To Link or Not to Link? Multiple Team Membership and Unit Performance

Multiple team membership is common in today’s team-based organizations, but little is known about its relationship with collective effectiveness across teams. We adopted a microfoundations framework utilizing existing individual- and team-level research to develop a higher-level perspective on multiple team membership’s relationship with performance of entire units of teams. We tested our predictions with data collected from 849 primary care units of the Veterans Health Administration serving over 4.2 million patients. In this context, we found multiple team membership is negatively associated with unit performance, and this negative relationship is exacerbated by task complexity

Diagnostic Medical Errors: Patient\u27s Perspectives on a Pervasive Problem

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient\u27s health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition. Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies. Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative analysis using Grounded Theory. Results. In the past five years, 39% of interviewed patients experienced diagnostic error. The errors mapped to the following categories: accuracy (30%), communication (34%) and timeliness (36%). Poor communication (13 responses) and inadequate time with doctors (7) were the most identified causes of errors. Impacts of errors included emotional distress (17 responses), adverse health outcomes (7) and impaired activities of daily living (6). Patients suggested improved communication (11 responses), clinical management (7) and access to doctors (5) as prevention strategies. For communication, patients rated talk to your doctor highest (mean 8.4, on 1-10 Likert scale) and text message lowest (4.8). Conclusions/Recommendations. Diagnostic errors are common and have dramatic impact on patients\u27 well-being. We suggest routine surveillance to identify errors, support for patients who have experienced errors, and implementation of patient and provider checklists to enhance communication. Future studies should investigate strategies to allow care providers adequate time with patients.https://scholarworks.uvm.edu/comphp_gallery/1246/thumbnail.jp

Fluctuation spectroscopy of giant unilamellar vesicles using confocal and phase contrast microscopy

A widely used method to measure the bending rigidity of bilayer membranes is fluctuation spectroscopy, which analyses the thermally-driven membrane undulations of giant unilamellar vesicles recorded with either phase-contrast or confocal microscopy. Here, we analyze the fluctuations of the same vesicle using both techniques and obtain consistent values for the bending modulus. We discuss the factors that may lead to discrepancies

THOSE WITH THE MOST FIND IT HARDEST TO SHARE: EXPLORING LEADER RESISTANCE TO THE IMPLEMENTATION OF TEAM-BASED EMPOWERMENT

We use a convergent parallel mixed methods approach to explore barriers to the successful implementation of a team-based empowerment initiative within the Veterans Health Administration. Although previous research has suggested that leaders often actively obstruct empowerment initiatives, little is known about the reasons behind and effects of such hindering. Using a longitudinal quasi-experimental design, we support a hypothesis that higher-status physician leaders are less successful than lower-status nonphysician leaders in implementing team-based empowerment. In parallel, we analyze qualitative data obtained through interviews conducted during early months of the teambased empowerment initiative to identify common themes for why and how leaders facilitated or obstructed implementation. Leader identity work and leader delegation were identified as themes explaining (1) why higher-status leaders struggled with the new empowering role and (2) how specific leader actions either facilitated or inhibited sharing of tasks and leadership. Results suggest that team-based empowerment creates a status threat for high-status leaders who then struggle to protect their old identity as someone with distinct professional capabilities, which in turn leads to improper delegation behavior. Therefore, in order for team-based empowerment to succeed, leaders may need to change their perceptions of who they are before they will change what they do

Simultaneous Optimization of the Cavity Heat Load and Trip Rates in Linacs Using a Genetic Algorithm

In this paper, a genetic algorithm-based optimization is used to simultaneously minimize two competing objectives guiding the operation of the Jefferson Lab\u27s Continuous Electron Beam Accelerator Facility linacs: cavity heat load and radio frequency cavity trip rates. The results represent a significant improvement to the standard linac energy management tool and thereby could lead to a more efficient Continuous Electron Beam Accelerator Facility configuration. This study also serves as a proof of principle of how a genetic algorithm can be used for optimizing other linac-based machines

Accelerated swell testing of artificial sulfate bearing lime stabilised cohesive soils

This paper reports on the physico-chemical response of two lime stabilised sulfate bearing artificial soils subject to the European Accelerated Volumetric Swell Test (EN13286-49). At various intervals during the test, a specimen was removed and subject to compositional and microstructural analysis. Ettringite was formed by both soils types, but with significant differences in crystal morphology. Ettringite crystals formed from kaolin based soils were very small, colloidal in size and tended to form on the surface of other particles. Conversely, those formed from montmorillonite were relatively large and typically formed away from the surface in the pore solution. It was concluded that the mechanism by which ettringite forms is determined by the hydroxide ion concentration in the pore solution and the fundamental structure of the bulk clay. In the kaolin soil, ettringite forms by a topochemical mechanism and expands by crystal swelling. In the montmorillonite soil, it forms by a through-solution mechanism and crystal growth

Ultramafic vegetation and soils in the circumboreal region of the Northern Hemisphere

The paper summarizes literature on climate, soil chemistry, vegetation and metal accumulation by plants found on ultramafic substrata in the circumboreal zone (sensu Takhtajan, Floristic regions of the world, 1986) of the Northern Hemisphere. We present a list of 50 endemic species and 18 ecotypes obligate to ultramafic soils from the circumboreal region of Holarctic, as well as 30 and 2 species of Ni and Zn hyperaccumulators, respectively. The number of both endemics and hyperaccumulators are markedly lower compared to that of the Mediterranean and tropical regions. The diversity of plant communities on ultramafics soils of the circumboral region is also described. The underlying causes for the differences of ultramafic flora between arctic, cold, cool temperate and Mediterranean and tropical regions are also discussed. © 2018, The Ecological Society of Japan

The status of the world's land and marine mammals: diversity, threat, and knowledge

Knowledge of mammalian diversity is still surprisingly disparate, both regionally and taxonomically. Here, we present a comprehensive assessment of the conservation status and distribution of the world's mammals. Data, compiled by 1700+ experts, cover all 5487 species, including marine mammals. Global macroecological patterns are very different for land and marine species but suggest common mechanisms driving diversity and endemism across systems. Compared with land species, threat levels are higher among marine mammals, driven by different processes (accidental mortality and pollution, rather than habitat loss), and are spatially distinct (peaking in northern oceans, rather than in Southeast Asia). Marine mammals are also disproportionately poorly known. These data are made freely available to support further scientific developments and conservation action