via http://www.effective-time-management-strategies.com

My QI (Quality Improvement) team has been pre-testing some clinical assessment questionnaires for Health Centers. The questionnaires consist of a checklist and a rating, for two assessors to fill out while observing a specific consultation eg an Antenatal Care visit. The checklist scores are weighted with qualitative ratings. For example, of the items which the midwife conducted during the Physical Examination, the assessors rate the quality in which these items were carried out.

There’s a lot of room for bias in any data collection method, but at least I want to know that my instrument is reliable. So I want to test the inter-rater agreement (eg did they see the same things? did they rate the items similarly?). You’d think this is a simple enough calculation to carry out in excel, in a neat and tidy point-and-click experience. But no. Apparently this seems to be an obscure corner of statistics that you need macros for to carry out in SAS and SPSS.

I ask for the billionth time in my short life: what did people do before internet? I’m a bit less stumped since I’ve found these handy sources below, which provide a free or low-cost stats package for content analysis. Whew!

• kappa2 – free downloadable automated excel workbook (although I’ve had some problems using this one)
• ReCal – free to use, online interface to enter your data
• AgreeStat – $45 downloadable automated Excel workbook

My current work has to do with quality improvement of health facilities in USAID-supported provinces. Two of the three people on my team have young babies, and we bring them along with us to the health centers. Since my husband does freelance and can work anywhere there’s an internet connection, he often joins us on my work trips.

One of the areas my team is working on is improvement of labor and delivery procedures. We’ve watched several deliveries lately – an endlessly fascinating miracle to me. It brings me back to the time my son became real to me, a little someone in my arms… Check these photos out. The baby is 2.5kg.

This weekend’s “debt deal” in Congress, which raised the debt ceiling and agreed to some cuts in the future, contains a change in how the international affairs budget is calculated within the federal budget. In Section 102 of the bill, Function 150 budgets are reclassified as “security.” This means foreign assistance and development programs — USAID, the Millennium Challenge Corporation (MCC) and lots of State Department programs — are now in the same budget category as the Departments of Defense, Homeland Security and the National Nuclear Safety Administration.

It might seem like a minor thing, but this actually provides a sneaky way for the Congress to cut money from “national security” without actually touching sacred DOD programs. By cutting assistance agencies like USAID — a GOP goal for the last 18 months — Congress can cut from development assistance programs and say it is reducing national security spending. This change in language is damaging in that it furthers the militarization of civilian aid programs.

Respected defense analysts like Gordon Adams and Cindy Williams have argued forcefully that USAID is a part of the national security budget. And they are right to a degree: The argument that the U.S. has a compelling national security interest in developing poor countries, in responding to disasters and in alleviating famine is a perfectly reasonable one. Afghanistan and Pakistan are two of the biggest recipients of USAID money because the Obama administration believes USAID’s programs serve a vital function in America’s relationship to both countries.

But just because USAID can serve a national security function, it doesn’t automatically mean the international affairs budget should be militarized, or even considered part of the security budget. USAID, but also the MCC and other Function 150 programs (consisting of 12 departments, 25 agencies and nearly 60 government offices) perform lots of functions that have no direct bearing on national security. There is intrinsic value in effective programs like the Millennium Challenge Account Philippines that advance American national interests but do not play a security function. But, now they are all fall under a rubric of “security.”

Medical Provider Adds Virtual House Calls To Its Services (image from CarenaMD.com)

Image from babynursingblog.com

Really?? A “leftist agenda” of a “nanny state”? I especially love the bashing of Michelle Obama’s breastfeeding advocacy after Palin’s own breastfeeding initiative in 2007.

Why people choose leaders with nothing constructive to add to the dialogue except to auto-bash the other party’s efforts is beyond me. Great quote from one of the commenters to the above blog post:

“Empty vessels make the loudest sound, they have the least wit and are the greatest blabbers” Plato

And a shame that people blindly follow.