Seeking Choice to Fulfill Health Literacy Needs: Health Literacy Opportunities for Consumers in Hospital Waiting Areas

In this research, we explore and theorize on the potential of hospital outpatient rehabilitation waiting areas to respond and contribute to the health literacy needs of consumers. Constructivist grounded theory informed the sampling and analytical procedures. Thirty-three consumers attending outpatient rehabilitation for a range of health conditions were recruited to this multi-site study. Semi-structured interview and participant observation data were collected and analyzed concurrently using the constant comparison method. The substantive theory of “seeking choice to fulfill health literacy needs” and five interdependent categories were developed. Results indicated that consumers sought choice reflective of their needs; however, the waiting area offered limited choice. Consumers shared ideas to address the lack of choice. Results provide insight into the health literacy needs of consumers in hospital outpatient waiting areas and how health services can appropriately respond to these needs. Future research should investigate the effect of health service environments on health outcomes.

Effects of the COVID-19 Pandemic on Place in End-of-Life Care: Insights From a Homeless Mobile Palliative Care Team

The effects of the COVID-19 pandemic on both those experiencing homelessness (Tsai & Wilson, 2020) and those with life-limiting illnesses (Abbott et al., 2020) is of great public health concern. This presentation details the findings from an organizational case study (Yin, 2014) aimed at investigating COVID-related changes to the service environments in which unhoused palliative care patients receive care. Through ethnographic field observation (Phillippi & Lauderdale, 2017) and interviews with a homeless palliative care team and their community partners (Turner, 2005), findings included 1) decreased staff capacity due to de-congregated care; 2) efforts to extend care in community settings due to relocation barriers; 3) conflict between reducing viral risk and honoring unique population needs; and 4) provider perceptions of COVID-19 as an “equalizer.” Findings illustrate the impact of emergency response within housing and healthcare systems on unhoused patients’ care and offer potential pathways to quality end-of-life care for homeless populations.

Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research

Background: Safewards is a complex psychosocial intervention designed to reduce conflict and containment on inpatient mental health units. There is mounting international evidence of the effectiveness and acceptability of Safewards. However, a significant challenge exists in promising interventions, such as Safewards, being translated into routine practice. The Consolidated Framework for Implementation Research (CFIR) provides a framework through which to understand implementation in complex health service environments. The aim was to inform more effective implementation of Safewards using the CFIR domains and constructs, capitalizing on developing an understanding of variations across wards.Method: Seven Safewards Leads completed the Training and Implementation Diary for 18 wards that opted in to a trial of Safewards. Fidelity Checklist scores were used to categorize low, medium and high implementers of Safewards at the end of the 12-week implementation period.Results: Qualitative data from the diaries were analyzed thematically and coded according to the five CFIR domains which included 39 constructs. Twenty-six constructs across the five domains were highlighted within the data to have acted as a barrier or enabler. Further analysis revealed that six constructs distinguished between low, medium, and high implementing wards.Discussion: Our findings suggest that for implementation of Safewards to succeed, particular attention needs to be paid to engagement of key staff including managers, making training a priority for all ward staff, adequate planning of the process of implementation and creating an environment on each inpatient unit that prioritize and enables Safewards interventions to be undertaken by staff regularly.

Management of Airframe In-Service Pitting Corrosion by Decoupling Fatigue and Environment

Corrosion-induced maintenance is a significant cost driver and availability degrader for aircraft structures. Although well-established analyses enable assessing the corrosion impact on structural integrity, this is not the case for fatigue nucleation and crack growth. This forces fleet managers to directly address detected corrosion to maintain flight safety. Corrosion damage occurs despite protection systems, which inevitably degrade. In particular, pitting corrosion is a common potential source of fatigue. Corrosion pits are discontinuities whose metrics can be used to predict the impact on the fatigue lives of structural components. However, a damage tolerance (DT) approach would be more useful and flexible. A potential hindrance to DT has been the assumption that corrosion-induced fatigue nucleation transitions to corrosion fatigue, about which little is known for service environments. Fortunately, several sources indicate that corrosion fatigue is rare for aircraft, and corrosion is largely confined to ground situations because aircraft generally fly at altitudes with low temperature and humidity Thus, it is reasonable to propose the decoupling of corrosion from the in-flight dynamic (fatigue) loading. This paper presents information to support this proposition, and provides an example of how a DT approach can allow deferring corrosion maintenance to a more opportune time.

Isothermal Oxidation Performance of Laser Cladding Assisted with Preheat (LCAP) Tribaloy T-800 Composite Coatings Deposited on EN8

It is anticipated that laser cladding assisted with preheat (LCAP)-deposited Tribaloy (T-800) composite coatings enhances resistance to structural degradation upon exposure to elevated-temperature oxidation service environments. The oxidation kinetics of LCAP T-800 composite coatings deposited on EN8 substrate and its mechanisms have not been explored in severe conditions that are similar to operational parameters. The isothermal oxidation behaviour of the T-800 composite coating deposited on EN8 via LCAP was studied at 800 °C in air for up to 120 h (5 × 24 h cycles) and contrasted to that of uncoated samples. The mass gain per unit area of the coating was eight times less than that of the uncoated EN8 substrate. The parabolic rate constant (Kp) for EN8 was 6.72 × 10−12 g2·cm−4·s−1, whilst that for the T-800 composite coating was 8.1 × 10−13 g2·cm−4·s−1. This was attributed to a stable chromium oxide (Cr2O3) layer that formed on the coating surface, thereby preventing further oxidation, whilst the iron oxide film that formed on the EN8 substrate allowed the permeation of the oxygen ions into the oxide. The iron oxide (Fe2O3) film that developed on EN8 spalled, as evidenced by the cracking of oxide when the oxidation time was greater than 72 h, whilst the Cr2O3 film maintained its integrity up to 120 h. A parabolic law was observed by the T-800 composite coating, whilst a paralinear law was reported for EN8 at 800 °C up to 120 h. This coating can be used in turbine parts where temperatures are <800 °C.

How Does Service Environment Enhance Consumer Loyalty in the Sport Fitness Industry? The Role of Servicescape, Cosumption Motivation, Emotional and Flow Experiences

The purpose of the current study was to investigate the structural relationship between the servicescape, the emotional experience, space flow, satisfaction, and consumer loyalty in the context of sport fitness centers. Furthermore, the present study aimed to examine the moderating role of knowledge acquisition motivation in the effect of the servicescape on the emotional experience and space flow. For these research purposes, a survey study targeting 400 consumers of sport fitness centers was conducted via online and offline survey platforms in South Korea. After deleting 16 incomplete cases, 384 cases were included in the final data analysis. The results of latent moderated equations modeling (LMS) showed that the servicescape directly enhances the emotional experience and space flow. Also, it indirectly affects consumer loyalty via the emotional experience, space flow, and consumer satisfaction. Meanwhile, knowledge acquisition motivation was found to moderate the effect of the servicescape on space flow. The present study has several theoretical implications. First, the current study illuminates the process mechanism of the effect of the servicescape in sport fitness centers on consumer loyalty. Second, the present study empirically shows different patterns of consumer experiences and decision-making depending on consumption motivation. Based on the results, sport fitness center managers should not only pay more attention to the convenience of their servicescape but they should also design service environments maximizing consumers′ emotional experiences. Additionally, the results imply that assigning exercise beginners to an attractive physical environment is an effective strategy, because they are more likely to evaluate their experiences based on the perceived servicescape.