Expert Report of Thomas J. Sugrue

At the end of the twentieth century, the United States is a remarkably diverse society. It grows more diverse by the day, transformed by an enormous influx of immigrants from Latin America, the Caribbean, Africa, and Asia. In an increasingly global economy, Americans are coming into contact with others of different cultures to an extent seen only in times of world war. Yet amidst this diversity remains great division. When the young black academic W.E.B. DuBois looked out onto America in 1903, he memorably proclaimed that the problem of the twentieth century is the problem of the color line. Over the last one hundred years, that color line has shifted but not disappeared. The brutal regime of Jim Crow and lynching was vanquished by a remarkable grassroots movement for racial equality and civil rights. Overt expressions of racism are less common than they were a half century ago. Many nonwhite Americans, among them African Americans, Hispanics, and Native Americans, are better off than their forbears. Despite all of the gains of the past century, however, the burden of history still weighs heavily. Color lines still divide and separate Americans. Many Americans have managed diversity by avoiding it-by retreating into separate communities walled off by ignorance and distrust. In American public and private life, there are far too few opportunities to cross racial and ethnic barriers, to understand and appreciate differences, to learn from diversity rather than use it as an excuse for reproach and recrimination

An experimental study of bubble departure diameter in subcooled flow boiling including the effects of orientation angle, subcooling, mass flux, heat flux, and pressure

The effects of orientation angle, subcooling, heat flux, mass flux, and pressure on bubble departure diameter in the isolated bubble regime of subcooled flow boiling were studied by high-speed video in a two-phase flow loop that can accommodate a wide range of flow conditions. Specifically, the following ranges were explored: orientation angles of 0° (downward-facing horizontal), 30°, 45°, 60°, 90° (vertical), and 180° (upward-facing horizontal); mass flux values of 250, 300, 350, and 400 kg/m2 s, corresponding to Froude numbers between 0.42 and 1.06; pressures of 101 (atmospheric), 202, and 505 kPa; two values of the subcooling degrees (10 and 20 °C); and two heat fluxes (0.05 and 0.10 MW/m2). The combination of the test section design, high-speed video camera and LED lighting results in high accuracy (order of 20 μm) in the determination of the bubble departure diameter. The data indicate that the bubble departure diameter increases with increasing heat flux, decreasing mass flux, decreasing subcooling, and decreasing pressure. Also, the bubble departure diameter increases with decreasing orientation angle, i.e. the largest bubbles are found to detach from a downward-facing horizontal surface. The mechanistic bubble departure diameter model of Klausner et al. and its recent modification by Yun et al. were found to correctly predict all the observed parametric trends, but with large average errors and standard deviation: 65.5 ± 75.8% for Klausner's and 37.9 ± 51.2% for Yun's. Since the cube of the bubble departure diameter is used in subcooled flow boiling heat transfer models, such large errors are clearly unacceptable, and underscore the need for more accurate bubble departure diameter models.Douglas C. Spreng FundNuclear Energy Institut

The Role of Monitoring Interpretive Rates, Concordance Between Cytotechnologist and Pathologist Interpretations Before Sign-Out, and Turnaround Time in Gynecologic Cytology Quality Assurance Findings From the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference Working Group 1

Context.-The College of American Pathologists (CAP) conducted a national survey of gynecologic cytology quality assurance (QA) practices. Experts in gynecologic cytology were asked to join 5 working groups that studied the survey data on different aspects of QA. Evaluating the survey data and follow-up questions online, together with a review of pertinent literature, the working groups developed a series of preliminary statements on good laboratory practices in cytology QA. These were presented at a consensus conference and electronic voting occurred. Objective.-To evaluate a set of QA monitors in gynecologic cytology. Working group 1 evaluated (1) monitoring interpretive rate categories for Papanicolaou tests (Pap tests), (2) concordance of cytotechnologist and pathologist interpretations before sign-out, and (3) turnaround time for Pap tests. Data Sources.-The statements are based on a survey of gynecologic cytology QA practice patterns and of opinions from working group members and consensus conference attendees. Conclusions.-The outcomes of this process demonstrate the current state of practice patterns in gynecologic cytology QA. Monitoring interpretive rates for all Bethesda System categories is potentially useful, and it is most useful to monitor interpretive rates for cytotechnologists individually and in comparison to the entire laboratory. Laboratories need to determine what level of discrepancy between cytotechnologist and pathologist interpretations of Pap tests is important to track. Laboratories should consider formalizing procedures and policies to adjudicate such discrepant interpretations. Turnaround time should be monitored in gynecologic cytology, but individual laboratories should determine how to measure and use turnaround time internally

Detroit's East Side Village Health Worker Partnership: Community-Based Lay Health Advisor Intervention in an Urban Area

In recent years, there have been few reports in the literature of interventions using a lay health advisor approach in an urban area. Consequently, little is known about how implementation of this type of community health worker model, which has been used extensively in rural areas, may differ in an urban area. This article describes the implementation of the East Side Village Health Worker Partnership, a lay health advisor intervention, in Detroit, Michigan, and notes how participatory action research methods and principles for community-based partnership research are being used to guide the intervention. Findings are presented on how the urban context is affecting the design and implementation of this intervention. Implications of the findings for health educators are also presented and include the utility of a participatory action research approach, the importance of considering the context and history of a community in designing a health education intervention, and the importance of recognizing and considering the differences between rural and urban settings when designing a health education intervention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67390/2/10.1177_109019819802500104.pd