Implementation of state and local grants programs [microform] : hearing before the Select Committee on Narcotics Abuse and Control, House of Representatives, One Hundredth Congress, second session, May 26, 1988.

"SCNAC-100-2-6."

Doctors and their patients: A context for understanding the wish to hasten death

There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n = 24) involved in the treatment and care of terminally ill patients were (i) the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii) the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii) the doctors' attitudes to euthanasia and (iv) the doctors' perception of their patients' views/beliefs 'regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group. This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill. Copyright (C) 2003 John Wiley Sons, Ltd.

Supervision practices in allied mental health: Relationships of supervision characteristics to perceived impact and job satisfaction

This study examined whether supervision characteristics impacted on mental health practice and morale, and developed a new Supervision Attitude Scale (SAS). Telephone surveys were conducted with a representative sample of 272 staff from public mental health services across Queensland. Although supervision was widely received and positively rated, it had low average intensity, and assessment and training of skills was rarely incorporated. Perceived impact on practice was associated with acquisition of skills and positive attitudes to supervisors, but extent of supervision was related to impact only if it was from within the profession. Intention to resign was unrelated to extent of supervision, but was associated with positive attitudes to supervisors, accessibility, high impact, and empathy or praise in supervision sessions. The SAS had high internal consistency, and its intercorrelations were consistent with it being a measure of relationship positivity. The study supported the role of supervision in retention and in improving practice. It also highlighted supervision characteristics that might be targeted in training, and provided preliminary data on a new measure.

Action research to explore perceptions of risk in project management

Uses research in a major UK company on the introduction of an electronic document management system to explore perceptions of, and attitudes to, risk. Phenomenological methods were used; with subsequent dialogue transcripts evaluated with Winmax dialogue software, using an adapted theoretical framework based upon an analysis of the literature. The paper identifies a number of factors, and builds a framework, that should support a greater understanding of risk assessment and project management by the academic community and practitioners.

Willingness to speak out about gay law reform: Some cause for optimism

We examined the extent to which people's private attitudes to gay law reform are influenced by the attitudes of others. Ninety-six university students were told that they were either in a minority or in a majority relative to their university group on their attitudes to gay law reform. Contrary to a number of assumptions made in the social psychological literature, participants who supported gay law reform were more prepared to act in line with their attitudes than were those who opposed gay law reform. Furthermore, anti-gay law reform participants appeared to reassess their attitudes when they were told they were in a minority; in contrast, pro-gay law reform participants were Unaffected by the group norm. This suggests that anti-gay law reform attitudes are softer and more easily influenced than are pro-gay law reform attitudes. The implications of these results for activists are discussed. (C) 2004 by The Haworth Press, Inc. All rights reserved.

Factors underlying support or opposition to biotechnology among Australian food consumers and implications for retailer-led food regulation

Despite current findings that consumers, on average, have negative attitudes to biotechnologies such as cloning and genetic engineering, considerable variability can be found in the direction and strength of these attitudes. This paper presents a path analysis of attitudinal, motivational, demographic and behavioural variables that influence consumer dispositions towards biotechnology. Among these variables, those found to be most important were: consumers' level of motivation to find natural foods; the extent to which they were motivated by convenience; whether they did the shopping for their household on a regular basis; and their sex. In terms of direct effects on dispositions to biotechnology, motivation to find natural foods had a very strong negative effect while convenience had a very strong positive effect. Sex had a moderate direct effect with women less likely to be positively disposed towards biotechnology than men. In an apparent contradiction, taking responsibility for household shopping had an equally strong positive effect on both naturalness and convenience. However, sex also played a crucial role here with a very strong effect on motivation to find natural foods (women more motivated), a minor effect on convenience (women less motivated) and a strong effect on responsibility for household shopping (women more likely to shop). The policy implications of these findings are important, given the apparent oppositional trends of some sections of the food industry to endorse biotechnology, and of the supermarkets to deliver `clean and green' non-GM foods to consumers. (c) 2005 Elsevier Ltd. All rights reserved.

Stormy Outlook? Domestic students' impressions of international students at an Australian University

The education of international students in Australian universities has grown significantly over recent years, with Australia now having the highest ratio of international students to domestic students among the major English-speaking destinations popular with international students. While there is a variety of research that examines the learning experiences of international students, little research has been conducted that examines the impact that international students have on their domestic counterparts. This paper reports on research that solicits the perceived advantages and disadvantages held by 301 domestic students, who are sharing their educational experience with international students studying hospitality and tourism management. The study reveals that there is a sizable proportion of domestic students (28%) who consider that there are too many international students on campus; that domestic and international students do not readily mix and it also highlights the fact that racist incidents occur. It is suggested that institutions wishing to increase their number of international students must take into consideration the feelings and concerns of their domestic students.

Does being against euthanasia legislation equate to being anti-euthanasia?

This study investigated issues raised in qualitative data from our previous studies of health professionals and community members, which suggested that being opposed to euthanasia legislation did not necessarily equate to being anti-euthanasia per se. A postal survey of 1002 medical practitioners, 1000 nurses and 1200 community members was undertaken. In addition to a direct question on changing the law to allow active voluntary euthanasia (AVE), four statements assessed attitudes to euthanasia with or without a change in legislation. Responses were received from 405 doctors (43%), 429 nurses (45%) and 405 community members (38%). Compared with previous studies there was a slight increase in support for a change in the law from medical practitioners, a slight decrease in support from community members and almost no change among nurses. Different interpretations of the results of the four attitude questions are possible, depending on the perspective of the interpreter.

DINÂMICA PSÍQUICA E EFICÁCIA ADAPTATIVA DE PACIENTES COM DIABETES MELLITUS TIPO 2

O diabetes é uma doença crônica conhecida há aproximadamente 3.500 anos e que atinge, atualmente, cerca de 18,8 milhões de pessoas no mundo, sendo, portanto, de grande interesse a diversos pesquisadores das mais variadas áreas. Esta doença é resultante de uma insuficiência de insulina, que desempenha papel fundamental nos processos metabólicos do organismo. A incidência do Diabetes Mellitus tipo 2 tem apresentado um considerável crescimento nas últimas décadas, principalmente decorrente da elevada expectativa de vida e, também, pelo resultado de comportamentos destrutivos a saúde, como o abuso de substâncias, dieta inadequada e um estilo de vida sedentário. O presente estudo teve por objetivos avaliar a Qualidade de Vida, a dinâmica psíquica, a eficácia adaptativa e verificar os níveis glicêmicos de pessoas com Diabetes Mellitus tipo 2 participantes de um grupo psicoeducativo. Participaram deste estudo 14 pessoas com Diabetes Mellitus tipo 2. Os instrumentos utilizados foram: 1. Escala da Associação Brasileira de Institutos de Pesquisa de Mercado (ABIPEME); 2. Escala Diagnóstica Adaptativa Operacionalizada (EDAO); 3. Teste das Relações Objetais de Phillipson (TRO); e, 4. WHOQOL-bref. Os resultados mostraram que alguns pacientes apresentaram uma melhora significativa em seus níveis glicêmicos após a realização do grupo psicoeducativo, mesmo verificando que alguns não atingiram ainda bom controle de sua glicemia. A qualidade de vida destes participantes apresentou-se com níveis muito bons. Ao avaliar a eficácia adaptativa e a dinâmica psíquica destes participantes, verificou-se o quanto é difícil aceitar que se tem uma doença crônica e ter atitudes para realizar o tratamento adequado. Concluímos que para estas pessoas com diabetes poderem aderir ao tratamento é necessário que ele apresente uma boa capacidade de solucionar conflitos, e, apresente seu mundo interno ligado à posição depressiva. Se estes fatores estiverem equilibrados o estilo de vida e o bem-estar desses pacientes serão positivos, de modo que eles possam apresentar consequentemente um bom prognóstico com menos complicações da doença durante mais tempo de vida.

Foreign direct investment, access to finance, and innovation activity in Chinese enterprises

A recent, comprehensive database is used to investigate the link between inward foreign direct investment (FDI) and innovation activity in China. The results of the analysis suggest that private and collectively owned firms with foreign capital participation and those with good access to domestic bank loans innovate more than other firms do. Among enterprises not owned by the state, inward FDI at the sectoral level is positively associated with domestic innovative activity only among firms that engage in their own research and development or that have good access to domestic finance. At the sector level the effect of inward FDI into technology transfer is distinguished from the effect on domestic credit opportunities. FDI affecting credit is of little significance for state-owned enterprises and is independent of their access to finance. In contrast, better access to credit is an important channel through which FDI affects the innovation of domestic private and collectively owned enterprises.

eHealth as a challenge to `expert' power: a focus group study of internet use for health information and management

Objective To investigate current use of the internet and eHealth amongst adults. Design Focus groups were conducted to explore participants' attitudes to and reasons for health internet use. Main outcome measures The focus group data were analysed and interpreted using thematic analysis. Results Three superordinate themes exploring eHealth behaviours were identified: decline in expert authority, pervasiveness of health information on the internet and empowerment. Results showed participants enjoyed the immediate benefits of eHealth information and felt empowered by increased knowledge, but they would be reluctant to lose face-to-face consultations with their GP. Conclusions Our findings illustrate changes in patient identity and a decline in expert authority with ramifications for the practitioner–patient relationship and subsequent implications for health management more generally.

Transglutaminase treatment of wool fabrics leads to resistance to detergent damage

Biological detergents are now routinely used in domestic laundry because the enzymes they contain provide the added benefit of low temperature washes with improved cleaning performance. One of the key enzymes found in these detergents are proteases, which if exposed to natural protein fibres such as wool or silk can cause irreversible damage, leading to loss of fabric strength, shape and poor colour fastness. Transglutaminases (TGases) are protein cross-linking enzymes capable of adding tensile strength to wool proteins, and as a consequence are capable of remediating the damage caused by previous chemical treatments, and more importantly, by proteases. In this paper we treated dyed wool fabric with TGase and then washed the fabric with biological and non-biological detergents to investigate whether TGases would protect wool garments from damage by the undue use of biological detergents in domestic laundry. We demonstrate using different cycles of detergent washes containing biological and non-biological detergents and different TGase treatments, that wool fabric treated previously with TGase release less dye into the washing liquor and in addition maintain fabric strength at levels greater than the washed controls. As a consequence, wool garments previously treated with TGase are likely to have increased resistance to domestic washing and thus provide increased longevity. © 2005 Elsevier B.V. All rights reserved.

Ownership characteristics and access to finance:evidence from a survey of large privatised companies in Hungary and Poland

We examine financial constraints and forms of finance used for investment, by analysing survey data on 157 large privatised companies in Hungary and Poland for the period 1998 - 2000. The Bayesian analysis using Gibbs sampling is carried out to obtain inferences about the sample companies' access to finance from a model for categorical outcome. By applying alternative measures of financial constraints we find that foreign companies, companies that are part of domestic industrial groups and enterprises with concentrated ownership are all less constrained in their access to finance. Moreover, we identify alternative modes of finance since different corporate control and past performance characteristics influence the sample firms' choice of finance source. In particular, while being industry-specific, the access to domestic credit is positively associated with company size and past profitability. Industrial group members tend to favour bond issues as well as sells-offs of assets as appropriate types of finance for their investment programmes. Preferences for raising finance in the form of equity are associated with share concentration in a non-monotonic way, being most prevalent in those companies where the dominant owner holds 25%-49% of shares. Close links with a leading bank not only increase the possibility of bond issues but also appear to facilitate access to non-banking sources of funds, in particular, to finance supplied by industrial partners. Finally, reliance on state finance is less likely for the companies whose profiles resemble the case of unconstrained finance, namely, for companies with foreign partners, companies that are part of domestic industrial groups and companies with a strategic investor. Model implications also include that the use of state funds is less likely for Polish than for Hungarian companies.

Germany and the European union:from 'tamed power' to normalized power?

Germany has traditionally played a key role in promoting European Union solutions to domestic policy problems. In doing so it gained a reputation as a 'tamed power' (Katzenstein). This article reviews Germany's diplomacy two decades after unification. It explores the 'tamed power' hypothesis with reference to three policy areas: constitutional reform in the EU; Justice and Home Affairs policy; and an issue that has made German European policy very salient of late, the management of the Eurozone. The article argues that Germany has become a much less inclusive actor in European policy, pursuing policy solutions through 'pioneer groups' where these offer greater promise than the EU itself and becoming increasingly attentive to domestic political constraints. The article argues that Germany has become a normalized power, with significant implications for the EU. © 2010 The Author(s). International Affairs © 2010 The Royal Institute of International Affairs.

Validity and reliability of the Spanish version of Caregiver Abuse Screen (CASE)

Detection of elder abuse risk is a critical issue because a lot of cases remain hidden. Screening tools can be used to detect elder abuse. However, few tools have been developed for use with caregivers. The purpose was to develop a translation and adaptation of a Spanish version of the Caregiver Abuse Screen (CASE) and to assess its validity and reliability. The CASE was then used with 211 primary caregivers. Validity and reliability were evaluated, as well as the factorial structure of the instrument. This version showed good psychometric properties. It was found to have strong internal consistency and split-half reliability as well as allowing for a good replication of the original factorial structure. Additionally, several variables related to elder abuse were linked to the CASE such as depression, burden, frequency, and reactions to problem behaviors. The version developed showed sufficient validity and reliability and could be considered as a suitable instrument to assess risks of elder abuse in a Spanish-speaking context.