New Morbidities 2.0

Robert Sanborn and Angelo Giardino\u27s introduction for Volume 4, Issue 1: New Morbidities 2.

Sustainability in Quality Improvement and Patient Safety Initiatives

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term \u27evaporation of improvements\u27 addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & Ketley, 2007). This article addresses the components of what makes a quality initiative sustainable by applying a framework developed that identifies components necessary within a sustainable quality initiative evident from the development process through to the implementation phase of the initiative which becomes part of the fabric of an organization

Comment on "Quantum discord through the generalized entropy in bipartite quantum states"

In [X.-W. Hou, Z.-P. Huang, S. Chen, Eur. Phys. J. D 68, 1 (2014)], Hou et al. present, using Tsallis' entropy, possible generalizations of the quantum discord measure, finding original results. As for the mutual informations and discord, we show here that these two types of quantifiers can take negative values. In the two qubits instance we further determine in which regions they are non-negative. Additionally, we study alternative generalizations on the basis of R\'enyi entropies.Comment: 5 pages, 4 figure

Sustainability and Spread of Community-based Initiatives: A case study of Community Cares, a Children’s Hospital’s 16 year effort to serve its community

The sustainability and spread of innovations is often elusive, presenting continuous challenges to clinicians and healthcare leaders. Somewhere between 33 - 70% of all innovations are reportedly not sustained, and even fewer are spread beyond the original team, or to other units within an organization. In plain language, sustainability is defined as locking in progress, while continually building upon that foundation, while spread is the exchange of knowledge and experience to others beyond the original implementing team. The literature supports the concept that sustainability is both multi-dimensional and multi-factorial and has several characteristics and pre-conditions. Tax-exempt, not-for-profit organizations in the USA must provide measurable community benefits to the populations they seek to serve. Many of these community benefits take the form of locating necessary services closer to or directly within the communities being served in order to enhance access. A case study of a 16 year effort to provide a medical home-oriented primary care model to underserved children in Houston, Texas Children’s Pediatrics’ Community Cares, is presented as illustrative of such a community benefit. Many of the characteristics and preconditions essential to a model for sustainability and spread are highlighted and the Community Cares case study is discussed from the standpoint of this framework

Review: The Batterer as Parent: Addressing the Impact of Domestic Violence on Family Dynamics

A Review of The Batterer as Parent: Addressing the Impact of Domestic Violence on Family Dynamics, 2nd Edition, by Lundy Bancroft, Jay G. Silverman, and D. Ritchie

Immunocytochemical Study of Apoptosis Signaling In Nb2 Lymphoma Cells

In the absence of mitogen, administration of Dexamethasone (Dex) induces apoptosis, or programmed-cell death in the Nb2 lymphoma cell. Addition of prolactin (Prl), on the other hand, blocks this effect. As a model for apoptosis, we were able to investigate this Dex-Prl interaction by means of a morphological approach: one that could be visualized under a light microscope. This approach allowed us to achieve several aims. First, we were able to develop a method of cell quantification befitting a morphological study based upon the hemacytometer. Second, with Trypan Blue exclusion, we were able to verify Dex/Prl-responsiveness in the Nb2 cells. Third, we were able to refine and characterize the TUNEL (Tdt-dependent dUTP-biotin Nick End Labeling) assay as a means of detecting apoptosis in both log phase and synchronized cells. With the synchronized cells, we observed that the time frame of apoptosis onset as measured by Trypan Blue and the TUNEL assay, occurred between 6 and 8 hours. Fourth, using immunocytochemistry (ICC), we were able to characterize and establish specificity of affinity purified polyclonal rabbit antibodies directed against the signal proteins, glucocorticoid receptor (GR), STATSb, NFkB and lkBα. Fifth, we were able to examine how these signal proteins changed in response to Dex treatment using ICC. According to our results, the percentage of positively stained cells for each of these signal proteins remained constant for each time point and treatment