a substantial impact on the average aircraft size, while it has caused a reduction of total airline seat capacity and flight frequency, with the percentage of airline seat capacity reduction reaching above 20% at its peak. The overall effect of the policy has a remarkable impact on low-cost and regional airlines, short-haul routes, spoke–spoke markets and monopolistic routes. Our results are the first empirical confirmation to the theoretical prediction in the aviation literature that emission charges will reduce flight frequency and increase load factors while having no effect on aircraft size.

Pengaruh Motivasi dan Pengalaman Kerja Terhadap Kinerja Pegawai Honor Dinas Perhubungan Kota Sungai Penuh

Human resource management can be interpreted as a movement that recognizes the importance of people in government when with proper management, planning and development will be able to provide maximum contribution to an organization. The purpose of this research is to determine the effect of motivation and work experience on employee performance. Data analysis used descriptive and inferential methods. The sample measurement uses the Slovin formula with 92 respondents, namely full river city transportation service employees. The method used is descriptive causal quantitative in order to determine the causal relationship between research variables. The results of the study are that motivation does not have a high enough influence on employee performance because the value of t count < t table. However, work experience has a high enough influence on the quality of the performance of honorary employees with a value of t count > t table. In the F test, it is known that F arithmetic > F table, motivation and work experience can have a significant influence on employee performance with a large percentage of 20.2%, which means the other 79.8% are influenced by other factors.

Teachers’ experiences of using the screening, identification, assessment and support strategy to support learners who present with characteristics of dyslexia

Background: Education White Paper 6 (EWP6) and screening, identification, assessment and support (SIAS) promote inclusive education for all learners, including those who present with learning difficulties and are vulnerable to exclusion. The article reports on the experiences of teachers using the SIAS strategy to support learners who present with characteristics of dyslexia at a primary school in Gauteng.Aim: The study sought to explore the experiences of teachers using the SIAS tool to support learners who present with characteristics of dyslexia at a primary school in Gauteng, South Africa.Setting: Three foundation, four intermediate, and two learning support educators participated in the study. The full service primary school has learners with mild learning difficulties.Method: Three foundation, four intermediate, and two learning support educators participated in the study. The full service primary school has learners with mild learning difficulties.Results: Teachers experienced limited success in the implementation of the SIAS tool requiring further professional development.Conclusion: The need for teacher training in the use of effective support strategies to assist learners who present with characteristics of dyslexia, is advocated for Teacher development for the effective implementation of the SIAS tool is recommended.

The Influence of Transformational Leadership Style to Nurse Job Satisfaction and Performance in Hospital

The complexity of today's healthcare system challenges hospitals to provide safe, patient-oriented, and cost-effective services. Leadership style in an organization is one factor that plays an essential role in increasing or slowing down the interest and commitment of individuals in the organization. The transformational leadership style emphasizes moral principles, cooperation, and community together united in the privilege of human ethics. Job satisfaction of nurses is expected to improve their performance to create full service to patients. This literature review aims to determine the effect of transformational leadership style on job satisfaction and performance of hospital nurses. The method in this study is a literature review by searching for articles through the Ebscohost, Science direct, and Proquest electronic databases published from 2016-2021 and meeting the inclusion criteria. The review process uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The results of this review obtained nine articles showing that the transformational leadership style has a positive influence on job satisfaction. Five reports show that leadership positively affects nurse performance in hospitals. Transformational leadership style influences job satisfaction and nurse performance in hospitals. Transformational leadership has more influence on nurse performance than transactional leadership in public hospitals. Nurses' job satisfaction is influenced by opportunity, structural empowerment, job attachment, work environment, and stress. At the same time, nurse performance is influenced by organizational commitment, employee empowerment, workload, motivation, stress, psychological safety, work attachment, and work environment.

The Influence of Transformational Leadership Style to Nurse Job Satisfaction and Performance in Hospital

The complexity of today's healthcare system challenges hospitals to provide safe, patient-oriented, and cost-effective services. Leadership style in an organization is one factor that plays an essential role in increasing or slowing down the interest and commitment of individuals in the organization. The transformational leadership style emphasizes moral principles, cooperation, and community together united in the privilege of human ethics. Job satisfaction of nurses is expected to improve their performance to create full service to patients. This literature review aims to determine the effect of transformational leadership style on job satisfaction and performance of hospital nurses. The method in this study is a literature review by searching for articles through the Ebscohost, Science direct, and Proquest electronic databases published from 2016-2021 and meeting the inclusion criteria. The review process uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The results of this review obtained nine articles showing that the transformational leadership style has a positive influence on job satisfaction. Five reports show that leadership positively affects nurse performance in hospitals. Transformational leadership style influences job satisfaction and nurse performance in hospitals. Transformational leadership has more influence on nurse performance than transactional leadership in public hospitals. Nurses' job satisfaction is influenced by opportunity, structural empowerment, job attachment, work environment, and stress. At the same time, nurse performance is influenced by organizational commitment, employee empowerment, workload, motivation, stress, psychological safety, work attachment, and work environment.

An Integrated Framework for More Efficient Web Services Selection Using an Improved Fuzzy AHP

With the rapid development of Cloud Computing and Service Oriented Computing, the process of selecting web services which gives the same functionality with different quality of service (QoS) become an important issue. To deal with the large number of Web services candidates, K-representative Skyline is appeared as a Skyline variant to find the short list of the most relevant Web services that represent a summary about the full skyline Web services result. However, it returns generally a conflicting result. To rank-order K-representative Skyline Web Services, we propose an improved Fuzzy AHP which allows to: i) elicit the QoS importance level using linguistic terms based on natural language, asking fewer efforts to users, ii) reduce the number of inputs and generate automatically all pair-wise matrix of Skyline Web services with respect to each attribute. The experimental evaluation conducted on real world dataset illustrates the feasibility and the effectiveness of our framework in comparison with existing works.

PAZARLAMADA ÜNLÜ KULLANIM STRATEJİSİ: TÜRK HAVA YOLLARI ÖRNEĞİ

ABSTRACT: In today’s highly competitive market, celebrity endorsement is a widely used marketing technique in marketing communications; a credible strategy endorsed by brands not only used to attract and engage target customers in local markets but also used to reach out the global communities in the overseas markets. Research findings show that celebrity endorsement, when used effectively, increases purchase intention and sales; enabling brand familiarity and awareness among consumers. This paper aims to explain the cultural foundations of the celebrity endorsement in the context of meaning transfer model; concurrently examining the Turkish Airlines (THY) celebrity endorsement strategy; a full service carrier operating in Turkey. THY proved itself as a successful brand in Turkey in the use of global celebrities in integrated marketing communications while reaching up to the global customer base; in summary ended up with positive outcomes.

Research on the Employment of College Graduates under the Background of the Normalization of the Epidemic — Taking School of Education of Zhaoqing University as an Example

Employment guidance and service work are an important part of ideological and political education in colleges and universities. Through the comparison of the employment rate, employment destination and employment structure of the 2016-2021 graduates of the School of Education Science of Zhaoqing University, it is found that there are problems in the employment work, such as process management, daily care services, and the lack of effective curriculum. In order to adapt to the new normal of employment in the context of the normalization of the epidemic, it is necessary to innovate working methods: implement practical process management, establish a "before-during-after" management system; do practical daily service work, build "special personnel on duty, full service" system; play an important role in curriculum guidance, and build a "three-course mutual aid" system.

Control of Grid-Tied Multiple Distributed Generation Systems With Cooperative Compensation Capabilities

This article deals with a cooperative controlof multiple distributed generation (DG) systems with power quality (PQ)-enhancing capabilities. This control algorithm is realized using an adaptive harmonic signals extraction method based on variable weight mixed norm least mean fourth–least mean square adaptive detection. This adaptive technique extracts all the necessary information required for the development of the proposed cooperative control algorithm. With this control algorithm, the voltage source inverters (VSIs) of the DG systems contribute to PQ improvement by mitigating harmonics and reactive currents in the distribution system. This algorithm operates the VSIs in maximum power generation and total harmonic distortion (THD) improvement modes. In maximum power generation mode, the algorithm utilizes the remaining capacity of the VSIs for compensation of nonactive currents drawn by the dedicated loads. Upon finishing the dedicated loads’ compensation, the remaining capacity is spent for compensation of the loads dedicated to other DG systems that are not in the position to render full compensation services. In THD improvement mode, the algorithm prioritizes compensation of harmonic currents generated by the loads. The efficacy of the proposed cooperative control algorithm for multiple DG systems is demonstrated via simulation and hardware-in-the-loop-based experimental results.

The association between workplace built environment and metabolic health: A systematic review and meta-analysis.

Metabolic health is one of the key determinants of healthy living. Specifically, maintaining healthy weight, regulation of blood pressure, lipids and glucose over the life course have been reported to be protective on chronic diseases and premature mortality. With the global workforce spending, on average, one-third of the weekly time budget in the workplace, the role of workplace environment in enhancing metabolic health becomes important. However, there has thus far been no review synthesizing evidence on the links between workplace built environment and metabolic health. A systematic review and meta-analysis was conducted synthesizing evidence on the associations of built environment attributes measured within the workplace neighbourhood and metabolic health. A total of 16 studies that fulfilled the inclusion/exclusion criteria were identified via systematic search of English language peer-refereed publications up to July 2021, in six databases. A systematic coding system was developed, indicating significant findings in expected/unexpected directions including null findings, and the quality of the pooled study was assessed. The Weighted-Z test method that accounts for the study quality was used to examine the strength of evidence. A quarter of the pooled studies were categorized to be of high quality. Among the workplace built environment attributes of access to/density of recreational facilities, street pattern, access to/density of destinations and services, and land use mix, very strong evidence was found for the association between access to/density of destinations and services and metabolic health (p<0.001); specifically, access to full service establishments such as supermarkets, grocery stores and restaurants (p=0.001). A relatively weak association between proximity to workplace and metabolic health (p=0.019) was also reported. Given the lack of high quality studies, overall confidence in the currently available evidence is 'low'. Well-designed longitudinal studies with rigorous measurements for exposures and outcome variables are necessary.

APAKAH METODE PEMBAYARAN PAYLATER AMAN?

The fintech phenomenon in Indonesia continues to develop, one of the innovations is the service from an attractive fintech, namely pay later. Pay later which is a credit installment with a full digital service where the document submission is done online. This study aims to determine the trust and security in reusing the pay later feature on the marketplace. The object of this research is Pay later users who are located in Denpasar. The number of samples in this study was 50 respondents. The technique used is purposive sampling. The results showed that the variables of trust and security partially affect reuse. The trust variable has a positive and significant effect on the reuse of the pay later feature in the marketplace. Security has a positive and significant effect on reusing the pay later feature on the marketplace. The results of this study are expected to be useful for all Pay later users who use the Pay later feature as a reference in investigating the factors that influence the reuse of the Pay later feature.

Remote and rural surgery training and recruitment: a national attitudinal survey of Scottish surgical trainees.

Scotland's healthcare system includes six rural general hospitals (RGHs) which provide a full surgical service to the most remote and rural populations. Constraints of geography and finance, and population need, mean that local delivery of surgical services will be required for the foreseeable future. These RGHs face difficulties in recruiting suitably trained general surgeons. This study aimed to describe Scottish surgical trainees' attitudes towards training and working in remote and rural surgery, perceived barriers to recruitment and potential solutions. A survey was distributed in paper and electronic forms to all Scottish trainees in core surgery (early-stage trainees) and general surgery (later-stage trainees). The survey collected data describing demographics, life and career experiences, and attitudes towards training in remote and rural environments. Univariate and multivariate analyses of influences on interest in rural training and recruitment were carried out, and thematic analysis of free-text responses. There were 152 respondents (response rate 59%). Most (81%) felt that surgical training should be offered in rural environments and 43% were personally interested in some rural training. On multivariate analysis, interest in rural training was associated with being a core trainee (odds ratio (OR) 7.54, 95% confidence interval (CI) 2.79-22.76), and rural work experience following graduation (OR 5.12, 95%CI 1.85-15.39). Respondents stating that they were likely to work in a rural environment (9.2%), were more likely on multivariate analysis to be core trainees (OR 5.70, 95%CI 1.37-28.99) and to have previously lived in a rural location (OR 5.49, 95%CI 1.33-25.93). When trainees were asked for their views on how RGH jobs could be made more attractive, themes identified were as follows: increasing and improving training opportunities in RGHs, increasing the breadth of surgical training, optimising links with referral centres, and improving pay and conditions. This is the first study in a UK setting to describe the views of surgical trainees towards training and working in rural environments. There is substantial support and interest for rural surgical training among Scottish surgical trainees. A minority are interested in a rural surgical career, with interest more likely in core trainees and in those who have lived rurally. Increasing surgical training opportunities in rural environments and maximising medical school intake from rural areas may be important in addressing recruitment concerns.

Examining the impact of cargo and ancillary revenues on net profit for full service carrier airlines

In this study, the relationships between cargo revenues, ancillary revenues and net profitability of airline companies were examined in the examples of three full-service airline companies (Turkish Airlines, American Airlines, Delta Air Lines). Methodologically, a logarithmic econometric model was used in which cargo revenues and ancillary revenues were included as independent variables and net profit as the dependent variables. The data used for the period 2014Q1-2019Q4 were collected from the annual reports on the official websites of related airline companies and The International Air Transport Association (IATA). EViews 10 and STATA-15 versions, which are the most modern econometric analysis programs that can be used to control the stationarity, were used in the analysis of the data. In addition to econometric analyzes and general statistics, Cross Section dependency tests, CADF second-generation unit root tests, Delta slope homogeneity tests, Panel cointegration analysis, Westerlund Panel cointegration tests and Dumitrescu Hurlin Panel Causality tests and Breusch Pagan LM Tests were also performed. The study revealed that there is cointegration between cargo revenues, ancillary revenues and net profit, and there is a one-way causality relationship from both cargo revenues to net profit and from ancillary revenues to net profit. The study also indicated a positive correlation between cargo revenues and ancillary revenues and net profit. In other words, cargo revenues and ancillary revenues have a positive effect on the net profit of airline companies. In addition, the study found that aviation ancillary revenues provide an important resource for airline companies; furthermore, two US companies are among the top three companies with the highest revenues in the world in terms of cargo and ancillary revenues; also showed that Turkish Airlines' ancillary revenues are lower than those of these two US companies. On the other hand, the study showed that the contribution of Turkish Airlines cargo revenues to net profit is much higher than the other two companies.