Drones and Its Impact - Free Essay Example

Sample details Pages: 6 Words: 1866 Downloads: 9 Date added: 2019/08/16 Category Society Essay Level High school Tags: Drones Essay Did you like this example? The idea of utilizing unmanned lethal technology in warfare has been heavily debated for a number of reasons. As the newest way of fighting, drone warfare currently has little legal restrictions that dictate what a government can or cannot order their soldiers to do (Thompson). One of the most prominent debates revolves around the psychological effects drone warfare has. Don’t waste time! Our writers will create an original "Drones and Its Impact" essay for you Create order Drone warfare not only has a negative psychological effect on the drone pilots, it also holds a psychological impact on the everyday citizen who becomes witness to these drones (Owen). In order to determine the ethics of drone warfare, governments must also consider the psychological damages that this new technology can bring. If governments wish to incorporate drone warfare, they should also implement ways to control the psychological impacts this technology holds. Despite drone warfare being considered new technology, many researchers have already conducted studies in regards to the psychological impacts. First of all, even the support personnel of the drone pilots, who do not kill the people they see on their screens, are psychologically affected by drone warfare (Otto). In theory, this should be a relatively easy task. They would not suffer from killing someone and they are still providing valuable information for the military. However, what should happen in theory does not. Though they are not killing anyone, these support personnel are forced to watch some of the most terrible things that can be done to another human being (Otto). In a survey conducted by the Air Force, they found that almost one in five of every drone operator has been witness to a rape in this year alone (Otto). For some, they have witnessed more than 100 different cases of a person being raped or killed (Otto). These factors lead to these support personnel having a grea ter chance of being diagnosed with post-traumatic stress disorder (Thompson). In comparison to the 2.1% of non-intelligence support personnel who get PTSD, 2.5% of intelligence support personnel are clinically diagnosed with PTSD (Thompson). Despite this happening, the drone operators have no choice but to continue watching what is happening (Otto). As their job, it is their duty to keep watching as they continue to watch out for threats (Otto).   Next, drone warfare has lead to built up stress in the pilots. Despite working in the safety of a building, these pilots experience the same amount of stress that a regular soldier would. With only what they see on the screen as their guide, these pilots must determine whether they are attacking a group of terrorists or a group of innocents. After doing so, they are expected to return home unaffected by their previous actions. When the Air Force conducted the PCL-M, the militarys test and evaluation for PTSD, they found that 1.6% of RPA operators experience a form of PTSD that could be considered an existential conflict (Chappelle). Because of all the guilt that is brought forth by their actions, drone pilots are much more susceptible to getting what is considered moral injuries (Chappelle). Those who get moral injuries have feelings of guilt, shame, anxiety, loss of self-worth, existential and spiritual issues, and questionings about their morality (Chappelle). These feelings end up bringing about devastating consequences. Similar to Vietnam War veterans, drone pilots also exhibit patterns in regards to emotional distress that is associated with their killings (Prince). With a higher frequency in killings, drone pilots become more susceptible to thoughts of suicide by two times in comparison to pilots that are considered to kill a moderate amount of people (Prince).   Not only can drone warfare cause post-traumatic stress disorder, it can also lead to mental fatigue. Chappelle, a psychologist specializing in military personnel, conducted a number of studies utilizing the Fatigue Scale, Fatigue Assessment Scale, Checklist Individual Strength Concentration Subscale, the World Health Organization Quality of Life Assessment Energy and Fatigue Subscale, and the Maslach Burnout Inventory Emotional Exhaustion Subscale in order to measure the fatigue experienced by drone operators. The tests showed that 53.6% of crew members in charge of artificial intelligence in warfare met the criteria for shift work sleep disorder (Chappelle). Shift work sleep disorder causes difficulties adjusting to a different sleep/wake schedule, which results in significant issues with falling asleep, staying asleep, and sleeping when desire (Chappelle). Not to mention, 51.5% of the tested drone operators were found to be above the cut-off of the Epworth Sleepiness Scale which me asures how sleepy a person is during the daytime (Tvarynas). This fatigue leads to a higher possibility of work burnout. The Maslach Burnout Inventory-General Survey conducted four different studies in order to measure the possibility of job burnout in drone operators (Tvarynas). Three aspects of occupational burnout are explored with the MBI-GSs: cynical behavior, emotional exhaustion, and productiveness (Tvarynas). In these three studies, the survey found that of the drone pilots, 14-33% experience emotional exhaustion, 7-17% suffer from cynicism, 0-6% are below the diagnosed cut-off for occupational productiveness (Tvarynas).   Another psychological aspect that should be considered when determined the ethics of artificial intelligence in warfare is the effects on the innocents caught in the crossfires of combat engaged by drones. In countries such as Afghanistan, Iran, and Pakistan, citizens are becoming increasingly familiarized with the sound of a drone flying above (Owen). Using artificial intelligence to fight wars has brought up a considerable issue: artificial intelligence is unable to differentiate between enemies and innocents (Owen). These drones hover above the villages, infringing on their right to privacy and bringing with them a source of fear and lethality (Owen). In a study led by Stanford University and New York University researchers called Living Under Drones, citizens of the region of Waziristan confessed to living in constant fear of the buzzing above their heads (Owen). When hearing the drones in the sky, some of these citizens were prone to anxiety attacks and the majority of them suff ered from insomnia (Owen). This constant fear disrupts their previous daily lives as well. Nearly all Waziristan children do not go to school and previous daily activities are avoided unless direly needed (Owen). There are a number of variables that could have affected the results observed for the psychological effects of drone warfare. First of all, the number of available studies on this topic is incredibly limited. Drone operators are not permitted to reveal any information of their occupation unless they are revealing the details to someone with adequate security clearances. Thus, most studies are only conducted after being requested by the Air Force and still then the Air Force is in charge of the researchers, often employing the same researchers consecutively. Also, all the current available research concentrates only on a single person, instead of the group as a whole. Following the whole operations team in charge of drone warfare could provide a more clear understanding of how these psychological effects develop. Last of all, one limitation could be the language barrier between different countries. Other nations may have done studies on the topic, but these studies were not made avail able to this report in the form of English-language journals. Despite the strategic advantages unmanned weaponry may bring, governments must take into consideration how this technology mentally affects not only the innocents caught in the warzone, but their own military personnel. Countries should begin to take action to create new policies that address the limits of using drones to prevent collateral casualties that lead to anxiety amongst the innocents. They should also ensure that the psychological needs of their soldiers are tended to, such as in the form increased accessibility of psychologists.   Work Cited Chappelle, W., Goodman, T., Reardon, L., Thompson, W. (2014). An analysis of posttraumatic stress symptoms in United States Air Force drone operators. Journal of Anxiety Disorders, 28, 480-487. doi:10.1016/j.janxdis.2014.05.003. Chappelle, W., McDonald, K., Prince, L., Goodman, T., Ray-Sannerud, B. N., Thompson, W. (2014a). Assessment of occupational burnout in United States Air Force Predator/Reaper drone operators. Military Psychology, 26(5-6):376-385. doi: 10.1037/mil0000046. Chappelle, W. L., McDonald, K. D., Prince, L., Goodman, T., Ray-Sannerud, B. N., Thompson, W. (2014b). Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force drone operators. Military Medicine, 179(8S), 63-70. doi:10.7205/MILMED-D-13-00501. Chappelle, W., McDonald, K., Thompson, B., Swearengen, J. (2012). Prevalence of high emotional distress, symptoms of post-traumatic stress disorder in U. S. Air Force active duty remotely piloted aircraft operators (2010 USAFSAM survey results). Technical report, USAF School of Aerospace Medicine, Brooks City-Base, Texas, December 2012. Chappelle, W., Prince, L., Goodman, T., Thompson, W., Cowper, S., Ray-Sannerud, B. (2014c). Occupational health screening of the virtual warrior: Distributed common ground system intelligence operators compared with non-combatant support personnel. Technical report, USAF School of Aerospace Medicine, Brooks City-Base, Texas, February 2014. https://oai.dtic.mil/oai/oai?verb=getRecordmetadataPrefix=htmlidentifier=ADA60 Chappelle, W., Salinas, A., McDonald, K. (2011). Psychological health screening of USAF remotely piloted aircraft (RPA) operators and supporting units. Symposium on Mental Health and Well-Being Across the Military Spectrum, Bergen, Norway, 12 April 2011. https://www.dtic.mil/dtic/tr/fulltext/u2/a582856.pdf Chappelle, W., Swearingen, J., Goodman, T., Cowper, S., Prince, L., Thompson, W. (2014). Occupational health screenings of US Air Force remotely piloted aircraft (Drone) operators. Technical report, USAF School of Aerospace Medicine, Brooks City-Base, Texas, April 2014. https://oai.dtic.mil/oai/oai?verb=getRecordmetadataPrefix=htmlidentifier=ADA60 Otto, J. L., Webber, B.J. (2013). Mental health diagnoses and counseling among pilots of remotely piloted aircraft in the United States Air Force. MSMR,20(3), 3-8. Ouma, J. A., Chappelle, W. L., Salinas, A. (2011). Facets of occupational burnout among US Air Force active duty and National Guard/Reserve MQ-1 Predator and MQ-9 Reaper operators. Technical report, USAF School of Aerospace Medicine, Brooks City-Base, Texas, June 2011. https://oai.dtic.mil/oai/oai?verb=getRecordmetadataPrefix=htmlidentifier=ADA54 Owen, Taylor. Drones Dont Just Kill. Their Psychological Effects are Creating Enemies. The Globe and Mail. 8 April 2018. https://www.theglobeandmail.com/opinion/drones-dont-just-kill-their-psychological-effects-are-creating-enemies/article9707992/ Prince, L., Chappelle, W., McDonald, K., Goodman, T. (2012). Main sources of occupational stress and symptoms of burnout, clinical distress, and post-traumatic stress among Distributed Common Ground System intelligence exploitation operators (2011 USAFSAM survey results). Technical report, USAF School of Aerospace Medicine, Brooks City-Base, Texas, September 2012. https://oai.dtic.mil/oai/oai?verb=getRecordmetadataPrefix=htmlidentifier=ADA57 Prince, L., Chappelle, W.L., McDonald, K.D., Goodman, T., Cowper, S., Thompson, W. (2015). Reassessment of psychological distress and post-traumatic stress disorder in SR of military drone operators. United States Air Force distributed common ground system operators. Military Medicine,180(3S), 171-178. doi:10.7205/MILMED-D-14-00397. Thompson, W. T., Lopez, N., Hickey, P., DaLuz, C., Caldwell, J. L., Tvaryanas, A. P. (2006). Effects of shift work and sustained operations: Operator performance in remotely piloted aircraft (OP-REPAIR). Technical Report, Air Force Research Laboratory, Brooks City-Base, Texas, January 2006. https://oai.dtic.mil/oai/oai?verb=getRecordmetadataPrefix=htmlidentifier=ADA44 3145 Tvaryanas, A. P., MacPherson, G.D. (2009). Fatigue in pilots of remotely piloted aircraft before and after shift work adjustment. Aviation, Space, Environmental Medicine,80(5), 454-461. doi:10.3357/ASEM.2455.2009 Tvaryanas, A. P., Thompson, W. T. (2006). Fatigue in military aviation shift workers: Survey results for selected occupational groups. Aviation, Space, and Environmental Medicine, 77(11), 1166-1170.

Trucking in the United States - 1022 Words

Jacob Baker ECON 210 Microeconomics Economics Research Paper Abstract: This paper will look at the work market for truck drivers in the United States. The effects of a shortage and/or surplus of drivers and how the work market effects the countrys economy, and the workers way of life will be broken down. This paper will look at how adding more jobs to this career also effects the supply and demand of goods, problems of finding qualified workers, and the chances of an individual getting a job with others competing for the same job. Trucking in the United States Introduction It is widely known that logistics is the life blood of anything major. The logistics and transportation industry in the United†¦show more content†¦Something else more experienced drivers are worried about. â€Å"10 years ago I loved driving, now I am scared to drive down the block,† says James about the influx of new drivers in the industry, a driver for Digby Southwest, a trucking company based out of Tucson, AZ. James has refused to divulge his last name. Conclusion In conclusion, to have a healthy economy, goods must be moved to be bought. The trucking industry has been a leading factor in moving goods since the 1900s. Without it, the United States will die in a minimum of 3 days. As for my thoughts on the matter, I believe the government needs to start deregulating this industry. Many veteran drivers are in their retirement years and we will need an influx of new drivers to take the helm. But unfortunately, many of these new drivers are leaving the industry because they cannot handle the pressure put on them by the government. The American highways are the safest they have ever been, so we need to stop thinking about how safe we can make the roads, and start thinking about how we can keep these guys in the industry. Sources -The Logistics and Transportation Industry in the United States. (n.d.). Retrieved July 5, 2015, from http://selectusa.commerce.gov/industry-snapshots/logistics-and-transportation-industry-united-states.html -Reports, Trends Statistics. (n.d.). Retrieved July 5, 2015, fromShow MoreRelatedThe Dispute Between Mexico Ad United States Regarding International Trucking Implemented By Nafta1437 Words   |  6 PagesSummary The case talks about dispute between Mexico ad United States regarding international trucking implemented by NAFTA. In year 1994, trade agreement was passed by NAFTA allowing trucks from Mexico to cross borders and deliver goods to their ultimate destination in USA to increase efficiency. Previously the trucks were not allowed to pass US border, the goods were unloaded and then loaded to American trucks, the process took lot of time and money. 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Analysis Of Letter From Birmingham Jail And Johnathan...

Change is a part of human nature. We grow and learn as a society, constantly striving to become our better selves. But as we grow older, some beliefs that are inflicted upon us become written in stone. They are truths we believe, but are not always ethically and morally correct. Society becomes blinded by its traditions about how things are supposed to be done that nobody sees the pain that is being inflicted. Martin Luther King Jr., â€Å"Letter from Birmingham Jail† and Johnathan Swifts, â€Å"A Modest Proposal,† persuade their audience in very different ways but are both effective in using pathos. In order to create an effective call to change, an author must use the emotions of the reader to create a need to take action. In analyzing the texts, the reader can tell right away that both authors take very different approaches to their topic. Swift creates this elaborate plan to end poverty in Ireland by selling children to the upper class for food. It is an extremely satirical essay using irony and logic to try and sway the reader towards his absurd idea, but even goes as far to say that it is not against the hierarchy to do something so extreme, â€Å"And besides, it is not improbable that some scrupulous people might be apt to censure such a practice, (although indeed very un-justly) as a little bordering upon cruelty†¦Ã¢â‚¬  (Swift 149). He used various examples of logic and statistics stating how he has already analyzed the different factors to make his idea logical, â€Å"I have already

Mb0045 Free Essays

Feb/Spring 2012 Master of Business Administration – MBA Semester IV MI0038 – Enterprise Resource Planning – 4 Credits Assignment – Set- 1 (60 Marks) Note: Each Question carries 10 marks. Answer all the questions. Q1. We will write a custom essay sample on Mb0045 or any similar topic only for you Order Now Q2. Q3. Q4. Why are ERP systems said to be flexible? Explain with an example. Explain with an example the concept of supply chain management? Differentiate between Open Source and Commercial ERP. Briefly explain the key principles to a proper ERP system selection process. What is ATO and how is it different from ETO? List the advantages of CAD/CAM. How does the plant maintenance module help in achieving competitiveness? Write a note of Quality Management. Explain the working of Warehouse Management and Purchase department with an example. Q5. Q6. Feb/Spring 2012 Master of Business Administration – MBA Semester IV MI0038 – Enterprise Resource Planning – 4 Credits Assignment – Set- 2 (60 Marks) Note: Each Question carries 10 marks. Answer all the questions. Q1. Q2. Q3. Q4. Q5. Q6. What is web ERP? What are its benefits? List out the different modules under ERP Inventory management. Also read  Modules 9 10 Briefly explain the functionalities of CRM sub modules. List out the benefits of CRM Systems. Illustrate the role of ERP systems in Human Resources. List out the benefits of Human Resource management systems. Describe how you would go about the different phases of the ERP implementation lifecycle, if it were being done in your company. Discuss briefly about JD Edward’s and PeopleSoft’s applications and their various modules. What is BAPI? Why BIAP is considered as commanding tool in the SAP consultant’s toolkit? How to cite Mb0045, Papers

Adolesence Psychology free essay sample

The most critical stage in a life of a person is in the period of adolesence.   It is a specifically turbulent as well as a dynamic period of any person’s life. It is also a period of â€Å"strorm and stress† characterized by moodiness, inner tormoil and rebellion.   This is a period of transision from childhood to adulthood.   This transition involves biological,   social, and psychological changes, though the biological ones are the easiest to measure objectively.Adolescence is a modern cultural and social phenomenon and therefore its endpoints are not easily tied to physical milestones . The time is identified with dramatic changes in the body, along with developments in a persons psychology and academic career. In the onset of adolescence, children usually complete elementary school and enter secondary education, such as middle school or high school. During this period, the young develops to sexual maturity and establishes an identity as an individual. We will write a custom essay sample on Adolesence Psychology or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page    Their   sense   of identity develops gradually out of the various identification of childhood. The adolescent is newly concerned with how they appear to others. Ego identity is the accrued confidence that the inner sameness and continuity prepared in the past are matched by the sameness and continuity of ones meaning for others, as evidenced in the promise of a career. The inability to settle on a school or occupational identity is disturbing. A major task confronting the adolescent is to develop a sense of individual identity, to find answers to the questions â€Å"Who am I† and â€Å"where am I going† .   The process also involves feelings about self-worth and competence.   Although development   of sel-concept starts in early childhood and continues throughout the lifespan. Searching of the unique identity is one of the problems that adolesence often face.   Some, but not all, teenager often challenge the authority or the rules as a way to establish their individuality.   There is also a probability of drugs and alcohol use, or mental health disorder, eating disorders and depression. Historically this stage of development began much later, sometime between the ages of fourteen and eighteen, which allowed the child to mentally and emotionally mature more and brought them closer to the age of consent before reaching this physical and emotionally challenging Physical maturation resulting from puberty leads to an interest in sexual activities  Ã‚   sometimes leading to teenage pregnancy.  Ã‚  Ã‚   Since teens may not be emotionally or mentally mature enough or financially able to support children, sexual activity among adolescents is problematic. Given the emotional immaturity of adolescents, many countries consider those under a certain age to be too young to engage in and other sexual activities, even if they are physiologically capable. Family conflict is more common during adolesence than during other period of development.   Puberty appears to play a central role in initiating this conflict.   Adolesence of both sexes have significantly more conflicts with their mothers than with their fathers.   Probably because mothers are more involve in regulating the everyday details of family life.   Parents are often torn between the necessity of maintaining the family system and allowing their child increasing jurisdiction over his or her behavior.   Childhood even with intact families is never troubled free.   The fact that the most important emotionla structure in the childhood’s life is the parents’ marriage.   Ends in failure becomes forever embeded in that child’s history. It can not be denied that fathers are very important in the family.   Without a father there is no family.   The absence of the father maybe associated with some undesirable behavior of the children.   Among wihich are poor school performance,poor relationships with peer, problems with impulse control, rebellious and other adjustment difficulties. It is like the case of a 16 year old girl whose parents are divorce.   She displayed undesirable behavior like rebellious, trouble in school and she desires male attention.   Adolesence are in the process of affirming up their identity.   They need both parents   to affirm them in developing womanliness and how to relate to other people of the opposite sex. Childhood, even with intact families is never troubled-free.   The fact that the most important emotional structure in the child’s life is the parents’ marriage – ends in failure becomes forever embeded in that child’s history.   Being a child of devorce,   there is a need of several therapy.   A joint therapy of parents is also needed to understand the need to work together for the children. In order to pass from childhood to adulthood the adolesence must solve a number of problems.   He must develop heterosexual interest, become free from home supervision, make new emotional and social adjustments to reality.   They should evolve a philosophy of life, achieve economic and intellectual independence and learn how to use their leisure time profitably.   If they fail of these any achievements, he fails to gain full maturity.   Because adolesence are caught between two worlds, one of the dependence, the other of the responsibility.   They would like the power to decide for themselves, but are not certain they want to increased responsibility that accompanies adulthood.

A Bear of Very Many Words Winnie-the-Pooh in the Dictionary

A Bear of Very Many Words Winnie-the-Pooh in the Dictionary A Bear of Very Many Words: Winnie-the-Pooh in the Dictionary Did you know that today, January 18, was A. A. Milne’s birthday? To mark this, people around the world are celebrating Milne’s much-loved creation, Winnie-the-Pooh. And for Winnie-the-Pooh Day this year, we thought we’d take a quick look at the language of Pooh. Pooh and friends. But what can a bear of very little brain offer the English language? More than you might expect! In fact, if we look at the Oxford English Dictionary, Pooh and his friends pop up a few times†¦ 1. Pooh-Sticks Perhaps the most obvious bit of Pooh in the dictionary comes with â€Å"pooh-sticks.† This is the game that Winnie-the-Pooh and his friends play by dropping sticks into a river on the upstream side of a bridge. The contestants then rush to the other side to see whose stick emerges first. This might not sound like a competitive sport, but the World Poohsticks Championships have been taking place in England for 35 years now! Pooh-sticks in action.(Photo: Malc McDonald) 2. Eeyore and Tigger Among Pooh’s friends in the Hundred Acre Wood, Eeyore and Tigger stand out for their contributions to the English language. Eeyore, the downbeat donkey, appears in the OED as a term for a â€Å"pessimistic, gloomy, or habitually disconsolate person† (or you can use the adjective â€Å"Eeyore-like, if you prefer). A â€Å"Tigger,† on the other hand, is defined as an â€Å"exuberant, energetic, and cheerful person.† The famously bouncy tiger has also inspired two adjectives: â€Å"Tiggerish† and â€Å"Tigger-like.† It seems, then, that Winnie-the-Pooh offers terms for people of very different temperaments! 3. Heffalumps and Woozles In A. A. Milne’s writing, heffalumps and woozles are (possibly imaginary) creatures that steal honey. And since Winnie-the-Pooh is really, truly very fond of honey, he has to be wary of these sneaky beasts! The words â€Å"heffalump† and â€Å"woozle,† and the creatures’ appearances, are based on the English words â€Å"elephant† and â€Å"weasel,† respectively. But outside of Milne’s writing, â€Å"heffalump† has become a playful word for real-life elephants (or sometimes, less politely, larger human beings). Sadly, the word â€Å"woozle† hasn’t yet made it into the dictionary. However, it has inspired the term â€Å"woozle effect.† This is based on the story of Pooh and Piglet mistaking their own footprints for those of a woozle, then chasing themselves in circles in a hunt for something that doesn’t exist. In the real world, the â€Å"woozle effect† occurs when a misleading or unsubstantiated idea is repeated and republished often enough that people start believing it (or chasing their own footprints, so to speak). So while â€Å"woozle† isn’t in the dictionary yet, it still might appear there one day!

Factors In Health Care Organizations That Affect Patient Safety. How

Factors In Health Care Organizations That Affect Patient Safety. How Factors In Health Care Organizations That Affect Patient Safety. How Is The Human Factor Revelant To – Article Example Factors in Health Care Organizations that Affect Patient Safety. How is The Human Factor Relevant to Patient Safety. of Factorsin Health Care Organizations that Affect Patient Safety. How is The Human Factor Relevant to Patient Safety.NameName of Institution Factors in Health Care Organizations that Affect Patient Safety. How is The Human Factor Relevant to Patient Safety? Patient safety is paramount to any hospital and health care worker. The health care workers take an oath that provides a promise to protect the sanctity of life. The factors that are paramount to patient safety all revolve around the medical personnel. This paper narrows down to the Human factors in patient safety. The organizational managerial procedures influence the human factor in terms of safety culture. The management has the task to cultivate this culture by giving questioner surveys to patients to monitor their staff (World Health Organization, 2009, p. 12). The leadership style that encourage patient saf ety, many hospitals its only doctors that are allowed to prescribe and the nurses effect the prescription. The structures of communication in the hospital on patient safety are essential in this case. The patient progress is noted down to encourage informed prescriptions. Team work is a human factor that is key to patient safety. It ranges from shifts that work in words to the team of experts in the theater room. The patient safety is guaranteed by team work tools like objective briefing for a particular team and management attitude tools as ORMAQ (World Health Organization, 2009, p. 25). Individual personalities play a big role in patient safety. Many refer to the medical field as a calling profession. This implies that the management should foster the care and concern attitude among its staff. Situation awareness and decision making skills are essential to ensure patient safety when the medical machines fail. The health workers should be in a position to monitor what is happeni ng and what to expect. In conclusion all these factors play a big role in patient safety. Fatigue management techniques are also essential to ensure that the patient well being is safe. ReferencesWorld Health Organization. (2009). Human Factors in Patient SafetyReview of Topics and Tools:Report for Methods and Measures Working Group of WHO Patient Safety April 2009. New York: World Health Organization.