Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access

Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management

Highlights Fund-defined attributes of an ideal care delivery system and best practices, including an internal electronic health record, primary care teams, physician quality metrics and mentors, and standardized care processes for chronic care management

The New York City Health and Hospitals Corporation: Transforming a Public Safety Net Delivery System to Achieve Higher Performance

Describes the results of the public benefit corporation's improvement initiatives -- a common clinical information system for continuity, coordination on chronic disease management, teamwork and continuous innovation, and access to appropriate care

Mayo Clinic: Multidisciplinary Teamwork, Physician-Led Governance, and Patient-Centered Culture Drive World-Class Health Care

Describes Fund-defined attributes of an ideal care delivery system, Mayo's model of multidisciplinary practice with salary-based compensation, and best practices, including a shared electronic health record and innovations to implement research quickly

Geisinger Health System: Achieving the Potential of System Integration Through Innovation, Leadership, Measurement, and Incentives

Presents a case study of a physician-led nonprofit healthcare group exhibiting the attributes of an ideal healthcare delivery system as defined by the Fund. Describes how its ProvenCare model improved clinical outcomes with reduced resource utilization

HealthPartners: Consumer-Focused Mission and Collaborative Approach Support Ambitious Performance Improvement Agenda

Presents a case study of a nonprofit healthcare organization that exhibits the six attributes of an ideal healthcare delivery system as defined by the Fund, including information continuity, care coordination and transitions, and system accountability

Scott & White Healthcare: Opening Up and Embracing Change to Improve Performance

Offers a case study of a multispeciality system with the attributes of an ideal healthcare delivery system as defined by the Fund. Describes a culture of continuous improvement, collaboration and peer accountability, and a comprehensive approach to care

Attention bias and anxiety in young children exposed to family violence

Background—Attention bias towards threat is associated with anxiety in older youth and adults and has been linked with violence exposure. Attention bias may moderate the relationship between violence exposure and anxiety in young children. Capitalizing on measurement advances, the current study examines these relationships at a younger age than previously possible. Methods—Young children (mean age 4.7, ±0.8) from a cross-sectional sample oversampled for violence exposure (N = 218) completed the dot-probe task to assess their attention biases. Observed fear/anxiety was characterized with a novel observational paradigm, the Anxiety Diagnostic Observation Schedule. Mother-reported symptoms were assessed with the Preschool-Age Psychiatric Assessment and Trauma Symptom Checklist for Young Children. Violence exposure was characterized with dimensional scores reflecting probability of membership in two classes derived via latent class analysis from the Conflict Tactics Scales: Abuse and Harsh Parenting. Results—Family violence predicted greater child anxiety and trauma symptoms. Attention bias moderated the relationship between violence and anxiety

How climate change affects extremes in maize and wheat yield in two cropping regions

Author Posting. © American Meteorological Society, 2015. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Climate 28 (2015): 4653–4687, doi:10.1175/JCLI-D-13-00326.1.Downscaled climate model projections from phase 5 of the Coupled Model Intercomparison Project (CMIP5) were used to force a dynamic vegetation agricultural model (Agro-IBIS) and simulate yield responses to historical climate and two future emissions scenarios for maize in the U.S. Midwest and wheat in southeastern Australia. In addition to mean changes in yield, the frequency of high- and low-yield years was related to changing local hydroclimatic conditions. Particular emphasis was on the seasonal cycle of climatic variables during extreme-yield years and links to crop growth. While historically high (low) yields in Iowa tend to occur during years with anomalous wet (dry) growing season, this is exacerbated in the future. By the end of the twenty-first century, the multimodel mean (MMM) of growing season temperatures in Iowa is projected to increase by more than 5°C, and maize yield is projected to decrease by 18%. For southeastern Australia, the frequency of low-yield years rises dramatically in the twenty-first century because of significant projected drying during the growing season. By the late twenty-first century, MMM growing season precipitation in southeastern Australia is projected to decrease by 15%, temperatures are projected to increase by 2.8°–4.5°C, and wheat yields are projected to decline by 70%. Results highlight the sensitivity of yield projections to the nature of hydroclimatic changes. Where future changes are uncertain, the sign of the yield change simulated by Agro-IBIS is uncertain as well. In contrast, broad agreement in projected drying over southern Australia across models is reflected in consistent yield decreases for the twenty-first century. Climatic changes of the order projected can be expected to pose serious challenges for continued staple grain production in some current centers of production, especially in marginal areas.This work was initiated at the Dissertations Initiative for the Advancement of Climate Change Research (DISCCRS) V Symposium, supported by the U.S. National Science Foundation through collaborative Grants SES-0932916 and SES-0931402. CCU was supported by a University of New South Wales Vice-Chancellor Fellowship and the Penzance Endowed Fund and John P. Chase Memorial Endowed Fund at WHOI. TET was supported by the U.S. Department of Energy Award DE-EE0004397. NC was funded by NSF Grant EAR-1204774. We are indebted to the FORMAS-funded Land Use Today and Tomorrow (LUsTT) project (Grant 211-2009-1682) for financial support