Parents' experiences of sharing neonatal information and decisions: Consent, cost and risk

This paper is about the care of babies with confirmed or potential neurological problems in neonatal intensive care units. Drawing on recent ethnographic research, the paper considers parents' experiences of sharing information and decisions with neonatal staff, and approaches that support or restrict parents' involvement. There are growing medico-legal pressures on practitioners to inform parents and involve them in their babies' care. Data are drawn from observations in four neonatal units in southern England, and interviews with the parents of 80 babies and with 40 senior staff. The paper compares standards set by recent guidance, with parents' views about their share in decision-making, their first meetings with their babies, 'minor' decision-making, the different neonatal units, being a helpless observer and missed opportunities. Parents' standards for informed decisions are summarised, with their reported views about two-way decision-making, and their practical need to know. Whereas doctors emphasise distancing aspects of the consent process, parents tend to value 'drawing together' aspects

Pierre François-Xavier de Charlevoix, S.J.: History and the French Atlantic World in the Short Eighteenth Century, 1682-1761

Abstract This dissertation demonstrates that Pierre François-Xavier de Charlevoix, S.J. (1682-1761) constructed in his historical writings a French Atlantic World that evolved during what I have termed the Short Eighteenth Century. The years 1682-1761 represent Charlevoix's lifespan as well as the approximate lifespan of the French colonial enterprise on what was, for them, the far side of the Atlantic Ocean. Charlevoix wrote about his world from multiple perspectives, all of which are evident in his writings. This study examines four of Charlevoix's works, La Vie de Marie de l'Incarnation (1724), Histoire de l'Isle Espagnole (1736), Histoire de la Nouvelle France (1744), and Histoire du Paraguay (1756) to elucidate those perspectives as well as their evolutions. It is evident that Charlevoix hoped to see the French Atlantic colonial enterprise prosper, but underthe auspices of the Catholic Church. The biography of Marie de l'Incarnation indicates how critical it was for the Jesuits to guide the spiritual development of those throughout the French Atlantic World. The other three works considered here continue that theme, but also reflect Charlevoix's fading optimism regarding the French and the Jesuits and the roles they would play in the Atlantic World. By the end of the short eighteenth century, neither the French nor the Jesuits were forces with which to be reckoned, and the French Atlantic World was but a weak reflection of potential never reached

Developing Targeted Interventions to Advance Maternal Health in a Geographic Medicaid Accountable Care Organization: Lessons From the Implementation of Camden Delivers

Through the design and launch of Camden Delivers the Coalition developed targeted interventions within an ACO infrastructure to advance maternal health in a Medicaid-covered population. Key insights from this process include the need to:* Utilize data to understand community need and design interventions around that need* Establish a population health surveillance system to produce actionable data to intervene with a complex population* Institute a tiered intervention system targeted to identified need, and* Leverage and coordinate across existing resources in the community to reduce duplication.Going forward, with the infrastructure developed by the Coalition to collect and review health data, along with the intricate web of community partners and resources, the next step in this program is to enhance feedback loops between partners and to help navigate patients seamlessly between partners during the highly fragmented experience of managing a pregnancy and healthcare during the interconception period. A formal network of communication between patients, case workers, care managers, providers and community resources through more sophisticated use of data and convening will allow us to support vulnerable patients in an even more effective manner. The Coalition looks forward to playing this convener role and working across groups to the end of better care management services and improved health for women of maternal age in Camden

The Core of Care Management: The Role of Authentic Relationships in Caring for Patients with Frequent Hospitalizations.

In the movement to improve the health of patients with multiple chronic conditions and vulnerabilities, while reducing the need for hospitalizations, care management programs have garnered wide attention and support. The qualitative data presented in this paper sheds new light on key components of successful chronic care management programs. By going beyond a task- and temporal-based framework, this analysis identifies and defines the importance of authentic healing relationships in driving individual and systemic change. Drawing on the voices of 30 former clients of the Camden Coalition of Healthcare Providers, the investigators use qualitative methods to identify and elaborate the core elements of the authentic healing relationship-security, genuineness, and continuity-a relationship that is linked to patient motivation and active health management. Although not readily found in the traditional health care delivery system, these authentic healing relationships present significant implications for addressing the persistent health-related needs of patients with frequent hospitalizations. (Population Health Management 2016;19:248-256)

SB89_21-22_Resolution Calling for the Immediate Resignation of Clayton Looney

SB89_21-22_Resolution Calling for the Immediate Resignation of Clayton Looney. This resolution passed 19Y-1N-0A during the February 27, 2022 meeting of the Associated Students of the University of Montana (ASUM)

SB89-21/22-Resolution Calling for the Immediate Resignation of Clayton Looney

SB89-21/22-Resolution Calling for the Immediate Resignation of Clayton Looney. This resolution passed 19Y-1N-0A during the February 27, 2022 meeting of the Associated Students of the University of Montana (ASUM)

Theory-based predictors of multiple clinician behaviors in the management of diabetes

Peer reviewedPostprin

Extension of Cloud Computing to Small Satellites

Time-to-insight is a critical measure in a number of satellite mission applications: detection and warning of fast-moving events like fires and floods, or identification and tracking of satellites or missiles, for example. Current data flows delay the time-to-insight on the order of minutes or hours, as all collected data must be downlinked in one or more contact windows, then transited over terrestrial networks to the location of the analytic software. Additionally, mission applications on spacecraft are often static: built prior to launch, they cannot rapidly adapt to changing needs based on these insights. To reduce time-to-insight and provide a dynamic application update capability, Amazon Web Services (AWS), D-Orbit, and Unibap conducted a joint experiment in which we deployed AWS edge compute and network management software onto Unibap’s SpaceCloud® iX5 platform for edge computing in space, integrated onto a D-Orbit ION Satellite Carrier launched into low-earth orbit (LEO) in early 2022. In this paper, we present the results of this experiment. We will discuss the software specifics and network management capabilities we developed to write mission applications and update those mission applications on-orbit, and detail the process of mission deployment and modification, communications latency, and data volume reduction. We will also discuss how the space and satellite community can use this capability to deploy new applications, performing complex tasks and reducing time-to-insight, to cloud-enabled satellites immediately without needing to wait for a new launch

Diabetes care provision in UK primary care practices

Background: Although most people with Type 2 diabetes receive their diabetes care in primary care, only a limited amount is known about the quality of diabetes care in this setting. We investigated the provision and receipt of diabetes care delivered in UK primary care. Methods: Postal surveys with all healthcare professionals and a random sample of 100 patients with Type 2 diabetes from 99 UK primary care practices. Results: 326/361 (90.3%) doctors, 163/186 (87.6%) nurses and 3591 patients (41.8%) returned a questionnaire. Clinicians reported giving advice about lifestyle behaviours (e.g. 88% would routinely advise about calorie restriction; 99.6% about increasing exercise) more often than patients reported having received it (43% and 42%) and correlations between clinician and patient report were low. Patients’ reported levels of confidence about managing their diabetes were moderately high; a median (range) of 21% (3% to 39%) of patients reporting being not confident about various areas of diabetes selfmanagement. Conclusions: Primary care practices have organisational structures in place and are, as judged by routine quality indicators, delivering high quality care. There remain evidence-practice gaps in the care provided and in the self confidence that patients have for key aspects of self management and further research is needed to address these issues. Future research should use robust designs and appropriately designed studies to investigate how best to improve this situation