A High-Fidelity Human Patient Simulation Initiative to Enhance Communication and Teamwork Among a Maternity Care Team.

OBJECTIVE: To use high-fidelity human patient simulation to enhance teamwork and communication during maternity care emergencies. DESIGN: Quality improvement initiative. SETTING/LOCAL PROBLEM: The labor and delivery team at a large suburban Level 2 facility in the Midwestern United States sought to apply evidence and use simulation to improve communication and teamwork. PARTICIPANTS: Approximately 170 maternity care staff members, including nurses, anesthesia providers, and pediatric and obstetric physicians. INTERVENTION/MEASUREMENTS: During each simulation, there were two scenarios with a debriefing session at the end of each. Teamwork and communication were evaluated using participant surveys. RESULTS: Participants reported improved communication (p = .031) and teamwork (p = .041) after simulation. Additionally, 81% of respondents believed that their ability to perform clinical skills improved. CONCLUSION: Use of high-fidelity human patient simulation was associated with improved teamwork and communication for a maternity care team. Simulation has been incorporated into standard education. We hope to sustain successful outcomes by providing ongoing simulation experiences for labor and delivery staff annually.

The educational legacy of unauthorized migration: comparisons across U.S.-immigrant groups in how parents' status affects their offspring.

This research compares several national-origin groups in terms of how parents' entry, legalization and naturalization (i.e., membership) statuses relate to their children's educational attainment. In the case of Asian groups, the members of which predominantly come to the United States as permanent legal migrants, we hypothesize (1) that father's and mother's statuses will be relatively homogenous and few in number and (2) that these will exert minimal net effects on second-generation attainment. For Mexicans, many of whom initially come as temporary unauthorized migrants, we hypothesize (1) that parental status combinations will be heterogeneous and greater in number and (2) that marginal membership statuses will exert negative net effects on education in the second generation. To assess these ideas, we analyze unique intergenerational data from Los Angeles on the young adult members of second-generation national-origin groups and their parents. The findings show that Asian immigrant groups almost universally exhibit similar father­mother migration statuses and high educational attainment among children. By contrast, Mexicans manifest more numerous discrepant father­mother combinations, with those in which the mother remains unauthorized carrying negative implications for children's schooling. The paper discusses the theoretical and policy implications of the delays in incorporation that result from Mexican Americans needing extra time and resources compared to the members of other groups to overcome their handicap of marginal membership status (i.e., being more likely to enter and remain unauthorized).

Multiple models for Rosaceae genomics.

The plant family Rosaceae consists of over 100 genera and 3,000 species that include many important fruit, nut, ornamental, and wood crops. Members of this family provide high-value nutritional foods and contribute desirable aesthetic and industrial products. Most rosaceous crops have been enhanced by human intervention through sexual hybridization, asexual propagation, and genetic improvement since ancient times, 4,000 to 5,000 B.C. Modern breeding programs have contributed to the selection and release of numerous cultivars having significant economic impact on the U.S. and world markets. In recent years, the Rosaceae community, both in the United States and internationally, has benefited from newfound organization and collaboration that have hastened progress in developing genetic and genomic resources for representative crops such as apple (Malus spp.), peach (Prunus spp.), and strawberry (Fragaria spp.). These resources, including expressed sequence tags, bacterial artificial chromosome libraries, physical and genetic maps, and molecular markers, combined with genetic transformation protocols and bioinformatics tools, have rendered various rosaceous crops highly amenable to comparative and functional genomics studies. This report serves as a synopsis of the resources and initiatives of the Rosaceae community, recent developments in Rosaceae genomics, and plans to apply newly accumulated knowledge and resources toward breeding and crop improvement.

Peroxidase activity and superficial scald development in apple fruit.

The relationship between soluble peroxidase (EC 1.11.1.7; POX) activity and the development of a chilling-related disorder, superficial scald, was studied in three apple fruit (Malus x domestica Borkh.) systems: a White Angel x Rome Beauty population with progeny with different scald susceptibilities; Delicious from three harvests with progressively declining scald susceptibility; and the scald-resistant Idared and the scald-susceptible Law Rome. Differences in incidence and severity of scald in progeny from White Angel x Rome Beauty progeny tended to show relationships with POX activity at harvest, but, overall, associations were not consistent. However, greater scald incidence and lower POX activity were found in less mature Delicious fruit than in later harvested fruit. Also, the scald-resistant Iotadared had a much higher POX activity compared with the scald-susceptible Law Rome. A general hypothesis that POX activity is related to scald susceptibility was generally supported, but exceptions were observed.