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PubMed2001

Safeguards at risk: John Graham and Corporate America's Back Door to the Bush White House Excerpts from a Public Citizen report.

The non-profit consumer organization Public Citizen released an investigatory report in March about the activities of industry-backed academic John Graham, head of the Harvard Center for Risk Analysis, who has been nominated by President Bush to lead the Office of Information and Regulatory Affairs (OIRA) within the White House s Office of Management and Budget (OMB). Public Citizen said at the time that the appointment would give industry a back door to the White House and enable it to step up its campaign to dismantle basic consumer protections under the pretense of applying sound science. Graham s nomination poses troubling implications, Joan Claybrook, president of Public Citizen, said. Rather than being a fair-minded assessor, Graham would continue to conspire with the chemical polluters, the tobacco industry, automakers, the oil and gas industries and others to stop the issuance of safety protections. The Senate must delve into the many conflicts he would bring to the job and reject this nomination. Below, we excerpt two portions of the Public Citizen report. One shows Graham s many corporate relationships; the other explains his involvement in environmental tobacco smoke issues. The full report, including the references that are omitted here, is available at www.publiccitizen.org. The report was researched and written by Laura MacCleery, with assistance from Paul Schmitt, Debbie Quint, Daniel Becker, and Ed Ricci. Editorial assistance and direction were given by Joan Claybrook, Booth Gunter, Angela Bradbery, Melissa Luttrell and David Vladeck.

Journal Article↗
PubMed1991

The Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS). An analysis of pass rates of the July 1984 through July 1987 examinations.

This report examines the experience of 48,509 (40,393 foreign nationals and 8,116 U.S. citizens) foreign medical students and graduates (FMGs) who took any part of the first seven Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) administered by the Educational Commission for Foreign Medical Graduates. The pass rate on all three sections (basic science, clinical science, and English) was 23.0%. Almost one-half (47.2%) of all FMGEMS examinees were between 25 and 29 years of age, 73.9% were men, 71.5% took FMGEMS after medical school graduation, and 79.7% claimed as their native tongue languages other than English. Correlates of pass rates included taking FMGEMS before medical school graduation (30.0% pass) and being a native English speaker (37.5% pass). The rates for foreign national FMGs (FNFMGs) and United States FMGs (USFMGs) were 22.5% and 25.2%, respectively. Native English-speaking FNFMGs achieved a 43.3% pass rate; native English-speaking USFMGs, 32.6%; non-native English-speaking FNFMGs, 19.9%; and non-native English-speaking USFMGs, 11.2%. Whereas FMGs were educated in 114 countries, 74.2% of USFMGs were educated in just eight countries, all located in the West Indies and Mexico. Logistical regression analysis showed that the strongest factors predicting full pass rates were being both younger than 30 years of age and a native English speaker. Conclusions are that approximately 3,200 FMGs per year pass FMGEMS and that FMGs with the highest probability of passing share characteristics of U.S. and Canadian medical graduates who pass the National Board medical examinations, which suggests that the latter examinations, when offered to FMGs, may have limited effect on overall pass rates.

Achievement↗
PubMed2000

Scientific animal breeding in Moravia before and after the rediscovery of Mendel's theory.

Leading Moravian sheep breeders, who joined with university professors and other educated citizens to form a Sheep Breeders' Society in 1814, looked to science to provide a reliable basis for breeding. Their activities reached a climax in the 1830s, when they defined and focused on heredity as the central research goal. Among the members taking part was Abbot Cyrill F Napp, who in 1843 would accept Mendel into the monastery. The contributions of Abbot Napp to the sheep breeders' view of heredity are here described. After 1900, when Moravian animal breeding sought to embrace Mendelism, in competition with other theories, a major influence was exerted by Jaroslav Krízenecký (1896-1964). In 1963, Krízenecký accepted responsibility for establishing the Mendel Museum (Mendelianum) in Brno as a vehicle for historical research into the origin and essence of Mendel's discovery.

Animal Husbandry↗
PubMed1979

Accountability in health care: an essay on mechanisms, muddles, and mires.

This paper presents a critical evaluation of several theories of accountability and their applicability to health care concerns. The authors first provide a preliminary refinement of the imprecise concept of accountability itself and then examine four major types (political; bureaucratic; professional; and economic-consumer). Then, by using disciplinary perspectives provided by several schools of thought in political science (legislative supremacy; general manager theory; government by bureaucracy; objective responsibility; citizen participation), they discuss the degree of accountability presently found in various American health policies. After identifying the inherent dilemmmas within any credible accountability approach to health care programs as now utilized in the United States, the authors recommend that all types of accountability be integrated and strengthened by relying more explicitly on practices characteristic of development administration.

Delivery of Health Care↗
PubMed2003

A women's scientific society in the west. The late eighteenth-century assimilation of science.

The Natuurkundig Genootschap der Dames (Women's Society for Natural Knowledge), formally established by and for women, met regularly from 1785 to 1881 and sporadically until 1887. It challenges our stereotypes both of women and the physical sciences during the eighteenth century and of the intellectual interests open to women in the early European republics. This essay aims not simply to identify the society and its members but to describe their pursuits and consider what their story adds to the history of Western science. What does this society's existence tell us about the relationship between women and early science in general and about science and society in the Dutch setting in particular? Science and gender look rather different when observed through the activities of the immensely prosperous women of Middelburg, citizens of one of the most highly literate Western countries. The elite lives of the first-generation members of the women's society also offer us a glimpse into the early domestication of science, a process vital to its acceptance and assimilation.

Female↗
PubMed1999

Are our universities producing too many PhDs?

As we enter the 21st century, we face a world that will be increasingly dominated by science and technology. More and more jobs will require many of the analytical and thinking skills of a scientist. Citizens everywhere must also become better able to evaluate and understand the judgements of scientific and technical experts when making personal and community decisions. To spread the values and knowledge of science much more widely throughout our societies, we must also spread scientists. Therefore, advanced training in science and the acquisition of important skills through an extensive exposure to research are valuable tools for a wide variety of occupations.

Education, Graduate↗
PubMed2005

Increasing awareness of health care resources for the uninsured and underinsured:a pilot study.

Programs are available to provide assistance to the uninsured, but information about how to access those programs is not readily available to the average uninsured citizen. A pilot study involving the University of Kentucky Family and Consumer Science Agents and Homemaker groups in two rural counties significantly increased the number of people who accessed one of the programs, Health Kentucky. Findings from the study could be validated in other Kentucky counties and with other types of health-related messages.

Adolescent↗
PubMed1991

Population behavior change: a theory-based approach.

Behavioral science provides useful ideas about how programs of mass communication and community participation can produce synergistic influences on the lifestyles and policy decisions of populations and their representatives. Media campaigns featuring real-life behavior models and community networks mobilized to promote behavior change provide a theoretically sound paradigm for community-level activities to accelerate the diffusion of innovation in health. Illustrative case studies demonstrate how behavioral science concepts can be applied to preventing HIV infections and to promoting citizen lobbying against selected nuclear weapons systems.

Health Behavior↗
PubMed2000

Telemedicine at the top of the world: the 1998 and 1999 Everest extreme expeditions.

The National Aeronautics and Space Administration (NASA) initially established a Commercial Space Center (CSC) in the Department of Surgery at Yale University School of Medicine to further develop and evaluate technologies in information systems, telecommunications applied to medicine, and physiologic sensors. The CSC is known as the Medical Informatics and Technology Applications Consortium (MITAC). The overall purpose for this NASA program is to leverage technology, innovation, and resources from industry and academia through collaborative partnerships. The Yale-NASA CSC/MITAC organized the Everest Extreme Expeditions (E3) for the spring Himalayan climbing seasons in the years 1998 and 1999. The primary mission was to deliver advanced medical support with global telemedicine capabilities to one of the world's most remote and hostile settings--Mount Everest. The purpose was both humanitarian (providing medical support) and scientific (conducting medical and technology research). The Yale team provided medical care for the Everest Base Camp community; conducted validation experiments for several types of advanced medical technologies in this remote, hostile environment; and performed real-time monitoring of selected climbers, while also assessing the basic science of altitude physiology. Additionally, the teams conducted outreach medical care to the citizens of Nepal and provided several educational forums for a variety of medical and nonmedical personnel--including school-age children. As part of the project's mission, the E3 medical teams at both Nepal and New Haven were on a 24-hour emergency call system to deliver medical care in the event of a crisis. Unlike most of the teams at Everest, the mission of E3 was not to climb the 29,028-foot mountain the Nepalese call Sagarmatha ("Sky Head"). The mountain served as an extreme testing ground for telemedicine. The lessons learned from this testbed are reviewed here and further clarify the abilities to provide better health care in remote and extreme environments--which for some may even be their home environment during/after a medical illness.

Altitude Sickness↗
PubMed1983

Psychiatry without asylums: origins and prospects in Italy.

In 1978, Italy became the first country in the world to pass a law eliminating mental hospitals and replacing them with services in the community. This victory was in large part due to the foresight and commitment of psychiatrist Franco Basaglia and his colleagues, whose work showed how psychiatric assistance could be realized in practice without asylums and without force and violence. This article analyzes why the anti-institutional reform took place in Italy when it did, and reviews twenty years of reform activity involving an alliance between democratic mental health professionals, politicians, workers' organizations, and private citizens. Although the reform gives psychiatry the opportunity to transform itself into a science of liberation, conservative political and scientific forces are attempting to maintain the logic of the asylum and replace the mental hospital with other institutions which continue to practice segregation in a decentralized form. The outcome of this radical experiment in creating a nonrepressive psychiatry remains uncertain.

Commitment of Persons with Psychiatric Disorders↗
PubMed2002

[The age of formation of Czech clinical medicine].

Era of Emperor Francis Joseph I is said to be a golden age for the Czech nation. It can be found in numerous panegyric articles to any jubilee of the emperor's rule. What was formally dictated by respect brought by education and by the system of the Greek and Roman tradition adopted in Austria in Middle Ages, seams to be valid today as most of the contemporary technical and economical progress roots within those days. The Czech cultures namely music and art reached international acknowledgement. Though with difficulties, Czech achieved in education and in science as a full-fledged language. After the year 1848 an average citizen was entitled to such freedom as never before. Technical, economical and cultural progress enabled real ascent of the Czech society and its social differentiation. In sixties, after the Austria-Hungary Alignment, Hapsburg government undertook no serious restrains. Such development was nothing unusual. Similar one underwent after the period of storms all European societies from south to north and form west to east. They brought ideas of the French revolution and years 1848/1849 are therefore called "the spring of European nations". In all countries where revolutionary ideas were represented and various countermeasures were accepted, governments were forced to accept temporary arrangements (in Austrian monarchy it was the promise of constitution, language compromise etc.). Nevertheless, in the second half of the 19th century the most important condition for further revival was the long period of peace and stability of international relations. The internal stability of the Austrian monarchy was achieved for long time by the Austria-Hungary Alignment in 1867. After the lost battle at Hradec Kralove in summer 1866 it became clear that contemporary centralistic organization of the state, balancing between absolutism and constitutionalism is not further tenable. Years long pressure of patriotic forces in the parliament brought about division of the Charles-Ferdinand University. Important role in the partition of the Czech Medical Faculty from the German one had the foundation of the Czech Medical Society and the Czech Medical Journal in 1862 patronaged by professors Purkynĕ, Eiselt, Grégr and others. That was the platform for the conception of the Czech medical terminology. Partition of faculties was decided by the law, which was accepted at February 28, 1882. The Czech Medical Faculty was opened only at 1883 because Emperor resolved that professors themselves had to decide to either faculty their clinics would belong. Only professor Eiselt with the First clinic of internal medicine, Weiss with the clinic of surgery and Streng with clinic of obstetrics were assigned to the Czech faculty. Till the official opening on October 15, 1882 all other departments and clinics had to be organized. Though Professor Vilem Weiss as the head of the department and dean of the faculty had his opening Czech lecture already on April 28, 1882, due to material and personal reasons the Czech Medical Faculty was opened only one year later than Faculties of law and philosophy. Most of the eminent members of the Medical faculty remained at the German faculty. However, having higher number of students the Czech faculty became larger and was attended by students from the whole Slavonic world.

Austria↗
PubMed2003

Further notes on public response to uncertainty in risks and science.

Given the prevalence of uncertainty and variability in estimates of environmental health risks, it is important to know how citizens interpret information representing uncertainty in risk estimates. Ranges of risk estimates from a hypothetical industry source elicited divergent evaluations of risk assessors' honesty and competence among New Jersey residents within one mile of one or more factories. A plurality saw ranges of risk estimates as both honest and competent, but with most judging such ranges as deficient on one or both dimensions. They wanted definitive conclusions about safety, tended to believe the high end of the range was more likely to be an accurate estimate of the risk, and believed that institutions only discuss risks when they are "high." Acknowledgment of scientific, as opposed to self-interested, reasons for uncertainty and disputes among experts was low. Attitude toward local industry seemed associated with, if not a cause of, attitudes about ranges of risk estimates. These reactions by industry neighbors appear to replicate the findings of Johnson and Slovic (1995, 1998), despite the hypothetical producer of risk estimates being industry instead of government. Respondents were older and less educated on average than were the earlier samples, but more diverse. Regression analyses suggested attitude toward industry was a major factor in these reactions, although other explanations (e.g., level of scientific understanding independent of general education) were not tested in this study.

Adolescent↗
PubMed2002

Emergency medical dispatch.

EMD will always remain somewhat of an imprecise science by nature. 911 is, after all, the access point for lifesaving assistance, and citizens must have absolute freedom to this service. The consequence of having the freedom to request help from any location at any time is that some individuals will use it for the wrong reasons. Present-day dispatchers must serve ever-broadening communities with multiple languages, cultural diversity, and unique health needs. Along with other essential personnel that make up the fabric of the public safety net, emergency medical dispatchers have now become essential to the provision of time-critical skills and compassion for perceived medical emergency.

Allied Health Personnel↗
PubMedDate not supplied

[Mass-Media and nurses: opportunities and remembrances of an evolving professional].

The actual Model that is developing in the relationship between who is giving (provider) and who is receiving health care, it is near to exceed the "modello paternalista" that for a long time used the citizen as people observing and collaborating, with the one were taking the decision according to the science. This kind of relationship, strongly without balancing, often produced an education of Health care operators, do not able to listen the people needs (Rotary International 2002) To defend this system someone stress the follow points: the patient does not have the right knowledge; the physical and mental conditions of the patient could be influenced, the different aims between patient and health care staff; the patient difficulty, to describe own feeling. The upper sentences shown an auto-referring System, do not well adapted to receive consent, to share aims, to satisfy needs; according to the respect of the sick (or patient), his values and his autonomy chosen; that comes from the developing of the social relationship. The communication is a tool that we can use to exceed this problem, if we understand the communication as a sharing and informative instrument the study leaded, shown how the nurses used the communication and its channels to share with the citizens the aims concerning the health; goals that the nursing acquired according to the principles declared in the Nurse/citizen Act.

Adult↗
PubMed1996

Global linkages in animal agriculture: new opportunities for United States agricultural universities.

Today's rapidly changing world offers new opportunities for Departments of Animal Science that wish to expand their international activity. Seeking a relevant role in the definition of sustainable agriculture, internationalizing courses and curricula for all students, supporting private sector enterprises at home and abroad (export promotion), maintaining collaboration with former students, and providing better information to our farmers and citizens about world conditions: these are some of the challenges now facing us. A survey of heads of departments of animal science at universities in the United States revealed that of 64 respondents, almost all report significant international activities. However, only 20% are satisfied with their present activity level, and 80% intend to seek an expanded international role. The expected benefits from international activity most often mentioned were a broadened faculty experience and a better capacity to prepare students for the 21st century. Anticipated problems are related to faculty and departmental recognition, faculty career trajectories, and continuity of work assignments. On balance, respondents overwhelmingly believe that expected benefits outweigh possible problems. Eighty percent of respondents reported a generally supportive attitude from their administration, but 75% indicated that the department itself needs to provide leadership in the search for new international linkages.

Agriculture↗
PubMed2001

Strengthening user participation through health sector reform in Colombia: a study of institutional change and social representation.

The challenge of achieving community participation as a component of health sector reform is especially great in low- and middle-income countries where there is limited experience of community participation in social policy making. This paper concentrates on the social representations of different actors at different levels of the health care system in Colombia that may hinder or enable effective implementation of the participatory policy. The study took place in Cali, Colombia and focused on two institutional mechanisms created by the state to channel citizen participation into the health sector, i.e. user associations and customer service offices. This is a case study with multiple sources of evidence using a combination of quantitative and qualitative social science methods. The analysis of respondents' representations revealed a range of practical concerns and considerable degree of scepticism among public and private sector institutions, consumer groups and individual citizens about user participation. Although participation in Colombia has been introduced on political, managerial and ethical grounds, this study has found that health care users do not yet have a meaningful seat around the table of decision-making bodies.

Attitude to Health↗