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This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization.

A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions.

This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met.

This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.

Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term “LEAP” is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention. The purpose of this paper is to evaluate the implementation of the SafetyLEAP program in the intensive care units (ICUs) of three large hospitals.

A comparative case study approach was used to compare and contrast the adherence to each component of the SafetyLEAP program. The study was conducted using a convenience sample of three (n=3) ICUs from two provinces. Two reviewers independently evaluated major adherence metrics of the SafetyLEAP program for their completeness. Analysis was performed for each individual case, and across cases.

A total of 257 patients were included in the study. Overall, the proportion of the SafetyLEAP tasks completed was 64.47, 100, and 26.32 percent, respectively. ICU nos 1 and 2 were able to identify opportunities for improvement, follow a quality improvement process and demonstrate positive changes in patient safety. The main factors influencing adherence were the engagement of a local champion, competing priorities, and the identification of appropriate resources.

The SafetyLEAP program allowed for the identification of processes that could result in patient harm in the ICUs. However, the success in improving patient safety was dependent on the engagement of the care teams.

The authors developed an evidence-based approach to systematically and prospectively detect, improve, and evaluate actions related to patient safety.

The spirits industry is a major economic contributor worldwide, often requiring years of maturation in barrels that is associated with significant release of ethanol into the surrounding environment. This provides carbon nutrition for colonisation of black fungal growths, one type being Baudoinia compniacensis, or Whisky Black. Although growth is localised in production areas, numerous sites exist globally, and this paper's purpose is to investigate the extent and implications of colonisation.

The paper presents and discusses the results of a visual survey of the area surrounding a site where whisky is maturing in nearby bonded warehouses. The evaluation considers radial zoning distance from the ethanol source and material substrate types and surface textures. Classical key stages of Building Pathology, namely manifestation, diagnosis, prognosis and therapy, are considered.

Key findings are that the colonisation of the fungus is non-uniform and dependent on the substrate building material. Additionally, rougher-textured building materials displayed heavier levels of fungal manifestation than smooth materials. Aspects such as distance, wind direction and moisture are considered relative to the extent and level of fungal growth.

This investigation provides the first assessment of the extent and nature of the fungal growth in properties built in surrounding areas to bonded warehouses. Such information can facilitate open dialogue between stakeholders that recognise the aspirations of values of corporate social responsibility, whilst balancing the economic importance of distilling with recognition of the fungus's impact on property values and appropriate recurring remedial treatments.

The purpose of this paper is to address the issue of perceptions of suitability of different materials for a repair. The use of highly cementitious materials in the repair of historic masonry is causing great concern due to their incompatibility with adjacent stone and the associated accelerated deterioration which results from their use. The relatively recent development of so‐called “restoration mortars” based on a “mix and go” application, combined with the enhanced weathering of stone in a changing climate, may be contributing to the use of “plastic” repair materials on stone across Scotland.

Following a literature review, case studies of repairs are presented to highlight the advantages and disadvantages of using such materials, and comparisons are made with the alternative options.

The case studies presented highlight the use of a number of different stone repair materials, sometimes in combination with stone replacement, representing functional and philosophical approaches to masonry repair. However, the research has also highlighted the increasing use of plastic repairs for large‐scale repair including façade rendering, which fail to incorporate these systematic and informed approaches, and can ultimately lead to failure of repairs.

An evaluation of the current standing of the materials, methods and the extent of this type of repair, is vital for the substantiation of further research, and to enhance the empirical knowledge of in‐use performance, longevity and failure. The increasing emergence of restoration mortars, and their manufacture and supply on an international scale, highlights the global impact and relevance of this research.

Sustainability is well understood to encapsulate economic, environmental and societal parameters. The efficiency of maintenance interventions for historic buildings is no exception and also conforms to these broad factors. Recently, environmental considerations for masonry repair have become increasingly important and this work supports this growing area. The purpose of this paper is to give insight on how an option appraisal approach of “Green Maintenance” modelling for historic masonry buildings repair practically determine and ultimately substantiate the decision-making process using a calculation procedures of life cycle assessment, within delineated boundaries.

Calculation procedures of the model enables an assessment of embodied carbon that is expended from different stone masonry wall repair techniques and scenarios for historic masonry buildings during the maintenance phase.

It recognises the importance roles Green Maintenance model can play in reducing carbon emissions and underpins rational decision making for repair selection.

It must be emphasised that the calculation procedures presented here, is not confined to historic masonry buildings and can be applied to any repair types and building form. The decisions made as a result of the utilisation of this model practically support environmentally focused conservation decisions.

The implementation of the model highlights the efficacy of repairs that may be adopted.

The paper is a rigorous application and testing of the Green Maintenance model. The model relays the “true” carbon cost of repairs contextualised within the longevity of the materials and its embodied carbon that consequently allows rational appraisal of repair and maintenance options.

Within the past few years, responsible educators, librarians, parents, counselors, social workers, therapists, and religious groups of all sexual persuasions and lifestyles have recognized the need for readily available reading material for lesbian and gay youth. Unfortunately, this material is often buried, because it is embedded in larger works. To meet this need, I have compiled and annotated 100 of the best works for young homosexuals, bisexuals, and heterosexuals. I have also included a few of the best works currently available on heterosexuality as a much needed source of knowledge for all young adults whether they are gay or straight, whether they remain childless or eventually become parents.

Deterioration in natural stone is associated with many decay mechanisms and often the inherent composition of the materials themselves. Sandstone varies considerably but they all require a cementing matrix to bind amongst others, the silica (SiO₂) particles together (Reading, 1989). In calcareous sandstones and limestones this binding matrix is principally calcium carbonate based (Muir, 2006; Reading, 1989; McMillan et al., 1999) in the form of calcite (CaCO₃). Friable sandstone substrates and stones suffering from “surface dissolution” or disaggregation (Muir, 2006; Smith et al., 1992) have been traditionally consolidated utilising a host of chemical compounds that had, in many cases negative effects on their long-term performance (Muir, 2006). A principle issue amongst many was moisture entrapment and irreversibility of the consolidants adopted. The paper aims to discuss these issues.

This paper investigates the effect of microbial induced calcite precipitation (MICP) as a natural treatment for the conservation of historic natural stone substrates. Sporosarcina pasteurii has been proven as a bacterium that can perform MICP effectively in extreme conditions making it the preferred bacterium for the MICP process within this study. Surface treatment experiments were analysed by measuring the mass increase and surface changes using scanning electron microscopy (SEM).

The surface treatments showed a noticeable mass increase and observable deposition when viewed using a SEM microscope. Bio cementation of loose sand particles was observed and the degree of cementation was determined using a Moh's hardness test.

Recommendations for further work to improve this study are: use an increased Sporosarcina pasteurii cell optical density which would provide a greater calcite output. Carry out a paired comparison initial surface absorption test (BS 1881: Part 208, 1996 or ASTM C 1585-04, 2004). To be carried out on untreated control and MICP samples which would determine the pore blocking effect and surface repair capability of the treated samples.

A method for obtaining optimal results in terms of surface treatment would involve reducing the time between mixing and application, this would require having the two reaction constituents mixed only seconds before use. Using a late mix spray application system has the potential to allow the two mixtures to combine in the spray nozzle whilst exiting the apparatus.

This paper investigates a safe, natural process for stone repair.

Identifies a number of critical spouse/partner preparation and adjustment factors derived from a larger study that examined the expatriate career management practices of 20 Australian business enterprises with a physical presence in the East‐Asian business region. Addresses concerns expressed by Adler (1991) that attention to the needs of an accompanying spouse is at best only having a neutral impact on spouse adjustment. That is, organizations have largely failed to assist spouses in establishing what Adler (1991) described as “a meaningful portable life”. Reviews spouse/partner preparation and adjustment from the views expressed by Australian business executives, expatriate and repatriates involved in business operations in East‐Asia. The views of spouses and partners were not gathered in this study. Results point to the need for re‐assessment of existing spouse/partner preparation and adjustment. While results are tentative, evidence from this study confirms the need for more attention by Australian organizations to spouse/partner preparation and adjustment, with particular attention to the development of business environment awareness and empathy which may assist in advancing Adler’s concept of “a meaningful portable life”.

Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.

The assessment of a deteriorating masonry structure should lead to an objective evaluation of condition. This process is, however, inevitably subjective owing to human interpretation. The condition of the substrate and the required repairs cannot be guaranteed and may vary from building inspector to inspector. For conservation works the determination of repairs is a function of condition but also directly relates to the underpinning framework of building conservation philosophy. These are also fundamentally subjective. The combination of both condition survey subjectivity and building conservation philosophy's nebulous nature creates the potential for project aesthetic and technical divergence. This paper aims to examine this issue.

The paper presents a literature review and hypothetical case studies.

It has been shown by various researchers that a visual survey is subjective and is therefore prone to differences in reporting. In addition, the application of building conservation philosophy is seen through the perspective of the professional specifying the repairs. The combination of these two factors leads to the potential for significant project outcomes.

Subjectivity of evaluation of condition for traditional masonry structures has been little studied by academics and practitioners alike, and it is generally assumed that these yield objective, rational data. This is not necessarily the case. The application of building conservation philosophy to determine repair strategies is also a subjective process. The combination of both may lead to significant project divergence. These combined factors have never previously been discussed.