Urban Air Mobility-defined as safe and efficient air traffic operations in a metropolitan area for manned aircraft and unmanned aircraft systems-is being researched and developed by industry, academia, and government. Significant resources have been invested toward cultivating an ecosystem for Urban Air Mobility that includes manufacturers of electric vertical takeoff and landing aircraft, builders of takeoff and landing areas, and researchers of the airspace integration concepts, technologies, and procedures needed to conduct Urban Air Mobility operations safely and efficiently alongside other airspace users. This paper provides high-level descriptions of both emergent and early expanded operational concepts for Urban Air Mobility that NASA is developing. The scope of this work is defined in terms of missions, aircraft, airspace, and hazards. Past and current Urban Air Mobility operations are also reviewed, and the considerations for the data exchange architecture and communication, navigation, and surveillance requirements are also discussed. This paper will serve as a starting point to develop a framework for NASA's Urban Air Mobility airspace integration research and development efforts with partners and stakeholders that could include fast-time simulations, human-in-the-loop simulations, and flight demonstrations.A https://ntrs.nasa.gov/search.jsp?R=20180005218 2020-07-07T23:11:55+00:00Z of ODM that is focused on air traffic operations in metropolitan areas with aircraft capable of seating a small number of passengers or equivalent volume of goods flying trips of about 100 nautical miles (nmi) or less.The technologies and procedures required for ODM were investigated in a NASA study [14] that covered the range of the airspace integration problem, including mission planning, separation from hazards (e.g., terrain, obstacles, other aircraft), contingency management, demand-capacity balancing, traffic flow management, as well as sequencing, scheduling, and spacing. A similar spectrum of topics will be covered in this complementary paper on UAM airspace integration. This paper also describes at a high level NASA's initial airspace integration concepts for both emergent and early expanded UAM operations. It also serves as a framework for NASA's UAM airspace integration research and development efforts with partners and stakeholders.The remainder of this paper is organized as follows. Section II reviews past and current UAM operations. Section III presents an overview of UAM, including the goals, principles, barriers, and benefits. This section also discusses the competing considerations that need to be taken into account and balanced for UAM operations, as well as the requirements for communication, navigation, and surveillance. Section IV defines the scope of the concepts with regard to missions, aircraft, airspace, and hazards. Section V describes at a high level NASA's initial airspace integration concepts for both emergent and early expanded UAM operations. Section VI discusses NASA's plan to develop and refi...

Despite improving patient safety in some perioperative settings, some checklists are not living up to their potential and complaints of "checklist fatigue" and outright rejection of checklists are growing. Problems reported often concern human factors: poor design, inadequate introduction and training, duplication with other safety checks, poor integration with existing workflow, and cultural barriers. Each medical setting-such as an operating room or a critical care unit-and different clinical needs-such as a shift handover or critical event response-require a different checklist design. One size will not fit all, and checklists must be built around the structure of medical teams and the flow of their work in those settings. Useful guidance can be found in the literature; however, to date, no integrated and comprehensive framework exists to guide development and design of checklists to be effective and harmonious with the flow of medical and perioperative tasks. We propose such a framework organized around the 5 stages of the checklist life cycle: (1) conception, (2) determination of content and design, (3) testing and validation, (4) induction, training, and implementation, and (5) ongoing evaluation, revision, and possible retirement. We also illustrate one way in which the design of checklists can better match user needs in specific perioperative settings (in this case, the operating room during critical events). Medical checklists will only live up to their potential to improve the quality of patient care if their development is improved and their designs are tailored to the specific needs of the users and the environments in which they are used.

During the predoctoral internship year, training staff and interns are often faced with the prospect of entering into social multiple-role relationships with each other. Such relationships can initially appear benign, and at times be beneficial but may pose some risk of harm both to interns and training staff.Building on the previous work of P. A. O'Connor Slimp and B. K. Burian (1994), a decision-making model is offered regarding social multiple-role relationships between interns and their trainers. It is designed to raise awareness of the issues involved in these relationships and provide structure in assessing their potential for harm.You, a staff member, and a predoctoral intern at your center have just completed an evening therapy group. You decide to stop at a restaurant for dinner before heading home. Do you invite the intern to join you? Do you make the same invitation next week? Every week? Despite more than 2 decades of focus and debate, social dual-or multiple-role relationships continue to pose many ethical dilemmas for psychologists. The literature has had little to say about the impact of developing familiarity and closeness that often comes with social relationships between instructors and students, let alone between training staff and predoctoral interns.In this article, we briefly discuss the impact of social multiple-role relationships between trainers and predoctoral interns and offer some specific suggestions about how to determine potential for harm and how to proceed should such relationships begin to develop.It is difficult to determine at what point a series of social activities have become a social relationship. In truth, whether or not a social relationship exists between an intern and staff member BARBARA K. BURIAN received her PhD in 1990 from Southern Illinois University at Carbondale. When this article was written, she was an assistant professor in the Division of Applied Psychology and Quantitative Methods at the University of Baltimore. She is currently a Senior Research

Background As surgical systems are forced to adapt and respond to new challenges, so should the patient safety tools within those systems. We sought to determine how the WHO SSC might best be adapted during the COVID-19 pandemic. Methods 18 Panelists from five continents and multiple clinical specialties participated in a three-round modified Delphi technique to identify potential recommendations, assess agreement with proposed recommendations and address items not meeting consensus. Results From an initial 29 recommendations identified in the first round, 12 were identified for inclusion in the second round. After discussion of recommendations without consensus for inclusion or exclusion, four additional recommendations were added for an eventual 16 recommendations. Nine of these recommendations were related to checklist content, while seven recommendations were related to implementation. Conclusions This multinational panel has identified 16 recommendations for sites looking to use the surgical safety checklist during the COVID-19 pandemic. These recommendations provide an example of how the SSC can adapt to meet urgent and emerging needs of surgical systems by targeting important processes and encouraging critical discussions.

BACKGROUND:The aim of this study was to identify what parts of the World Health Organization Surgical Safety Checklist (WHO SSC) are working, what can be done to make it more effective, and to determine if it achieved its intended effect relative to its design and intended use. STUDY DESIGN: We conducted a qualitative thematic analysis and meta-meta-analyses of findings in WHO SSC systematic reviews following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS:Twenty systematic reviews were included for qualitative thematic analysis. Narrative information was coded in 4 primary areas with a focus on impact of the WHO SSC. Four themesd-Clinical Outcomes, Process Measures, Team Dynamics and Communication, and Safety Culturedpertained directly to the aims or purposes behind the development of the SSC.The other 2 themesdEfficiency and Workload involved in using the checklist and Checklist Impact on Institutional Practicesdare associated with SSC use, but were not focal areas considered during its development. Included in the 20 systematic reviews were 24 unique observational cohort studies that reported pre-post data on a total of 18 clinical outcomes. Mortality, morbidity, surgical site infection, pneumonia, unplanned return to the operating room, urinary tract infection, blood loss requiring transfusion, unplanned intubation, and sepsis favored the use of the WHO SSC. Deep vein thrombosis was the only postoperative outcome assessed that did not favor use of the WHO SSC. CONCLUSIONS: The WHO SSC positively impacts the things it was explicitly designed to address and does not positively impact things it was not explicitly designed for.