Lorain County Community College

Purpose As service organizations continue to expand internationally, the need to be able to understand consumers in faraway places is increasing. Marketing research is a key mechanism through which service companies understand their current as well as potential customers. As service organizations contemplate the global marketplace, there is increasing demand for managers to understand customer behavior in multiple countries. This article aims to discuss the importance of market research information in developing a market orientation and its impact on international service organizations. Design/methodology/approach Extant literature is reviewed and discussed pertaining to the interrelationships between market research, market orientation and customer relationship management (CRM)‐related issues. Conceptual models are presented to illustrate the interrelationships between these streams of research. Findings Several anecdotal and case examples are used to illustrate the essential linkages between market research, market orientation, and CRM. These include the Ritz Carlton Hotel Company, Federal Express, Hallmark Cards, Harrah's Entertainment and, most notably, VeriFone. Practical implications The key implications revolve around the notion that in today's hyper‐competitive markets service firms must be market‐oriented in order to be competitive, and that market research plays a critical role in generating the needed data on which a market orientation can be developed and implemented, which, in turn, can enhance the practice of CRM. Originality/value The article promises to help service providers address the challenge of generating and using market research data to develop a market orientation and a corresponding CRM program.

BACKGROUND: The StarClose Vascular Closure System is a femoral access site closure technology that uses a flexible nitinol clip to complete a circumferential, extravascular arteriotomy close. The Clip CLosure In Percutaneous Procedures study was initiated to study the safety and efficacy of the StarClose device in subjects undergoing diagnostic and interventional catheterization procedures. METHODS: A total of 17 U.S. sites enrolled 596 subjects, with 483 subjects randomized at a 2:1 ratio to receive StarClose or standard compression of the arteriotomy after the percutaneous procedure. The study included roll-in (n = 113), diagnostic (n = 208), and interventional (n = 275) arms with a primary safety endpoint of major vascular complications through 30 days and a primary efficacy endpoint of postprocedure time to hemostasis. RESULTS: The results of the diagnostic StarClose cohort have been reported separately. Results for the interventional arm revealed major vascular complications occurring in 1.1% of StarClose subjects (2/184) and 1.1% in manual compression subjects (1/91; P = 1.00). No infections were seen in either cohort. Minor complications in the StarClose interventional group occurred at a rate of 4.3% (8/184) and with compression at 9.9% (9/91; P = 0.107). Pseudoaneurysm or arteriovenous fistula was not seen with StarClose. With StarClose, procedural success was 100% (136/136) for the diagnostic group and 98.9% (181/183) in the interventional group. Device success for the treatment group was 86.8%. In the interventional cohort, 87.3% (158/181) of StarClose subjects reported a pain scale of 0-3 compared with 93.3% (84/90) in the compression group, which was not statistically different. CONCLUSIONS: The clinical results of this study demonstrate that the StarClose Vascular Closure System is noninferior to manual compression with respect to the primary safety endpoint of major vascular events in subjects who undergo percutaneous interventional procedures. StarClose significantly reduced time to hemostasis, ambulation, and dischargeability when compared with compression.

The atmosphere is populated by a diverse array of dispersing insects and their predators. We studied aerial insect communities by tracking the foraging altitudes of an avian insectivore, the Purple Martin (Progne subis). By attaching altitude loggers to nesting Purple Martins and collecting prey delivered to their nestlings, we determined the flight altitudes of ants and other insects. We then tested hypotheses relating ant body size and reproductive ecology to flight altitude. Purple Martins flew up to 1,889 meters above ground, and nestling provisioning trips ranged up to 922 meters. Insect communities were structured by body size such that species of all sizes flew near the ground but only light insects flew to the highest altitudes. Ant maximum flight altitudes decreased by 60% from the lightest to the heaviest species. Winged sexuals of social insects (ants, honey bees, and termites) dominated the Purple Martin diet, making up 88% of prey individuals and 45% of prey biomass. By transferring energy from terrestrial to aerial food webs, mating swarms of social insects play a substantial role in aerial ecosystems. Although we focus on Purple Martins and ants, our combined logger and diet method could be applied to a range of aerial organisms.

PURPOSE: We explored the meaning and outcomes of a 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners participating in a Community of Practice. METHOD: A one-group (N = 117) mixed-methods design using a pretest-posttest survey and qualitative analysis of written reflections was used to explore the meaning and outcomes of the building capacity process. RESULTS: Statistically significant improvements (p < .02) in pretest-posttest scores of knowledge, beliefs, and actions related to a public health approach to mental health were found. Qualitative findings suggest that participation resulted in a renewed commitment to addressing children's mental health. CONCLUSION: The building capacity process expanded practitioner knowledge, renewed energy, and promoted confidence, resulting in change leaders empowered to articulate, advocate for, and implement practice changes reflecting occupational therapy's role in addressing children's mental health.

Complex coacervation of polymers can be a route to the compartmentalization of aqueous solutions. Presented here is a study of the hydrogen-bonded complex coacervation of poly(acrylic acid) and poly(ethylene glycol) or Pluronic block copolymers and the ability of these coacervates to encapsulate various ionic and nonionic dyes as well as a pharmaceutical compound within them. The formation of complex coacervate driven by hydrogen bonding is studied as a function of both pH and salt content with turbidimetry and isothermal calorimetry. Small-angle X-ray scattering shows the presence of micelles within Pluronic containing coacervate materials formed with a Pluronic block copolymer concentration higher than its critical micelle concentration. Although dyes generally partition to the coacervate phase, in the absence of salt, dyes that are able to hydrogen bond with the coacervate components are better incorporated into the coacervate. It is observed that the addition of salt to the polymer solutions increases the hydrophobicity of the environment within the coacervate, increasing the ability to sequester dye molecules for which there is no hydrogen bonding with the coacervate components. These materials are characterized with UV–vis spectroscopy, dynamic light scattering, zeta potential measurements, isothermal calorimetry, small-angle X-ray scattering, and fluorescence spectroscopy.

BACKGROUND: A major factor limiting efficiency and quality gains from clinical information technologies is the lack of full use by the clinicians. PURPOSE: To identify the practice and physician characteristics that influence the use of e-scripts after adoption. METHODS: Data were obtained from 27 primary care medical group practices that had e-script technology for 2 years. Physician and practice characteristics were obtained from the clinics, and the proportion of each physician's prescriptions sent electronically was calculated from the prescription records. Practice culture data were obtained from a survey of the physicians in each practice. Data were analyzed using hierarchal regression. FINDINGS: Practice-level variables explain most of the variance in the use of e-scripts by physicians, although there are significant differences in use among specialties as well. General internists have slightly lower use rates and pediatricians have the highest rates. Larger practices and multispecialty practices have higher use rates, and five practice culture dimensions influence these rates; two have a negative influence and three (organizational trust, adaptive, and a business orientation) have a positive influence. PRACTICE IMPLICATIONS: While previous studies have identified physician characteristics and product deficiencies as factors limiting the use of electronic information technologies in medical practices, our data indicate that the influence of these factors may be highly dependent on the culture of the practice. Consequently, practice administrators can improve physician acceptance and use of these technologies by making sure that there is a culture/technology fit before deciding on a product.

New research is emerging that focuses on the role the physical classroom space plays in the teaching-learning dynamic.  The purpose of this exploratory research is to describe the students’ and instructors’ perspectives of how the classroom space and environment impact teaching and learning.  Focus groups were utilized with data points coming from the transcribed interactions of the participants.  There were four focus groups: two groups of college students (N=15), and two groups of college faculty (N=9).  Results yielded three main themes: 1) the Conditions theme, which represented all the issues in the rooms such as space, temperature, and light, 2) the Outcomes theme, which entails all the consequences of the rooms, such as concentration, engagement, and student grades, and 3) the Values theme, which exemplifies the extent classrooms impact teaching and learning

Abstract Andrew Eshleman has argued that atheists can believe in God by being fully engaged members of religious communities and using religious discourse in a non-realist way. He calls this position ‘fictionalism’ because the atheist takes up religion as a useful fiction. In this paper I critique fictionalism along two lines: that it is problematic to successfully be a fictionalist and that fictionalism is unjustified. Reflection on fictionalism will point to some wider problems with religious anti-realism.

This article is based on research and practice experience from projects and cases in both public child welfare agencies and private adoption agencies. Here, the authors summarize the research on sibling relationships, including a description of sibling relationships in families where children have been abused and neglected. The authors also discuss the barriers in child welfare that can result in the separation of siblings. Finally, they offer best practice solutions that support maintaining sibling relationships throughout temporary and permanent placement. An assessment tool to assist in the decision-making process for the placement of siblings is also included. This tool will help practitioners think systematically about the placement of siblings in order to make the best decisions.

It is critically important that speech-language pathologists understand the difference between educational identification of a speech-language impairment under the Individuals with Disabilities Education Act (IDEA) and the procedures used for a clinical determination of speech or language impairment. The authors review variations in terminology, federal and state regulations, and state, local, and professional guidance. Federal evaluation requirements and examples of differing state requirements are provided along with evidence-based recommendations for comprehensive assessment of students.

Clostridioides difficile (CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only 72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level (n=79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI=-3.71, 11.91). At the food-set level (n=232), the weighted prevalence ranged between 4.5% (95%CI=3-6%; all studies) and 8% (95%CI=7-8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks (p<0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude (p<0.001). In conclusion, CD in the human diet is a global nonrandom-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence towards tropic) is unexpectedly inverse to the epidemiological observations of CD-infections in humans (frequent in temperate regions). Findings suggest the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.

Aerial predator-prey interactions may impact populations of many terrestrial species. Here, we use altitude loggers to study aerial foraging in a native insectivore, the purple martin (Progne subis), in the southern USA. Purple martins fed primarily on mating queens and males of the invasive red imported fire ant (Solenopsis invicta), and doubled their foraging efficiency by doing so. Across the USA, purple martins likely eat billions of fire ant queens each year, potentially impacting the spread of this species. Alternatively, predation on fire ants may help sustain populations of purple martins and other aerial insectivores.

Solanidine, leptinidine, and acetylleptinidine from Solanum chacoense Bitter were structurally characterized by high-resolution MS and high-field 1H-NMR and 13C-NMR. 1H-NMR and 13C-NMR chemical shifts were assigned for solanidine and acetylleptinidine using DEPT, HMBC, and HMQC. Complete carbon chemical shift assignments are presented for all three alkaloids. The orientation of the C-23 acetoxyl group of acetylleptinidine was determined to be axial. Keywords: NMR-MS spectroscopy; solanidine; leptinidine; acetylleptinidine

BACKGROUND AND AIMS: Xylazine is a non-opioid sedative which has spread rapidly throughout the US illicit drug supply. This study aimed to describe the spread of xylazine throughout the UK illicit drug supply. METHODS: Xylazine detections in human biological samples were collated from toxicology laboratories operating in the United Kingdom with the date, location, case type, xylazine concentration and co-detected drugs (with quantifications where performed) detailed, where permitted, by the corresponding coroner. Drug-testing cases positive for xylazine were collated from the Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) drug-testing postal service with the date, location, purchase intent and co-detected drugs detailed. Drug seizures made by UK law enforcement were communicated by the Office for Health Improvement and Disparities with the date and location detailed. RESULTS: By the end of August 2023, xylazine was detected in 35 cases from throughout toxicology, drug-testing and drug seizure sources covering England, Scotland and Wales. There were no cases reported from Northern Ireland. Xylazine was detected in biological samples from 16 people. In most cases where full toxicology results were provided, xylazine was detected with heroin and/or a strong opioid (n = nine of 11), but this polydrug use pattern was not evident in all cases (n = two of 11), suggesting a wider circulation of xylazine in the UK illicit drug market beyond heroin supplies. Evidence from WEDINOS supports this claim, as all 14 drug samples (100%) submitted from across the UK contained xylazine; however, in none of these cases was heroin the purchase intent but rather counterfeit prescription medication tablets (n = 11 of 14), tetrahydrocannabinol (THC) vapes (n = two of 14) or white powder (n = one of 14). Additional evidence for the spread of illicit xylazine comes from five drug seizures made by law enforcement. CONCLUSIONS: Xylazine has penetrated the UK illicit drug market and is not limited to heroin supplies.

A prospective, continuous quality improvement study was implemented at a hospital on two rehabilitation units: stroke and brain injury. The purpose of the study was to decrease restraint use by 25% and to maintain fall rates no greater than 10% over baseline. A multi-component restraint reduction program was implemented that focused on administrative support, education, consultation, and feedback. Monthly restraint rates and fall rates were monitored and compared to the previous year's rates. Both units reduced restraint use. Importantly, this reduction was accomplished at the same time as a decline in fall rates.

PURPOSE: The purpose of this study was to compare dental hygiene student radiographic performance using film and charge-coupled device (CCD) systems. Specific objectives were to compare the 1) number of technique errors, 2) error type, 3) retake frequency, and 4) learning experience using both systems. METHODS: Twenty-eight subjects exposed two 18-projection full series, one film-based, and one CCD-based system, on a manikin. One examiner, using standardized image quality criteria, evaluated all images. Each subject was assigned to one of four focus groups. Quantitative data were analyzed using ANOVA and Wilcoxon tests. Emic expressions and percentages were used to report qualitative data with themes supported by performance data. RESULTS: A greater number of technique errors occurred using the CCD system than the film system (p < 0.0001), with vertical angulation being the most common error (53%). Using the film-based system, 66% of the errors were due to incorrect horizontal angulation. Subjects exposed an average of 10 retakes per series using the CCD versus 3 retakes using film. Forty-four percent of the subjects felt their most common CCD errors were film placement and vertical angulation compared to 59% who believed horizontal angulation was the main technique error when using film. Difficulty placing the CCD sensor intraorally was expressed by 74%. The CCD system was reported to be beneficial for teaching theory (67%), with 59% preferring film for learning the psychomotor skill. CONCLUSION: In pre-clinical situations, the CCD system may be an effective tool for teaching technique. Radiographic errors are dependent on the type of image receptor used.

In November 1994 methyl parathion (MP), a restricted agricultural pesticide, was discovered to have been illegally sprayed within hundreds of residences in Lorain County, Ohio. Surface levels and air concentrations of MP revealed detectable levels of the pesticide 3 years after spraying. Because of the high toxicity of MP (lethal dose to 50% of rats tested [LD50] = 15 mg/kg) and long half-life indoors, risk-based relocation and decontamination criteria were created. Relocation criteria were derived based on levels of p-nitrophenol in urine, a metabolic byproduct of MP exposure. In Ohio, concentrations of MP on surfaces and in the air were also used to trigger relocations. The criteria applied in Ohio underwent refinement as cases of MP misuse were found in Mississippi and then in several other states. The MP investigation (1994-1997) was the largest pesticide misuse case in the nation, ultimately involving the sampling of 9,000 residences and the decontamination of 1,000 properties. This article describes the methodology used for relocation of residents and decontamination of properties having MP.

ABSTRACT This paper discusses a collaborative approach to a community-wide needs assessment in a county in Ohio. A neighborhood service provider for elderly residents in the community initiated the research project. To promote ownership in the evaluation process and to conserve resources, the evaluators used a stakeholder participatory approach. This effort not only resulted in increased cooperation among all parties involved (stakeholders, evaluators, community agencies), but culminated in the acceptance and utilization of controversial findings.

Mutations involving the Tol-Pal complex of Escherichia coli result in a subtle phenotype in which cells chain when grown under low-salt conditions. Here, the nonpolar deletion of individual genes encoding the cytoplasmic membrane-associated components of the complex (TolQ, TolR, TolA) produced a similar phenotype. Surprisingly, the overexpression of one of these proteins, TolQ, resulted in a much more overt phenotype in which cells occurred as elongated rods coupled in long chains when grown under normal salt conditions. Neither TolR nor TolA overexpression produced a phenotype, nor was the presence of either protein required for the TolQ-dependent phenotype. Consistent with their native membrane topology, the amino-terminal domain of TolQ specifically associated in vivo with the periplasmic domain of FtsN in a cytoplasm-based two-hybrid analysis. Further, the concomitant overexpression of FtsN rescued the TolQ-dependent phenotype, suggesting a model wherein the overexpression of TolQ sequesters FtsN, depleting this essential protein from the divisome during Gram-negative cell division. The role of the Tol-Pal system in division is discussed.

The concept of nursing diagnosis has recently become a topic of major importance in nursing. Incorporation of well-developed nursing diagnoses into oncology nursing practice can assure comprehensive, yet individualized care for the oncology patient. According to a review of literature, oncology nurses have developed the Outcome Standards, assessment tools, and care plans that can provide the framework from which oncology nursing diagnoses can be developed. Each of the nursing diagnoses should be analyzed and evaluated to determine their relevance and reflect the complexity of the problems experienced by cancer patients. The ultimate benefit is improved cancer care.