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OBJECTIVES/SPECIFIC AIMS: This study seeks to understand the relationship between opioid prescribing and patient satisfaction among non-surgical, hospitalized patients. As part of this study, we qualitatively examined challenges in delivering safe and patient-centered care through voices of physicians’, and nurses.’ METHODS/STUDY POPULATION: We collected data through in-person interviews using semi-structured guides tailored to the informant roles. Study participants came from 1 healthcare system located in a mid-Western state. Each interview lasted 30–45 minutes, was audio-recorded with consent, and transcribed for analysis. Two researchers each coded 17 transcripts for discussions around patient-centeredness (including patient satisfaction, patient experiences), and patient safety for hospitalized patients experiencing pain. Analysis followed a general inductive approach, where researchers identified themes related to the research questions using an open coding technique. They discussed and reached consensus on all codes, and extracted several preliminary themes. The analysis was supported by NVivo software. RESULTS/ANTICIPATED RESULTS: The following themes emerged: (1) complex decision-making process to prescribe opioids for hospitalized patients; (2) the role of objective findings in prescribing decisions; (3) bargaining process in prescribing opioids; (4) balancing patient-centeredness and patient safety for selected populations; (5) opioids are the predominant medications for pain care. DISCUSSION/SIGNIFICANCE OF IMPACT: Clinicians’ decision to prescribe opioids for nonsurgical hospitalized patients is based on multiple factors, including patient’s condition, patient’s preference for pain medications, or standard hospital’s pain care regimen. Interventions that improve clinicians’ ability to prescribe opioids may be needed to improve delivery of patient-centered and safe pain care.
‘Classics in Hong Kong’ is not a phrase one comes across on a regular basis, so when I was asked to write this article on my experiences of teaching Classics in Hong Kong specifically and my perspective on Classics in Asia generally, I was delighted at the opportunity. I joined The Independent Schools Foundation Academy (The ISF Academy, Hong Kong) just over two years ago, having studied, trained and taught Classics in London previously. When the prospect arose of teaching the subject I love on the other side of the globe, it was an offer I could not refuse, out of curiosity if nothing else! Although my teaching experiences on my Asian adventure thus far have been quite different and often unfamiliar, I still passionately believe that Classics is equally important everywhere: appreciating the achievements of the ancients; questioning human nature and the world we live in; and learning from heroes and villains, mortals and immortals. After all, the Ancient Greeks and Romans played an important role both in the West and the East, with interaction between the civilisations across the ages; Alexander the Great's empire is of course one such example of the mutual intellectual, political and economic exchange between the western and eastern worlds.
This book explores the philosophical implications of the popular adage that 'you are what you eat' through twentieth-century literature. It investigates the connections between the alimentary and the ontological: between what or how one eats and what one is. Maria Christou's focus is on two influential modernist figures, Georges Bataille and Samuel Beckett; and two influential postmodernist figures, Paul Auster and Margaret Atwood. She aims to theorize the relationship between modernism and postmodernism from a specifically alimentary perspective. By examining the work of these major twentieth-century authors, this book focuses on strange or unusual acts of eating - 'eating' otherwise - as a means to ways of 'being' otherwise. What can eating tell us about being, about who we are and about our being in the world? This powerful, innovative study takes literary food studies in a new direction.
Diminishing irrigation water availability and increased crop evapotranspiration (ET) have already been shown to pose threats to agricultural productivity. The aim of the current study was to estimate the values and trends of both ET and net irrigation requirements (NIR) of those crops consuming most water due to the size of their cultivated area (citrus and potatoes) in a water-scarce region with typical Mediterranean climate, such as Cyprus, analyse possible spatial and temporal variations of these parameters, and discuss implications of this analysis on agricultural water conservation. A linear regression analysis of ET and NIR values of potatoes and citrus during recent decades in their four main cultivated areas uncovered both increasing and decreasing trends for these parameters. Overall, however, the results did not show any change in irrigation water demands for these crops during recent years. In accordance with this outcome, average ET and NIR values of the majority of cultivated crops on the island showed no statistically significant differences between the periods 1976–2000 and 1990–2014. Conversely, this was not the case when data were analysed within each weather station across crops. It is suggested, therefore, that agricultural water resource management schemes should not be focused merely on a regional analysis of changes but that emphasis should be given to site-specific values and trends of ET and NIR estimations, ultimately serving the conservation of agricultural water.
Security Threats Emanating from a Global Cyberspace
Compared to the increasing relevance of global cyberspace to the societal, commercial and military sectors in both the European Union and China, cybersecurity is the blind spot in the overall EU–China relationship. It was only in 2013 that the EU and China formally expressed a common general interest in cyberspace (EEAS 2013). At the same time, both actors, with differences in content, scope and timing, have developed their own approaches to cybersecurity and the respective threats they perceive in global cyberspace.
Cybersecurity policy has been on the radar of the EU for many years. It established the European Network and Information Security Agency in 2004 in order to facilitate a movement toward shared knowledge and improved “best” practice among EU member states. There was also a clear security (sub)dimension connected to the evolution of the EU's “information society” agenda. The issue was moved up the EU's political agenda in 2007, with NATO, the EU and other actors forced to radically rethink their approach following distributed denial of service (DDoS) attacks on Estonia's public and private infrastructure. Thus the EU's threat perception and vulnerability in relation to cybersecurity is connected to Europe's economic transformation, as well as the social and political consequences of cybercrime, attacks on information systems and protecting cyberspace in order to ensure its effective operation in military and civilian dimensions. Cyberspace, if not secured, from an EU perspective, threatens the very existence and evolution of all Europeans across social, economic and political realms.
The EU's policy has since developed and been underpinned by the need to achieve the objectives it has set for itself in its document on the digital agenda for Europe (European Commission 2010), and equally as significant, the driving force of such an agenda, the Europe 2020 strategy (EEAS 2013). In addition, it has recognized that, as a security issue, the protection of cyberspace is borderless, and it has highlighted these issues in its policy documents and internal security strategies, including a set of principles and guidelines for internet resilience and stability (European Commission 2011) and a cybersecurity strategy (European Commission 2013). Furthermore, it has recognized the importance of working in partnership with global partners to address the civilian and military aspects of cybersecurity challenges.
We surveyed all stars in Taurus (3h 45m < α < 4h 15m, 15° < δ < 35°) for multiplicity which are contained in the Herbig-Bell catalogue of young stars and have a 2 micron brightness of K ≤ 9.5 mag. This sample consists of 106 stellar systems (single or multiple), of which 43 are double or multiple according to the criteria of our survey, i.e. with separations of ≈0″.2 ≤ d ≤ 10″. Of these, 23 binaries are new detections found in this survey. The resulting degree of multiplicity, 43/106 = 41±6%, is higher than found for main-sequence stars. Provided that the period distribution is the same for young stars as on the main sequence, our result implies that the vast majority of stars are born in binary or multiple systems.
We present a preliminary report on radial–velocity and infrared interferometric observations, with emphasis on the newly resolved nearby sources Gl 609.2 and Gl 804. We briefly discuss their low–mass companions, their luminosities, and their individual masses inferred from the combined solution of their spectroscopic and visual orbits.
In this work we attempt to make progress into assessing the importance of secular interactions between planetary satellites. In recent years, discrepancies have been observed in the expected positions of small planetary satellites (Bosh & Rivkin, 1996; Roddier et al., 1998). The existing ephemerides-producing algorithms for these objects assume fixed, elliptical and inclined orbits whose rate of precession is determined by oblateness alone. Even though the masses of these satellites are quite small relative to the planet (∼ 10−9 – 10−10) their small mutual separations and the existence of much larger satellites further out leaves open the possibility that in some cases at least the fixed-orbit assumption is only a crude approximation to reality. Two important dynamical mechanisms through which these orbits may evolve are resonant or secular interactions. In order to explore the possibility of the latter we have set up a simple planar system where an satellite in a circular orbit around a spherical planet is perturbing a massless particle which moves in proximity to various mean motion resonances. We aim to examine the effect of the resonance on the particle’s reference orbit by measuring the secular frequency. The effects of oblateness have not been taken into account as they are adequately modeled by orbit-fitting theories and can thus be readily subtracted.