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In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided.

The role of values in organizations has been a highly researched topic (Collins in Good to Great, HarperCollins, New York, 2001; Collins and Porras in Built to Last: Successful Habits of Visionary Companies, HarperCollins, New York, 1997; Frederick and Weber 1990; Kouzes and Posner, The Leadership Challenge, 4th ed, Jossey-Bass, San Francisco, 2007; Pattison et al. Emerging Value in Health Care: The Challenges for Professionals, Jessica Kingsley Publishers, Philadelphia, 2010). However, little research has focused on values in health care settings. In addition, the research that has been done has focused on values from an organizational perspective, not from an individual perspective. Based on these two factors, in addition to the maturation and growth of the hospice industry and the researcher’s prior studies on hospice leadership and organizational practices, a research study was conducted to evaluate the core values of hospice professionals. Another key driver of the research was the expressed difference identified by leaders within the hospice industry that values of individuals new to hospice were different than those who have worked in the industry longer. A web-based survey was utilized to gather core values and demographic data from hospice professionals. Data were collected over a one-year period and involved 531 hospice professionals from 33 states. The demographic information collected was similar to comparative data from previous hospice studies. The top three core values identified in the study were family, faith, and love, and represented 76 % of all responses. No statistically significant identifiable differences, based on demographic variables, were found. Based on the findings, no support was found for the perceived differences noted by leaders working in the hospice industry. However, it identified that hospice professionals regardless of demographic characteristics appear to hold similar values as being important. Based on the findings, core values appear to be an area of commonality versus difference among hospice professionals and could serve as a focal point for building a positive organizational culture. Further research is suggested to evaluate the unique meaning of the key values identified by hospice professionals in the study. In addition, replication of the study in other health care settings would be encouraged.

The Arctic is a challenging environment for making in-situ radiation measurements. A standard suite of radiation sensors is typically designed to measure the total, direct and diffuse components of incoming and outgoing broadband shortwave (SW) and broadband thermal infrared, or longwave (LW) radiation. Enhancements can include various sensors for measuring irradiance in various narrower bandwidths. Many solar radiation/thermal infrared flux sensors utilize protective glass domes and some are mounted on complex mechanical platforms (solar trackers) that rotate sensors and shading devices that track the sun. High quality measurements require striking a balance between locating sensors in a pristine undisturbed location free of artificial blockage (such as buildings and towers) and providing accessibility to allow operators to clean and maintain the instruments. Three significant sources of erroneous data include solar tracker malfunctions, rime/frost/snow deposition on the instruments and operational problems due to limited operator access in extreme weather conditions. In this study, a comparison is made between the global and component sum (direct [vertical component] + diffuse) shortwave measurements. The difference between these two quantities (that theoretically should be zero) is used to illustrate the magnitude and seasonality of radiation flux measurement problems. The problem of rime/frost/snow deposition is investigated in more detail for one case study utilizing both shortwave and longwave measurements. Solutions to these operational problems are proposed that utilize measurement redundancy, more sophisticated heating and ventilation strategies and a more systematic program of operational support and subsequent data quality protocols.

The healthcare industry is a rapidly changing environment requiring leaders to possess a high level of leadership skills. Leaders in the hospice industry have experienced the same level of change, but over the brief span of 25 years. With the aging of hospice executives and the dynamic environment of the hospice industry, the need for strong leadership is more important than ever. This research study reports on the perceived leadership skills of hospice executives and is a replication of an earlier study (Longenecker, 2006). All study participants were executives of organizations that participated in clinical and operational benchmarking activities at the national level. The study evaluated leadership skills using transformational leadership theory as the conceptual model by which leadership skills were measured. The results of the study identified that the participants perceived they displayed an ideal use of skills based on transformational leadership theory.

Health care is a rapidly changing environment requiring a high level of leadership skills by executive level personnel. The hospice industry is experiencing the same rapid changes; however, the changes have been experienced over the brief span of 25 years. Highly skilled hospice executives are a necessity for the growth and long-term survival of hospice care. This descriptive study was conducted to evaluate the leadership skills of hospice executives. The study population consisted of hospice executives who were members of the state hospice organization in Ohio and/or licensed by the state (88 hospice providers). Three questionnaires were utilized for collecting data. These questionnaires collected data on transformational leadership skills of participants, participants’ personal demographics, and their employer’s organizational demographics. Forty-seven hospice executives responded (53%). Key findings reported were high levels of transformational leadership skills (mean, 3.39), increased use of laissez-faire skills with years of hospice experience ( P = .57), and positive reward being a frequent leadership technique utilized (mean, 3.29). In addition, this was the first study of leadership skills of hospice executives and the first formal collection of personal demographic data about hospice executives.

“Although American higher education can justifiably take pride in its capacity to develop the student's ability to manipulate the material world through its programs in science, medicine, technology, and commerce, it has paid relatively little attention to the student's “inner” development—the sphere of values and beliefs, emotional maturity, moral development, spirituality, and self-understanding.” —from the Foreword to Encouraging Authenticity and Spirituality in Higher Education by Alexander W. Astin and Helen S. Astin

Ozonesonde, Umkehr, and lidar aerosol data obtained at Mauna Loa and Boulder from 1984-1988 are compared with SAGE II data and the results are discussed.

A magnetic field model with a linearly superposed uniform external field is used to study the effects of the magnetotail field intensity B/sub T/ on the relationship between the convection pattern in the polar cap and the interplanetary magnetic field (IMF). It is found that as B/sub T/ increases, the polar cap size increases, overall electric field intensity decreases, and the dependence of the total ''open'' flux on the magnitude and direction of the IMF weakens. In addition, the tail field introduces significant differences between the convection patterns corresponding to ''toward'' and ''away'' IMF sectors, respectively: in the northern (southern) polar cap, features such as polar cap boundary displacements and electric field intensity gradients are more pronounced when the earth is in an ''away'' (''toward'') sector. On the other hand, in the case of a northward-tilted IMF, sunward convection in the north (south) polar cap is extended over a larger area for a ''toward'' (''away'') sector. Since dipole tilt was not taken into account in the model, these results should mainly apply to periods around equinox.

Major life events and daily stressors have been associated with women's experience of perimenstrual symptoms (PS). The purpose of this study was to determine the relationship of major life events and daily stressors to PS. Seventy-four women between 18 and 35 years of age kept daily recordings of stressors and symptoms for 2 months after which they completed the Schedule of Recent Events and the Moos Menstrual Distress Questionnaire (MDQ). Major life events were associated with PS reports on the MDQ but not with symptoms reported in the daily health diary. Daily stressors were more influential in perimenstrual symptoms than the cumulation of major life events. Moreover, a generally stressful life context was more influential in the experience of perimenstrual symptoms than episodes of stressful experiences during a particular menstrual cycle phase.

An experiment was performed to study the hypothesis that two distinct selves occur when moods are varied. Following a definition of the term "self" an experiment was designed to produce hypnotically two distinct sell concepts by the induction of the moods of depression and elation. Twenty Ss. responded to an identical self-reference scale 3 times, first during a waking state, then under hypnotic depression, followed by hypnotic elation. Memory was controlled hypnotically. The scale consisted of 100 items evenly divided for adjustment and maladjustment. Chi-square analyses for each S. revealed that 14 Ss. apparently shifted orientation while 6 Ss. did not. It was speculated that there was considerable similarity between these artificially induced value orientations and actual case recordings.

Major life events and daily stressors have been associated with women's experience of perimenstrual symptoms (PS). The purpose of this study was to determine the relationship of major life events and daily stressors to PS. Seventy-four women between 18 and 35 years of age kept daily recordings of stressors and symptoms for 2 months after which they completed the Schedule of Recent Events and the Moos Menstrual Distress Questionnaire (MDQ). Major life events were associated with PS reports on the MDQ but not with symptoms reported in the daily health diary. Daily stressors were more influential in perimenstrual symptoms than the cumulation of major life events. Moreover, a generally stressful life context was more influential in the experience of perimenstrual symptoms than episodes of stressful experiences during a particular menstrual cycle phase.