General Experience Research Articles

THE CONCEPT OF PERSONNEL ADAPTATION AT ENTERPRISES: ONBORDING AND E-LEARNING

It is substantiated that the basis of the successful activity of any enterprise today is its personnel potential. From the qualification level of personnel, his general experience and motivation depends on the effectiveness of the enterprise. It is proved that possessing specific operational and strategic functions, the staff provides a leading role in the development of any enterprise. Until recently, such concepts as "personnel adaptation system" and "personnel management" were completely absent in the practice of management at enterprises.It is analysed that modern conditions of management require HR management to improve the system of adaptation of personnel at enterprises. This is the most important factor in the system of ensuring the efficiency of staff.It is substantiated that the adaptation of personnel is a complex process of familiarizing new employees with the conditions and rules of work in the enterprise, as well as assistance in integrating a new colleague into the team. This adaptation is necessary for both new employees and those who change positions, but remain to work in the enterprise. The article notes that in addition to the individual selection of personnel, the general system of personnel adaptation at enterprises is aimed at creating a favourable microclimate in the team, establishing partnerships, securing new employees at the enterprise. As a result of the functioning of this system, the enterprise receives economic stability, increasing labour productivity and the level of individual responsibility, increasing staff motivation, creating a positive image of a company or enterprise, improving competitive positions in the labour market. It is investigated that despite the fact that each individual enterprise carried out adaptation and management of personnel directly through the top management, it had an established system of personnel management. In connection with the processes of decentralization, all talent management systems needed a thorough review and updating. Change of these systems began with the introduction of social packages, flexible work schedules, moral and material incentives for staff

The Effect of Intersectionality on Attrition among US General Surgery Trainees.

To examine the association between intersectionality of race, ethnicity, and sex on retention of U.S. general surgery residents. There are limited data on the role that intersectionality plays on the US general surgery resident experience. Analysis was performed using Association of American Medical Colleges (AAMC) data for general surgery residents who started their training between 2005-2015 (followed through completion). Regression analyses were used to assess demographic associations with time to attrition or successful completion of residency training. Associations between faculty and resident demographics were assessed. 25,029 residents were included. Over the decade-long study period, the number of underrepresented in medicine (UIM) residents as a percentage of all residents remained similar from 17% to 19% (P=0.24). The percent of UIM males starting training in 2005 was 11% and 12% in 2015 (P-value=0.38). UIM females comprised 5.5% of trainees in 2005 and increased to 6.9% (P-value=0.003) in 2015; and female non-UIM residents increased from 23 to 28% (P-value<0.001). The overall rate of resident attrition was 15%. UIM females had the highest yearly attrition rate at 21% compared to non-UIM males at 13% (HR 1.7, P<0.001). UIM females were more likely to leave residency compared to UIM males (HR: 1.5; P<0.001). The percent of UIM faculty was positively correlated with percent of UIM residents (r=0.64, P<0.001). Increasing intersectionality is positively associated with attrition during surgery residency. The diversity of faculty appears to be associated with resident diversity.

PECULIARITIES OF THE PROCESS OF DIGITALIZATION OF THE COMMUNICATIVE COMPONENT IN THE ACTIVITY OF PUBLIC AUTHORITIES

Due to the constant development of technology and rapid digital progress in today's world, digitalization in public administration communication is very important. Researching its features is essential in developing a modern state and improving the quality of public services for citizens. Despite numerous studies on this topic, it should be emphasized that the specifics of digitalization's impact on ensuring the efficiency, transparency, and accessibility of public services and the development of Ukraine's digital transformation are still not sufficiently disclosed and require further elaboration. This study aims to determine the main features of the digitalization process in public administration communication in modern conditions. The main feature of digitalization in the communication of public administration in Ukraine is its unique blend of technological development and societal needs. This research highlights a key aspect of this process - the introduction of electronic services and online platforms, which play a pivotal role in ensuring the accessibility and convenience of services for citizens. Based on the research results, the leading digitalization technologies used in public administration to provide public services are singled out: cloud computing, artificial intelligence, the Internet of Things, and big data analytics. These technologies' role in modernizing public services, increasing efficiency, and improving citizens' general experience is clarified. It has been proven that efficiency, transparency, and convenience are the possibilities that should accompany digitalization in the communication of public administration in Ukraine. Problematic issues and risks of the digitization process in public administration communication are outlined, among which should be presented: lack of developed digital skills of public servants, cost, cyber threats, different capabilities of territorial communities (digital inequality), and dependence on light and the Internet.

A scoping review of ethics review processes during public health emergencies in Africa.

The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics.

Feasibility of Intraoperative Proctosigmoidoscopy After Discoid Bowel Resection for Deep Infiltrating Endometriosis: A Pilot Multicenter Study

Although surgery is the gold standard treatment for pain refractory to medical management or partial occlusion owing to rectosigmoid endometriosis, surgical resection can be associated with major perioperative complications. From general surgery experience, intraoperative proctosigmoidoscopy has shown encouraging results as a feasible, safe, and effective technique in reducing the risk of complications related to intestinal anastomosis after segmental resection. Unfortunately, there are no studies evaluating its role after discoid resection for rectosigmoid endometriosis. A pilot, multicentric, observational, prospective, cohort study. Two academic hospitals, from March 1 to December 31, 2022. We enrolled all consecutive fertile-age patients affected by symptomatic endometriosis scheduled for laparoscopic discoid bowel resection. Inclusion criteria were (1) age between 18 and 50 years, (2) diagnosis of rectosigmoid endometriosis performed by transvaginal ultrasound and/or magnetic resonance imaging, and (3) women scheduled for laparoscopic discoid bowel resection of endometriosis at low risk of segmental resection. During data analysis, enrolled patients were divided into 2 study groups for comparisons based on whether or not the intraoperative proctosigmoidoscopy was performed upon surgeons' discretion after discoid resection for treating endometriosis, in addition to standard integrity tests. Primary outcome was the rate of intraoperative proctosigmoidoscopy success. Secondary study outcomes were the differences between the intraoperative proctosigmoidoscopy group and the nonintraoperative proctosigmoidoscopy group in (1) mean of total operative time and (2) rate of perioperative complications. A total of 28 patients were enrolled and equally distributed in the 2 groups. The rate of intraoperative proctosigmoidoscopy success was 86%. No significant difference was reported between the 2 groups in terms of total operative time (p = .1) and intraoperative and postoperative complications (p = .5 and p = 1, respectively), with no surgical complication related to intraoperative proctosigmoidoscopy. Intraoperative proctosigmoidoscopy seems as a feasible and non-time-consuming intraoperative procedure in women undergone discoid resection for rectosigmoid endometriosis. Larger studies with longer follow-up period are necessary to confirm our findings and assess clinical benefits over standard procedure.

Motherhood, Human Trafficking, and Asylum Seeking: The Experiences and Needs of Survivor Mothers in Birthing and Postnatal Care

This article aims to illuminate the little-studied phenomenon of asylum-seeking child-bearing women in the UK, survivors of violence and human trafficking. This is a significant issue in terms of the proportion of women affected and the paucity of care and support currently available to them as mother survivors. This study looked to examine the frontline support services of one project to survivor mothers through two collaborating organisations, Happy Baby Community and Hestia, and how their services support mothers’ experiences of perinatal mental health, infant feeding, and the general experiences of migrant women and trafficking survivors in maternity care in the UK. Using evidence collected from semi-structured service-users’ interviews and focus groups, and an anonymous online staff survey, this article shows the types of care and support that are required to address not only the challenges faced by any new mother, but also the additional challenges experienced with trafficking and seeking asylum such as mental health, housing, and legal and access to other support. This article illustrates the many complex and inter-related challenges these women face, and the way the project meets practical, informational, emotional, appraisal, and social needs. It concludes by identifying several implications of the support provided and/or needed, which could be considered by other services or policymakers looking to meet the fundamental needs and rights of this cohort.

999 telephone triage: a comparison of UK ambulance nurse and paramedic case mix, outcomes and audit compliance

PurposeMost UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.Design/methodology/approachThe retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.FindingsThere was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.Research limitations/implicationsThere continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.Practical implicationsThe practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.Social implicationsIt has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.Originality/valueMost UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

Trauma exposure correlates among patients receiving care in federally qualified health centers.

Over 80% of adults in the general population experience trauma. Rates of patients with posttraumatic stress disorder (PTSD) are high in primary care settings and are likely to be even higher in federally qualified health centers (FQHCs). Trauma exposure has been linked to psychiatric symptoms and physical health comorbidities, though little research has focused on FQHC patients. This study addresses this by examining clinical and sociodemographic correlates of specific trauma types among FQHC patients. We analyzed secondary data from patients who screened positive for PTSD and were receiving health care in FQHCs in a clinical trial (N = 978). Individuals who did versus did not experience a specific trauma type were compared using between-group tests. In the sample, 91.3% of participants were exposed to a DSM-5 Criterion A traumatic event, with 79.6% experiencing two or more trauma types. Witnessing a life-threatening event (57.3%) and physical assault (55.7%) were the most common traumatic experiences. Physical health comorbidities and worse physical health functioning were associated with a higher likelihood of exposure to all trauma types, with effect sizes larger than PTSD, ds = 0.78-1.35. Depressive and anxiety symptoms were also associated with a higher likelihood of experiencing nearly all trauma types to a lesser magnitude. People of color, OR = 2.45, and individuals experiencing financial inequities, OR = 1.73, had higher odds of experiencing serious accidents as well as other trauma types. The findings highlight the need for trauma-informed care, including routine trauma and PTSD screening, for FQHC patients.

Cancer experience in metaphors: patients, carers, professionals, students – a scoping review

The use of metaphors to talk about cancer experiences has attracted much research and debate, especially in the case of military metaphors. However, questions remain about what metaphors are used...

Patient experiences of interprofessional collaboration and intersectoral communication in rare disease healthcare in Germany – a mixed-methods study

BackgroundRare diseases are often complex, chronic and many of them life-shortening. In Germany, healthcare for rare diseases is organized in expert centers for rare diseases. Most patients additionally have regional general practicioners and specialists for basic medical care. Thus, collaboration and information exchange between sectors is highly relevant. Our study focuses on the patient and caregiver perspective on intersectoral and interdisciplinary care between local healthcare professionals (HCPs) and centers for rare diseases in Germany. The aims were (1) to investigate patients’ and caregivers’ general experience of healthcare, (2) to analyse patients’ and caregivers’ perception of collaboration and cooperation between local healthcare professionals and expert centers for rare diseases and (3) to investigate patients’ and caregivers’ satisfaction with healthcare in the expert centers for rare diseases.ResultsIn total 299 individuals of whom 176 were patients and 123 were caregivers to pediatric patients participated in a survey using a questionnaire comprising several instruments and constructs. Fifty participants were additionally interviewed using a semistructured guideline. Most patients reported to receive written information about their care, have a contact person for medical issues and experienced interdisciplinary exchange within the centers for rare diseases. Patients and caregivers in our sample were mainly satisfied with the healthcare in the centers for rare diseases. The qualitative interviews showed a rather mixed picture including experiences of uncoordinated care, low engagement and communication difficulties between professionals of different sectors. Patients reported several factors that influenced the organization and quality of healthcare e.g. engagement and health literacy in patients or engagement of HCPs.ConclusionsOur findings indicate the high relevance of transferring affected patients to specialized care as fast as possible to provide best medical treatment and increase patient satisfaction. Intersectoral collaboration should exceed written information exchange and should unburden patients of being and feeling responsible for communication between sectors and specialists. Results indicate a lack of inclusion of psychosocial aspects in routine care, which suggests opportunities for necessary improvements.

Emotions and Networked Learning

Emotions in networked learning have been underresearched despite their importance. The present research is one of the first few attempts to better understand adult learners’ emotional experiences in a specific networked learning context—an online doctoral programme designed and organised based on networked learning principles. This paper takes the initial step of unpacking the intricate interplay between emotions and networked learning experiences, utilising a longitudinal, mixed methods research approach to demonstrate the diversity and complexity of emotions experienced in networked learning situations. Online doctoral students (n=48) completed a questionnaire four times during the first six months of their PhD program, with an interval of five to six weeks. This is the most critical period for students to develop multiple connections promoting networked learning both within and outside the programme. They connected to new people, ideas, and resources, becoming an integral part of learning networks. The questionnaire quantitatively measured the intensity of 36 different emotions felt by each student, respectively, about their networked learning experiences and general life experiences. Participants also qualitatively reflected on the most intense emotions and wrote “why” they felt such ways. Based on quantitative data, a principal component analysis extracted five meaningful clusters of emotions and repeated-measures ANOVAs further showed meaningful patterns and changes in those emotions. The qualitative data was analysed using a constant comparative method to identify dominant themes to provide deeper insights into student emotions. Findings suggest that emotions are in a constant state of flux, reflecting the multifaceted nature of networked learning experiences, through which learners juggle multiple responsibilities and connections across different times and spaces. Two distinct categories of emotions emerged: positive and negative. Despite the challenges and complexities of online doctoral studies, positive emotions remained resilient, underscoring networked learning as a source of inspiration—with the heightened 'Intrigued' component at specific learning milestones. Negative emotions are nuanced, with negative cognitive emotions, associated with networked learning experiences, intensifying initially and decreasing as students adapt; while negative gut reactions are more prevalent in general life. However, a notable release of negative cognitive emotions in general life suggests the interplay between emotions arising from networked learning and their influence on students' broader experiences. Surprisingly, the study challenges assumptions about isolation in online learning, revealing a consistent sense of social inclusion and support within the learning network. Overall, this study provides a comprehensive understanding of emotions in networked learning, offering valuable insights for supporting adult learners.

A Study on Customer Satisfaction of Titan Watches

This study looks on the level of customer satisfaction with Titan watches, a well-known brand in the watch industry. The study intends to examine a number of factors that affect consumer satisfaction, such as product quality, design, brand perception, after the sale servicing, and general customer experience. The study gathers and examines customer feedback using a thorough process that includes surveys and data analysis in order to identify the primary factors that influence satisfaction. The research provides significant insights into the dynamics of customer satisfaction within the watch industry by concentrating on Titan watches. The study's conclusions can help Titan with its marketing plans, new product ideas, and brand positioning. They can also advance knowledge about customer satisfaction in the watch industry.

General Practitioners' Experience of Remote Consultations by Telephone in the General Practice Setting during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID 19) pandemic brought substantial changes in the way doctors used to interact with patients. In the general practice, consultation over the phone has become a norm now. However, it is not well known how this new mode of consultation affected clinicians' practices. Objective of this study was to find out if doctors working in the general practices were trained enough for telephonic consultation and how this new mode of consultation affected their clinical practice in general. It was an online survey. Information was gathered by using an online questionnaire which was sent electronically to general practitioners (GPs) and general practitioner speciality trainees (GPSTs) working in the general practices based in Leicestershire. Data were analyzed by using software SPSS. Descriptive characteristics of participants were reported in terms of numbers and percentages, whereas Chi square test was run to assess if there is a difference between GPs and GPSTs in terms of their experience of remote consultations by telephone. The questionnaire response rate was 69.3% (n = 133/192). Of the total, 54.1% (n = 72/133) of participants were women. About 36% (n = 48/133) of the participants were GPSTs, whereas 64% (n = 85/133) were qualified GPs. Not having enough training for phone consultation, technical issues during consultation, inadequate supervision framework, difficulties in building therapeutic alliance with patients, making diagnosis and risk assessment, and increased duration of consultation were identified as issues. Similarly, concerns around patients' confidentiality and medico legal issues were highlighted. GPs and GPSTs reported similar difficulties. In conclusion, lack of training for the telephonic consultation has been identified as a unanimous issue along with other challenges to phone consultations. There is an urgent need to take measures to make telephone consultation more successful, enjoyable, and safe for patient care by addressing identified issues. Larger studies with representative samples are needed to increase generalizability of our findings.

The Relationship Between Cognitive Intrusion of Pain, Fear of Surgery, and Comfort

The aim of this study was to examine the relationship between cognitive intrusion of pain, fear of surgery, and comfort in the perioperative period. This was a descriptive study conducted with 180 patients hospitalized for surgery in a training and research hospital. A sociodemographic questionnaire, Surgical Fear Questionnaire, General Comfort Questionnaire, and Experience of Cognitive Intrusion of Pain Scale were administered to the participants prior to surgery, while General Comfort Questionnaire and Experience of Cognitive Intrusion of Pain Scale were administered after surgery. Of the participants with a mean age of 49.94 ± 17.26 years, 62.2% were male and 31.1% had at least one chronic disease. The mean preoperative and postoperative pain scores were 2.65 and 3.47, respectively. There was a statistically significant negative correlation between perioperative experience of cognitive intrusion of pain and perioperative comfort and a positive correlation between perioperative experience of cognitive intrusion of pain and preoperative fear of surgery (p < .05). Cognitive intrusion of pain does not change in the perioperative period. As the cognitive intrusion of pain increases, patient comfort decreases and surgical fear increases. Our study contributes to the literature since it is the first study evaluating the cognitive intrusion of pain in the perioperative period.

B-33 | We Get Better When We Measure: Building a Cardiogenic Shock Program, Tampa General Experience

B-33 | We Get Better When We Measure: Building a Cardiogenic Shock Program, Tampa General Experience

Humanism during the COVID-19 pandemic: video call as a strategy to satisfy the communication needs of Intensive Care Unit patients and their family members.

Background: Patients affected by the COVID-19 pandemic required physical/social isolation due to the transmissibility of SARs CoV-2; those hospitalized in healthcare facilities often suffered loneliness due to a complete separation from their loved ones through visitor restrictions.(1) Human contact and movement were restricted to contain the spread of disease. When this kind of restriction must be employed, the “Guidance for Managing Ethical Issues in Infectious Disease Outbreaks”, states that it is necessary to provide people with “effective alternative communication strategies”. (2) Methods: This is an observational descriptive study that uses qualitative variables to analyze information obtained by virtual focus groups consisting of either medical professionals or family members of hospitalized patients in the ICU of the Eugenio Espejo Hospital (EEH) in Quito, Ecuador. Each video call allowed us to assess anonymous opinions concerning communication methods utilized during the delivery of daily clinical updates in the ICU. By focusing on a patient-and family-centered model, this study aims to minimize the impact of social isolation in hospitalized patients through the implementation of regular doctor-led video conference calls with family members, as well as video calls between the patient and family members when feasible.(1) Results: This study evaluates the increased satisfaction of family members and medical professionals with the implementation of video calls when compared to traditional telephone calls. A contrast between the time before implementing the telehealth team and the time afterward was observed in at least five positive characteristics: 1) the general telehealth experience, 2) the clarity of the messages, 3) the quality of care, 4) the sense of comfort, and 5) the improvement of communication. Conclusions: There was a positive effect on communication quality for both family members and medical professionals, increasing their satisfaction in terms of finding new methods to reduce the social isolation enforced by the current pandemic. Nevertheless, the future role of virtual communication remains undefined as we return to individualized face-to-face meetings.

Role of the addiction clinical nurse specialist in acute hospital settings.

The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery. To determine general nurses' experience of caring for patients who misuse substances, and to gauge nurses' views on the implementation of an ACNS role in an acute general hospital. This study used a qualitative design involving online interviews with 11 hospital nurses. Many participants felt that an ACNS could provide them with education and support around substance misuse, while also advocating for patients who misuse substances, reducing stigma and enhancing patient care. Participants indicated several benefits to implementing an ACNS role in their hospital, such as ensuring that patients who misuse substances experienced continuity of care which began at admission, was followed-up during inpatient stays and was maintained in the community.

Ignorance is not always bliss: A qualitative study of young adults' experiences with being ghosted

AbstractGhosting, or ignoring someone to end a relationship, is often considered a harmful aspect of growing digital connectivity. However, research on ghosting has focused on the experiences of European/European Americans in romantic contexts. Thus, we broadly explored experiences of being ghosted among 29 undergraduates primarily from underrepresented populations (75.9% Latinx, 6.9% Asian, 6.9% Black) in the United States. We conducted face‐to‐face semi‐structured interviews regarding general experiences with being ghosted, a memorable experience of being ghosted, and attitudes toward ghosting. Inductive thematic analysis yielded eight themes surrounding the process of being ghosted (Sensing Shifts in Communication Patterns), ghosting attributions (Unreciprocated Feelings, Incompatibility), responses to ghosting (Stages of Grief, Various Coping Methods, Lost Respect for Ghoster, Insight from Experiencing Both Sides), and ghosting attitudes (Good Reasons). Future research might examine the role of both individual (e.g., cultural values) and situational (e.g., ghosting circumstance) factors in various trajectories of ghosting responses, as well as the psychological consequences of these trajectories.

Market Orientation’s Effect on Customer Value, Trust, Satisfaction, and EWOM when using the MRT

The purpose of this study is to ascertain how market orientation affects customer value, trust, contentment, and word-of-mouth when using mass transit. MRT users comprised the study's demographic. Passengers who had taken the MRT more than twice were given a sample of 224 individuals by purposeful sampling. With the usage of smartPLS software, structural equation modeling, or SEM, is the analytical technique employed. According to the study's findings, market orientation significantly affects customer value, trust, contentment, and word-of-mouth when utilizing the MRT, both directly and indirectly. Effective marketing tactics and market orientation can enhance customer value perception, trust, and user pleasure. Relevant stakeholders and business practitioners can better grasp how maximizing market orientation fosters positive interactions with MRT users thanks to the research's findings. These findings' practical applications can aid in the creation of more potent marketing campaigns and enhance the general MRT user experience.

Video double-lumen tube for one lung ventilation: implementation and experience in 343 cases of routine clinical use during the first 20 months of the SARS-CoV-2 pandemic

BackgroundDouble-lumen tubes (DLTs) are the preferred device for lung isolation. Conventional DLTs (cDLT) need a bronchoscopic position control. Visualisation of correct DLT positioning could be facilitated by the use of a video double-lumen tube (vDLT). During the SARS-CoV-2-pandemic, avoiding aerosol-generation was suggesting using this device. In a large retrospective series, we report both general and pandemic related experiences with the device.MethodsAll anesthesia records from patients aged 18 years or older undergoing surgery from April 1st, 2020 to December 31st, 2021 in the department of thoracic surgery requiring intraoperative lung isolation were analyzed retrospectively.ResultsDuring the investigation period 343 left-sided vDLTs (77.4%) and 100 left-sided cDLTs (22.6%) were used for one lung ventilation. In the vDLT group bronchoscopy could be reduced by 85.4% related to the cDLT group. Additional bronchoscopy to reach or maintain correct position was needed in 11% of the cases. Other bronchoscopy indications occured in 3.6% of the cases. With cDLT, in 1% bronchoscopy for other indications than conforming position was observed.ConclusionsThe Ambu® VivaSight™ vDLT is an efficient, easy-to-use and safe airway device for the generation of one lung ventilation in patients undergoing thoracic surgery. The vDLT implementation was achieved easily with full interchangeability to the left-sided cDLT. Using the vDLT can reduce the need for aerosol-generating bronchoscopic interventions by 85.4%. Continuous video view to the carina enabling position monitoring of the DLT without need for bronchoscopy might be beneficial for both employee’s and patient’s safety.