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.     

星巴克：像品咖啡一样去生活

对于爱喝咖啡的人来说,星巴克（Starbucks）是一个耳熟能详的名字,它最早来源于19世纪美国文坛杰出大师赫尔曼·梅尔维尔的经典著作——《白鲸——莫比·迪克》的主人公。1971年,杰拉德·鲍德温和戈登·波克在美国西雅图开设第一家咖啡豆和香料的专卖店星巴克公司。1987年,霍华德·舒尔茨（Howard Schultz）斥资400万美元重组星巴克,推动了星巴克向意式咖啡馆的转型,并完全以自己的理念来经营星巴克,为公司注入了长足发展的动力。     

德国：世界会展王国

会展业,展览会与博览会的总称,在西方国家已有上百年的历史。这个古老却兴盛的行业,随着工业和商业的文明不断演进着。如今,会展业已成为现代服务业的一朵奇葩,一种投入少、社会效益高、无污染、零排放的绿色产业。     

Dyadic Exploration of the Relationship of Leisure Satisfaction,Leisure Time,and Gender to Relationship Satisfaction

The stress suppressing model proposes that sufficient resources reduce stress. The stress exposure model suggests that certain factors expose individuals to more stress. The current study tested these two models by assessing the within-person lagging effect of leisure time on perceived severity of daily stressors. Analyzing eight-day diary data (N=2,022), we found that having more leisure time than usual on a day reduced perceived severity of daily stressors the next day and that the decrease in severity became larger with further increase in leisure time. Additionally, the effect is much stronger among busy individuals who usually had little leisure time. The findings demonstrated an accelerated suppressing effect that differed between-person, and the lagging effect affords stronger implication for causality than correlational analysis.     

Tourism destination preferences of low-cost airline users in the East Midlands

Increasing demand for air travel, associated with the boom in low-cost airlines, has assisted tourism growth. Expanding opportunities from regional airports underpin an increased propensity to fly. This paper examines European tourism destination preferences and price sensitivity to fly by population segment from an air travel household survey in the East Midlands region of the United Kingdom. Of the eight typical low-cost airline destinations presented to respondents cultural locations such as Rome are preferred. Weekend break leisure trips are particularly attractive to those in employment. Price sensitivity, suggests that increasing financial pressures will have an impact upon growth, however demand for an annual holiday is important, particularly for families.     

Consumers as researchers – innovative experiences in UK National Health Service Research

Consumer involvement is an established priority in UK health‐ and social‐care service development and research. To date, little has been published describing the process of consumer involvement and assessing ‘consumers’ contributions to research. This paper provides a practical account of the effective incorporation of consumers into a research team, and outlines the extent to which they can enhance the research cycle; from project development and conduct, through data analysis and interpretation, to dissemination. Salient points are illustrated using the example of their collaboration in a research project. Of particular note were consumers' contributions to the development of an ethically enhanced, more robust project design, and enriched data interpretation, which may not have resulted had consumers not been an integral part of the research team.     

Embedding consumer culture in health and social care education – a university office's perspective

Health and social care services are changing – and this change is radical. Service user and carer involvement has been a key aspect of health and social care policy for a number of years. In terms of the National Health Service (NHS), this has been significantly strengthened by the report ‘High Quality Care for All’. The NHS will no longer be a monolith dictating what services it offers. It is beginning to take seriously the views of its consumers: the patients, service users and carers. The NHS is starting to put the patient experience at the centre of everything it does, and its regulators are asking for evidence of public and patient involvement. This process may yet prove to be one of the NHS' greatest challenges as it transforms to prioritize the consumer viewpoint. Social care, though further down the line in relation to involvement, is now responding to the relatively new personalization agenda. This paper will consider what the university sector can do to embed the consumer and service culture within the education of health and social care professionals. It looks at the challenges of involvement and required culture change, highlighting the key points to address in the early and middle stages of involvement from a university office's perspective. It includes examples of consumer involvement in teaching, assessment and the selection of students and how their input is starting to make a difference. Finally, the paper outlines what is needed in a development office to establish and support effective service user and carer involvement on health and social care courses in higher education. The article concludes by acknowledging that there is much more work that needs to be done in this field to embed the work of a development office, but that early steps have been promising.     

An investigation into the relationship between training evaluation and the transfer of training

The purpose of this study was to investigate the relationship between training evaluation and the transfer of training in organizations. We hypothesized that training evaluation frequency will be related to higher rates of transfer because evaluation information can identify weaknesses that lead to improvements in training programs and create greater accountability among stakeholders for training outcomes. The data were obtained from 150 training professionals who were members of a training and development association in Canada. The results indicated that training evaluation frequency is positively related to training transfer. However, among Kirkpatrick's four levels of evaluation criteria, only behavior and results criteria were related to higher rates of transfer of training, indicating that the level of evaluation criteria is important for training transfer. These results indicate the importance of organizational‐level initiatives such as training evaluation in addition to individual‐level practices for facilitating the transfer of training.     

Linkages between creativity and intention to quit: An occupational study of chefs

Human resource issues persist as a vexation for tourism managers. Foodservice is a core component of many tourism destinations and attractions yet the foodservice labour market is historically volatile. This article reports on the findings of a job satisfaction survey of chefs working in Australia's tourism and hospitality industry. This study's aim is to determine empirically whether there is a positive relationship between creativity and job and occupational satisfaction. A customised instrument is designed to mitigate the shortcomings of generalising scale items and findings of generic job satisfaction surveys to a single occupation. This paper focuses on identifying a range of dimensions of job satisfaction and occupational attributes connected to creativity and its associated dimensions. Reliability and data reduction analyses were conducted to validate the construction of composite ‘creativity’ variables for the basis of further comparisons. The findings indicate that the sample ranks creativity more highly than working conditions and that there is a clear relationship between creativity and both organisational and occupational satisfaction. Results vary as a function of gender. In conclusion, theoretical and practical implications for occupational and tourism management are discussed.     

Editorial

The relationship marketing paradigm is gaining increasing credence in consumer markets. Marketers need to get close to their customers to establish exchange relationships, and this “intimacy” is achieved using database technology and direct marketing communications. However, in implementing relationship marketing in this way, the potential exists for the use of technology to result in invasions of individual consumer privacy. The literature on relationship marketing and privacy are reviewed, and the findings of six exploratory focus group discussions, conducted in the UK, are presented. The study suggests that what some consumers define as “intrusion” is similar to what has been called “intimacy” by marketers. Nine propositions are presented which reflect the implications of current approaches to relationship marketing in consumer markets. In particular, the integral elements of meaningful relationships are absent or inhibited as a result of consumer concerns over intrusions of their privacy. Thus, marketers need to adapt their attitudes, behaviours, and processes in order to accommodate the participation of the consumer in the relationship. The implications for marketers are identified, and directions are offered for future research.