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The Problem of Practice Variation in Newborn Medicine

Neonatal intensive care unit (NICU) teams in the US and around the world receive performance reports that locate their particular value for selected process and outcome measures within the range of values from all reporting NICUs. Understandably, many providers focus primarily, if not exclusively, on their particular value. When a value appears undesirable, providers often justify it in an apparent reflex response rather than critically analysing their data. Exceedingly few reflect on the width or implications of the range within which their performance lies. Standard medical education does not include these skills, yet unwarranted practice variation necessarily compromises a population’s overall quality of care. Researchers report wide variation in health care resource use with little connection to patient outcomes, challenging the belief that directing incrementally more resources at certain healthcare problems necessarily produces better results. This book provides requisite knowledge to enable readers without research expertise to understand the notion of unwarranted practice variation, how to recognize it, its ubiquity, and why it is generally undesirable – why narrowing is pervasiveness improves quality. The book begins by describing practice variation, its prevalence, and why it matters. Next, it examines alternative conceptualizations of NICU work. One view is task-oriented, while the other is aim-oriented. NICU teams rarely articulate their aims explicitly, so this book offers examples that guide thinking and action. Finally, this book asks, “Which rate is 'right'; what is the performance target?” The answer entails identifying the lowest resource use rate associated with desirable outcomes. This requires data describing efficient and predictably performing provision of current evidence-based care, along with relationships to a variety of outcomes. Provider conceptualization of healthcare quality also is often vague. The challenge lies in defining this notion operationally. This book does precisely that and gives readers tools to think critically about process, outcome, and quality measures, via some understanding of systems, risk-adjustment modelling, and discriminating signal from noise in process data.
Design Your Life

Design Your Life is a series of irreverent and realistic snapshots about objects and how we interact with them. By leading design thinker Ellen Lupton and her twin sister Julia Lupton, it shows how design is about much more than what's bought at high-end stores or the modern look at IKEA. Design is critical thinking: a way to look at the world and wonder why things work, and why they don't. Illustrated with original paintings of objects both ordinary and odd, Design Your Life casts a sharp eye on everything from roller bags, bras, toilet paper, and stuffed animals to parenting, piles, porches, and potted plants. Using humor and insight Ellen and Julia explore the practical side of everyday design, looking at how it impacts your life in unexpected ways and what you can do about it. Speaking to the popular interest in design as well as people's desire to make their own way through a mass-produced world, this thoughtful book takes a fresh and humorous approach to make some serious points about the impact of design on our lives. Find out what's wrong with the bras, pillows, potted plants, and the other hopeless stuff you use, buy, clean, water, or put away everyday. Discover how to secretly control the actions of those around you by choosing and placing objects carefully. Find out how roller bags are threatening civilization, and how the layout of your own house might be making you miserable. Use the tools of self-publishing to take the power of branding into your own hands. Taking a fresh, funny look at parenthood, housekeeping, entertaining, time management, crafting, and more, Design Your Life shows you how to evaluate the things you use, and how to recognize forms of order that secretly inhabit the messes of daily life, be it a cluttered room or a busy schedule. Use this book to gain control over your environment and tap into the power of design to communicate with friends, family, and the world.
STEAM Meets Story

Author: Gloria D. Campbell-Whatley
language: en
Publisher: Teachers College Press
Release Date: 2021-06-11
This innovative STEAM guide will help general and special education teachers to increase effective instruction with adolescents (grades 5-10). The authors show teachers how to link STEM concepts with popular fiction and film selections as a catalyst to launch student interactions, discussions, projects, and investigations. This approach will promote problem solving and reasoning skills by initiating the scientific process, rather than simply presenting established facts. The book includes a wealth of lesson plans that connect abstract STEM ideas to realistic experiences that students encounter. Sample lessons call on students to produce drawings and models that move STEM to STEAM. Grounded in popular film and some of the most-read young adult books, the text includes teaching strategies found to be effective with traditionally underserved students and those with disabilities. Book Features: Standards-based STEM lessons interrelated and interwoven with writing, reading, speaking, and other skills. Practical ideas and hands-on activities for engaging adolescents in both traditional and virtual environments. Guidance for working with diverse populations, such as students with different abilities, culturally and linguistically diverse students, translingual students, and transnational students. Templates, handouts, and lessons linked to Star Wars, The Giver, The Immortal Life of Henrietta Lacks, Harry Potter, To Kill a Mockingbird, Star Trek, The Matrix, Holes, and more.