How can nurses help patients work more effectively with nurses to improve the safety of patient care?

The literature seems quite clear that patients still regard the nurse as the principal link between the technical and interpersonal aspects of their care. The often-discussed medical error crisis tends to create in the patient mistrust of all care providers. The health care industry is driving towards a system that requires patients to be self-reliant in managing their care, without allowing for factual limitations in patient capability, ability, and interest in such an enterprise. Unfortunately for the overworked, understaffed nurse, patients still look to them to provide quality compassionate care without the patient having to police them. Health care providers have been mandated to provide assessment and intervention for pain management. It was mandated because we as health care professionals failed to perform this vital function in a consistent, quality manner. It did add to the workload of the nurse. However, if done properly, it is a valuable communication tool for the nurse and the patient to comfortably discuss pain and its management--the interpersonal part of care.     

A fragmented patient safety concept: the structure and culture of safety management in health care

The uniform and visible commitment to safety management is a cultural and structural change that health care organizations have not typically attempted. Committee structures are just one example of how culture drives structure in managing health care safety. The question is: "Are we interested in making nonpatient safety programs as well understood and as culturally significant as patient safety programs?" Models exist to institutionalize safety management in health care. We need only look to the JCAHO or OSHA and other high-hazard industry models for examples of safety management. Change requires a focus on safety, not occupational safety or patient safety, but just safety. In health care, safety would be a key characteristic of organizational culture. The organizational expectation is then that all employees will work safely and practice safety. Employees will apply safe practices when handling chemicals, in lifting, and when giving medications. Only when safety imbues the work and decisions of each employee in this way will the highest level of safety be attained.     

Exports,Supply Constraints and Growth: An Investigation using Regional Data

In this work we first model the role of demand‐ and supply‐side factors (labour market adjustment, productive efficiency) in explaining economic growth. Empirically testing the model, we evaluate why different growth regimes may appear in the 20 Italian administrative regions. This exercise uses a two‐stage econometric approach. Estimates for the elasticity of manufacturing output to exports are obtained from regional time series: a significant long‐run relationship indicates the existence of a demand‐constrained growth regime. We then ascertain whether the regional dispersion of supply‐side factors has an impact on the regional dispersion of growth regimes. The empirical evidence supports our expectations of strong regional differences. Southern regions are less likely to display demand‐constrained regimes. In explanation of these differences, second‐stage analysis reveals that a strong role is played by such efficiency‐enhancing factors as technological innovation, bank diffusion and ‘social capital’. No role is found for labour market rigidities.     

Economic Growth and Productivity Gains from Capital Inflow: A Rejoinder

Journal of Quantitative Economics -     

Minority banks and minority communities: Are minority banks good neighbors?

The lagging development of many minority communities has had an adverse effect on economic growth in the United States. One factor historically associated with creating or exacerbating this minority problem is the unwillingness of banks to service minority communities adequately. The federal government used two initiatives to address banks' reluctance to aid minorities: the Community Reinvestment Act (CRA) that ended the practice of redlining and required all federally regulated banks to demonstrate that they served the convenience and credit needs of their local communities, particularly minorities, women, and other underserved groups, and the establishment and preservation of minority owned banks that were expected to be more sympathetic to the needs of their communities. This paper evaluates the extent to which minority banks have met the needs of minority communities. The assessment is conducted in the context of the ratings received by minority banks on their Community Reinvestment Act (CRA) audits. Through the use of CRA audits, the performance of minority banks is also compared to the performance of the general banking community to determine the validity and success of the government's minority banking initiative. Analysis of CRA audit ratings also compares the performance of minority banks among different ethnicities.     

Deposit insurance and bank regulation in a monetary economy: a general equilibrium exposition

Summary. It is commonly argued that poorly designed banking system safety nets are largely to blame for the frequency and severity of modern banking crises. For example, underpriced deposit insurance and/or low reserve requirements are often viewed as factors that encourage risk-taking by banks. In this paper, we study the effects of three policy variables: deposit insurance premia, reserve requirements and the way in which the costs of bank bailouts are financed. We show that when deposit insurance premia are low, the monetization of bank bailout costs may not be more inflationary than financing these costs out of general revenue. This is because, while monetizing the costs increases the inflation tax rate, higher levels of general taxation reduce savings, deposits, bank reserves, and the inflation tax base. Increasing the inflation tax rate obviously raises inflation, but so does an erosion of the inflation tax base. We also find that low deposit insurance premia or low reserve requirements may not be associated with a high rate of bank failure.Received: 2 January 2002, Revised: 1 March 2003JEL Classification Numbers: D5, E5, G1.B. D. Smith: Sadly, our co-author, colleague and dear friend, Bruce D. Smith, died on July 9, 2002.     

Geography,demography, and economic growth in Africa

This paper presents the effects of climate, topography, and natural ecology on public health, nutrition, demographics, technological diffusion, international trade and other determinants of economic development in Africa. The goal of this paper is to emphasize the need for intensified research on the issues at the intersection of ecology and human society. Geography was given emphasis because of three reasons: the minimal gain from another recitation of the damage caused by statism, protectionism and corruption to African economic performance; negligence of the role of natural forces in shaping economic performance; and tailoring of policies to geographical realities. The paper also discusses the general problems of tropical development and the focus of Africa's problems in worldwide tropical perspectives; demographic trends in Africa; use of standard cross-country growth equations with demographic and geographic variables, to account for the relative roles of geography; and the future growth strategies and the need for urban-based export growth in manufacturing and services. Lastly, the authors provide a summary of conclusions and discuss the agenda for future research.     

The educational attainment of immigrants: trends and implications

"This paper uses the 1970, 1980, and 1990 U.S. Censuses to study trends in educational attainment of immigrants relative to natives. Immigrants have become relatively less highly educated, but have become more highly educated in an absolute sense. The effects of changes in relative educational attainment between immigrants and natives on earnings are studied. Educational differences are found to explain more than half the observed wage gap between the two groups. The paper also allows for non-linearities in returns to education. Sheepskin effects influence earnings in different ways for natives and immigrants. Differences in returns to pre- and post-migration education also appear. The paper also finds evidence that immigrants crowd natives out of education, although the effects are stronger in secondary than in postsecondary education."     

An Approach to a Visual Language for Convective Fluid Flows: Visualization of Geophysical Simulations

It was known that deep within numbers and binary data from simulations of geophysical convective flows resided various patterns. Two models of convective fluid flows were being considered. One was a model of two-dimensional (768 × 256) air convection with finite Prandtl number of one and Rayleigh number of 10⁸?10¹⁰, and another was a model of three-dimensional (up to 120 × 120 × 90) mantle convection with infinite Prandtl number and Rayleigh number of 10⁶?10⁸. Clearly, phenomena existed which superceded each individual dimensionless computer model to provide a piece of information regarding actual fluid flows. The problem was how to find, prove, and communicate these patterns and phenomena for convection simulations with gigabytes of data. In a search for such an analytical and communicative tool, the alternative of visualization was considered. The need for visualization was recognized and discussed. Then, utilizing both two- and three-dimensional models of high Rayleigh number convection, basic techniques of style and content were developed. Applications of the visualization techniques were designed utilizing IBM’s Data Explorer in order to create communicative images and movies, and after the applications, the problems of data storage and transfer became apparent. Throughout the process though, it became clear how important the language of vision actually could be in the geophysics community. In a field in which words such as plumes and internal waves have in ways replaced mathematics as the basic language for science, there is a need for another resource, another language-the visualization of convective fluid flows.