Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

The objectives of this study are threefold. First, we evaluate the applicability of the information–motivation–behavioral skills (IMB) model for predicting organic food purchase intention (OFPI) in adults with chronic conditions. Second, we examine the indirect effects of organic food knowledge, attitudes toward organic food purchase, and subjective norms on OFPI through self-efficacy. Third, we examine whether these indirect effects are moderated by gender and educational attainment. Data were collected from Indian adults with chronic conditions using a self-administered questionnaire. The results show significant indirect effects of organic food knowledge, attitude toward organic food purchase, and subjective norm on OFPI through self-efficacy. Moreover, the mediating effect of knowledge was moderated by gender and education attainment, with the effect being stronger for females and among individuals with a lower level of education. Organic food marketers, social marketers, and public health agencies promoting organic food consumption to people with chronic conditions should aim to increase their confidence in comprehending organic food. This study contributes to the literature by assessing the applicability of Fisher and Fisher’s (1992) IMB model in understanding behavioral intention toward organic food.

A particular challenge in the conceptual design of direct-from orbit delivery systems is the seemingly well-known kinematics retain fallacies whose efficacies are reduced over great distances. Rotation about the local wing of an aerospace vehicle is almost never the pitch angle, yet modern application of kinematics often assumes such (with accompanying angular error). The same assertion is usually true about the nature of roll and yaw angles. Expressing motion in coordinates of rotating reference frames necessitates transformation between reference frames, and one such transformation is embodied in the Direction Cosine Matrices (DCM) formed by a sequence of three successive frame rotations. One of two ubiquitous sequences of three rotations used to construct the DCM involves first a rotation around the inertial z-axis, then intermediate y-axis, then finally about the body’s x-axis; a sequence commonly called the “aerospace sequence” or the a “3-2-1 rotation sequence”. The second ubiquitous sequence is the so-called “orbital sequence” or “3-1-3 rotation sequence” with rotations about the inertial z axis first, then about the intermediate x-axis, then finally about the body z-axis. This manuscript evaluates which sequence is the most advantageous for an object starting in space and then travels through the atmosphere to a target on the Earth’s surface. Six degrees of freedom of vehicle motion were simulated starting in orbit with a given thrust and commanded maneuver. The simulation performs all twelve possible rotation sequences (transforming inertial coordinates to body coordinates) with comparison by computational burden and error representing rotations about body axes (roll, pitch, and yaw respectively). Simulation precision is validated using the quaternion normalization condition indicating near machine precision (0.9\times{10}^{-15}) and reveals the so-called 132 rotation is the most accurate with an average error of 0.14° and a computational time of 0.013 seconds: resulting in a 97.95% increase in accuracy over the so-called 321 rotation and a 99.84% increase over the so-called 313 rotation.

Autonomous navigation of spacecraft necessitates innovative technologies, methods, and algorithms, particularly when orbiting in proximity of other space objects. Optimization methods are useful for autonomous spacecraft navigation, guidance, and control, but their performance is hampered by noisy multi-sensor technologies and poorly modeled system equations, and real-time on-board utilization is generally computationally burdensome. Some proposed methods use noisy sensor data to learn the optimal guidance and control solutions real-time (online), where non-iterative instantiations are preferred to reduce computational burdens. This study aims to highlight efficacy and limitations of several common methods for optimizing guidance and control while proposing a few more, where all methods are applied to the full, nonlinear, coupled equations of motion including cross-products of motion from the transport theorem. Five disparate types of optimum guidance and control algorithms are presented and compared to a classical benchmark. Comparative analysis is based on tracking errors (both states and rates), fuel usage, and computational burden. Real-time optimalization with singular switching plus nonlinear transport theorem decoupling proves superior by matching open-loop solutions to the constrained optimization problem (in terms of state and rate errors and fuel usage), while robustness is validated in the utilization of mixed, noisy state and rate sensors and uniformly varying mass and mass moments of inertia. State tracking errors are reduced one-hundred ten percent. Rate tracking errors are reduced one-hundred thirteen percent. Control utilization (e.g., fuel) is reduced eighty four percent, while computational burden in reduced ten percent simultaneously.