Improving disclosure of medical errors: Including patients and family members in the disclosure process

Over the last decade, adverse events and medical errors have become a main focus of interest for the standards of quality and safety in the U.S. healthcare system (Weinstein & Henderson, 2009). Particularly when a medical error occurs, the disclosure of medical errors and its practices have become a focal point of the healthcare process. Patients and family members who have experienced a medical error might be able to provide knowledge and insight on how to improve the disclose process. However, patient and family member are not typically involved in the disclosure process, thus their experiences go unnoticed. ^ The purpose of this research was to explore how best to include patients and family members in the disclosure process regarding a medical error. The research consisted of 28 qualitative interviews from three stakeholder groups: Hospital Administrators, Clinical Service Providers, and Patients and Family Members. They were asked for their ideas and suggestions on how best to include patients and family members in the disclosure process. Framework Analysis was used to analyze this data and find prevalent themes based on the primary research question. A secondary aim was to index categories created based on the interviews that were collected. Data was used from the Texas Disclosure and Compensation Study with Dr. Eric Thomas as the Principal Investigator. Full acknowledgement of access to this data is given to Dr. Thomas. ^ The themes from the research revealed that each stakeholder group was interested and open to including patients and family members in the disclosure process and that the disclosure process should not be a "one-way" avenue. The themes gave many suggestions regarding how to best include patients and family members in the disclosure process of a medical error. Secondary aims revealed several ways to assess the ideas and suggestion given by the stakeholders. Overall, acceptability of getting the perspective of patients and family members was the most common theme. Comparison of each stakeholder group revealed that including patients and family members would be beneficial to improving hospital disclosure practices. ^ Conclusions included a list of recommendations and measureable appropriate strategies that could provide hospital with key stakeholders insights on how to improve their disclosure process. Sharing patients and family members experience with healthcare providers can encourage a shift in culture where patients are valued and active in participating in hospital practices. To my knowledge, this research is the very first of its kind and moves the disclosure process conversation forward in a patient-family member inclusion direction that will assist in improving disclosure practices. Future research should implement and evaluate the success of the various inclusion strategies.^

Diseño y desarrollo de un sistema basado en Learning Analytics para evaluar la competencia de trabajo en equipo.Design and development of a Learning Analytics System to evaluate group work competence

La adquisición de la competencia grupal es algo básico en la docencia universitaria. Esta tarea va a suponer evaluar diferentes factores en un número elevado de alumnos, lo que puede supone gran complejidad y un esfuerzo elevado. De cara a evitar este esfuerzo se puede pensar en emplear los registros de la interacción de los usuarios almacenados en las plataformas de aprendizaje. Para ello el presente trabajo se basa en el desarrollo de un sistema de Learning Analytics que es utilizado como herramienta para analizar las evidencias individuales de los distintos miembros de un equipo de trabajo. El trabajo desarrolla un modelo teórico apoyado en la herramienta, que permite relacionar las evidencias observadas de forma empírica para cada alumno, con indicadores obtenidos tanto de la acción individual como cooperativo de los miembros de un equipo realizadas a través de los foros de trabajo. Abstract — The development of the group work competence is something basic in university teaching. It should be evaluated, but this means to analyze different issues about the participation of a high number of students which is very complex and implies a lot of effort. In order to facilitate this evaluation it is possible to analyze the logs of students’ interaction in Learning Management Systems. The present work describes the development of a Learning Analytics system that analyzes the interaction of each of the members of working group. This tool is supported by a theoretical model, which allows establishing links between the empirical evidences of each student and the indicators of their action in working forums.

Mammalian Trithorax and Polycomb-group homologues are antagonistic regulators of homeotic development

Control of cell identity during development is specified in large part by the unique expression patterns of multiple homeobox-containing (Hox) genes in specific segments of an embryo. Trithorax and Polycomb-group (Trx-G and Pc-G) proteins in Drosophila maintain Hox expression or repression, respectively. Mixed lineage leukemia (MLL) is frequently involved in chromosomal translocations associated with acute leukemia and is the one established mammalian homologue of Trx. Bmi-1 was first identified as a collaborator in c-myc-induced murine lymphomagenesis and is homologous to the Drosophila Pc-G member Posterior sex combs. Here, we note the axial-skeletal transformations and altered Hox expression patterns of Mll-deficient and Bmi-1-deficient mice were normalized when both Mll and Bmi-1 were deleted, demonstrating their antagonistic role in determining segmental identity. Embryonic fibroblasts from Mll-deficient compared with Bmi-1-deficient mice demonstrate reciprocal regulation of Hox genes as well as an integrated Hoxc8-lacZ reporter construct. Reexpression of MLL was able to overcome repression, rescuing expression of Hoxc8-lacZ in Mll-deficient cells. Consistent with this, MLL and BMI-I display discrete subnuclear colocalization. Although Drosophila Pc-G and Trx-G members have been shown to maintain a previously established transcriptional pattern, we demonstrate that MLL can also dynamically regulate a target Hox gene.

The role of members of the pertussis toxin-sensitive family of G proteins in coupling receptors to the activation of the G protein-gated inwardly rectifying potassium channel

Inwardly rectifying potassium (K+) channels gated by G proteins (Kir3.x family) are widely distributed in neuronal, atrial, and endocrine tissues and play key roles in generating late inhibitory postsynaptic potentials, slowing the heart rate and modulating hormone release. They are directly activated by Gβγ subunits released from G protein heterotrimers of the Gi/o family upon appropriate receptor stimulation. Here we examine the role of isoforms of pertussis toxin (PTx)-sensitive G protein α subunits (Giα1–3 and GoαA) in mediating coupling between various receptor systems (A1, α2A, D2S, M4, GABAB1a+2, and GABAB1b+2) and the cloned counterpart of the neuronal channel (Kir3.1+3.2A). The expression of mutant PTx-resistant Gi/oα subunits in PTx-treated HEK293 cells stably expressing Kir3.1+3.2A allows us to selectively investigate that coupling. We find that, for those receptors (A1, α2A) known to interact with all isoforms, Giα1–3 and GoαA can all support a significant degree of coupling to Kir3.1+3.2A. The M4 receptor appears to preferentially couple to Giα2 while another group of receptors (D2S, GABAB1a+2, GABAB1b+2) activates the channel predominantly through Gβγ liberated from GoA heterotrimers. Interestingly, we have also found a distinct difference in G protein coupling between the two splice variants of GABAB1. Our data reveal selective pathways of receptor activation through different Gi/oα isoforms for stimulation of the G protein-gated inwardly rectifying K+ channel.

Factors Affecting Women Leaders in the Denver Group of the Colorado Mountain Club

A study of women leaders in the Colorado Mountain Club (CMC) demonstrated that this group perceived pace as an impediment to leadership growth. This study is an exploratory-quantitative inquiry that assessed the views of 20 of the active women hike leaders in the Denver group. The author designed a survey of factors women hike leaders would rate according to their CMC experiences. Although there are more women members of the Denver group, women leaders comprise only 30% of the leadership group The results from this first ever survey of CMC's women leaders provides a knowledge base for CMC and other interested parties. This study clearly demonstrated the need for more research into its topic of women in leadership positions.

The Visegrad group and Germany: towards a new paradigm. CEPS Commentary, 28 November 2013

In surveying the strategic realignment now underway in Central Europe among the four members of the Visegrad Group, Michal Simecka observes in a new CEPS Commentary that it is hard to think of another point in modern history that permitted a scenario of Germany and its eastern neighbours working together to constructively shape Europe.

Shifting EU Institutional Reform into High Gear. Report of the CEPS High-Level Group. CEPS Task Force Reports

To contribute to the important debate on EU institutional reform in the run-up to the European Parliament elections and the start of a new Commission, CEPS formed a High-Level Group on EU Institutional Reform under the leadership of Danuta Hübner MEP and member of the CEPS Board of Directors. The report of this distinguished group of MEPs, former and current EU institutional members and leading scholars on EU law and institutional affairs focuses on reforms that could be taken within the framework of the current treaties to build a more responsive and accountable Union. The report analyses the main inter- and intra-institutional weaknesses in terms of efficiency, democracy and differentiation and puts forward a number of recommendations addressing issues such as the reorganisation of the College of Commissioners, the promotion of strategic legislative planning, the enhancement of the role of the EP and the rotating Presidency of the Council, the improvement of the democratic accountability of the European Council and the adequate engagement of the national parliaments.

Europe’s Untapped Capital Market: Rethinking integration after the great financial crisis. Final report of the European Capital Markets Expert Group. Task Force Report, February 2016

In December 2014, ECMI and CEPS formed the European Capital Markets Expert Group (ECMEG) with the aim of providing a long-term contribution to the debate on the Capital Markets Union (CMU) project, proposed by the European Commission. After an intensive, year-long research effort and in-depth discussions with ECMEG members, this final report aims to rethink financial integration policies in the European Union and to devise an EU-wide plan to remove the barriers to greater capital markets integration. It offers a methodology to identify and prioritise cross-border barriers to capital markets integration and provides a set of policy recommendations to improve its key components: price discovery, execution and enforcement of capital markets transactions.

Identity construction through phonetic crossing among young Capetonian gang members

Uncountable gangs operate in post-Apartheid South Africa, particularly in greater Cape Town, competing over turf and controlling the drug trade. Consequently, gang violence is rife in Western Cape and especially widespread in urban areas. In this paper young Capetonians’ narratives of gang violence are analyzed. In the narratives of attacks on Black or White South Africans by Coloured gang members, the Coloured narrators make use of their victims’ varieties of English, more precisely, of phonetic features. Hence, the aggressors do language crossing towards their targets when narrating their feats. Rampton (1995a:485) considers language crossing a ‘code alternation by people who are not accepted members of the group associated with the second language that they are using (code switching into varieties that are not generally thought to belong to them)’. This switching involves a transgression of social or ethnic boundaries that allows the young gangsters to construct, negotiate, uphold and manage their social identities, as language still functions as an utterly important identity marker in post-Apartheid South Africa.

Group of Two Women and a Child

Sculpture, Egyptian, Middle Kingdom to early New Kingdom; 2 51/64 in.x 1 11/16 in.x 3 15/64 in.; painted limestone

Ship Burial, Mound 1, excavated artifact, Group of Shoulder-Clasps

Sutton Hoo, England; gold, glass, garnet

Statewide screening activities for Illinois' low-level radioactive waste (LLRW) disposal facility : final report to the Illinois Low-Level Radioactive Waste Task Group and the director, Illinois Department of Nuclear Safety /

"This report was prepared under a contract with the Illinois Dept. of Nuclear Safety (IDNS) in support of the Illinois Low-Level Radioactive Waste Task Group. Numerous staff members of the Illinois State Geological Survey (ISGS) and the Illinois State Water Survey (ISWS) contributed to this report, which was compiled under the general administrative direction of Bill Shilts and Derek Winstanley, Chiefs of the ISGS and ISWS, respectively."--P. iv.

Members of University of Michigan Department of Anthropology and their spouses

on reverse: Party at 819 Avon Road for Mrs. Burd who was leaving her position as Sec'y Dept. of Anthropology after many years. Standing L-R 1. Estelle Titier 2. Mischa Titier 3. Lila Burns 4. Joan Meggitt 5. Mrs. Yengoyan 6. Katya Wolf 7. Agnes Miner 8. Ruby Griffin 9. Leslie White 10. Ellen Burd 11. Meggit 12. Norma Diamond 13. Stevie Service 14. Joyce Jones 15. Horace Miner 16. Mac Spuhler 17. [blank] 18. [blank] 19. Eloise Kerlin 20. J. N. Spuhler 22. Marjorie Goldschmidt 22. Aram Yengoyan 23. Ernst Goldschmidt; Seated L-R James B. Griffin, Frank Livingstone, Volney H. Jones, Robert Burns, Eric Wolf, Reclining: Elman R. Service

Percival C. Lowery in group photograph

Scene showing a group of men, women, and children. The men appear to be members of the Grand Army of the Republic, possibly the Gov. Crapo Post #145

Not being what you claim to be: impostors as sources of group threat

We examine the notion of impostors within groups, defined in this paper as people who make public claims to an identity while disguising their failure to fulfil key criteria for group membership. In Experiment 1, vegetarians showed heightened levels of negative affect toward vegetarians who ate meat occasionally compared to an authentic vegetarian. In contrast, non-vegetarians saw the impostor to be marginally more likeable than the authentic vegetarian. In Experiments 2 and 3, participants evaluated only a vegetarian who ate meat. Evaluations of the target were influenced by group attachment, such that participants who identified strongly as vegetarians downgraded the target more strongly and experienced more negative affect than did moderate identifiers and non-vegetarians. Participants were also sensitive to the size of the gulf between the target's claims for identity and their behaviour. Thus, targets who made public claims to being a vegetarian but ate meat were evaluated more negatively than were people who kept their claims for identity private (Experiment 2). Similarly, targets who tried to keep their deviant behaviour secret were evaluated more negatively than were people who openly admitted their deviant behaviour (Experiment 3). The reasons why impostors might threaten the integrity of group identities are discussed. Copyright (C) 2003 John Wiley Sons, Ltd.