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The quality of discharge letters has been evaluated in order to initiate a process of improved communications between the hospital and general practitioners. From each of 37 volunteer clinical departments of a French university hospital, a random sample of 30 stays was selected among the hospitalisations for one year. The quality of discharge letters was assessed according to recipients’ needs and to French legislation. In total, 1,024 medical records were relevant and were analysed. This study showed deficiencies in management of discharge letters in the hospital. It constitutes the first step of a quality improvement process based on the awareness of concerned actors through information feedback and the follow‐up of specific indicators.

The purpose of this paper is to investigate trends in patient hospital quality perceptions between 1999 and 2010.

Original data from 11 cross-sectional surveys carried out in a French single university hospital were analyzed. Based on responses to a 29-item survey instrument, overall and subscale perception scores (range 0-10) were computed covering six key hospital care quality dimensions.

Of 16,516 surveyed patients, 10,704 (64.8 percent) participated in the study. The median overall patient perception score decreased from 7.86 (25th-75th percentiles, 6.67-8.85) in 1999 to 7.82 (25th-75th percentiles, 6.67-8.74) in 2010 (p for trend <0.001). A decreasing trend was observed for the living arrangement subscale score (from 7.78 in 1999 to 7.50 in 2010, p for trend <0.001). Food service and room comfort perceptions deteriorated over the study period while patients increasingly reported better explanations before being examined.

Patient perception scores may disguise divergent judgments on different care aspect while individual items highlight specific areas with room for improvement.

Despite growing pressure on healthcare expenditure, this single-center study showed only modest reduction in patients’ hospital-care perceptions in the 2000s.

This paper aims to evaluate the effectiveness of a program designed to improve the quality of drug prescription‐writing at a university hospital in France. Improvement actions included feed‐back from yearly audits and the dissemination of recommendations on how best to write the prescriptions. A random sample of 30 stays was selected from among the hospitalizations for the year 1996. From each patient, medical records were searched for the first prescription order of the stay and its quality was assessed according to standards. A total of 872 records were relevant and included 3,289 medications. The results were compared to those obtained for the two previous years. Actions to sensitize prescribers resulted in an insufficient improvement of most indicators of prescription‐writing quality with results remaining well below ideal standards. The hospital staff concerned had a positive opinion of the program which led to an awareness of prescription problems. This assessment showed that the program had a moderate impact on prescribers’ practice and efforts must be continued.

The purpose of this study was to obtain some anthropometric dimensions of students in secondary schools necessary for the design of school furniture and use them to establish the models that best determine the relationships among the anthropometric dimensions and standing height.

A total of 480 students aged 10 to 18 years (n = 480, SD = ± 2.3 years) were randomly selected from eight public and eight private secondary schools in Ibadan, South West Nigeria. All the dimensions were subjected to curve estimation using Statistical Products and Services Solution 16.0 Statistical Package. The models with p < 0.005 and highest coefficient of determinations were selected as the best models to predict the relationships among the standing height and other variables.

The study proposes 11 models using standing height to estimate necessary anthropometric dimensions for the design of school furniture. The results of the study show that all anthropometric dimensions correlate more non-linearly with standing height than linearly.

The proposed models will have wide applications for the estimation of anthropometric data necessary for the design and construction of school furniture for use in secondary schools in South Western Nigeria.

Clarify the effects of potato flour (PF) addition on dough properties and quality characteristics of pie bread, thus providing a theoretical basis for potato-wheat-yogurt pie bread processing.

The seven pie bread formulations were prepared with addition of different amount of PF (0, 10, 20, 30, 40, 50 and 60 per cent) by replacing wheat flour (WF). The influence of replacement of PF with WF on the dough development, gas behavior, microstructural, gluten-starch interaction inside dough matrix and the nutritional and textural properties of pie bread was analyzed.

Compared to dough with WF, dough height was decreased significantly but total gas volume showed no significant difference with the addition of PF (10-60 per cent), and the dough height was decreased gradually with the increasing addition of PF (p = 0.0012). Scanning electron microscopy and confocal laser scanning microscopy showed that dough with 10-30 per cent PF revealed smooth surface and continuous network structure was also existed between starch and gluten, this was similar to the structure of wheat dough, while the surface was rough and the connection was not continuous when the PF addition was further increased from 40 to 60 per cent. Nuclear magnetic resonance showed dough with 10-60 per cent PF presented larger content of immobilized water compared to the wheat dough, and its content was also increased with the increasing addition of PF (p = 0.0008). Pie bread with 10-60 per cent PF exhibited lower fat, carbohydrate content and energy value compared to the wheat pie bread, and the fat, carbohydrate, energy was further decreased with the increasing addition of PF (p = 0.0012, 0.0002, 0.0007, respectively), while the dietary fiber content increased (p = 0.0011). In addition, specific volume and height/diameter ratio showed no significant difference in pie bread with 0-40 per cent PF, which were 2.1-2.4 cm³/g and 0.16-0.19, respectively (p = 0.004), whereas they were reduced significantly when the PF was increased to 60 per cent (p = 0.001, p = 0.002). In addition, the lightness (L) of pie bread decreased gradually with the increasing amount of PF, and the browning index was increased. Pie bread with 0-40 per cent PF showed similar hardness, springness and chewiness value, which were also increased when the PF was increased to 60 per cent (p = 0.001). The above results indicated that PF could improve the nutritional quality of pie bread, and the appropriate addition amount should be no more than 40 per cent.

The mechanisms of this study should be clarified for further study.

PF was an excellent food ingredient and could be used for pie bread making at 30 per cent replacement level to overcome use of WF.

The results of this study can provide a new kind of potato staple food with high nutrition and low energy for market and consumers.

PF was first used to produce yogurt pie bread to improve the nutritional properties of traditional WF yogurt pie bread.

There is the need to focus on humans while designing engineering facilities for users. The need to focus on Nigerians when designing for them is presented in this paper. The paper aims to discuss these issues.

Relevant literatures were consulted on the history of ergonomics and its importance was stressed. Some instances where ergonomics should be applied in the country were identified.

The paper observed that the application of ergonomics in Nigeria is low and some constraints that are militating against the use of ergonomics in Nigeria are discussed.

The paper suggested ways to fully imbibe the use of human-centered engineering (ergonomics) in Nigeria.

The purpose of this paper is to evaluate the impact of educating adolescents in practical ways of looking after their backs to reduce the incidence of back‐pain, with particular focus on the use and carrying method of ergonomically designed schoolbags.

An educational leaflet containing a range of back care information was designed specifically for a target population group of Year 7 schoolchildren, aged 11 to 12 years, and distributed to Year 7 students (n=682) attending three main secondary education schools in West Sussex during September 2004. A feedback form was used to evaluate the impact of the leaflet on one class in each school (total n=81).

The main findings in this paper indicated education had immediate positive impact on students' awareness of the importance of looking after their backs, and achieving positive back‐health. Information gained was likely to influence future choice of schoolbag type, and intention to change to more back‐health aware schoolbook and equipment carrying behaviours.

The paper shows that long‐term impact was not evaluated, and is a limitation of this study. Further research is required to evaluate the long‐term impact of education on back care in adolescents, and at which age optimum educational impact in this area is gained.

This paper contributes evidence, which could be used to inform national and international health agendas, focusing on the specific area of healthy back education for adolescents through a school‐based health promotion initiative.

The purpose of this paper is to develop a more thorough understanding of cognitive social capital (shared representations) building in a multicultural marketing context.

An ethnographic study with in-depth interviews and observations are used to explore how Chinese entrepreneurs utilize cultural metaphors to build their cognitive social capital in the USA. Both Chinese entrepreneurs and their American stakeholders (consumers and business associates) are interviewed.

The three themes from the findings are cultural conceptual blending, frame shifting with stereotype dilution and metaphor conversion. These form the sub-processes of an overall process the authors name “cross-cultural shifting.” The use of visual and verbal cultural metaphors by the Chinese entrepreneurs leads to conceptual blending, a process of blending of elements and relations from various scenarios in the mind. A frame shifting and stereotype dilution follows, culminating in the conversion of the cultural metaphors into the deep (universally recognized) metaphors of resource and connection.

Given that metaphors are one manifestations of culture and also effective for communicating universally, they play a role in cognitive social capital building in a multicultural context. This exposition calls for further research the utilization of cultural metaphors in international marketing.

The variability in communication and comprehension of business stakeholders from different cultures influence their cognitive social capital building (cooperative behavior to exchange resources). This makes it imperative for multicultural marketers to understand the use of cultural metaphors to enhance cognitive social capital in a multicultural context.

This exposition on cross-cultural frame shifting will result in improved knowledge of the role of cultural metaphors in enhancing multicultural understanding, shared representations and cognitive social capital in international marketing.

The relationship between individuals and institutions is a core feature of the microfoundations of institutional theory. This chapter analyzes the role of conceptual metaphors, a standard ingredient of theory building, in shaping how we theorize this relationship. Using illustrations from the emergent literature on emotions in institutional theory, the author shows the significance of conceptual metaphors for theory building and argues for selecting conceptual metaphors that help craft a dynamic, recursive relationship between individuals and institutions, respecting core premises of institutional theory and offering new creative insights into this relationship.

We investigate how Salesforce’s key people used analogies and metaphors during the deployment of their (then) radical business model innovation. Our analysis shows how Salesforce’s entrepreneurial team skillfully used a mix of analogies and metaphors to communicate its innovations and differentiate the company from its competitors. We also show how business model innovators can weave together analogies and metaphors to create distinct meta-narratives that elicited strong emotions and helped construct a memorable organizational identity that galvanized stakeholders around the firm’s ecosystem appeal. We conclude by discussing the implications of our findings for business model and cognition research.