Percent Increase In Time Research Articles

Interpretation time in an ethnically diverse pediatric orthopedic clinic

Purpose - The purpose of this paper is to determine whether there were differences in clinical encounter time between patients who speak English and those who require an interpretation service in an ethnically diverse pediatric clinic. Design/methodology/approach - Encounter time with patients requiring interpretation was compared to encounter time with patients who spoke English. The sample consisted of 310 encounters at a pediatric orthopedic clinic where patients spoke over 18 primary languages. Data were analyzed using ANOVA to compare four types of encounters. Findings - Approximately 12 percent (n=38) required interpretation and encounters requiring interpretation took 30 percent (nine minutes) longer than those that did not, p < 0.01(25 vs 16 minutes). Furthermore, this difference was mainly among new patients: Approximately, 53 percent increase in time for new patient encounters requiring interpretation (36 vs 23 minutes) while only 25 percent increase in encounter time for established patients (20 vs 16 minutes) was detected. Research limitations/implications - Preventing problems due to language barriers requires time for interpretation which places demands on staff resources and presents clinical challenges. However, long-term benefits of quality health care outweigh the costs associated with interpretation service. Originality/value - To the knowledge, this is the first study to investigate actual encounter time differences in a pediatric clinical setting. The authors found that clinical encounters requiring interpretation took approximately nine minutes longer in general and four minutes longer for established patients. These findings could give much needed information for hospital administrators to allocate appropriate amounts of time and resources to care for those who need interpretation services. However, they also indicate a broader concern of the reduction of clinical encounter time for overall health care system in the country that might need further investigation.

The effect of hoof abnormalities on sow behavior and performance

The objective of this study was to evaluate the effects of cracks in the outer hoof wall [CK], length differences between the medial and lateral toe of the hoof [TS], and over-grown toes [OG] on sow lactation performance and behavior. Sows' hooves were observed and assigned a severity score (1 to 3), or 0 for control sows. Lactation sow performance from 223 litters was collected over 2 experiments. Sow behavior was measured in experiment 1 and was scored continuously for 45min prior to and 1h post feeding (n=150). The ethogram contained 4 postures and a maximum of 4 behaviors within each posture. Performance and behavior data were analyzed using a multiple linear regression. All sows began the experiment with similar litter weights (P>0.15) and number of piglets/litter (P>0.15). A significant, negative partial regression coefficient was observed for piglets weaned/litter for sows in the CK and TS groups (P<0.05). A trend (P=0.10) was observed for the association of sows in the CK group to wean −0.21 fewer piglets/litter than control sows. An increase in OG lesion severity score was associated with lighter adjusted litter wean weights compared to control sows. Sows in the control group spent 18.9% standing and 12.7% of the total time standing and eating. The amount of time spent standing and eating before feed presentation was negatively associated with time spent eating after feeding (b=−0.24, P<0.01); that is, each percent increase in time spent eating prior to feeding was associated with a 79% decrease in time spent standing and eating post feeding. Sows in the OG group spent 50% less time kneeling for each incremental increase in OG lesion score. Post feeding, each OG lesion score increase was associated with a 40% decrease in time spent standing and eating. Results from this study demonstrate that foot lesions can impair productivity and behavior of lactating sows.

A Framework for Discipline in Programming

Programmers, even in well-organized software environments which utilize some modern software engineering practices, are often lacking of a discipline in their individual programming effort. There has not been an emphasis on discipline in progamming practice, as is traditional in other engineering and scientific fields' instruction. A framework organized to be suitable for early presentation and developing usage is presented and evaluated. It integrates the notions of top-down design, stepwise refinement, structured flowcharting, test case description, and analysis in the context of a framework for systematically developing and concurrently documenting programs. The framework was evaluated in actual usage during introductory programming instruction by comparing it to a typical conventional approach. A comparison of programming effort showed only a 16 percent increase in time required in the disciplined approach, which certainly makes it feasible for introductory instruction. Program quality comparisons were carried out by a comprehensive testing for logic errors in the completed projects. The results were impressively favorable for the disciplined approach.