The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Patient Satisfaction/Patient Experience, Patient-Reported Outcomes, and Healthcare Quality: Are We Focusing on the Wrong Metrics?

Background: To meet the Institute of Medicine goal of patient-centered healthcare quality, Patient Satisfaction/Patient Experience (PS/PE) has evolved to become 25 percent of the U.S. government’s Medicare and Medicaid Value-Based Purchasing (VBP) Program. PS/PE is most commonly measured by CAHPS® and Press Ganey® (PG) surveys. Patient-reported Outcomes (PROs) are also measured as part of the VBP, but are not used for reimbursement. Materials and Methods: We performed a MEDLINE literature search to evaluate whether high-level evidence (randomized controlled trials, systematic reviews, or meta-analyses) exist to show that CAHPS®, PG®, and PROMIS® survey scores correspond with improved quality of healthcare. Results: The number of publications on PS/PE and PRO has increased significantly since the initiation of patient surveys. One systematic review found that CAHPS® scores were inconsistently associated with patient-reported quality. Zero studies were found to show that PG® scores were associated with improved quality. Five studies showed that PROMIS® had convergent validity with legacy measures of PRO. Further review of the literature showed concerns inherent in the way CAHPS® and PG® are used which may adversely affect healthcare quality. Conclusion: PS/PE is weighted highly for reimbursement. The most-utilized PS/PE surveys have psychometric and methodologic flaws and, using the above literature search method, we found very little high-level data showing that CAHPS® and PG® scores correlate with improved healthcare quality as defined by the IOM. PROMIS® is a reliable, valid, and precise measure of patient-reported health status. CMS should consider a policy change to decrease the weight of PS/PE in the VBP program. At the same time, CMS should consider incorporating PRO data into reimbursement

Health Service Access, Use, and Insurance Coverage Among American Indians/Alaska Natives and Whites: What Role Does the Indian Health Service Play?

Objectives. We compared access and utilization of health services among American Indians/Alaska Natives (AIANs) with that among non-Hispanic Whites. Methods. We used data from the 1997 and 1999 National Survey of America’s Families to estimate odds ratios for several measures of access and utilization and the effects of Indian Health Service (IHS) coverage. Results. AIANs had less insurance coverage and worse access and utilization than Whites. Over half of low-income uninsured AIANs did not have access to the IHS. However, among the low-income population, AIANs with only IHS access fared better than uninsured AIANs and as well as insured Whites for key measures but received less preventive care. Conclusions. The IHS partially offsets lack of insurance for some uninsured AIANs, but important needs were potentially unmet

Comparing Lasater's clinical judgment rubric scores across faculty, self-assessement, and outcomes scores

As more schools of nursing begin and/or continue to implement the use of human patient simulation, an objective evaluation tool needs to be used to measure nursing students' clinical judgment competency level. Assessment of nursing students' competency level is important because it identifies the students' strengths and weaknesses. This allows nurse educators to remediate content areas to make sure the student is clinically competent upon program completion and successful on the NCLEX-RN exam. The purpose of this study was to compare the accuracy of students' self-assessment of clinical judgment skills with faculty assessment of students' clinical judgment skills upon completion of a high-fidelity simulation experience. This study also compared the relationship between students' self-assessment and faculty assessment of clinical judgment competency levels during HPS and students' scores on a customized HESI nursing exam. Furthermore, the researcher investigated how high-fidelity simulation influences baccalaureate nursing student's clinical judgment competency level. The researcher collected quantitative data using a pretest/post-test experimental design. Participants included students in the third semester of upper division in a baccalaureate nursing program. The findings indicated that there was a slightly significant positive correlation between the faculty's assessment of students' clinical judgment skills score and the students' self-assessment of clinical judgment skills score. Secondly, there was a significant positive correlation between the faculty's assessment of students' clinical judgment skills score and students' HESI scores (post intervention). Thirdly, there was no correlation between students' self-assessment score and HESI score (post-intervention). Lastly, the data revealed that the experimental group scored significantly higher than the control group on the HESI exam (post-intervention). The results of this study indicate that students who undergo a cardiovascular HPS clinical experience perform significantly better on a customized cardiovascular parallel HESI exam than those students who do not receive a HPS experience. (Published By University of Alabama Libraries