Implementing electronic lab order entry management in hospitals: Incremental strategies lead to better productivity outcomes

This paper evaluates the impact of varying implementation of electronic lab order entry management (eLAB) system strategies on hospitals’ productivity in the short run. Using the American Hospital Association's Annual Surveys for 2005–2008, we developed hospital productivity measures to assess facilities’ relative performances upon implementing eLAB systems. The results indicate that different eLAB system implementation strategies were systematically related to changes in hospitals’ relative productivity levels over the years studied. Hospitals that partially implemented an eLAB system without completing the roll-out experienced negative impacts on productivity. The greatest loss in short-term productivity was experienced by facilities that moved from having no eLAB system to a complete implantation in one year—a strategy called the “Big Bang”. The hybrid approach of a limited introduction in one period followed by complete roll-out in the next year was the only eLAB system implementation strategy associated with significant productivity gains. Our findings support a very specific strategy for eLAB system implementation where facilities began with a one-year pilot program immediately followed by an organization-wide implementation effort in the next period.     

Reconciling two approaches to critical success factors: The case of shared services in the public sector

Shared services have been embraced by the private, and increasingly, the public sectors. Yet implementation has often proved to be difficult and the factors which are critical to success are not yet well understood. In this paper existing research in the area of critical success factors (CSFs) is examined and it is suggested that that research actually covers two distinct phenomena. One approach is focused on identifying the factors required for a specific individual to achieve their outcomes. The second on determining the general success factors for implementing a project of a certain type. A reconciliation of the two approaches is proposed within a framework that distinguishes between three different types of CSF – outcome, implementation process and operating environment characteristic. A case study of a project to implement shared services in the Australian public sector is examined using the reconciled framework. The case shows that the reconciled approach by including, and differentiating between, outcome, process and operating environment characteristic factors provides a richer and more complete picture of requirements. Further benefits from the synthesis are also highlighted including that factors are a mix of universal and context specific, different perspectives on factors exist and not all environmental factors perceived to be critical have to necessarily be present.     

‘Putting up your Dukes’: Statues social memory and Duke Paoa Kahanamoku

Public statues that commemorate the lives and achievements of athletes are pervasive and influential forms of social memory in Western societies. Despite this important nexus between cultural practice and history making, there is a relative void of critical studies of statuary dedicated to athletes. This article will attempt to contribute to a broader understanding in this area by considering a bronze statue of Duke Paoa Kahanamoku, the Hawaiian Olympian, swimmer and surfer, at Waikīkī, Hawaii. This prominent monument demonstrates the processes of remembering and forgetting that are integral to acts of social memory. In this case, Kahanamoku's identity as a surfer is foregrounded over his legacy as a swimmer. The distillation and use of Kahanamoku's memory in this representation is enmeshed in deeper cultural forces about Hawaii's identity. Competing meanings of the statue's symbolism indicate its role as a ‘hollow icon’, and illustrate the way that apparently static objects representing the sporting past are in fact objects of the present.     

Pre-competition imagery,self-efficacy and performance in collegiate golfers

In this study, we examined the relationships between self-efficacy, pre-competition imagery use and performance. A modified version of the Sport Imagery Questionnaire was used to assess both the motivational and cognitive functions of imagery used by 51 varsity golfers during the hour before a Provincial University Golf Championship. In line with Martin and co-workers' model of imagery use in sport, we hypothesized that self-efficacy would be positively related to motivational general-mastery imagery use and motivational generalmastery imagery use would be predictive of golf performance. Also, consistent with theorizing by Bandura, we hypothesized that self-efficacy would predict golf performance, but that the relationship between self-efficacy and performance would be mediated by imagery use. The results of hierarchical multiple regression analyses revealed that pre-competition motivational general-mastery imagery accounted for significant variance in both self-efficacy (adjusted R 2 = 0.26, P ? 0.01) and performance (adjusted R 2 = 0.31, P ? 0.01). The results also indicated that self-efficacy was predictive of golf performance and that motivational general-mastery imagery use mediated the relationship between self-efficacy and performance. The results are discussed in relation to athletes' pre-competition preparation and intervention.     

Effect of Age,Sex, and Type of Feedback on Motor Performance and Locus of Control

The purpose of this study was to determine the effects of consistent positive and negative feedback on motor performance and a shift in locus of control. Comparisons of the data were made on the basis of age, sex, type of feedback, and internal–external (I–E) disposition. Extreme internal and external participants were offered positive or negative feedback on a rotary pursuit motor task over 20 trials, twice per week, for 6 weeks (a total of 240 trials). The results were as follows: (a) all eighth-grade (13-year-old) subjects displayed superior motor skill performance as compared to fifth-grade (10-year-old) students; (b) subjects across age groups who received positive feedback performed better than subjects given negative feedback; (c) a significant locus of control by feedback interaction indicated that high internals were superior to high externals under positive feedback conditions but that negative feedback produced inferior performance by internals compared to heightened performance by externals; (d) older subjects were more internal than younger subjects based on locus of control questionnaire data both prior to and immediately following the 6-week experiment; and (e) neither age group demonstrated a significant shift in locus of control in response to both the positive and negative feedback conditions.     

Carnosine and taurine contents in individual fibres of human vastus lateralis muscle

Analysis of ATPase characterized type I and type II fibres from biopsy samples of the vastus lateralis muscle of four male subjects showed a selective distribution of carnosine and free taurine similar to that observed in other species. The mean carnosine concentration was twice as high in type II compared with type I muscle fibres (23.2 +/- 17.8 and 10.5 +/- 7.6 mmol . kg -1 dry weight, respectively), while taurine was four times higher in type I compared with type II muscle fibres (39.2 +/- 17.8 and 9.6 +/- 2.6 mmol . kg -1 dw, respectively). Overlap in the concentration of carnosine or taurine between fibre types occurred only once in one subject. There was no overlap between fibre types in the ratio of carnosine to taurine. Higher carnosine concentrations in type II fibres will result in a greater contribution to the buffering of H+ arising from anaerobic metabolism. The contribution in a type II fibre with the highest carnosine content was estimated to equal 28% of that from other sources.     

The creatine content of Creatine Serum™ and the change in the plasma concentration with ingestion of a single dose

Three samples of Creatine Serum? ATP Advantage from Muscle Marketing USA, Inc. were assayed for creatine by two different techniques by four independent laboratories, and for creatinine by two different techniques by two laboratories. A further sample was assayed for phosphorylcreatine. Dry weight and total nitrogen were also analysed. Six male volunteers ingested in random order, over 3 weeks: (A) water; (B) 2.5?g creatine monohydrate (Cr?·?H₂O) in solution; and (C) 5?ml Creatine Serum? (reportedly containing an equivalent amount of Cr?·?H₂O). Blood samples were collected before and up to 8?h after each treatment and plasma was analysed for creatine and creatinine. Eight-hour urine samples were analysed for creatine. Ingestion of 2.5?g creatine monohydrate in solution resulted in a significant increase in plasma creatine (from 59.1±11.8?μmol?·?l^?1 to 245.3±74.6?μM μmol?·?l^?1; mean±s) and urinary creatine excretion. No increase in plasma or urinary creatine or creatinine was found on ingestion of Creatine Serum? or water. Analysis showed 5?ml of Creatine Serum? to contain <10?mg Cr?·?H₂O and approximately 90?mg creatinine. Phosphorylcreatine was not detectable and only a trace amount of phosphorous was present. Total nitrogen analysis ruled out significant amounts of other forms of creatine. We conclude that the trace amounts of creatine in the product would be too little to affect the muscle content even with multiple dosing.