Unreasonable Expectations Research Articles

Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study.

BackgroundPatient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized.ObjectiveThe purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina.MethodsWe conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses.ResultsMost patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload.ConclusionsPatients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients.

Media portrayal of spinal cord injury and its impact on lived experiences: a phenomological study.

This is a qualitative, phenomenological study. To investigate media portrayal of spinal cord injury (SCI) as perceived by people with SCI and explore its impact on their lived experience. People with SCI living in Australia. Twenty-four participants, recruited using purposive and snowball sampling, completed in-depth, semi-structured interviews. Thematic data analysis followed an inductive, iterative process. Participants perceived media portrayed SCI through a narrow lens, describing how people with SCI were 'absent' or portrayed as either 'pity or pedestal'. Participants said media portrayed an inaccurate picture of their lived experience that perpetuated misunderstandings of SCI. This portrayal fostered unreasonable public expectations and assumptions about living with SCI, which presented in the participant's lives as uncomfortable interactions and inappropriate remarks. The impact for participants was a burden to explain SCI and justify what it meant for them. People with SCI would like media to portray a broader, more authentic representation of SCI to improve public understanding and to reduce the negative impact on their lives. People with SCI perceived a narrow and inaccurate portrayal of SCI in media that overlooked potential quality of life, overshadowed health and life domains they considered important and reinforced the idea that SCI can be overcome. People with SCI were mostly concerned with what was absent in media portrayal of SCI rather than what was present. Action for change lies in promoting information, expanding narratives and raising awareness to diverse abilities of people with SCI.

“Now All Was Contrary to Her Expectation”: Destructive Expectations in Tess of the d’Urbervilles

Up until now, scholars have not analysed the destructive role that expectations play in Tess of the d’Urbervilles. This article will therefore attend to this subject by exploring a series of relationships depicted in Thomas Hardy’s novel. To do so, this study will begin with the “fatal love” of Tess Durbeyfield and Angel Clare (Garson 130). Both individuals share confessions upon their wedding night that challenge the very foundations upon which their relationship was built. Having both held idealised perceptions of the other, Tess and Angel are forced to either adjust to these new parameters or see their relationship destroyed. Where Angel adopts a rigid inflexibility of conviction, Tess adapts her opinions and expectations, extending this behaviour to her relationship with Alec d’Urberville. In doing so, Tess is able to accommodate the changing and sometimes contradictory elements of the other characters’ identities. However, Tess fails to extend this courtesy to herself when presented with situations that she cannot control. Instead, Tess internalises perceptions of her behaviour that result in unjust opinions and unreasonable expectations of herself. Therefore, through critically examining these events and characters, this article will demonstrate how the perpetuation of rigid expectations can be detrimental to individuals and relationships alike.

Review Essay: “Free Radical: Music, Violence and Radicalism”

Review Essay: “Free Radical: Music, Violence and Radicalism”

Prevalence and determinants of violence against health care in the metropolitan city of Peshawar: a cross sectional study

BackgroundViolence against healthcare personnel is a major public health problem. Healthcare personnel are at the frontline dealing with people in stressful and unpredictable situations. Therefore, this study was conducted to determine the prevalence and associated factors of violence against health care personnel.MethodsA cross sectional study was conducted in the district Peshawar. Healthcare personnel from public and private sectors working in both the primary and tertiary levels of healthcare were invited to participate. Violence was assessed through a structured questionnaire previously used in Pakistan and was defined as experiencing and/or witnessing any form of violence in the last 12 months. Mental health was assessed through the General Health Questionnaire. Logistic regression was used to estimate the association of violence against healthcare personnel with psychological distress and demographic characteristics. Data entry and analysis were conducted in STATA 14.ResultsA total of 842 healthcare personnel participated in the study. The prevalence of violence experienced and/or witnessed by healthcare personnel in Peshawar was 51%. Verbal violence remained the predominant form of violence and almost half of the healthcare personnel (45%) were exposed to it. A quarter of the respondents (24%) reported physical violence alone or in combination with other forms of violence. In almost two third of the incidents the perpetrators were either attendants, relatives or the patients. The emergency unit and wards within healthcare facilities were the most common places where violent events took place. The major factors responsible for the violent incidents were communication failure, unreasonable expectations and perceived substandard care. No uniform policy/procedure existed to manage the incidents and the healthcare personnel adopted different responses in the wake of violent events targeting health care. Working in public healthcare facilities and having a larger number of co-workers/colleagues significantly increased the risk of violence in the healthcare settings while being a paramedic significantly reduced the risk as compared to physicians.ConclusionsViolence against healthcare personnel is a serious public health issue and the prevalence is quite high. A holistic effort is needed by all stakeholders including healthcare community, the administration, lawmakers, law enforcement, civil society, and international organizations.

The problematic ally: Italy, Britain and the Entente

ABSTRACT British statesmen and generals held Italy in low regard because of racial attitudes, ignorance of the conditions under which Italian soldiers fought, and a conviction that Italy should subordinate its interests to those of the United Kingdom. They placed unreasonable expectations on the Italian army and interpreted its failure to meet them as confirmation of British prejudices. British politicians viewed their Italian counterparts as ‘devious’ when they pursued national self-interest while those same British leaders put the interests of the British empire above those of the Entente. If Italian soldiers failed to press home an attack or hold a position, British generals accused them of defeatism, lack of fighting spirit or outright cowardice but did not level the same criticism at their own troops when they suffered reverses. Not until the summer of 1917 did a high-ranking British officer even tour the Italian front. British generals repeatedly dismissed Italian intelligence as alarmist only to have it proved correct. Throughout the war, the British treated Italy as a junior member rather than an equal partner in the alliance. This study reveals how prejudice, ignorance and arrogance shaped Anglo-Italian relations and adversely effected allied strategic planning.

The Female Standard:

The year 2020 has made plain many injustices present in the systems and worldviews of American society. In a divisive election year, the factor of “electability” was of key importance in the effort to nominate a candidate to oppose the sitting President. In considering the question “Where do we go from here?”, we ought to wrestle with our communal decision that the female candidates vying for the Democratic nomination were categorically unelectable or less electable simply because of their femaleness. This paper seeks to explore how interpretation of our Scriptures has played a role in sustaining the societal structures which foster inequality. And, more importantly, how our Scriptures can fruitfully be interpreted to validate female leadership.
 Using the example of the story of Martha and Mary in the Gospel of Luke, this paper will problematize modern readings that have created a culture of devaluing female leadership. The history of interpretation of the story of Martha and Mary has evolved in many phases, the most relevant being that interpretation has narrowed from a story of discipleship for all Christians to a story that only has meaning for women. Reflecting on both Scripture and current gender studies commentary, this paper will call into question the unreasonable expectations of American women and consider where we ought to go from here.

Prevalence and predictors of burnout syndrome, post-traumatic stress disorder, depression, and anxiety in nursing staff in various departments

BackgroundHospital settings are a highly challenging work environment because of the increased demands of most of the works assigned to do, changes in the everyday routine of work, unreasonable expectations of patients and their relatives, and serious legal and death problems. Nurses experience stress due to work exhaustion that makes them vulnerable to many psychiatric disorders. This study aimed to assess the prevalence of burnout syndrome, post-traumatic stress disorder, depression, and anxiety in nursing group and their possible risk factors. A cross-sectional study was conducted among 181 nurses working at Al Zahraa University Hospital, Cairo, Egypt; the sociodemographic characteristics and occupational data were collected and Hospital Anxiety Depression Scale, Davidson Trauma Scale, Maslach Burnout Inventory, and Proactive Coping Inventory were completed.ResultsPsychiatric symptoms were prevalent among nurses, 79% were positive for depression and 64.6% were positive for anxiety. The prevalence of post-traumatic stress disorder was 19.9%, while 87.8% of nurses were positive for burnout syndrome and had symptoms for at least one of the 3 types of burnout syndrome: 73.5% for emotional exhaustion, 61.9% for depersonalization, and 68.5% for personal accomplishment. Eighty-six percent of nurses who had post-traumatic stress disorder were also positive for burnout syndrome. ICU nurses had 100% emotional exhaustion symptoms compared with other departments; lack of use of different coping approach towards stressors at work and work experience was risk factors of burnout syndrome.ConclusionBurnout syndrome, post-traumatic stress disorder, depression, and anxiety were common in a wide group of nurses; the development of health educational program for nurses about different coping strategies to face stressors and conflicts at work is mandatory.

Sustainable Careers of Teachers of Languages Other than English (LOTEs) for Sustainable Multilingualism in Chinese Universities

This paper explores Chinese universities’ policies related to the research performance review of language other than English (LOTE) teachers with respect to promotion. Drawing on a variety of data including policy documents and interviews with 32 individual LOTE teachers from 16 universities, we identified that Chinese universities have unreasonable expectations in terms of research publications and research funding for language teachers, including LOTE teachers, which make their career prospects unsustainable. We also evaluated the contextual realities for LOTE teachers regarding academic publication and research funding, and identified a widespread feeling of anxiety and stress among LOTE teachers. Though LOTE teachers are committed to undertaking various efforts to overcome challenges in their research performance review for promotion, we call on university management and policy makers to provide additional support to LOTE teachers, so that they can develop sustainable careers and universities, including Chinese universities, will be able to rely on sustainable multilingualism.

Geographies of local government

Geographies of local government

Determinants of non-prescription antibiotic dispensing in Chinese community pharmacies from socio-ecological and health system perspectives.

Although non-prescription antibiotic dispensing (NPAD) has been officially forbidden by the Chinese government since 2004, it is still a common practice throughout the country. In this study, we use China as an example to explore the determinants of NPAD within the framework of its health system from a socio-ecological perspective. A mixed-method combining the simulated client method (SCM) and key informant interviews conducted in Zhejiang, Hubei, and Sichuan provinces was adopted. 73.3% of the SCM interactions engendered NPAD (91.7% through antibiotic requests vs. 55% through consultation) in Chinese community pharmacies; a much higher rate than the global average. At the intrapersonal level, NPAD was found to be driven by profits from selling non-prescription antibiotics and traditional Chinese medicine. At the interpersonal level, NPAD was driven by fierce competition in the community pharmacy market and by customers' unreasonable expectations. At the institutional level, it is easy for community pharmacies to evade the Food and Drug Administration's (FDA) supervision by obtaining unsupervised and fake prescriptions, refusing to give customers sale receipts, and hiding their antibiotic supplies and sale records. At the policy level, the low cost of violating the prescription-only antibiotic sale regulation and poor FDA supervision facilitated NPAD. The Chinese health system has thus failed to establish and regulate a diverse network of pharmacies for patients to fill their prescriptions; few antibiotic prescriptions are transferred from hospitals to community pharmacies. Education campaigns to increase awareness about the risks of self-medication with antibiotics among the general public, recognizable standardize prescriptions for customers to fill their prescriptions in community pharmacies, regulations on Internet and private clinic doctors' antibiotic prescribing behaviors, electronic tracking and tracing system to purchases and sales data of antibiotics and other prescription drugs, increasing cost of violating the prescription-only regulations for antibiotics sales are expected interventions to reduce NPAD.

Unreasonable Expectations From the Outside and Within

Unreasonable Expectations From the Outside and Within

Research on the institutional design of accounting systems: Theoretical and methodological considerations

Subject. The article discusses rules, ethical principles for the emergence of institutional design of accounting systems and their distinctions. Objectives. The study identifies and evaluates how ethical principles will influence the institutional design of the national accounting system. We also provide hands-on advise on the use of its constituents. Methods. The study is based on general and special methods of research, such as theoretical principles of the institutional theory, dialectical method, methods of abstract research, logic method, systems analysis, generalization, classification, comparative analysis and synthesis of data. Results. I analyzed general methods of accountancy and sorted comparative characteristics inherent in the establishment of the accounting process given there is a limited number of accounting methods and accounting judgments, limited room for the artificial manipulation of data and transactions, prohibition to depart from effective rules for the institutional design of accounting systems that stemmed from the existing moral and ethical principles. I substantiated the content of moral and ethical principles in the concept of law and their use in accounting, considering that they unveil key dealing restrictions. The article sets forth the procedure for making them, determining how they can be practiced across jurisdictions in accordance with the existing macroeconomic development traits. Conclusions and Relevance. What really matters for the development of accounting is an opportunity for business to continue their usual working process during crises and under pressure of the external market. In such circumstances, it is crucial to exclude unreasonable expectations of accounting users in case of risk events which do not result from corporate operations. What else deserves further research is a variety of accounting models that exist worldwide, rather than characteristics of the accounting system that we spotlight. As the accounting system evolves and gets more refined as an inseparable part of a greater accounting system, cross-disciplinary approaches become more and more relevant, since they blend some scientific visions. The findings can be used in the theory of accounting development.

My Journey to Open Science

My Journey to Open Science

Professional Dissonance and Burnout in Primary Care

Burnout negatively affects physician health, productivity, and patient care. Its prevalence is high among physicians, especially those in primary care, yet few qualitative studies of burnout have been performed that engage frontline primary care practitioners (PCPs) for their perspectives. To identify factors contributing to burnout and low professional fulfillment, as well as potential solutions, by eliciting the views of PCPs. For this qualitative study, focus group discussions and interviews were conducted between February 1 and April 30, 2018, among 26 PCPs (physicians, nurse practitioners, and physician assistants) at a US academic medical center with a network of 15 primary care clinics. Participants were asked about factors contributing to burnout and barriers to professional fulfillment as well as potential solutions related to workplace culture and efficiency, work-life balance, and resilience. Perceptions of the factors contributing to burnout and low professional fulfillment as well as potential solutions. A total of 26 PCPs (21 physicians, 3 nurse practitioners, and 2 physician assistants; 21 [81%] women) from 10 primary care clinics participated. They had a mean (SD) of 19.4 (9.5) years of clinical experience. Six common themes emerged from PCPs' experiences with burnout: 3 external contributing factors and 3 internal manifestations. Participants described their workloads as excessively heavy, increasingly involving less "doctor" work and more "office" work, and reflecting unreasonable expectations. They felt demoralized by work conditions, undervalued by local institutions and the health care system, and conflicted in their daily work. Participants conveyed a sense of professional dissonance, or discomfort from working in a system that seems to hold values counter to their values as clinicians. They suggested potential solutions clustered around 8 themes: managing the workload, caring for PCPs as multidimensional human beings, disconnecting from work, recalibrating expectations and reimbursement levels, promoting PCPs' voice, supporting professionalism, fostering community, and advocating reforms beyond the institution. In sharing their perspectives on factors contributing to burnout, frontline PCPs interviewed during this study described dissonance between their professional values and the realities of primary care practice, an authority-responsibility mismatch, and a sense of undervaluation. Practitioners also identified possible solutions institutions might consider investing in to resolve professional dissonance, reduce burnout rates, and improve professional fulfillment.

I Am Error: The Nintendo Family Computer by Nathan Altice

Reviewed by: I Am Error: The Nintendo Family Computer by Nathan Altice Casey O’Donnell (bio) I Am Error: The Nintendo Family Computer. By Nathan Altice. Cambridge, MA: MIT Press, 2015. Pp. 440. Paperback $30. I desperately wanted to write this book. Of course, then it wouldn’t have been this book. When I was told someone else was going to be writing “the NES book,” I was intensely jealous. Consequently, I went into my reading of the text with unreasonable expectations. I have critiqued the atheoretical perspective of many of the platform studies texts, and I have an intense sense of care for the object of this text. Nathan Altice does an exceptional job of overcoming my unreasonable expectations, making this jilted lover of the Nintendo Entertainment System (NES) appreciate his take on the project. The NES and its Japanese counterpart the Nintendo Famicom (Famicom) sit central in this Platform Studies series text published by MIT Press, [End Page 378] edited by Nick Montfort and Ian Bogost. The series draws heavily on a conceptual framework rooted in object-oriented ontology. What is most intriguing in the choice of studying both the NES and Famicom simultaneously is that Altice runs the perfect gambit by destabilizing the “objectness” of the NES/Famicom from the very beginning. While it does not run explicitly throughout the text, he leverages “translation” in an explicitly Derridean sense, which again defuses some of my critiques of the platform studies approach. Most importantly, the book also explores the NES/Famicom as an object not ready made, but rather an object becoming. Throughout the text, the NES/Famicom shifts and swerves over time. On the one hand, we have the opportunity to learn of the history of the Famicom and its simultaneously limited and yet innovative design and construction. The nuances of this device have come to have lasting impacts on videogame design and development and an entire generation of developers that drew heavily on the resulting “8-bit” aesthetics. Altice gives us a distinct perspective on the NES/Famicom and the games produced for these systems through the lens of translation: PAL/NTSC, Japanese/English, and PRG-ROM/CHR-ROM. While on the one hand the book can feel at times overly technical, Altice decodes the objects and ushers the reader through a very nuanced and detailed unpacking of a device almost constantly under translation. The author walks readers through the construction of things like levels of Super Mario Bros., which becomes a kind of translational object for understanding game design and development practice. “Design data” is as much a part of a game as its “engine” or pixelated art “assets.” There is a sense of contingency and lack of closure, which at its core troubles the foundations of platform studies. The NES/Famicom as a platform under translation and manipulation sits at the core of the text. Altice draws on Mark Sample’s notion of the “pre-platform,” or as I might say, the object-becoming. Early versions of a North American bound version of the NES trouble the idea of a kind of steady or self-assured product development cycle. The Famicom’s strange set of peripheral devices that made the device’s lifespan in Japan significantly longer than that of its American-bound counterpart encourage us to see every port on the device as an opportunity for platforms to swerve out of control. Clearly this level of attention tells us something new about platforms, particularly those like the NES/Famicom. Ever present in the text is the figure of the emulator, to which members of the Entertainment Software Association (ESA) would be well suited to pay heed. The history and archival future of videogames is intimately tied to software systems that they would rather classify as the tools of pirates. Throughout the text, FCEUX (an NES/Famicom/Famicom Disk System emulator) and Macifom (an NES emulator) loom large. [End Page 379] Piracy and ideas about software and development become encoded into the platform in interesting ways, as I have written about in my work as well. Altice’s devotion to the device makes it clear that this is a kind of labor of love...

Investors' Perception and Audit Expectation-Performance Gap (AEG) in the Context of Listed Firms in Sri Lanka

Corporate failures around the globe in recent times have placed the auditing profession in the spotlight. The profession is beset by confusion and crises caused by the differences in the beliefs held by auditors and the public concerning the auditor’s duties, which have even led to lawsuits against auditors. This situation is the result of what is known as the ‘Audit Expectation–Performance Gap’ (AEG). In the light of the contemporary importance of the subject, lack of theoretical underpinnings of the causes of AEG and the dearth of studies on it in Sri Lanka, the present study attempts to ascertain the status of AEG and to examine the factors contributing to AEG, in the Sri Lankan context. A positivist approach was adopted and a structured questionnaire survey done involving professional auditors and investors of listed firms. The results of independent sample t-test indicated a statistically significant difference between the perceptions of professional auditors and investors regarding the duties of auditors in the context of listed firms in Sri Lanka. The relative contribution to the overall AEG was that much of the gap (50 per cent) in AEG was attributable to deficient standards, 16 per cent to unreasonable expectations of society about auditors’ duties, and 34 per cent was due to the perceived sub-standard performance of auditors. On the other hand, in terms of the contributory factors, the mean ranking with one sample t-test results found that 12 factors contributed significantly to AEG. The main contributory factors highlighted by respondents were the lack of auditing education and lack of auditing experience among users. Thus, as regards policy implications, it was noted that policymakers and regulators need to increase community awareness through audit education to reduce AEG in Sri Lanka as one of the main measures.

Parents as Gatekeepers? An Indirect Account on the Image of Vocational Education in Historical Context

Vocational education and training (VET) is high on the European agenda. This article adds nuance to the policy ambition of “fixing” parents’ views on VET. It is based on extensive qualitative research in Romania, with over 250 young people. An unanticipated finding was the “absence” of parents from the young people’s accounts, along with a tendency by the teachers and employers to blame young people for having “unreasonable expectations.” This article explores the deeper structural reasons for the current state of “parental disengagement.” It links parents’ precarious working lives with young people’s sense of disillusionment and communist nostalgia.

The Prosthetic Impulse Revisited in <em>A.I. Artificial Intelligence</em>

The Prosthetic Impulse Revisited in <em>A.I. Artificial Intelligence</em>

Cybercrime as a Consequence of Unreasonable Expectations

The studies published by the Global Drugs Survey research team1,2 indicate that using the dark web to acquire illicit drugs is increasingly common. It is perceived as a safer alternative to the more traditional routes of obtaining drugs, such as lysergic acid diethylamide, which are difficult to detect in the postal mail without opening the packaging.