The implementation of environmental health policies in health care facilities: The case of Malawi.

Establishing and maintaining safe and sufficient environmental health (EH) conditions in health care facilities (HCFs) is important to prevent and control infections. In 2018, the Government of Malawi finalized an environmental health policy that defines specific targets and programs for EH in healthcare settings. This and other related policies have been used since 2010 as a guide for EH practice in HCFs, but the implementation of these policies has been incomplete to-date. This study qualitatively examines the successes and shortcomings of implementing these policies in Malawi's public HCFs. Thematic analysis of interviews with 53 respondents from all levels of government was used to identify the successes of the policies and the barriers to effective implementation using Contextual Interaction Theory. The greatest identified strength lies in the design of the EH department and its ability to connect individual HCFs and EH actors directly to the policy-making level of government. Identified barriers to implementation include: insufficient financial support; lack of human resources; incomplete reporting; poor stakeholder coordination; and insufficient training of EH actors. We recommend refresher trainings for all EH actors, the establishment of a directorate level EH position, and strengthened coordination to improve the collection, analysis, and reporting of monitoring data to enable EH actors to advocate for the additional funding needed to develop programs for EH personnel and to apply effective EH interventions.

How Do Logical Inference Rules Help Construct Social Mental Models?

Starting from recent approaches in mental model research, it is argued that (1) logical inference rules are used in order to construct mental cliques from learned sentiment relations, and (2) social context cues (operationalized as primes) play a crucial role in activating such rules. Transitivity and antitransitivity are taken as examples, and are shown as core constituents of such models. In a first experiment, priming was achieved by announcing the sorting of fictitious persons in either two or three cliques. Thirty-one subjects studied eight sets of sentiment relations among these persons that either did or did not satisfy their primed clique expectations. They showed longer study times and more requests for additional information in the case of inconsistent fits between prime and set. Their sorting solutions also showed clear priming effects. A second experiment (n = 30) showed that when undergoing a recognition test after seeing the relation sets, subjects tended to confuse model-consistent distractors with information they had actually seen. In a third experiment (n = 30) the results from Experiment 1 were replicated using more realistic learning materials.

Temporal Adjustments in the Evaluation of Events: The "Rosy View"

In a series of three investigations we examined people's anticipation of, actual experiences in, and subsequent recollection of meaningful life events: a trip to Europe, a Thanksgiving vacation, and a 3-week bicycle trip in California. The results of all three studies supported the hypothesis that people's expectations of personal events are more positive than their actual experience during the event itself, and their subsequent recollection of that event is more positive than the actual experience. The "rosy view" phenomenon is associated with an increase in the number of negative thoughts during the event which seem to be caused by distractions, disappointment, and a less positive view of the self. However, these effects are short-lived; within days after the event, people have much more positive evaluations of the event. We discuss alternative interpretations for our findings and implications for group and organizational settings.

The pseudotransition zone in long segment Hirschsprung's disease.

Two cases of Hirschsprung's disease with psuedotransition zones are presented. The location and appearance of the transition zone, transverse contractions proximal to the radiographic transition zone, and a delayed film aid in distinguishing a false transition zone from a true transition zone.