Encounter Happens Research Articles

A study to assess the compliance to golden hour admission process for in-patient units at Apollo speciality Hospital, Vanagaram

Background: The admission and discharge processes is the area where the patient encounter happens often and so tailback occurs in many of the hospitals and thus adversely affect the efficiency of the hospital. So this topic has been selected to capture the compliance of first golden hour. Methods: Quantitative descriptive research design was adopted for this study. The study was conducted at Apollo Speciality Hospitals, Vanagaram for a duration of 3 months, 60 samples using simple random sampling who met the inclusion criteria were selected as study samples. Data collection tool such as socio demographic proforma and clinical variable proforma after obtaining ethical clearance, Socio- Demographic Data (Age in years, Sex, Marital Status, Education, Area of Work, Years of Experience) and clinical variables proforma of golden hour admission process such as Awareness on readiness of the room/ bed before receiving the patient, Charge Nurse / team leader met the patient in first 15 minutes, Diet order initiated within 15 minutes, Consultant is informed in first 15 minutes, Compliance on action taken by the charge Nurse / team leader within 15 minutes, Identity band is placed, Vital signs are recorded and acted accordingly in first 30 minutes, Investigations are initiated in first 30 minutes (if advised), Treatment is initiated in first 30 minutes (if advised), Nursing admission assessment is completed (as mentioned below) in first 30 minutes, Fall risk assessment is completed in first one hour of admission, Vulnerability band is placed, Skin assessment is completed in first one hour of admission, Care plan is initiated in first one hour was also observed Result: The level of compliance to golden hours, No significant compliance (7%), Moderated Compliance (14 %) Highly Compliance (79%). Conclusion: Compliance must be ensured. There is no right or wrong approach to improve the patient experience, but the reality is that patient experience is the responsibility of every member of the care team. Every interface and every service provided creates an opportunity to impact the experience.

Finnish vocational education and training experts’ reflections on multiculturalism in the aftermath of a major reform

ABSTRACT In the present study we examine how Finnish vocational education and training (VET) experts reflect on multiculturalism in the aftermath of a major reform. The research material consists of interviews with educational policy experts in Finnish VET, namely: principals, government officials and lobbyists (N = 11). A qualitative thematic analysis reveals the following three latent themes through which experts reflect on multiculturalism: 1) multiculturalism as individualisation; 2) multiculturalism as competition; and 3) multiculturalism as shared responsibility. The results show that Finnish VET experts see multiculturalism as a critical challenge for education and working life. On the other hand, it is still unclear whether the 2018 VET reform will be able to resolve the different dilemmas and contradictions that the experts connect with multiculturalism. Experts understand multiculturalism narrowly as synonymous with immigration and as something that happens in encounters with Finns, even though it is not shared by Finns themselves. While most of the experts argue that personalisation and working life are particularly important for immigrants and students with an immigrant background, others are worried about the future of broader social competences in Finnish VET.

Structural Characterization of LpqH (19 kDa surface antigen), an Immunomodulatory Lipoprotein of Mycobacterium tuberculosis

Tuberculosis, caused by Mycobacterium tuberculosis, is predominantly a disease of the lungs acquired by inhaling mycobacteria from infected individuals via airborne droplets. As soon as Mycobacterium reaches the lungs, its first encounter happens to be with the resident alveolar macrophages which immediately can phagocytose, but cannot kill the pathogen. Thus, the pathogen‐laden macrophages now disseminate to other organs, aiding in the spread of infection in an undetected manner. Certain mycobacterial surface motifs known as pathogen‐associated molecular patterns (PAMPs), recognize specific pattern recognition receptors (PRRs) present on the host cell surface, thereby mediating these early interactions of the mycobacteria with macrophages. A major group of these bacterial PAMPs includes mycobacterial lipoproteins, of which, the 19 kDa surface antigen LpqH, have a critical role in shaping the host immunological response in tuberculosis. The protein pleiotropically modulates the host immune response by interacting with Toll‐Like Receptors (TLRs) such as TLR2 homodimers and TLR1/TLR2, TLR2/TLR4, and TLR2/TLR6 heterodimers. On one hand, it acts as an apoptosis‐inducing factor for macrophages whereas on the other, it shows that prolonged exposure of LpqH to TLRs eventually favours immune evasion, thereby allowing the dissemination of the pathogen. Despite the essential role of LpqH in tuberculosis,till date, the detailed structure‐function relation of this protein remains to be elucidated. We have determined the high‐resolution crystal structure of Mycobacterium tuberculosisLpqH at a resolution of 1.26Å and refined to Rwork and Rfree of 14.29% and 17.79%, respectively. It has been observed that the structural architecture of LpqH is indeed unique and has never been previously described. Furthermore, sequence identity between LpqH and other well‐known mycobacterial lipoproteins is very low, which further implies that the protein is indeed unique and its structural characterization is vital to the overall understanding of its pathogenesis in case of active tuberculosis.

Recognition Plots and Intercultural Encounters in Aidan Chambers’ <i>Dance on My Grave</i> (1982)

<p class="first-line-indent">This article offers a new interpretation of Aidan Chambers’ novel <em>Dance on My Grave</em> (1982) by pointing to the interconnection between representations of cultural others in fiction and the recognition plotlines that are so important to YA storytelling. It also proposes the relevance of the method of literary genetics to YA studies, and vice versa. Literary genetic analysis in this article shows how Chambers developed <em>Dance on My Grave</em>’s adolescent characters Hal and Barry, flagging key decisions that the author made to create a dynamic of otherness between them. Archival material from Seven Stories, the British National Centre for Children’s Books, can be used to reconstruct Chambers’ decision to differentiate Barry from Hal by religious tradition. Investigating his engagement with Judaism during <em>Dance on My Grave</em>’s genesis leads to this article’s discussion of authorial positionality, intention, and the interrelation between intercultural encounters and otherness and plot development in the novel. <em>Dance on My Grave</em>’s reliance on tropes of anagnorisis, which Chambers calls “recognition” (<em>The Age Between</em> 91), constructs Hal’s encounter with Barry’s Judaism as a cultural learning experience that enables both Hal’s growing-up process and Chambers’ writing process. This is problematic because this intercultural encounter happens at Barry’s expense: he dies; Hal dances on his grave. Judaism emerges during <em>Dance on My Grave</em>’s genesis to deepen Hal’s understanding of death, life, love, and himself. A means, not an end, cultural learning contributes to a recognition plotline that enables spiritual enlightenment in Chambers’ construction of adolescence.

Putting down verbal and cognitive weaponry: the need for ‘experimental-relational spaces of encounter’ between people with and without severe intellectual disabilities

Social inclusion policies often assume that community integration is beneficial for all people with disabilities. Little is known about what actually happens in encounters between people with and without severe intellectual disabilities in the public space. Based on social-constructionist and responsive-phenomenological insights, we performed participant observation, semi-structured interviews and researcher reflexivity to study encounters between Harry (pseudonym), a man with a severe intellectual disability, his neighbours, fellow service-users, support professionals, and the first author. A thinking-with-theory strategy was adopted to interpret and deepen observations and reflections. We argue for more ‘experimental-relational spaces of encounter’ between people with and without severe intellectual disabilities, wherein the latter put down their verbal and cognitive weaponry. This proved to be more appropriate for spending ‘quality time’ with Harry then typical satisfactory neighbourhood interactions – often embedded in verbality, habits, routines and rationalizations that do not reflect the existence of people with severe intellectual disabilities. Points of interest An increasing number of people with severe intellectual disabilities live in homes in a neighbourhood setting. However, in everyday neighbourhood life people with and without severe intellectual disabilities hardly ever encounter each other in a way both of them like. The research shows that this lack of pleasant encounters can be related to powerful rules about how we should interact in the public space in the 21st century. In the neighbourhoods we studied, people without intellectual disabilities are in control of these rules. They prefer verbal and cognitive interactions in the public space. Non-verbal and less cognitive approaches are often seen as inappropriate. The research recommends that people without intellectual disabilities should open up for more fitting ways to communicate with people who cannot speak (for themselves).

The first encounter with death: A physical experience

Our first encounter with death is a key moment in our lives. The effect of this encounter depends on different factors, including the stage of cognitive and emotional development when it happens. The concept of death becomes cognitively fixed by about the age of seven. When this first encounter happens to a child during pregnancy or in the early years of life, only with just a mother’s belief that this child could die can create a physiological reaction which becomes stuck in the body of both mother and child, creating a feedback loop.Knowing how our body tries to deal with the first encounter with death can help us create specific interventions to resolve these kinds of physical symptoms, ones that might otherwise remain unknown.

Long-term evolution of the Galilean satellites: the capture of Callisto into resonance

Context. The Galilean satellites have very complex orbital dynamics due to the mean-motion resonances and the tidal forces acting in the system. The strong dissipation in the couple Jupiter–Io is spread to all the moons involved in the so-called Laplace resonance (Io, Europa, and Ganymede), leading to a migration of their orbits. Aims. We aim to characterize the future behavior of the Galilean satellites over the Solar System lifetime and to quantify the stability of the Laplace resonance. Tidal dissipation permits the satellites to exit from the current resonances or be captured into new ones, causing large variation in the moons’ orbital elements. In particular, we want to investigate the possible capture of Callisto into resonance. Methods. We performed hundreds of propagations using an improved version of a recent semi-analytical model. As Ganymede moves outwards, it approaches the 2:1 resonance with Callisto, inducing a temporary chaotic motion in the system. For this reason, we draw a statistical picture of the outcome of the resonant encounter. Results. The system can settle into two distinct outcomes: (A) a chain of three 2:1 two-body resonances (Io–Europa, Europa–Ganymede, and Ganymede–Callisto), or (B) a resonant chain involving the 2:1 two-body resonance Io–Europa plus at least one pure 4:2:1 three-body resonance, most frequently between Europa, Ganymede, and Callisto. In case A (56% of the simulations), the Laplace resonance is always preserved and the eccentricities remain confined to small values below 0.01. In case B (44% of the simulations), the Laplace resonance is generally disrupted and the eccentricities of Ganymede and Callisto can increase up to about 0.1, making this configuration unstable and driving the system into new resonances. In all cases, Callisto starts to migrate outward, pushed by the resonant action of the other moons. Conclusions. From our results, the capture of Callisto into resonance appears to be extremely likely (100% of our simulations). The exact timing of its entrance into resonance depends on the precise rate of energy dissipation in the system. Assuming the most recent estimate of the dissipation between Io and Jupiter, the resonant encounter happens at about 1.5 Gyr from now. Therefore, the stability of the Laplace resonance as we know it today is guaranteed at least up to about 1.5 Gyr.

Die Berufung des Andreas und des Philippus nach dem Johannesevangelium (Joh 1.35–46)

In the Gospel of John, the apostles Andrew and Philip enjoy a privileged position right from the beginning. The reason seems to lie in the fact that they, being from Bethsaida in Galilee and probably fluent in Greek, could serve as intermediaries between ‘Greeks’ and Jesus, whom they wanted to ‘see’. Such an encounter happens in John 12.20–2. According to John, Jesus called Andrew before his brother Peter, whom Andrew then led to Jesus. Philip is the second person directly called by Jesus, himself leading another future disciple to Jesus: Nathanael (John 1.35–46). James and John are completely missing not only in the Johannine scene of the calling of disciples but also in the whole of the Fourth Gospel. The importance of Andrew and Philip follows also from the rest of the Gospel of John. The evangelist seems to depend on an early tradition attested in Asia Minor and to modify the synoptic tradition on its basis.

OWN AND OTHER: CONTENT AND METHODOLOGY OF TRADITIONAL CULTURE IN PRIMARY EDUCATION

OWN AND OTHER: CONTENT AND METHODOLOGY OF TRADITIONAL CULTURE IN PRIMARY EDUCATION

The data processing and analysis for the CE-5T1 GNSS experiment

In this paper the performance of a high sensitivity GPS/GLONASS receiver mounted on CE-5T1 Service Module is studied and the data received on the first Earth-lunar transfer orbit is processed and analyzed. At least four GLONASS satellites are visible for 46% of the data span while for 98% of the data span at least four GPS satellites are visible. GLONASS serves as a necessary supplement to GPS in real time positioning whenever less than four GPS satellites are tracked, and helps to optimize the observation geometry by reducing the Position Dilution of Precision (PDOP) values by up to 77%. However, noisier GLONASS pseudorange data should be properly weighted in order not to deteriorate the positioning accuracy. Studies indicate that when the inverse square of the pseudorange measurement error of each satellite is applied as the weight value, single point positioning (SPP) accuracy improves from 57.7m (RMS) with GPS data alone to 44.6m (RMS) with the addition of GLONASS data. Transmitter antenna Equivalent Isotropic Radiated Power (EIRP)s of all the four blocks of GPS satellites as well as GLONASS satellites are derived from the received C/N0 data and show significant variance in sidelobe power patterns. In general, the EIRP patterns of GPS Block IIR-M and GLONASS satellite antennas have a comparatively flat power level of around 10dBW within the off-boresight angle range of 30–80° and roll off at the off-boresight angle of about 80°, offering deep space applications greater benefits than the other three blocks of GPS satellites. In addition, an interesting close encounter happens between CE-5T1 spacecraft and GLONASS satellite R06. Investigations indicate that the PDOP value increases up to 1.4 times and the SPP accuracy deteriorates by more than 142% if satellite R06 is excluded in the positioning computation.

The Visionary Space of Story

> Friendship, magnanimity, wit in conversation shared in laughter and tears, and truthfulness exist in the contact with the you that you affirm yourself to be, with your visions, respecting you, listening to your story.1 In The First Person Singular , Alphonso Lingis writes the subject—an I—as an embodied encounter with others. The I–and–you encounter happens in the sharing and receiving of stories—though not stories composed in a rationalist or logical sense of this happened, that happened; who and what and why and how. No. Lingis says our stories are not tales of “plans, initiatives, achievements that would be the diagram of [our lives].”2 Nor are our stories “inner representation[s], which [we] contemplate and figure out, find the meaning of, understand.”3 Instead, our stories are formed through and out of the vast open space of “an outside where unintelligible, visibly random forces hold sway.”4 This “visionary space” is not one in which we make ourselves intelligible and worthy to a scrutinizing other—reader and/or listener—but rather, an offering of the “halos, mirages of the world” in which we lead lives that makes us laugh and weep, that make us “cry out blessings or curses.”5 In Lingis's estimation, readers and/or listeners must not …

Protocols, mobility models and tools in opportunistic networks: A survey

In opportunistic networks, instead of assuming an end-to-end path as in the traditional Internet model, messages are exchanged opportunistically when an encounter happens between two nodes. In the last years, several forwarding algorithms to efficiently decide when to forward messages were proposed. Those protocols are commonly suitable to a specific scenario, which has led to the creation of new subtypes of networks. Two different examples are pocket switched networks – PSN and vehicular networks – VANETs, since those networks have different features like a specific mobility pattern and intermittent connectivity. In this article we present an overview of opportunistic networks, proposing a taxonomy which encompasses those new types of network. We discuss the commonly used tools, simulators, contact traces, mobility models and applications available. Moreover, we analyzed a set of forwarding protocols to map the approach used by the research community to evaluate their proposals in terms of mobility, contacts and traffic pattern, reliability of simulations and practical projects. We show that although researchers are making efforts to use more realistic contact models (e.g., using real traces) the traffic pattern is generally disregarded, using assumptions that may not fit real applications.

The Rise of Evidence-Based Policing: Targeting, Testing, and Tracking

Evidence-based policing is a method of making decisions about “what works” in policing: which practices and strategies accomplish police missions most cost-effectively. In contrast to basing decisions on theory, assumptions, tradition, or convention, an evidence-based approach continuously tests hypotheses with empirical research findings. While research on all aspects of policing grew substantially in the late twentieth century, the application of research to police practice intensified in the early twentyfirst century, especially for three tasks that make up the “triple-T” strategy of policing: targeting, testing, and tracking. Evidence-based targeting requires systematic ranking and comparison of levels of harm associated with various places, times, people, and situations that policing can lawfully address. Evidence-based testing helps assure that police neither increase crime nor waste money. Tracking whether police are doing what police leaders decide should be done may grow most rapidly in coming years by the use of GPS records of where police go and body-worn video records of what happens in encounters with citizens.