Obama was right to strike a deal to bring Bowe Bergdahl home, but should have adopted a lower-key approach to the prisoner swap

At the end of May, President Obama announced that a deal had been struck to free Sergeant Bowe Bergdahl from captivity in exchange for the release of five Taliban commanders. Obama has come under heavy criticism for the decision, as questions have surfaced concerning Bergdahl’s disappearance and service record. Daniel Strieff argues that Obama was right in making the deal to free Bergdahl, but erred in treating it as a celebratory moment. He writes that Obama should have focused on his commitment to bring home all American prisoners of war, rather than on Bergdahl’s military service and his parents

Patient Engagement: A Key Concept to Surgical Site Infection Reduction in Colorectal Patients

Abstract Problem: Colorectal surgery is a procedure with one of the highest surgical site infection (SSI) rates; therefore, necessary efforts were implemented to reduce harm (Harris, 2018). Approximately 60% of these surgical infections are preventable (Ban et al., 2017). SSIs can have severe consequences, including extended length of stay, high morbidity and mortality rates, delayed recovery, and high healthcare costs (Harris, 2018). The financial burden of SSI is substantial. Context: This project aimed to explore opportunities for enhancing patient engagement and awareness of SSI preventive measures. After an extensive microsystem analysis, a knowledge gap in patient education on preoperative colorectal SSI prevention strategies was identified. Patients and their families need to take an active role in reducing SSI risk to improve their surgical outcomes (Park & Giap, 2019). Interventions: Preventive education will drive patients to seek greater understanding or awareness of their surgical journey and their willingness to take steps on their own to prevent harmful events. Educational tools and preoperative phone calls were developed to improve patient engagement in their surgical care. These tools target patient education on 2% chlorhexidine gluconate (CHG) bathing, umbilicus hygiene, and SSI prevention to promote patient engagement in SSI prevention. Measures: The outcome measure for this project is to reduce the National Surgical Quality Improvement (NSQIP) risk-adjusted ratio of colorectal SSI from 1.23 to 1.0 by October 2020. The first process measure is to improve CHG skin preparation compliance to 95% or higher. The secondary process measure is qualitative interviews with colorectal surgical patients using pre- and post-intervention questionnaires. The balancing measure is patient satisfaction scores collected from the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems. Results: From May 2020 to October 2020, the NSQIP risk-adjusted ratio of colorectal SSIs decreased from 1.23 to 0.9. The overall colorectal SSI rates were reduced by 2.2%. In total, 100 colorectal surgical patients completed the questionnaires from August 2020 to October 2020. The pre-intervention questionnaires demonstrated an immediate need to improve SSI education in colorectal surgical patients. The results from Post-intervention data on the implementation of patient engagement and education on SSI prevention can influence positive change. After implementing staff education, CHG skin preparation compliance rates increased to 98%. Patient overall satisfaction scores increased from 75% to 85% from May 2020 to October 2020. Conclusions: As the role of patient engagement in the context of surgical care continues to evolve, the importance of patient education and sustainable engagement will become increasingly important. Patient engagement and education on SSI prevention is the first step towards impacting outcomes. Integrating patient participation within prevention measures for SSI is imperative. Ultimately, patient engagement aims to improve patient outcomes and reduce the risk of SSIs following colorectal surgery

The president and the peacemaker: Jimmy Carter and the domestic politics of Arab-Israeli diplomacy, 1977-1980

This thesis offers a study of the impact of American domestic politics on President Jimmy Carter’s role as diplomat-in-chief during the Camp David peace process. It argues that Carter’s personal involvement in fostering an Egyptian-Israeli dialogue, the Camp David Accords and Palestinian autonomy talks created a circular pattern of influence between domestic politics and foreign affairs. Carter’s role as president-mediator engaged political actors, focused public attention and raised the domestic stakes. As his term progressed, he subordinated diplomatic objectives to political needs, which in fact had grown more urgent by controversy in Arab-Israeli negotiations. As chief diplomat, Carter became intimately identified with American policy, which was completely imbued with his own political character. That activated a number of reinforcing domestic factors, some general to American foreign policy and others specific to the Arab-Israeli arena, which served to constrain what he could achieve. By examining newly released archival material, and engaging with news reportage and opinion polling, this thesis demonstrates how advice reaching the president from multiple sources – his domestic, foreign and media advisors – served to augment the other. This thesis does not purport to offer a complete history of the Camp David peace process, Egyptian-Israeli negotiations or Carter’s presidency. Instead, it examines the possibilities and the hazards of presidential diplomacy. It argues that the domestic aspects of the dispute narrowed Carter’s options, limited public debate and influenced decisions at pivotal moments. These forces circumscribed what was politically possible, and interacted with strategic and diplomatic considerations to affect policy. Broadly, this thesis offers fresh perspectives on the nature and limits of presidential power, the role of the news media in American life, U.S. public opinion and foreign policy, and public engagement with the Arab-Israeli conflict

FLAG and the diplomacy of the Iran hostage families

The extraordinary public diplomacy carried out by the families of the American hostages held in Iran from 1979 -1981 domesticated and humanised the biggest foreign policy crisis of Jimmy Carter's presidency. The families, notably represented by the Family Liaison Action Group (FLAG), led an unprecedented campaign to raise awareness of the plight of their relatives. The families designed their efforts to garner public and media attention, and manage relations with the press. To that end, the news media emerge as a singularly influential domestic actor in this episode. Moreover, women constituted the vast majority of family members regularly cited in news coverage and occupied a sizeable leadership role within organised activities during the crisis. The centrality of the families helped harden American attitudes toward Iran: not merely an outgrowth of a diplomatic dispute, it represented a sort of personal violence toward individual Americans and their families

Cob, Future Heritage of the 21st Century?

The technique of cob is present on almost every continent. Qualities of soils, climates and history of local constructive cultures have generated multiple variants of its implementation, but it can be defined as a monolithic earth wall made from earth clods.. In Europe, this technique is found from the north in Estonia, to the south in Abruzzo, from Ireland in the west, to Austria in the easti . In France this technique is present over a western arc, with the highest concentration in Normandy and Brittany. In the UK, cob is found in comparable proportions, especially throughout the south-western part of England