Outcome study: An industrial rehabilitation program

A review of work hardening outcome research reveals a wide range of return to work statistics between 50% to 80%. Managed care issues are forcing therapy services to objectively quantify their successes to ensure a future in health care. Work Venture has been maintaining program outcome statistics since 1994. In this report, 1997 and 1998 return to work statistics are documented and compared to multiple programs. Work Venture's average annual return to gainful employment percentages for 1997 are 61.2% at 3 months and 61.8% at 6 months, and in 1998, 76.8% at 3 maonths and 76.6% at 6 months after discharge. Many factors are involved in successful return to work with workers compensation claims. Due to these factors it is difficult to compare one program's results with another. It is recommended that a uniform method of collecting and presenting data be developed to ensure valid comparison.     

Ethical dilemmas in a professional service context

This paper reports on the results of action research exploring the kinds of ethical problems that confront employees in the professional services industry. Data were collected from a single firm via participant observation methods at eight locations across the country. Issues raised included service delivery, responses to life threatening situations, marketing, client relationships, client entertaining, bribery, billings, as well as intra-firm issues such as support for professional judgments in the field, employee health and safety, and compensation. The paper concludes with an assessment of the utility of the approach taken by the firm, the generalizability of the issues beyond the single case setting, as well as an assessment of the managerial issues related to fostering and sustaining an ethical environment within a business organization.     

Rehabilitation outlooks for rural Louisiana: educational developments,economic trends,and global perspectives

The objective of this article is to examine current medical, economic, and social trends affecting the provision of rehabilitation services for rural citizens with disabilities. While the population of interest is citizens of Louisiana, the concepts are applicable across all geographic boundaries. The article is a review of clinical practice, job placement alternatives, economic trends, and assessment of process applications. It is concluded numerous steps may be taken to enhance the availability and quality of services provided for rural citizens with disabilities: greater statistical inquiry into rural disability trends, increased incorporation of the Internet into all aspects of rural economic and educational developments, further development of distance learning, promotion of sensitivities towards rural cultures, and continued recruitment of rural allied and vocational rehabilitation professionals.     

Identity in political context: lesbian/gay representation in the public sphere

Discourses constructed to represent lesbians and gay men in the public sphere generate an essentialist identity which is both necessary and damaging. Legislative debate illustrates the production of a constrictive and homogeneous identity rejected by many gay/lesbian scholars and activists. Discussion of the rhetorical power of identity claims has produced alternative stances toward variant sexuality. This discussion can be advanced by challenging dominant constructions of civil rights and the public sphere.     

Adolescent Women's Recommendations for Enhanced Parent-Adolescent Communication About Sexual Behavior

Family communication about adolescent sexual health and behavior promotes adolescent health and family connectedness. However, few studies seek the perspective of adolescents regarding their recommended strategies for family communication. Findings of a survey of female adolescent family planning patients (n = 249) indicated adolescent recommendations for better family communication included treat teen as an equal, 63%; increase parental knowledge about lifestyle and peer pressures, 61%, and improve parental listening skills, 61%. There were no statistically significant differences according to age, pregnancy history, or school enrollment status for suggested strategies for improved communication with parents. Sexually active adolescent daughters expressed interest in maintaining family connectedness and support with increased time for family activities as well as increased quality and quantity of dialogue between the adolescent girl and her parents.     

Improving performance in a contracted physician network

Health care organizations face significant performance challenges. Achieving desired results requires the highest level of partnership with independent physicians. Tufts Health Plan invited medical directors of its affiliated groups to participate in a leadership development process to improve clinical, service, and business performance. The design included performance review, gap analysis, priority setting, improvement work plans, and defining the optimum practice culture. Medical directors practiced core leadership capabilities, including building a shared context, getting physician buy-in, and managing outliers. The peer learning environment has been sustained in redesigned medical directors' meetings. There has been significant performance improvement in several practices and enhanced relations between the health plan and medical directors.     

将你的问题外包处理了吗？

外包是改善运营的众多选择中的一个对许多企业来说,外包是将麻烦转到别人身上的途径。但是这并不能给你带来什么好处。这里有三个方法,可以使你在外包之前改善运营缺陷并获得成本优势。对于一个美国著名的投资管理企业的高级经理来说,起初做这样的决定是件很容易的事情。后台财务支持已成为     

Combining Food Frequency and Survey Data to Quantify Long-Term Dietary Exposure: A Methyl Mercury Case Study

Twenty-four-hour recall data from the Continuing Survey of Food Intake by Individuals (CSFII) are frequently used to estimate dietary exposure for risk assessment. Food frequency questionnaires are traditional instruments of epidemiological research; however, their application in dietary exposure and risk assessment has been limited. This article presents a probabilistic method of bridging the National Health and Nutrition Examination Survey (NHANES) food frequency and the CSFII data to estimate longitudinal (usual) intake, using a case study of seafood mercury exposures for two population subgroups (females 16 to 49 years and children 1 to 5 years). Two hundred forty-nine CSFII food codes were mapped into 28 NHANES fish/shellfish categories. FDA and state/local seafood mercury data were used. A uniform distribution with minimum and maximum blood-diet ratios of 0.66 to 1.07 was assumed. A probabilistic assessment was conducted to estimate distributions of individual 30-day average daily fish/shellfish intakes, methyl mercury exposure, and blood levels. The upper percentile estimates of fish and shellfish intakes based on the 30-day daily averages were lower than those based on two- and three-day daily averages. These results support previous findings that distributions of "usual" intakes based on a small number of consumption days provide overestimates in the upper percentiles. About 10% of the females (16 to 49 years) and children (1 to 5 years) may be exposed to mercury levels above the EPA's RfD. The predicted 75th and 90th percentile blood mercury levels for the females in the 16-to-49-year group were similar to those reported by NHANES. The predicted 90th percentile blood mercury levels for children in the 1-to-5-year subgroup was similar to NHANES and the 75th percentile estimates were slightly above the NHANES.