Psychosocial Distress Screening in a Community Cancer Center: An Examination of Gender Differences

Objective: The aim of this study was to gain a better understanding of the needs of male and female oncology patients within a community cancer setting to inform the provision of psychosocial services. Data obtained from 835 single-page measures of oncology patient distress were collected and analyzed to examine the relationship between gender and reported level of distress, the source of this distress, and requests for follow-up from psychosocial service providers.Method: Patients in medical and radiation oncology were given a distress screener tool that included a distress thermometer, a problem checklist, and a list of psychosocial service providers with whom the patient could request to speak.Results: Women reported higher levels of distress than men (p=.003). Women were also more likely than men to endorse practical problems as the cause of their distress (p=.003). A marginally significant relationship between gender and requesting the cancer resource navigator was also found (p=. 059)Conclusion: Gender is a salient factor in reported distress among cancer patients. Although no single variable can entirely explain an individual's response to cancer, male and female patients do appear to have distinctive, gender-specific needs. Psychosocial interventions that account for differences related to gender-role may be particularly beneficial. These results also illustrate the utility of consistent screening practices to better understand and meet the psychosocial needs of oncology

Erosion of universal health coverage in Spain

Whereas the recent UN resolution urges governments to accelerate progress towards universal access to affordable and quality health-care services, the Spanish Government, bypassing the parliamentary procedure, enacted a Royal Decree to limit access to free services at the point of delivery for all-undermining the principle of universal coverage. Spanish health and social service budgets have been subjected to large cuts (13,7% in 2012 and 16,2% in 2013) with some regions imposing additional budget cuts.

The philanthropic work of Josephine Shaw Lowell: containing a biographical sketch of her life, together with a selection of her public papers and private letters

collected and arranged for publication by William Rhinelander Stewart.

Evaluation of semi-passive treatment technologies for septic lagoon capacity expansion

In Canada, increases in rural development has led to a growing need to effectively manage the resulting municipal and city sewage without the addition of significant cost- and energy- expending infrastructure. Storring Septic Service Limited is a family-owned, licensed wastewater treatment facility located in eastern Ontario. It makes use of a passive waste stabilization pond system to treat and dispose of waste and wastewater in an environmentally responsible manner. Storring Septic, like many other similar small-scale wastewater treatment facilities across Canada, has the potential to act as a sustainable eco-engineered facility that municipalities and service providers could utilize to manage and dispose of their wastewater. However, it is of concern that the substantial inclusion of third party material could be detrimental to the stability and robustness of the pond system. In order to augment the capacity of the current facility, and ensure it remains a self-sustaining system with the capacity to safely accept septage from other sewage haulers, it was hypothesized that pond effluent treatment could be further enhanced through the incorporation of one of three different technology solutions, which would allow the reduction of wastewater quality parameters below existing regulatory effluent discharge limits put in place by Ontario’s Ministry of the Environment and Climate Change (MOECC). Two of these solutions make use of biofilm technologies in order to enhance the removal of wastewater parameters of interest, and the third utilizes the natural water filtration capabilities of zebra mussels. Pilot-scale testing investigated the effects of each of these technologies on treatment performance under both cold and warm weather operation. This research aimed to understand the important mechanisms behind biological filtration methods in order to choose and optimize the best treatment strategy for full-scale testing and implementation. In doing so, a recommendation matrix was elaborated provided with the potential to be used as a universal operational strategy for wastewater treatment facilities located in environments of similar climate and ecology.

Liberalising trade in services: creating new migration opportunities? Research Paper in Law, 1/2010

Introduction. It is quite uncommon to associate migration with the rules on services trade. Indeed, all economic definitions of services insist on their immaterial nature and on the increased possibility of trading them ‘virtually’ over networks or else, without any physical movement of the parties involved. Somehow this ‘immaterial’ nature of services reflects on their providers/recipients which seem to be ‘invisible’. Even though most services still require the physical contact of the provider with the recipient1 and, when provided over national borders, do entail migration, service providers and/or recipients are rarely thought of as ‘immigrants’. This may be due to the fact that they enter the foreign territory with a specific aim and, once this aim accomplished, move back to their state of origin; technically they only qualify as short term non-cyclical migrants and are of little interest to policy-makers. A second reason may be that both service providers and recipients are economically desirable: the former are typically highly skilled and trained professionals and the latter are well-off ‘visitors’, increasing consumption in the host state. The legal definition of services in Article 57 TFEU (ex Art. 50 EC) further nourishes this idea about service providers/recipients not being migrants: the relevant Treaty rules only apply when the provisions on free movement of workers and freedom of establishment – themselves clearly linked to migration – do not apply. This distinction has been fleshed up by the ECJ which has consistently held that the distinction between the rules on establishment, on the one hand, and the rules on services, on the other, lies on duration.2 Indeed, all EC manuals state four types of service provision falling under the EC Treaty: a) where the service provider moves to the recipient’s state, for a short period of time (longer stay would amount to establishment), b) where the service recipients themselves move to the state where the service is offered (eg for medical care, education, tourism etc), c) where both service providers and recipients move together in another member state (eg a tourist guide accompanying a group travelling abroad) and d) where the service itself is provided across the borders (typically through the use of ICTs). None of these situations would typically qualify as migration. The above ‘dissociation’ between services and migration has been gradually weakened in the recent years. Indeed, migration is increasingly connected to the transnational provision of services. This is the result of three kinds of factors: developments in the European Court of Justice’s (ECJ) case law; legislative initiatives in the EU; and the GATS. Each one of these is considered in some detail below. The aim of the analysis which follows is to show the extent to which (legislative and judicial) policies aimed at the free provision of services actively affect migration conditions within the EU. The EC rules on the provision of services primarily affect the movement of EU nationals. As it will be shown below, however, third country nationals (TCNs) may also claim the benefits of the rules on services, either as recipients thereof or as employees of some EC undertaking which is providing services in another member state (posted workers).

The Economics of EU Railway Reform. Bruges European Economic Policy (BEEP) Briefing 8/2004

The EU began railway reform in earnest around the turn of the century. Two ‘railway packages’ have meanwhile been adopted amounting to a series of directives and a third package has been proposed. A range of complementary initiatives has been undertaken or is underway. This BEEP Briefing inspects the main economic aspects of EU rail reform. After highlighting the dramatic loss of market share of rail since the 1960s, the case for reform is argued to rest on three arguments: the need for greater competitiveness of rail, promoting the (market driven) diversion of road haulage to rail as a step towards sustainable mobility in Europe, and an end to the disproportional claims on public budgets of Member States. The core of the paper deals respectively with market failures in rail and in the internal market for rail services; the complex economic issues underlying vertical separation (unbundling) and pricing options; and the methods, potential and problems of introducing competition in rail freight and in passenger services. Market failures in the rail sector are several (natural monopoly, economies of density, safety and asymmetries of information), exacerbated by no less than 7 technical and legal barriers precluding the practical operation of an internal rail market. The EU choice to opt for vertical unbundling (with benefits similar in nature as in other network industries e.g. preventing opaque cross-subsidisation and greater cost revelation) risks the emergence of considerable coordination costs. The adoption of marginal cost pricing is problematic on economic grounds (drawbacks include arbitrary cost allocation rules in the presence of large economies of scope and relatively large common costs; a non-optimal incentive system, holding back the growth of freight services; possibly anti-competitive effects of two-part tariffs). Without further detailed harmonisation, it may also lead to many different systems in Member States, causing even greater distortions. Insofar as freight could develop into a competitive market, a combination of Ramsey pricing (given the incentive for service providers to keep market share) and price ceilings based on stand-alone costs might be superior in terms of competition, market growth and regulatory oversight. The incipient cooperative approach for path coordination and allocation is welcome but likely to be seriously insufficient. The arguments to introduce competition, notably in freight, are valuable and many e.g. optimal cross-border services, quality differentiation as well as general quality improvement, larger scale for cost recovery and a decrease of rent seeking. Nevertheless, it is not correct to argue for the introduction of competition in rail tout court. It depends on the size of the market and on removing a host of barriers; it requires careful PSO definition and costing; also, coordination failures ought to be pre-empted. On the other hand, reform and competition cannot and should not be assessed in a static perspective. Conduct and cost structures will change with reform. Infrastructure and investment in technology are known to generate enormous potential for cost savings, especially when coupled with the EU interoperability programme. All this dynamism may well help to induce entry and further enlarge the (net) welfare gains from EU railway reform. The paper ends with a few pointers for the way forward in EU rail reform.

El contratismo y su integración al modelo de agronegocios : Producción y servicios en la región pampeana

Si bien existen estudios sobre el desarrollo de los prestadores de servicios agropecuarios de labores culturales -"contratistas" en la jerga nativa-, a lo largo del siglo XX, el crecimiento exponencial de esta actividad y las vertiginosas dinámicas de innovación tecnológica para el agro en relación a este rubro, han abierto nuevos interrogantes respecto de las características productivas y las identidades construidas por estos sujetos. El objetivo de este trabajo es dar cuenta de las distintas estrategias desplegadas respecto a la compra-venta de servicios por parte de estos actores de la producción agrícola, así como también comprender cómo estas estrategias se relacionan con el modelo productivo predominante. El acercamiento que proponemos a continuación, es en base a un relevamiento cuantitativo de hogares de productores agropecuarios (provincias de Buenos Aires y de Santa Fe) y a entrevistas cualitativas sobre trayectorias de vida y empresariales. A partir de la construcción de estos datos analizamos las características de aquellos que implementaron la prestación de servicios agrícolas, en base a las dimensiones materiales e identitarias estudiadas

Title IIIB EOA projects /

Cover title: OEO programs for migrant and seasonal farm workers.

The Project Share collection.

Cumulates abstracts which appeared in Journal of human services abstracts.

Time for a change : remaking the nation's welfare system : report of the Welfare Simplification and Coordination Advisory Committee.

"June 1993."

Charity organization bulletin.

Title from caption.

The role of faith-based charities in the District of Columbia : hearing before the Subcommittee on Oversight of Government Management, Restructuring, and the District of Columbia of the Committee on Governmental Affairs, United States Senate, One Hundred Fifth Congress, second session, May 18, 1998.

Shipping list no.: 98-0363-P.

A Thousand points of light : the ninth hundred.

Shipping list no.: 93-0170-P.

A Thousand points of light : the sixth hundred.

Shipping list no.: 92-0456-P.

Program statistics.

Report year ends June 30.