Handle this challenging question

A qualitative case study approach was used to examine four nursing homes. Extreme case examples-high- andlow-performing nursing homes-were purposefully selected. More than 100 hr of observation, 70 formal interviews, numerous informal interviews, and document review were the primary data collection methods.

Findings:

Using select complexity science principles added richness to the analysis, highlighting the stark contrast between the high- andlow-performing nursing homes. Leaders in the high-performing homes behaved congruently with the nursing home's stated and lived mission by fostering connectivity among staff, ample information flow, and the use of cognitive diversity. In contrast, leadership in low-performing homes behaved dis harmoniously with the stated mission, which confused and eroded trust and relationships among staff members, contributed to poor communication, and fostered role isolation and discontinuity in resident care.

Practice Implications:

The study offers insights into the importance of mission- and values-based leadership behaviors, suggesting that an overuse of mechanistic, linear command-and-control approaches to improving care, such as punitive measures to insist on regulatory compliance, will do little to ultimately improve care. Rather, relationship-centered leadership that embraces comanagement and mutual shaping of resident care complements doing the right thing for residents from a values-based shared experience. Examples of practice implications include developing a strong, coherent organizational mission; having fewer, more flexible rules to foster creativity; and allowing lateral decision making.

Question 11

Dear authors, why are gastric ulcers more common along the lesser

curve, near the pylorus of the stomach?

Question 12

What is the best time of day to administer omeprazole, and why?

Question 13

Is it safe to use the drugs omeprazole and ranitidine during pregnancy?

Question 14

Are non-steroidal anti-inflammatory drugs harmful to the stomach when

taken parenterally, for example by intravenous or intramuscular routes?

Question 15

Is it safe to give a patient with a past history of bleeding peptic ulcer

aspirin in an antiplatelet dose of 75-325 mg?

Question 16

Is sulpiride effective in the treatment of a peptic ulcer or gastrooesophageal reflux disease (GORD)?

Question 17

Is clopidogrel gentle on the stomach?

Question 18

Is there a drug interaction between non-steroidal anti-inflammatory

drugs (NSAIDs) and proton pump inhibitors (PPIs)?

Question 19

Does antacids enhance mucosal resistance in the gastric mucosa? If so,

please indicate the mechanism.

Question 20

Is there a drug interaction between antacids and H2-receptor blockers?