Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.     

Contribution of low-level flammable vapor concentrations to dust explosion output

As a result of extensive dust explosion research, additional areas of hazards have arisen. The potential of combining small percentages of flammable vapors (below the lower explosion limit) introduces additional dust explosion hazards.     

Visitor centre staffing: Involving volunteers

Volunteer involvement in visitor centres has received little attention by tourism researchers despite the critical role staff play in welcoming tourists to a destination and promoting tourism activities. The community function of visitor centres - of which volunteering is part - has also been underplayed in previous research. Using data from a survey and interviews with visitor centre managers in Australia, this paper investigates the rationales for staffing visitor centres with volunteers and/or paid employees and, related to motivations for volunteering, the factors influencing the attractiveness of visitor centre volunteer programmes. The dominant rationales for involving volunteers are need, community involvement, visitor experience, and the personal qualities and motivations of volunteers. Visitor centre volunteering is attractive because of location and local pride, interactions with tourists and social relationships with other volunteers, and the reputation of the visitor centre and its volunteer programme.     

Supply structure: The pendulum in action

Using an in-depth longitudinal case study based on an “historical retrospective”, this article focuses on how some factors (“drivers”) set into motion the pendulum of change in supply structures, a research theme neglected in the supply field. It examines, over a 20-year period, the changes made to the supply structure of a well-known organization. The data comes mainly from: (a) semi-structured interviews with 21 managers and professionals within eight operating units, and (b) documentary analyses of the archives. This article shows how to map structural changes of the supply function, while explaining the nature and the causes of these changes. Understanding the pendulum movement from one supply structure to another can be very valuable, as well for academics as for managers.     

Procedural Fairness, Return to Work, and the Decision to Dispute in Workers' Compensation

This study investigates how injured workers evaluate the fairness of the workers' compensation claims process and how that evaluation affects the decision to formally dispute their claim. Survey and administrative data are used to test a model where individuals are hypothesized to base their overall impression of the fairness of the process based on dimensions of procedural justice criteria. They are then hypothesized to decide whether to formally dispute the claim based on a combination of procedural fairness concerns and whether or not they returned to work with the same employer. The implications of the results for structuring the workers' compensation claims process are then discussed.     

Comparing variations in labor costs for two vs. one full-time nurse manager

Labor costs for two versus one full-time nurse manager were compared. Results revealed reductions in nursing costs per patient day. These results suggest that innovative models may hold promise as organizations struggle to retain nurses and decrease costs.