Evaluation of an inter-organizational program for prevention of work-related injuries in a WHO Safe Community

OBJECTIVE: To evaluate the effect of a community-based injury prevention program on work-related injuries. STUDY DESIGN: A population-based quasi-experimental design was used with pre- and post-implementation measurements in an intervention and a control area. The program was based on cross-sectoral participation in detecting and taking action against work-related injuries. Change in the relative risk of injury was estimated by the odds ratio. RESULTS: The relative risk of work-related injury decreased following program exposure, whereas a tendence toward increase was observed in the control area. Middle-aged men accounted for the largest decrease in injury risk. Among the women, a decrease was observed only in the upper middle-aged group. No female-dominated occupational area showed a decrease in injury risk following exposure to the program. CONCLUSION: The study showed that the community-based approach had a general effect on the incidence of work-related injuries.     

A Critical Look at Risk Assessments for Global Catastrophes

Recent articles by Busza et al. (BJSW) and Dar et al. (DDH) argue that astrophysical data can be used to establish small bounds on the risk of a "killer strangelet" catastrophe scenario in the RHIC and ALICE collider experiments. The case for the safety of the experiments set out by BJSW does not rely solely on these bounds, but on theoretical arguments, which BJSW find sufficiently compelling to firmly exclude any possibility of catastrophe. Nonetheless, DDH and other commentators (initially including BJSW) suggested that these empirical bounds alone do give sufficient reassurance. This seems unsupportable when the bounds are expressed in terms of expectation value-a good measure, according to standard risk analysis arguments. For example, DDH's main bound, p(catastrophe) < 2 x 10(-8), implies only that the expectation value of the number of deaths is bounded by 120; BJSW's most conservative bound implies the expectation value of the number of deaths is bounded by 60,000. This article reappraises the DDH and BJSW risk bounds by comparing risk policy in other areas. For example, it is noted that, even if highly risk-tolerant assumptions are made and no value is placed on the lives of future generations, a catastrophe risk no higher than approximately 10(-15) per year would be required for consistency with established policy for radiation hazard risk minimization. Allowing for risk aversion and for future lives, a respectable case can be made for requiring a bound many orders of magnitude smaller. In summary, the costs of small risks of catastrophe have been significantly underestimated by BJSW (initially), by DDH, and by other commentators. Future policy on catastrophe risks would be more rational, and more deserving of public trust, if acceptable risk bounds were generally agreed upon ahead of time and if serious research on whether those bounds could indeed be guaranteed was carried out well in advance of any hypothetically risky experiment, with the relevant debates involving experts with no stake in the experiments under consideration.     

Physician incentive plan boosts physician/patient satisfaction. 5-year-old plan at priority health shows success

Physician involvement is crucial to creating a healthy physician incentive program. Look at how one large, Michigan-based managed care organization established their program.     

Wandering in the desert. Lessons from a life in health care

A physician executive who's worked in many different areas of health care explains the nearly universal problems he's encountered with the "broken" system. He also suggests ways to fix it.     

Five-Hundred Life-Saving Interventions and Their Cost-Effectiveness

We gathered information on the cost-effectiveness of life-saving interventions in the United States from publicly available economic analyses. "Life-saving interventions" were defined as any behavioral and/or technological strategy that reduces the probability of premature death among a specified target population. We defined cost-effectiveness as the net resource costs of an intervention per year of life saved. To improve the comparability of cost-effectiveness ratios arrived at with diverse methods, we established fixed definitional goals and revised published estimates, when necessary and feasible, to meet these goals. The 587 interventions identified ranged from those that save more resources than they cost, to those costing more than 10 billion dollars per year of life saved. Overall, the median intervention costs $42,000 per life-year saved. The median medical intervention costs $19,000/life-year; injury reduction $48,000/life-year; and toxin control $2,800,000/life-year. Cost/life-year ratios and bibliographic references for more than 500 life-saving interventions are provided.     

The effect of functional circuit training on physical frailty in frail older adults: a randomized controlled trial

The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (± SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p < .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.     

Corporate divestiture and performance: an institutional view

In this study, we investigate how the institutional environment affects shareholders’ reaction to a firm’s announcement of divestitures. Traditionally, divestiture research has adhered to a financial economics perspective, in which shareholders anticipate certain economic outcomes from corporate divestitures and react accordingly. However, this research has not delivered a distinct understanding of the performance effects of corporate divestitures. To structure and integrate previous work, we apply a neo-institutional perspective of the stock market. We argue that at certain times, the institutional support for corporate diversification is relatively low. During these periods, there is a high rate of divestitures. The high divestiture activity legitimizes this corporate action and leads to a positive reaction of the stock market to new divestiture announcements. This means that individual evaluations of the possible performance outcomes of divestments are not the only factor determining the stock market reaction to a corporate divestiture announcement. Rather, investors might consider the perceived institutionalization of this corporate action when making their purchasing decisions. Using a meta-analytical technique, we find support for our prediction that different performance effects of divestitures, as revealed by previous studies, can be attributed to different conditions of the macro-economic environment. We discuss the implications of this result for research and management practice.     

Creating caring institutions for community informatics

This paper explores the potential affordances of applying a feminist ethics of care approach to community informatics practices in public internet access facilities. As feminist technology scholars have long observed, technology and technoculture are strongly encoded as masculine, privileging traits such as scientific knowledge, rationality, objectivity, and distance. These characteristics are expressed in traditional infomediary practices in a variety of ways, including notions of expertise, ways of conceptualizing technology, emphasis on skills attainment, and deficit-based models of user behavior. In contrast, ethics of care emphasizes the importance of relational and situated knowledge, pluralistic voices and experiences, and relationships bound by mutual interdependence. Traditionally, caring has been feminized and thus necessarily excluded from technoculture and relegated to invisible and unpaid labor. Caring and associated affective labor practices remain an under-examined subject in infomediary practices. Public libraries and community technology centers are logical places to explore for care work, given that they share many characteristics of the spaces where care work has historically been performed. We argue that an ethics of care framework has several possible affordances for infomediary practices in these institutions, including highlighting the gendered power dynamics that define and shape existing practices; distributing care work and making existing care work visible; and envisioning a more holistic and ethical approach to engaging diverse publics. We translate Tronto’s seven warning signs for ‘bad care’ in institutions into seven positive guidelines for providing ‘good care’ in public internet access facilities, then contextualize these for community informatics institutions and practices.     

A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or “spectra”). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.     

Sexual Quality of Life and Aging: A Prospective Study of a Nationally Representative Sample

Unlike other life domains, sexual quality of life (SQoL) has a negative relationship with age. This study disentangled the effect of age in this relationship from confounding sociocultural influences (e.g., the period of time in which data were collected, and cohort differences) and aimed to understand the roles of other sexual domains (i.e., frequency, perceived control, thought and effort invested in sex, and number of sexual partners). We analyzed data from the longitudinal Midlife in the United States study (n = 6,278; age range 20–93), which were collected between 1995 and 2013. Repeated measures linear mixed-effects models showed that age was the most robust time-related predictor of declining SQoL. However, after the sexual domains were included in the model, age had a positive relationship with SQoL and older adults’ SQoL was differentially influenced by the quality—not quantity—of sex. When partnership characteristics were included in the model, age was no longer related to SQoL. These findings suggest that aging may be associated with the acquisition of skills and strategies that can buffer age-related declines in SQoL, particularly in the context of a positive relationship. We summarize these findings as sexual wisdom.