Advancing Patient Safety in the U.S. Department of Veterans Affairs

As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics. A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale. The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients' daily care plans. A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence. Other initiatives have reduced rates of health care -- associated infections, patient mortality, and post-operative complications. Success factors include leadership accountability for performance and organizational support for testing, expanding, and adopting improvements

American Women and Flight since 1940

Women run wind tunnel experiments, direct air traffic, and fabricate airplanes. American women have been involved with flight from the beginning, but until 1940, most people believed women could not fly, that Amelia Earhart was an exception to the rule. World War II changed everything. “It is on the record that women can fly as well as men,” stated General Henry H. Arnold, commanding general of the Army Air Forces. The question became “Should women fly?” Deborah G. Douglas tells the story of this ongoing debate and its impact on American history. From Jackie Cochran, whose perseverance led to the formation of the Women’s Army Service Pilots (WASP) during World War II to the recent achievements of Jeannie Flynn, the Air Force’s first woman fighter pilot and Eileen Collins, NASA’s first woman shuttle commander, Douglas introduces a host of determined women who overcame prejudice and became military fliers, airline pilots, and air and space engineers. Not forgotten are stories of flight attendants, air traffic controllers, and mechanics. American Women and Flight since 1940 is a revised and expanded edition of a Smithsonian National Air and Space Museum reference work. Long considered the single best reference work in the field, this new edition contains extensive new illustrations and a comprehensive bibliography. I have nothing but admiration for Douglas’s expanded account of the many contribution women have made to the history of flight. -- Ann Carl, author of A Wasp Among Eagles A wonderful service to all women in aviation. From the Air Transport Auxiliary of the 1940s—we 24 gals that Jackie Cochrane took to England to ferry aircraft—to the present, this book will be an essential tool for students and researchers. -- Ann Wood-Kelly, original member of the ATA, later Staff Vice President of Pan Am An accomplished historian, Debbie Douglas has written the authoritative account of contemporary American women’s contributions to civil and military aviation. Based on solid scholarship, this even-handed book documents not only women’s numerous aerial feats, but what transpired on the ground for them to be able to achieve in the air. -- Capt. Rosemary Bryant Mariner, United States Navy (Ret.), former tactical jet pilot An excellent survey of the progress and accomplishments of women in all aspects of aviation in the second half of the 20th century. Douglas reveals the hard-fought struggle to attain real equality in the cockpit, as part of the larger societal struggle, and her first-rate bibliography includes non-aviation gender titles and studies. The book is an important motivational and educational resource for young women. -- Dorothy Cochrane, Curator, Aeronautics Division, National Air and Space Museum The numbers of women pilots sharing the skies with men have advanced at turtle-speed. However, Deborah Douglas offers evidence that women of talent and persistence are making dramatic inroad into all fields of aviation. Her powerful story offers assurance to every young girl that only the imagination, not the sky, is the limit. -- Gene Nora Jessen, author of The Powder Puff Derby of 1929 An interesting and compelling read about awe-inspiring women who pursued their passion against imposing odds and often with extreme sacrifice. -- H-Minerva Reading like a novel, but too unbelievable to be one, Debbie Douglas\u27 work is a powerful statement of how women have changed the world of flight. -- Roger Launius, Chair, Division of Space History, Smithsonian Institution This book . . . is not just about obstacles and barriers; it is just as much about the vital roles women have played in aviation, and it has implications that are broader than just women\u27s history. -- Technology and Culture Provides a thorough analysis of the barriers women had to overcome in aviation, even in roles more socially acceptable than pilot, astronaut, or air-traffic controller. -- Wellesley Magazinehttps://uknowledge.uky.edu/upk_history_of_science_technology_and_medicine/1000/thumbnail.jp

Reconciling Community-Based Versus Evidence-Based Philanthropy: A Case Study of The Colorado Trust’s Early Initiatives

One of the dominant tensions in philanthropy involves the question of whether foundations should focus their grantmaking on projects that come from the community versus projects that have a base of scientific evidence. How a foundation answers this question leads to different strategic orientations. This article describes how this tension was expressed and resolved during The Colorado Trust’s early years of initiative-based grantmaking. The community-based philosophy is illustrated through the Colorado Healthy Communities Initiative, while Home Visitation 2000 serves as an exemplar of the evidence-based approach. The Colorado School Health Education Initiative purposefully integrated the two philosophies. The community-based and evidence-based philosophies each have inherent limitations which can be overcome by incorporating the opposing philosophy. This finding is consistent with Barry Johnson’s (1992) Polarity Management model and potentially at odds with the principle of strategic alignment

The focus group as a tool for health research: issues in design and analysis

The focus group is a technique for eliciting information from specific population subgroups. Issues addressed may be little known or relatively well known to the researcher. The method is most effectively used when the objective of the investigation is to elicit points of view of client or consumer groups which may differ from those of providers. Despite the frequency with which focus groups are used, few published materials describe the practical application of the method. This paper presents a detailed methodology for the conduct of focus groups and analysis of focusgroup data with the intention of improving its use among researchers and health-care professionals. Data from two studies, immunization compliance in West Africa, and barriers to use of prenatal-care services in Bolivia, are used as illustrative examples

Irrigation externalities: pricing and charges

Irrigation externalities: pricing and charges by Gavan Dwyer, Robert Douglas, Deb Peterson, Jo Chong and Kate Maddern was released on 14 March 2006. The paper discusses the nature and causes of environmental change related to rural water use, and provides a taxonomy of the many diverse types. It also examines the issues surrounding possible charges on water use for water related externalities. There have been few attempts by water utilities to incorporate externalities into full cost pricing of irrigation water. The aim of this Staff Working Paper was to: examine the extent to which charges imposed by irrigation water utilities could address externalities from irrigation water supply and use; and to develop a framework to identify and characterise changes in environmental conditions from the supply and use of irrigation water that may lead to environmental externalities. The authors found that many factors influence the extent to which charging for water would change water use. These include the volume of water available to irrigators, the extent to which trade can occur, the size of the charge or tax, the price responsiveness for irrigation water and the existing mechanisms to address externalities. A tax on water use may increase economic efficiency where external costs are related only to the level of water use. However, such a tax is an unsuitable instrument if the Government's policy objective is to reduce environmental damage to a predetermined level or to raise a target level of revenue to address the externalities. The views expressed in this paper are those of the staff involved and do not necessarily reflect those of the Productivity Commission.Resource /Energy Economics and Policy,

An Integrated EMBA for an Integrated World

Internal and external stakeholders to the academic community have expressed concern about the MBA and have urged systemic transformation in curriculum content and course delivery. Corporations want business leaders who can provide creative solutions for problems that cut across business functions. Organizations want business graduates who have been taught how to think about business not as a series of functional smokestacks but as an integrated whole

Spatial and Electronic Manipulation of Silicon Nanocrystals by Atomic Force Microscopy

[As silicon-based devices shnnk, interest is increasing in fast, low-power devices sensitive to small numbers of electrons. Recent work suggests that MOS structures with large arrays of Si nanocrystals comprising a floating gate can be extremely fast, reliable and nonvolatile relative to conventional floating gate memories. In these structures approximately one electron is stored per nanocrystal. Despite promising initial results, current devices have a distribution of charge transit times during writing of nanocrystal ensembles, which limits speed. This behavior is not completely understood, but could be related to a dispersion in oxide thicknesses, nanocrystals interface states, or shifts in the electronic bound states due to size variations. To address these limitations, we have developed an aerosol vapor synthesis/deposition technique for silicon nanocrystals with active size classification, enabling narrow distributions of nanocrystal size (~10-15% of particle in the 2-10 nm size range). The first goal of these experiments has been to use scanning probe techniques to perform particle manipulation and to characterize particle electronic properties and charging on a single-particle basis. Si nanocrystal structures (lines, arrows and other objects) have been formed by contact-mode operation and subsequently imaged in noncontact mode without additional particle motion. Further, single nanocrystal charging by a conducting AFM tip has been observed, detected as an apparent height change due to electrostatic force, followed by a slow relaxation as the stored charge dissipates. Ongoing and future efforts will also be briefly discussed, including narrowing of nanocrystal size distributions, control of oxide thickness on the nanocrystals, and measurements of electron transport through individual particles and ensembles

Numerical study of coherence of optical feedback in semiconductor laser dynamics

The nonlinear dynamics of semiconductor laser with coherent, as compared to incoherent, delayed optical feedback systems have been discussed and contrasted in prior research literature. Here, we report simulations of how the dynamics change as the coherence of the optical feedback is systematically varied from being coherent to incoherent. An increasing rate of phase disturbance is used to vary the coherence. An edge emitting, 830nm, Fabry Perot semiconductor laser with a long external cavity is simulated. Following this study, consideration of prior and future experimental studies should include evaluation of where on the continuum of partial coherence the delayed optical feedback sits. Partial coherence is a parameter that will affect the dynamics

Exposing Sex Stereotypes in Recent Same-Sex Marriage Jurisprudence

In 1993, the Hawaii Supreme Court held in Baehr v. Lewin that same-sex couples denied the right to marry could state a claim for sex discrimination. With that decision, an argument that had previously been primarily a matter of academic debate was thrust into the center of one of the defining cultural wars of our time. Following Baehr, same-sex couples filed lawsuits in at least eleven states. In the past few years, the highest state courts in Vermont, Massachusetts, New Jersey, New York, and Washington, as well as intermediate courts in Arizona and Indiana, have ruled on the issue; as of May 2007, appeals are pending in the highest courts in California, Connecticut, and Maryland. Some suits have been won by plaintiffs, leading either to marriage (Massachusetts) or civil unions providing all of the benefits of marriage (New Jersey and Vermont). Others, largely in closely divided opinions, have been lost by plaintiffs (New York and Washington). But while sex discrimination has been argued by the plaintiffs in each of these cases, no state high court since Baehr has found that denying a same-sex couple the right to marry successfully states a sex discrimination claim. Rather, the subsequent decisions have either ignored or rejected sex discrimination arguments. Indeed-and most troubling-several of the more recent opinions rejecting same-sex couples\u27 claims to the right to marry have actually relied in part on sex stereotypes, even as they reject arguments that such stereotypes are embodied in and perpetuated by exclusionary marriage laws. This Article considers the sex discrimination arguments in the context of the flurry of recent decisions issued by state courts and the arguments presented by parties and amici before those courts