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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

The childhood memory remains vivid. Floyd Westerman’s political anthem “Custer Died for Your Sins” blared on the family 8-track, imploring that a new day must begin, as the author’s parents unwound from a long but impactful week. This report is a reflection on past, present, and future, as Bryan Brayboy recounts how his parents worked to bring about that new day. His father helped their tribal nation access quality health care. His mother worked with Native nations and non-Native institutions of higher learning in the name of self-determination through education. “It was quiet. Active. Subtle. Effective. Nation building,” Brayboy writes. “I am a product of my parents. In so many ways. I am my parents.” Nation building is the active fulfillment of the belief that we are responsible to our ancestors and responsible for our descendants. It answers the question: How can I be of service and what can I build? It begins a new day. Bryan Brayboy has spent 25 years researching and writing about the role of higher education as it relates to Indigenous Peoples and shares “principles and ideas crucial to engaging in nation building work from within institutions that have traditionally been antithetical to how we think about knowledge and the ways we do our work.”

For the Society of Early Americanists' conference at the University of Maryland in June 2023, the Native American and Indigenous Studies Subcommittee organized a roundtable discussion of academics and knowledge keepers (people responsible for carrying cultural information in their community) actively working to reclaim, preserve, and speak their languages. KIMBERLY TONEY is a member of the Hassanamisco Band of Nipmuc and Coordinating Curator of Native American and Indigenous Collections at both the John Hay Library at Brown University and the John Carter Brown Library in Providence, Rhode Island. Kim's own research interests include language and cultural reclamation, equitable access to libraries and archives, community engagement, and the connecting of Indigenous knowledges and practices to all scholarly endeavors. In order to ground myself in the learning I need to be connected to the knowledge keepers in our community and learning from them but also to the documents themselves that have captured our language even though they're really problematic in themselves, in how they were used and what they do.

In language as perceptive as it is poignant, poet Gwen Nell Westerman builds a world in words that reflects the past, present, and future of the Dakota people. An intricate balance between the singularity of personal experience and the unity of collective longing,Follow the Blackbirdsspeaks to the affection and appreciation a contemporary poet feels for her family, community, and environment. With touches of humor and the occasional sharp cultural criticism, the voice that emerges from these poems is that of a Dakota woman rooted in her world and her words. In this moving collection, Westerman reflects on history and family from a unique perspective, one that connects the painful past and the hard-fought future of her Dakota homeland. Grounded in vivid story and memory, Westerman draws on both English and the Dakota language to celebrate the long journey along sunflower-lined highways of the tallgrass prairies of the Great Plains that returns her to a place filled with \"more than history.\" An intense homage to the power of place, this book tells a masterful story of cultural survival and the power of language.

Jean Westerman Gregg died on June 22, 2013. Gregg is remembered as a past president of the National Association of Teachers of Singing, a distinguished voice teacher and speech pathologist, and a prolific author.

Engineers of the Soul, about Soviet writers under Stalin, and Ararat, in which Westerman considers science and religion, fact and faith, while climbing this biblical mountain on the Turkish-Armenian border. [...] one of your books, Ararat, won awards in at least three categories: literature, travel, and popular science.

The primary aim of this study was to screen for mental health problems in Australian Indigenous young people in a youth detention centre using the Westerman Aboriginal Symptoms Checklist - Youth (WASC-Y). Over the study period, all Indigenous young people admitted into custody were referred for screening with the WASC-Y, a culturally validated fivescaled instrument developed to identify Indigenous young people at risk for a range of mental health or substance abuse problems. The WASC-Y also incorporates a separate scale for cultural resilience. High levels of mental health and substance abuse problems were reported, with 94.6% of males and 100% of females surveyed screening above the designated clinical cut-off on at least one scale. Based on moderate/medium levels of risk, 27.7% screened positive for depression, 34.0% for suicide ideation or intent, 89.4% for substance use, 36.2% for impulsivity, and 68.1% for symptoms of anxiety. Females screened higher than males across all five subscales, though differences reached statistical significance only for suicidal ideation or intent. Cultural resilience as a protective factor for mental health problems (excluding substance abuse) approached clinical significance. Given their pervasively high levels of psychological distress, it is recommended that on admission into custody all Indigenous youth are referred for a mental health assessment and substance abuse counselling. It is important to assess for culturally resiliency or other strengths that may be protective against mental health problems.

Glencore's north Queensland Copper Assets CEO Mike Westerman said the business would be committed to continuing copper smelting operations in Mount Isa while they remained economically viable.

At the top level is business revenue, product performance, those kinds of things. Making the link between IT and these top level measures can be a little tough. But we also found a powerful middle level, which is business process performance -- what's the quality, the efficiency of business processes? There's a direct link to IT there, and there's also a business process link with most executives in the company. So, what you want to do as a CIO is get out of your IT-centric metrics and talk about those business metrics. GW: It's a leadership challenge. As the leader of the IT organization you should be going out and trying to find the place where your intervention is most useful. And so if you're spending a lot of time focusing on something that's already pretty good, it's time to move onto something else. GW: A lot of work has been done on benchmarking, how well does your performance match the metrics from others. It's very useful stuff, but we're taking a different focus. We're focusing less on what the specific level of a certain measure should be -- what should your percentage of successful projects be, how much return should you get on a project, etc. - and focusing on how you use metrics to steer the conversation. The metrics are important only to the extent that you use them to have a better conversation and to make better decisions.

Two of the three critically injured boaters were flown to Orlando Regional Medical Center. The third was flown to Florida Hospital East. The three others were taken to area hospitals for treatment. Their injuries appeared to be non-life-threatening, Orange County sheriff's spokeswoman Barbara Miller said. Ray and Marge Westerman, whose house is near the dock, were awakened by the crash. Minutes later, they heard frantic knocking on their door. Ray Westerman looked through a window and saw a soaking wet young man screaming for help. Marge Westerman called 911.