Environmental sustainability and the human element: Decision making in National Cancer Institute-designated cancer centers and Practice Greenhealth subscribing institutions

Background. Various aspects of sustainability have taken root in the hospital environment; however, decisions to pursue sustainable practices within the framework of a master plan are not fully developed in National Cancer Institute (NCI) -designated cancer centers and subscribing institutions to the Practice Greenhealth (PGH) listserv.^ Methods. This cross sectional study was designed to identify the organizational characteristics each study group pursed to implement sustainability practices, describe the barriers they encountered and reasons behind their choices for undertaking certain sustainability practices. A web-based questionnaire was pilot tested, and then sent out to 64 NCI-designated cancer centers and 1638 subscribing institutions to the PGH listserv.^ Results. Complete responses were received from 39 NCI-designated cancer centers and 58 subscribing institutions to the PGH listserv. NCI-designated cancer centers reported greater progress in integrating sustainability criteria into design and construction projects than hospitals of institutions subscribing to the PHG listserv (p-value = <0.05). Statistically significant differences were also identified between these two study groups in undertaking work life options, conducting energy usage assessments, developing energy conservation and optimization plans, implementing solid waste and hazardous waste minimization programs, using energy efficient vehicles and reporting sustainability progress to external stakeholders. NCI-designated cancer centers were further along in implementing these programs (p-value = <0.05). In comparing the self-identified NCI-designated cancer centers to centers that indicated they were both and NCI and PGH, the later had made greater progress in using their collective buying power to pursue sustainable purchasing practices within the medical community (p-value = <0.05). In both study groups, recycling programs were well developed.^ Conclusions. Employee involvement was viewed as the most important reason for both study groups to pursue recycling initiatives and incorporated environmental criteria into purchasing decisions. A written sustainability commitment did not readily translate into a high percentage that had developed a sustainability master plan. Coordination of sustainability programs through a designated sustainability professional was not being undertaken by a large number of institutions within each study group. This may be due to the current economic downturn or management's attention to the emerging health care legislation being debated in congress. ^ Lifecycle assessments, an element of a carbon footprint, are seen as emerging areas of opportunity for health care institutions that can be used to evaluate the total lifecycle costs of products and services.^

Doctor-patient communication in the medical interaction: Context, implications, and practice

Effective communication; whether from an interpersonal, mass media, or global perspective, is a critical component in public health. It is an essential conduit in increasing public awareness of available health resources, potential health hazards and related disease prevention strategies, and in delivering better health care. Within this context, available literature asserts doctor-patient communication as central to healthcare delivery. It has been shown to affect patient health outcomes, satisfaction with care, adherence to treatment recommendations, and even understanding of medical information. While research supports the essential imperative of interventions aimed at teaching doctors and patients the communication skills necessary for a successful and meaningful medical interaction, most interventions to date, focus on teaching these communication skills to doctors and seem to rely, largely, on mass media for providing patients with the information needed to increase communication efficacy. This study sought to fill a significant gap in the doctor-patient communication literature by reviewing the context of the doctor-patient exchange in the medical interaction, the implications of this exchange in resulting care of the patient, and the potential improvements to practice through interventions aimed at improving the communication exchange. Closing with an evaluation of a patient-centered communication intervention, the “How to Talk to Your Doctor” (HTTTYD) program that combines previously identified optimal strategies for improving communication between doctors and patients, this study examined the patients’ perspective of their potential as better communicators in the medical interaction. ^ Specific Aims, Hypotheses or Questions (Aim I) To examine the context of health communication within a public health framework and its relation to health care delivery. (Aim II) To review doctor-patient communication as a central focus within health care delivery and the resulting implications to patient care. (Aim III) To assess the utility of interventions to improve doctor-patient communication. Specifically, to evaluate the effectiveness of a patient-centered community education intervention, the “How to Talk to Your Doctor” (HTTTYD) program, aimed at improving patient communication efficacy.^

A study of factors influencing high school students' attitudes and opinions about violence

Tenth grade students in a lower income neighborhood Houston school were surveyed on violence related beliefs, attitudes, and coping ability. Self-administered questionnaires were used to collect information for scale scores for statistical analysis.^ One hundred twenty six students participated of which 60% were Hispanic, 18% Black, 18% White, 2 American Indians, and 3 Asian/Pacific persons. There were 60 males, mean age 16.03, and 66 females, mean age 15.49. One-half of the sample reported repeating a grade, 53.4% of males, and 47% of females. Females' self-reported grades were slightly higher than males.^ Measures of student acceptance of violence and ability to handle conflict peacefully were studied in relation to student responses to questions about five areas: parental monitoring of the student, parent type of punishment, optimism about future prospects, frustration tolerance, and perceived peer group attitudes and practices.^ Significant gender differences included males having higher violence acceptance scores and females higher on coping with conflict peacefully. No significant race differences or gender interactions were found.^ Females' scores on future orientation were inversely related to their scores on the measure of acceptance of violence. For males, parents' punishment and perceived peer attitudes were positively related to their acceptance of violence, p $<$.0083.^ Female handling of conflict was significantly related to frustration tolerance and optimism; not significant were perceived peer attitudes, parent monitoring or punishment method. For males significantly related to handling conflict were perceived peer attitudes, parental monitoring, and severity of punishment, with the last two terms having a significant interaction effect, and inversely correlated (less monitoring, harsher punishment explained lower ability to handle conflict). ^

A Path Forward: Evidence-Based Approaches to Educational Policy and Practice

In the complex landscape of public education, participants at all levels are searching for policy and practice levers that can raise overall performance and close achievement gaps. The collection of articles in this edition of the Journal of Applied Research on Children takes a big step toward providing the tools and tactics needed for an evidence-based approach to educational policy and practice.

Formless as Water, Flaming as a Fire-Some observations on the Theory and Practice of Self-Determination

The concept of national self-determination is a highly contested concept from very outset. It is partly due to its dual parentage, namely nationalism and liberalism. Prior to 1945 it was only a political concept without legal binding. With the incorporation of the principle in the UN Charter it was universalized and legalized. However, there were two competing interpretations at the UN based on de-colonization and representative government. How to define self and what really determined remain highly controversial. How to reconcile the international norm of sovereignty of state and self determination of people became more complex problem with the tide of secessionist movements based on ethno-nationalism. The concept of internal self-determination came as a compromise; but it is also very vague and harbors a wide range of interpretations.

Towards a concurrent semantics-based analysis of CC and CLP. principles and practice of constraint programming

Abstract is not available.

Training organization of a middle-size company engaged in information technology services: theory and practice

In order to establish an active internal know-how -reserve~ in an information processing and engineering services . company, a training architecture tailored to the company as an whole must be defined. When a company' s earnings come from . advisory services dynamically structured i.n the form of projects, as is the case at hand, difficulties arise that must be taken into account in the architectural design. The first difficulties are of a psychological nature and the design method proposed here begjns wi th the definition of the highest training metasystem, which is aimed at making adjustments for the variety of perceptions of the company's human components, before the architecture can be designed. This approach may be considered as an application of the cybernetic Law of Requisita Variety (Ashby) and of the Principle of Conceptual Integrity (Brooks) . Also included is a description of sorne of the results of the first steps of metasystems at the level of company organization.

The Theory and Practice of Restoration in England in the Second Half of the 19th Century: The Work of George E. Street

Análisis de la teoría y práctica de la restauración en Inglaterra en la segunda mitad del siglo XIX, enfocada al trabajo realizado por el arquitecto George Edmund Street, desde el punto de vista de su investigación sobre la historia de la construcción de la arquitectura gótica en Europa.

Insights, attitudes, and perceptions about asthma and its treatment : a multinational survey of patients from Europe and Canada

Acknowledgments Editorial assistance was provided by Ken Kauffman and Patricia Abramo, Adelphi Communications, New York, NY. This assistance was funded by Merck & Co., Inc.

Understanding the Leadership Capacity and Practice of Assistant Principals

The purpose of this study was to explore the leadership capacities and practices of assistant principals. The research also sought to determine what relationships existed between capacity and practice and to see if there was a difference based on experience, context and personal characteristics. Since the majority of principals first serve as assistant principals, their work and experiences as assistant principals will have significant consequences (Kwan, 2009). The literature has long held and continues to challenge the notion that the role of assistant principal is adequate preparation for the principalship (Chan, Webb, & Bowen, 2003; Harris, Muijs, & Crawford, 2003; Kwan, 2009; Mertz, 2000; Webb & Vulliamy, 1995). Based on empirical findings, this study has affirmed the need to further research and refine the role of the assistant principal. The results indicate that in addition to strengths, there are explicit gaps and missed opportunities in the leadership practices of assistant principals that impact the potential for building a leadership pipeline within schools. The work of the assistant principal is characterized by a proliferation of duties rather than a strategic set of practices that support distributed leadership and sustainability.

Translating and Subtitling Humor Through Theory and Practice

This project assesses translating and subtitling humor in Italian and Spanish language films subtitled into English. Humor in film is problematic to translate when subtitling: visual humor may need no assistance to be delivered to a target audience, but verbal humor requires thorough analysis to be constructed effectively in the target language. To keep humor alive in target language translations, translators must understand the structure and function of humor. This project researches humor theory, translation and subtitling. It analyzes humor function through humor theory and applies this knowledge to translating audiovisual mediums. An understanding of joke structure and humor function can serve as a guide for translators to recognize, devise and evaluate equivalent translations of humor in film.