Servant Leadership in Healthcare

America\u27s $1.4 trillion healthcare industry is poised to grow rapidly in volumes, revenues and expenditures. Rising healthcare expenditures signal a return of medical inflation, with double-digit premium increases for employers and consumers, and an increased threat of more government regulation and healthcare reforms. In addition, the post 9/11 economic recession and layoffs have increased the number of uninsured patients. While hospitals are investing in expansion initiatives, there is a continued workforce shortage, particularly in nursing. According to Russell Coile, Jr. (1999), healthcare is in crisis. More focus is being placed on leadership to empower employees and create positive patient care experiences. Healthcare leadership carries enormous responsibility; effective leadership is crucial for effective, safe patient care. Servant leadership, first popularized by Robert Greenleaf in 1970, provides an effective model for healthcare leadership because it puts serving others as the number one priority. The characteristics of a servant leader include: listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of the people, and building community. These characteristics mirror many values in healthcare and the successful implementation of a servant leadership culture will enable hospitals to navigate through the current crisis. Servant leadership is being successfully implemented in many industries, but there are only a few examples in healthcare. This paper explores the trends in healthcare and their implication for leadership. It explains the value of adopting a servant leadership model and examines how a servant leadership culture can be successfully developed and sustained

Biogeography and potential factors regulating shallow subtidal reef communities in the western Indian Ocean

Includes bibliographical references (p. 209-274).The biogeography and ecology of benthic shallow subtidal reef communities in the western Indian Ocean is poorly known, particularly in north-eastern South Africa and southern Mozambique. This thesis uses quantitative information to resolve biogeographic patterns, define reef community types, elucidate potential abiotic determinants of community composition, and evaluate whether subsidies of riverine-derived particulate organic matter (POM) support filter-feeder biomass and drive biogeographic patterns. A large-scale biogeographic analysis was conducted using quantitative biomass data derived from 55 shallow subtidal reefs spanning five countries in the western Indian Ocean. Two statistically distinct marine provinces, Tropical Indo-West Pacific and Subtropical Natal, were recognised by differences in community composition and separated by a biogeographic break in the vicinity of Cape Vidal, South Africa. The biogeographic break took the form of a transitional or overlap area corresponding in location to the Delagoa Bioregion, one of three bioregions also revealed by post-hoc analyses. Significant differences in total average biomass and trophic structure were evident among bioregions, with a number of inter-bioregional trends in trophic groups being apparent. In total, 12 reef community types were recognised, based on similarity profile permutation tests. Most reefs in the Subtropical Natal Bioregion were dominated by a community type characterised by a high biomass of the filter-feeding ascidian Pyura stolonifera and various species of articulated coralline algae. In the Delagoa Overlap Bioregion, a comparatively high diversity of community types was defined, many dominated by algal turf, P. stoloniferaand various Alcyonacea and Scleractinia. Further north, P. stolonifera diminished and the contributions of Scleractinia, especially Porites spp., Pocilloporaspp. and Galaxea spp. increased. Many of these community types are not represented within protected area networks, particularly those in southern Mozambique. When the biomass data were correlated with nine abiotic variables, likely determinants of community composition emerged at both inter- and intra-regional scales. Sea surface temperature, significant wave height, chlorophyll-a and suspended inorganic sediment were the variables highly correlated with community composition and therefore most likely to drive biogeographic differences. Within each bioregion, different sets of abiotic variables were found to be important in driving community differences among sites, including turbidity, chlorophyll-a, reef susceptibility to sand inundation, reef heterogeneity and sea surface temperature. Striking differences in the oceanographic conditions of bioregions were evident, especially between Subtropical Natal and Delagoa Overlap bioregions. In particular, the strong influence of wave height emerged as a novel and unexpected correlate at a biogeographic scale. These differences initiated a trophic study conducted in the Subtropical Natal Bioregion, aimed at determining the importance of riverine-derived POM subsidies in supporting the high filter-feeder biomass in this bioregion. Using carbon, nitrogen and sulphur isotopes and a three-source Bayesian mixing model to calculate proportional contributions, I determined that marine-derived POM formed the bulk of the diets of four species of filter-feeders, but the assimilation of riverine-derived POM was nevertheless notable, ranging from 8 to 33 %. I concluded that riverine POM is likely to play an important but secondary role to factors such as increased levels of turbidity and productivity in explaining the high filter-feeder biomass in the Subtropical Natal Bioregion. These findings provide the first evidence of riverine-inshore-pelagic coupling in filterfeeder communities in this bioregion, and throw light on the factors linked to large-scale biogeographic patterns

EB Sagamore Parkway Over the Wabash River Bridge Project

The Sagamore Parkway bridges over the Wabash River are vital crossings for the citizens of West Lafayette and Lafayette. This presentation will walk attendees through the entire design and construction process for this unique bridge replacement project. The presentation will also discuss Parsons’ role with the JTRP project that focuses on the verification of the substructure design loads by using embedded strain gauges that were installed in the substructure

Eigenvector-Based Centrality Measures for Temporal Networks

Numerous centrality measures have been developed to quantify the importances of nodes in time-independent networks, and many of them can be expressed as the leading eigenvector of some matrix. With the increasing availability of network data that changes in time, it is important to extend such eigenvector-based centrality measures to time-dependent networks. In this paper, we introduce a principled generalization of network centrality measures that is valid for any eigenvector-based centrality. We consider a temporal network with N nodes as a sequence of T layers that describe the network during different time windows, and we couple centrality matrices for the layers into a supra-centrality matrix of size NTxNT whose dominant eigenvector gives the centrality of each node i at each time t. We refer to this eigenvector and its components as a joint centrality, as it reflects the importances of both the node i and the time layer t. We also introduce the concepts of marginal and conditional centralities, which facilitate the study of centrality trajectories over time. We find that the strength of coupling between layers is important for determining multiscale properties of centrality, such as localization phenomena and the time scale of centrality changes. In the strong-coupling regime, we derive expressions for time-averaged centralities, which are given by the zeroth-order terms of a singular perturbation expansion. We also study first-order terms to obtain first-order-mover scores, which concisely describe the magnitude of nodes' centrality changes over time. As examples, we apply our method to three empirical temporal networks: the United States Ph.D. exchange in mathematics, costarring relationships among top-billed actors during the Golden Age of Hollywood, and citations of decisions from the United States Supreme Court.Comment: 38 pages, 7 figures, and 5 table

Managing Diverse Stakeholders

For every public project, there is a diverse group of stakeholders who need and want information. During this session we outline important stakeholders, how and when to involve them in the planning process, and how targeted messaging might be the key to your project’s success. We also discuss how to identify and manage stakeholders who oppose your project

Direct measurement of superdiffusive and subdiffusive energy transport in disordered granular chains

The study of energy transport properties in heterogeneous materials has attracted scientific interest for more than a century, and it continues to offer fundamental and rich questions. One of the unanswered challenges is to extend Anderson theory for uncorrelated and fully disordered lattices in condensed-matter systems to physical settings in which additional effects compete with disorder. Specifically, the effect of strong nonlinearity has been largely unexplored experimentally, partly due to the paucity of testbeds that can combine the effect of disorder and nonlinearity in a controllable manner. Here we present the first systematic experimental study of energy transport and localization properties in simultaneously disordered and nonlinear granular crystals. We demonstrate experimentally that disorder and nonlinearity --- which are known from decades of studies to individually favor energy localization --- can in some sense "cancel each other out", resulting in the destruction of wave localization. We also report that the combined effect of disorder and nonlinearity can enable the manipulation of energy transport speed in granular crystals from subdiffusive to superdiffusive ranges.Comment: main text + supplementary informatio