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At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

What does it mean to be green?

Today a company is not considered environmentalist unless it moves beyond mere compliance with government regulations to behavior its competitors, and even customers, do not expect. How should it set its agenda? Author Art Kleiner proposes that, to be green, a company must ask three questions: What products should we bring to market? How much disclosure of pollution information should we support? And how can we reduce waste at its source? These questions can't be answered, Kleiner says, unless managers insist on sustainable growth. In this sense, a big investment in environmentalism is like a big one in R&D--both presuppose patient capital and managerial maturity. What are green products? Kleiner cautions against giving in to misinformed public opinion--as McDonald's did in giving up its styrene "clamshells," which were more recyclable than the composite papers it switched to. Rather, companies should rely on literature that analyzes the product life cycle. As for public disclosure, the benefits may be unexpected. Federal legislation requiring companies to report the emission of potentially hazardous waste to a central data bank has not made environmentalists attack them. Rather, it has forced companies to learn what chemicals they inadvertently produce and how much--knowledge that helps them improve production processes. Sharing it helps ecological researchers study the combined effects of plant emissions. As for pollution prevention, Kleiner notes the analogy to quality and observes that it is better to design harmful waste products out of the system than catch them at the end of the line.(ABSTRACT TRUNCATED AT 250 WORDS)

Community-Institutional Relations↗
PubMedDate not supplied

Collective bargaining for radiologic technologists: organizational vehicles.

This is the second in a series of articles written by members of the professional affairs committee of The American Society of Radiologic Technologists. The first article alluded to the analogy of a person who was learning to drive vis-a-vis a person who was learning about collective bargaining. The article suggested that the first step might be to study the rules of the road and in this context discussed briefly some of the federal laws that affect the collective bargaining relationship between employees and their employers. In this article, the analogy is carried still further in a discussion of the various types of organizations or groups that could be used for bargaining purposes.

Allied Health Personnel↗
PubMed2004

Wisconsin Medical Home Learning Collaborative: a model for implementing practice change.

A child with special health care needs is defined as having, or are at increased risk for, a chronic physical, developmental, behavioral, or emotional condition that requires health and related services of a type or amount beyond that required by children generally. In Wisconsin nearly 14% of children are identified as having or being at risk for special health care needs. Healthy People 2010 and the federal Child Health Maternal Bureau have challenged each state to "assure access to ongoing comprehensive health care through a medical home" for all children with special health care needs. A medical home is defined as "an approach to providing continuous and comprehensive primary pediatric care." States are challenged to translate the concepts of medical home to clinical practice activities. This article discusses Wisconsin's participation in a national Medical Home Learning Collaborative and Wisconsin's replication of the Collaborative as a means to develop practical strategies for practice implementation of a medical home.

Child↗
PubMedDate not supplied

The diagnosis of LD in English learners: is it nondiscriminatory?

This study examined the operationalization of one of the key reforms initiated by the Education for All Handicapped Children Act of 1975 (U.S. Congress, 1975) and continued through the 2004 reauthorization of the Individuals with Disabilities Education Act (U.S. Congress, 2004)--namely, nondiscriminatory assessment. The original and current specifications in federal law require that tests be selected and administered so as not to be racially, culturally, or sexually discriminatory. The specific dimensions studied here pertain to the nondiscriminatory diagnosis of learning disabilities (LD) in English learners. A checklist of legal and professional guidelines for making assessments of English learners was used to evaluate 19 psychological reports made on English learners as part of the assessment process for special education eligibility in a small, urban elementary school district in California. The results of this study present a fairly compelling profile of how the writers of psychological reports--school psychologists--do not use extant legal or professional guidelines for making nondiscriminatory assessments of bilingual children.

Child↗
PubMed1998

Conforming strategies of public health campaigns to disease specificity and national contexts: Rockefeller Foundation's early campaigns against hookworm and malaria in Brazil.

The early experience of Rockefeller Foundation in Brazil, starting in 1915, reflected the idea of extending learned experience in Southern US to a wide international context. Health education and the creation of permanent local health services were expressed as main guidelines for cooperation with State and federal Brazilian agencies. Translating to the shaping of public health models the terms of scientific hygiene associated with the pastorian revolution, RF pictured different actions as part of a three step rationale of survey, experiment and demonstrations. In this paper we focus on Lewis Hackett's campaign, designed as a demonstration campaign of the "intensive method" of hookworm control, with the final purpose of enlisting local agencies in long-term action (1919-1924) and the malaria campaign in Rio de Janeiro State Lowlands (1922-1928) led initially by Mark Boyd as an "experimental control work" of field observation, campaign, control and maintenance to set guidelines to malaria control in tropical areas. The course and ultimate results of these experiences showed the need to adapt formal models to complex national and State-building context and to disease specificity, leading to pragmatic adaptations in the issue of control and eradication and on the shaping of vertical and horizontal health services. The failure of these two experiences in terms of disease control helped to strengthen the move, predominant in the next two decades, to vertical campaigns with least dependency on local social and political dynamics, as in the exemplar case of Frederick Soper's Anopheles gambiae eradication campaign (1938-1942).

Brazil↗
PubMed2001

Monitoring and enforcing cultural competence in Medicaid managed behavioral health care.

In recent years cultural competence has expanded beyond language provisions to include understanding and factoring into services provision the cultural perspectives clients may have that are different from the majority culture. The federal government requires state Medicaid programs to offer culturally competent services, but little is known about how states implement such mandates and monitor and enforce them. We reviewed the origins and implications of cultural competence mandates and conducted a brief case study of 5 states to learn about the implementation of cultural competence provisions in behavioral managed care contracts. We found that states and managed behavioral health organizations (MBHOs) vary in their definitions and implementation of standards to ensure mental health care access for vulnerable populations. Although states had a variety of oversight mechanisms, varying contractual requirements ranging from optional to required, vague contract language, no existing standardized indicators or definitions, and scant data on the cultural characteristics of the populations enrolled in Medicaid managed care hamper monitoring and enforcement of cultural competence by states. Implications for MBHOs, states, and the federal government, as well as services researchers, follow.

Clinical Competence↗
PubMed2000

Lead abatement training for underserved populations: lessons learned.

An environmental-justice (equity) grant program was used to make accessible an existing lead-training program to minority persons and residents of low-income communities. The purpose of the program was to enhance the knowledge base within the communities concerning lead hazards and intervention strategies and expand possibilities for employment in the lead abatement industry. Barriers to attendance were anticipated and addressed, and included transportation, meals, license application fees, reminders of course date and location, and day care. The program was evaluated through measures of recruitment rates, pre- and post-testing scores, and change in perception of confidence at pre-test, post-test, and at four-month follow-up. Fee-paying registrants over the same time period were used as a comparison group. First day attendance rates for individuals recruited into the equity-grant was 59 percent, of these 94 percent completed all days. Equity and fee-paying groups had similar scores on the pre-test (p = .209), while mean scores on the final exam differed significantly (p < .001) between the groups and were 77 percent and 85 percent, respectively. After adjusting for demographic and course type attended, perceptions of self-efficacy (benefit) and outcome-effectiveness (confidence) increased significantly from pre- to post-tests for both groups and remained at post-course levels at four months follow-up. Lessons learned include: (1) Lead abatement and other related activities can be successfully taught through traditional training methods; (2) A necessary element for delivery of educational services to minority groups is forming workable ties with local community groups, but eligibility requirements must be maintained; (3) Once barriers to first-day attendance are overcome, the information necessary to perform specific work skills can be taught; (4) Positive changes in belief are not dependent on minority status, income, or education levels; (5) Training and education increased confidence in ability to perform learned skills, and belief that there will be a beneficial outcome when performed for themselves, their families, and communities; and, (6) A consensus regarding applicability of regulations must be achieved among federal, state, and local communities.

Adult↗
PubMedDate not supplied

How to provide around-the-clock CPR certification without losing any sleep.

Teaching and reviewing cardiopulmonary resuscitation (CPR) to employees is an important part of the role and responsibilities of hospital nurse educators. The new teaching technologies of computer-assisted instruction and interactive video have been merged into a teaching/learning system that was tested by a rural federal hospital. Over a 2-month period, more than one third of the hospital's staff members were certified in CPR by the standards of the American Heart Association with the learning system. Ease of operation, employee enthusiasm, and easy access to the equipment were identified as important factors that contributed to the successful implementation of this innovative CPR training/review program. Additional evaluation of the system confirmed that the system was efficient, cost effective, and time-saving.

Computer-Assisted Instruction↗
PubMed2006

Medical students' perceptions of their learning about the doctor-patient relationship: a qualitative study.

OBJECTIVE: To describe and discuss Year 5 medical students' perceptions of their own learning about the doctor-patient relationship. METHODS: We carried out a qualitative study of semi-structured interviews with 16 Year 5 medical students using 3-way analysis at the School of Medicine, Federal University of São Paulo, São Paulo, Brazil. RESULTS: For experiences at the pre-clinical stage, the subcategories were: positive aspects of the medical psychology course; great distance between theory and reality, and strong desire for clinical practice. For experiences at the clinical stage, the subcategories were: demand for opportunities to discuss the doctor-patient relationship; teachers as either role models or anti-models; clinical situations favourable for developing empathic relationships, and clinical situations unfavourable for developing empathic relationships. For views about future experiences, the subcategories were: apprehension about ethical behaviour; anxiety about handling patients' psychosocial characteristics, and fear of professional ethics cases or legal action. DISCUSSION: To compensate for the lack of practical activities during the pre-clinical stage, students search for extracurricular activities that often overload them. Because teachers function as professional role models, their attitudes towards patients have great importance. Students fear not being able to maintain their empathic capacity in the future because of work-related issues. Knowledge of the psychological aspects of the doctor-patient relationship helps students to comprehend their experiences. Gradual contact between student and medical practice from the beginning of the course is advised. It should be followed by interdisciplinary discussions that deal with the technical aspects of cases and the doctor-patient relationship.

Adult↗
PubMed2004

VISION2003: virtual learning units for medical training and education.

The project VISION2003 consists of several partners with different professions ranging from medicine to medical informatics, from computer science to didactics. Its aim is the development, testing, introduction and a long-time maintenance of an open, web-based, intelligent and adaptive teaching and learning system for medical education. The system is expected to enhance the acceptance and efficiency of conventional ways of learning by supplementing and supporting them and creating new methods for imparting knowledge ["VISION2003, Lehr-und Lernsysteme in der Medizin: Intelligente und Multimediale, Internetbasierte adaptive und intelligente Autorensysteme für kooperatives Training in der Medizin", (last valid on 17 January 2003) and Ein offenes sprachkonzept für verteilte wissensverarbeitung in der medizin, Tagungsabstract XVI International Congress of the European Federation for Medical Informatics MIE, September 2000]. This is done exemplarily in the specific fields of oncology, accident-surgery and cardiology in consideration of actual standards and didactical measures. The range of possible applications is wide, from electronically accessible scripts through example cases to complex simulations. The main focus of the project is the creation of an open and flexible internet platform for delivering multimedia-based learning units and the development of adaptive and intelligent authoring systems.

Computer-Assisted Instruction↗
PubMed2006

The clinical trial research participant as an inside trader: a legal and policy analysis.

This Article examines whether a participant in a clinical research trial for a drug obtains material nonpublic information about the drug and its manufacturer or licensor and, if so, whether the participant may lawfully trade securities based on that information. This issue has been noted but not examined in depth in several articles in recent years. After an introduction to the federal law of insider trading and a discussion of relevant aspects of a supervised research trial, the Article concludes that, absent an agreement to the contrary, the participant would be free to trade securities based on any material nonpublic information learned in the trial. The author evaluates the extent to which the information is material and nonpublic and then presents the policy issues surrounding whetherthe participantshould be precluded from trading when in possession of material nonpublic information gained as a result of participation in the trial. While not resolving the competing policy considerations, including the value of allowing participants to make disclosure of their experiences in the trial before publication of the results in a peer reviewed journal, the Article presents an approach for preventing the misuse of material nonpublic information gained in the clinical trial context, by obtaining an agreement from the participant, and an agreement from the limited circle of persons to whom the participant should be allowed to make disclosure in any event (such as his personal physician and family members), that would render any trading by them unlawful under the federal law of insider trading.

Clinical Trials as Topic↗
PubMed1995

Decategorizing health services: interim findings from the Robert Wood Johnson Foundation's Child Health Initiative.

Although results from the evaluation are preliminary thus far, certain tentative conclusions can be reached. First, both care coordination on a small scale and the production of community health report cards are achievable within the relatively short life of a foundation grant. Moreover, both efforts can result in tangible improvements for children and their families. Report cards associated with the initiative have made children's issues more prominent and appear to have led many community leaders to focus greater attention on children's needs. Likewise, many of the care coordination systems developed under the initiative have produced real change for children and their families by guiding them to needed health care and other services. It is important, however, to keep these accomplishments in perspective. While of significant benefit to demonstration communities, the monitoring and care coordination components of this initiative are not unique. A large number of communities have adopted monitoring and reporting programs in recent years. Similarly, care coordination efforts are well established in many communities. What is unique about the RWJF initiative is its attempt at decategorization, and much less progress has been demonstrated for this component. The less-than-hoped-for progress in implementing decategorization at the original sites appears to be the product of a number of interrelated factors. These include an absence of existing models and appropriate technical assistance; political difficulties in gaining cooperation from multiple local agencies involved in service provision; limited progress in establishing needed connections with the state and federal agencies that have authority over categorical programs; and difficulties in implementing major programatic changes when the health care system itself is undergoing rapid change. In combination, these barriers have proven to be largely insurmountable for the originally funded sites, although it is too early in the project to determine which of these factors is predominantly responsible for the lack of success. Whether the newer sites can learn from the experience of the first group and adapt strategies to overcome the multiple hurdles involved remains to be seen. Decategorization is a tool that has the potential to rationalize a fragmented service system by facilitating the coordination of services, especially for children and families with multiple needs. The need for decategorization of funds will not disappear, even if the federal government chooses to combine more of its grant programs to the states into block grants.(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMed2001

The School of Posture as a postural training method for Paraíba Telecommunications Operators.

This work proposes to show the experience of posture training accomplished in the Paraíba State Telecommunication Company, using the knowledge of the Back School. The sample was composed of 12 operators, employees of the company, representing 31% of this population. The model applied in TELPA (Paraíba Telecommunication Company, Brazil) was based on the models of Sherbrooke, Canada, and of the School of Posture of Paraìba Federal University. Fifty-eight point four percent of participants showed a reduction of column pain, 25% improved the quality of the rest and the received training was considered enough for the learning of correct postures at work in 75% of the cases. The whole population approved of the training, and 83.3% of the cases considered that this training influenced their lives very positively.

Adult↗
PubMedDate not supplied

Falling through the cracks: rehabilitation services for adults with learning disabilities.

The present study investigated the knowledge and perceptions of vocational rehabilitation (VR) of adults with learning disabilities (LD), as well as control variables which describe adults with LD and may have a bearing on access to VR services. This was accomplished by (1) determining the knowledge adults with LD had of their rights under federal rehabilitation regulations; (2) examining demographic control variables (e.g., sex, age, education level, hometown population, employment history, and income), which may have a bearing on the need for or access to VR services by adults with LD; and (3) examining experiences/perceptions of adults with LD regarding the VR application/eligibility process. A pretested questionnaire appeared in the January 1989 ACLD Newsbriefs. Findings indicate that while there was a group of respondents who were satisfied with the rehabilitation services they had received, there was also a large group of respondents who were either ineligible for rehabilitation services or dissatisfied with services they received. Generally, respondents' knowledge of VR was limited.

Achievement↗
PubMed1998

Effective regulatory approval process for food ingredient technologies.

Most sciences and technologies related to food safety have advanced exponentially over the 40 years since passage in the U.S. of the Food Additive Amendment of 1958 to the Federal Food, Drug and Cosmetic (FD&C) Act. Effective regulatory decision making places a high premium on competent professional and administrative judgement applied to sound scientific data. This review discusses changes and lessons learned in the food safety sciences over the last 4 decades. Other segments of the safety and compliance infrastructure necessary to assure that the public receives safe and wholesome foods have not kept pace with the new scientific knowledge. The quality of foods in our marketplace can be improved only after the regulatory and legislative segments of the infrastructure, discussed in a companion symposium paper, are brought into better synchrony with the sciences.

Agriculture↗
PubMed2003

Does the Animal Welfare Act apply to free-ranging animals?

Despite the long-standing role that institutional animal care and use committees (IACUCs) have played in reviewing and approving studies at academic institutions, compliance with the Animal Welfare Act (AWA) is not always complete for government natural resource agencies that use free-ranging animals in research and management studies. Even at universities, IACUCs face uncertainties about what activities are covered and about how to judge proposed research on free-ranging animals. One reason for much of the confusion is the AWA vaguely worded exemption for "field studies." In particular, fish are problematic because of the AWA exclusion of poikilothermic animals. However, most university IACUCs review studies on all animals, and the Interagency Research Animal Committee (IRAC) has published the "IRAC Principles," which extend coverage to all vertebrates used by federal researchers. Despite this extended coverage, many scientists working on wild animals continue to view compliance with the AWA with little enthusiasm. IACUCs, IACUC veterinarians, wildlife veterinarians, and fish and wildlife biologists must learn to work together to comply with the law and to protect the privilege of using free-ranging animals in research.

Animal Care Committees↗
PubMed1988

Health promotion in medical education.

A significant portion of the deaths in the United States could have been prevented or postponed using known interventions. One reason this did not occur is because medical science and medical education are disease, not health, oriented. Since physicians are at the center of the health care delivery system, their disease orientation pervades the industry. Historically, there have been calls for physicians to focus more on disease prevention; however, medical education does not teach disease prevention/health promotion. There are several reasons for this: 1) medical school faculty conceptual discordance between "certainty" of curative disease vs. the "probability" of risk factor reduction; 2) gaps in the knowledge of effective interventions; 3) the concept that health promotion/disease prevention are outside the province of physicians; 4) the significant role of biomedical research grants on medical school funding; 5) the close association of medical education and the acute care hospital; and 6) the use of rote memory/lecture based teaching methods of traditional medicine vs. the problem-based learning necessary to teach disease prevention/health promotion. Some medical schools have begun to use problem based learning and to introduce health promotion concepts. Widespread and long-lasting change requires support of the leadership in medical schools and the preventive medicine/public health community, and grant funding from state and federal sources to support research on medical education research and change.

Curriculum↗