A tale of 2 countries: the cost of my mother's cardiac care in the United States and India.

When my mother fell ill while visiting me in the United States, I had the opportunity to compare costs of surgical cardiac care in the United States and India. I faced challenges in making well-informed decisions in the United States due to the lack of cost transparency and the minimal flexibility offered in choice of care, whereas in India costs are readily available and allow most people to freely choose their preferred type of care.

England's Experience incorporating "anecdotal" reports from consumers into their national reporting system: lessons for the United States of what to do or not to do?

The English National Health Service's public reporting website--known as NHS Choices--has been incorporating anecdotal comments from patients about primary and hospital care since 2007. Publicly reporting patients' narrative comments along with numerical ratings of their experience and clinical quality metrics presents opportunities as well as challenges for reporting systems. This article reviews the lessons learned in England that could be useful to other health systems that are considering a similar approach. We explore five key design considerations for publicly reporting anecdotal comments--including how to collect, moderate, and display comments and how to encourage the public and the health care providers use them. While anecdotal comments might represent an untapped seam of valuable information about service quality and a potential hook for engaging patients to use comparative performance data, the jury is still out on where narrative comments fit in the complex landscape of quality measurement and reporting.

Creating philanthropic foundations to deal with grief: case studies of bereaved parents.

The current study involves the analysis of six bereaved parents' stories and argues that the development of philanthropic foundations helped these parents make meaning of their children's deaths and find purpose in the midst of their grief. Furthermore, philanthropy, as a way of making meaning and finding purpose, is a mutually beneficial process because it helps both the bereaved founders and the communities the organizations reach. Connections between these narratives and the bereavement literature help us better understand the individual/family grief process and meaning making, as well as how internal grief states intersect with communities.

Reflections of older adults on the process preceding their suicide attempt: a qualitative approach.

The study explores the reflections of older adults on the process preceding their suicide attempt. Data were gathered using in-depth interviews with eight older inpatients who had attempted suicide. Grounded theory methodology was used for data analysis. They described their life and the self as disrupted after experiencing a loss, loneliness, loss of control, and unwillingness to continue living the current life. The findings suggest that the concurrence of these constructs precedes a suicide attempt in later life.

O presente pelo passado: variação verbal em narrativas de deficientes visuais

Este livro analisa a variação verbal entre o chamado pre¬sente histórico1 (PH) e o pretérito perfeito do indicativo (PP) em narrativas orais, de experiência pessoal, tendo como infor-mantes sujeitos com deficiência visual

A win for HROs. Employing high-reliability organization characteristics in EMS.

Was I insubordinate, arrogant or disrespectful? You may feel that I was. But in reality, I was educated to a level that could have been validated and should have been respected by command. I was, in fact, practicing a key aspect of HRO. I was stopping an obvious dangerous condition before it could harm or kill emergency responders. My IC colleague knew it from the facts presented and, in fact, joked with me about my "subtle sarcasm" and moved the perimeter to the recommended half-mile distance. Did I win, or did a proactive HRO win? Actually, HRO won and potentially saved 30 lives. I simply presented the hazards of CFC inhalation. A high-reliability organization must not rely on only one source of data when detailed information on a hazard isn't immediately available, or if it isn't very informative during an emergency decision-making process. Read "EMS & High Reliability Organizing: Achieving safety & reliability in the dynamic, high-risk environment and practice its important principles," pp. 60-63. It's really common sense, not rocket science, and may save you, your crews or others in your community.