"I understood what she meant when she said '21st century medicine'": A qualitative analysis of patient responses for plans for colorectal cancer screening following a recommendation from their physician

Although physician recommendation has been significantly associated with colorectal cancer screening (CRCS), it still does not motivate all patients to get CRCS. Although improved physician recommendation for CRCS has been shown to increase patient CRCS screening, questions remain about what elements of that discussion may lead to screening. The objective of this study is to describe patients' perceptions and interpretations about their physician's recommendation for CRCS during their annual wellness exam. A subset of patients (n=51) participating in a supplement study of a behavioral intervention trial designed to increase CRCS completed a follow-up, open-ended interview two to four weeks after their annual wellness visit. Using qualitative methods, transcripts of these interviews were analyzed. Findings suggest that most patients would follow their physician's recommendation for CRCS despite not engaging in much discussion. Patients may refrain from CRCS discussion because of a commitment to CRCS, awareness of screening guidelines, and trust in physician's honesty and beneficence. Yet many patients left their wellness exams with questions, refraining because of future plans to consult with their physicians, perceived time constraints or a lack of a patient-physician relationship. If patients are leaving their wellness exams with unanswered questions, interventions should prepare physicians for patient reticence, teaching physicians how to assure patients that CRCS is a primary care activity where all questions and concerns, including cost and scheduling, may be resolved.^

Family to Family: Child Welfare for the 21st Century

Child welfare services have undergone many revisions and transformations since their initiation. Some scholars trace the beginning of child welfare in the United States to events such as a 1655 Massachusetts conviction for maltreatment leading to the death of a 12-year-old boy (Watkins, 1990). The predominant philosophy of child welfare has shifted over time from an early emphasis on child saving, to child protection, to family preservation. Building on family preservation, one of the current transformations in child welfare that is taking place in isolated pockets to whole states, is family-centered, neighborhood-based services. One force behind implementation of this transformation is the Family to Family Initiative of the Annie E. Casey Foundation. This paper places family-centered, neighborhood-based child welfare services within the historical context of development of child welfare and within the recent move to reinvent human services (Adams & Nelson, 1995). Against this backdrop, a locality-based implementation of the Family to Family Initiative is described.

Project based learning activities as a means of adapting conventional curricula to the demands of the 21st century aeronautical engineer: The design and building of the EYEFLY 1.

In this paper we report the process of designing and building the EYEFLY 1, a real UAS platform which has just performed its maiden flight. For the development of this aircraft, 30 groups of students from successive years at the Escuela Universitaria de Ingeniería Técnica Aeronáutica (EUITA) of the Universidad Politécnica de Madrid (UPM) carried out their compulsory End of Degree Project as a coordinated Project Based learning activity. Our conclusions clearly indicate that Project Based Learning activities can provide a valid complement to more conventional, theoretically-based, teaching methods. The combination of both approaches will allow us to maintain traditional but well-tested methods for providing our students with a sound knowledge of fundamental engineering disciplines and, at the same time, to introduce our students to exciting and relevant engineering situations and sceneries where social and business skills, such as communication skills, team-working or decision-taking, can be put into practice.

Changes in the governance system for higher education in Peru to meet the challenges of the 21st century

The competition in markets, the distribution of limited resources based on productivity and performance, and the efficient management of universities are changing the criteria of trust and legitimacy of the educational system in Peru. Universities are perceived more as institutions of the public sector, while the services they offer must rather contribute to the modernization of the emerging society and the knowledge economy. Higher Educations reforms - initiated in the 1980s - have been inspired by the successful university organizations that have managed to change their governance and addressed to transform certain bureaucratic institutions into organizations capable of playing active role in this global competition for resources and best talent. Within this context, Peruvian universities are facing two major challenges: adapting themselves to new global perspectives and being able to develop a better response to society demands, needs and expectations. This article proposes a model of governance system for higher education in Peru that gives a comprehensive solution to these challenges, allowing dealing with the problems of universities for their development and inclusion within the global trends. For this purpose, a holistic and qualitative methodologic approach was developed, considering an integrated method which considered educational reality as a whole, understanding its facts, components and elements that affects its outcomes. It is proposed to define a policy for university education in Peru that permeates society, by changing the planning model from a social reform model to a policy analysis model, where the Peruvian State acts as sole responsible for responding to the demanding society as its legal representative complemented with some external and independent bodies that define the basis of best practice, as it is being done in many university models worldwide.

"Another Way": The Pneumatology of Deleuzean Minoritarian Communal Interpretation in Scripture, the 16th Century Radical Reformation, and Alternative 21st Century Anabaptist Community

This dissertation proposes a constructive theology of the Holy Spirit called the "pneumatology of minoritarian communal interpretation," the alternative creation of meaning within an oppressive majority context. It illustrates the convergence of Deleuzean philosophy with Anabaptist pneumatology and media communal interpretation theory in three particular locations: 1) selected mentions of the Holy Spirit in the Hebrew Bible and Christian New Testament; 2) the 16th century Radical Reformation; and 3) "Another Way," a 21st century alternative Anabaptist group focused around the spiritual discussion of art and popular media. Chapter One outlines the three theories. Chapter Two examines the Holy Spirit in the Hebrew Bible, particularly 1 Samuel 8, the book of Ezekiel, and the Gospel narratives. Chapter Three examines the pneumatological writings of the Radical Reformers, concentrating particularly on their theologies of the intersection between church and the surrounding majoritarian culture. Chapter Four outlines my original field research with Another Way, and examines the tension between minoritarian communal interpretation and the 21st century semiotic regime. Chapter Five then summarizes the conversations between theory and illustration to propose the pneumatology of minoritarian communal interpretation for Christian theology.

The Healthy Workplace of the 21st Century: The Benefit of Organizational Wellness Programs on Employee Health and Absenteeism

Every year, obesity rates continue to rise and have reached epidemic proportions throughout the United States. The costs associated with obesity are staggering and many researchers feel that the workplace should be the new front line in the battle for a healthier workforce. Employers must take action to address this worsening health crisis and help reduce spiraling medical costs and absenteeism rates. This capstone reviews the current literature on wellness programs and discusses different companies' approaches to wellness programs that have special emphasis on nutrition and physical activity. It also provides strategies and recommendations for companies eager to initiate a comprehensive, dynamic and directed wellness program to improve the current and future health of their workforce.

Ageing Modernity: Growing old in the EU in the 21st Century. EU Centre in Singapore Background Brief No. 7, December 2012

How do urban growth and an ageing population affect or inform planning at the national and regional level in the European Union? At a time when economic stagnation, environmental concerns and demographic changes are affecting social and political discourses, they are also influencing urban form and development. Furthermore, as people are living longer, they still have much to contribute in their later years to their communities and to the economy. As a result, the policy and urban design paradigm is shifting as the relative importance of older people grows. By looking at the connections between ageing, design and the environment, and the role of policy and planning strategies, this brief seeks to understand how the EU plans for an ageing population and attempts to reshape communities in an increasingly challenging socioeconomic context. This brief looks at some of the regional initiatives and guidelines and highlights the role the EU is playing in influencing some of the development trends, particularly those in urban centres.

Modelo Europeu como referencia par a integracao na American Latina do seculo XXI = Europe as a model in the integration of Latin American in the 21st century. Jon Monnet/Robert Schuman Paper Series Vol. 13 No. 5, February 2013

No abstract.