Health care technology. Evolution toward revolution

The assessment process has a significant effect on the development and diffusion of any new technology. An assessment during the infancy of a new technology may have to be updated as more experience and data accumulate and change the analysis of the technology's safety and effectiveness. An outdated assessment can result in inappropriate utilization either by hindering diffusion of a valuable technology or by promoting utilization of an inappropriate technology. Those who conduct technology assessments must recognize that technologies have life cycles of their own.     

Halfway technologies

An extraordinary gamut of medical and surgical therapies could be considered "halfway technologies," addressing mere symptoms or manifestations of disease, rather than the underlying pathogenesis. When a "halfway" technology is also lifesaving, its value cannot be underestimated by the individual patient. The example of organ transplantation explored in this column represents a halfway technology. It does not treat the underlying disease itself, but reflects the absolute failure of all efforts at medical and conservative therapy and is a last ditch, gerry-rigged lifesaving solution. And what about "quarter technologies"--the bridge to transplant devices--designed to get the patient halfway to the final halfway procedure?     

Fighting back: Vulnerabilities,blunders, and countermobilization by the targets in three animal rights campaigns

Among the determinants of social movement success, the characteristics and responses of nonstate organizations under attack by protestors have been overlooked. We examine three campaigns by animal rights groups against experimentation, in 1976–1977, 1987–1988, and 1988–1989. The first two campaigns stopped the research, while the third did not. One influential set of factors was the preexisting vulnerabilities—e.g., unpopular practices, internal factions—on the part of targeted organizations. Another was the strategic responses of these organizations, especially the avoidance of blunders. A growing countermovement, thirdly, affected the organizations' ability to respond effectively and avoid blunders. As a social movement expands and strengthens, it encourages counterorganizing and a hardening of resistance, so that many social movements may actually be less successful as they become larger and more visible.Revised version of a paper presented at the annual meeting of the American Sociological Association, Washington, DC, August 1990.     

Knowledge gap effects in a health information campaign

The evaluation of a campaign to increase cardiovascular health knowledge indicates that within the treatment community, education was a significant predictor of knowledge before the campaign but was not a significant predictor after the campaign. Two variables related to motivation to acquire information about cardiovascular health (age and perceived threat of heart attack) were not significant predictors of knowledge before the campaign but were significant predictors afterwards. These results suggest that the infusion of information into a social system via the mass media can close as well as open knowledge gaps and that motivation to acquire information in a specific knowledge domain is a factor controlling gap effects.     

Dropouts and continuers in Gamblers Anonymous: Part four. Evaluation and summary

In this fourth part of a study of dropouts from Gamblers Anonymous, the design, aims and rationale of which are outlined in part 1 (Brown, 1985b) experiences of GA by a sample of dropouts who had attended more than one meeting are analyzed and compared with similarly obtained responses from a group of continuing attenders who had not gambled for at least one year. The overall pattern of findings from the three prior parts of the study is interpreted as suggesting that

1. Gamblers anonymous may be better at coping with those whose gambling has been severely excessive and had led to many problems. However GA's approach is not so easily accepted and therefore not so effective with those who seek help at an earlier stage in the development of their problems.
2. Gamblers Anonymous may work better with those who have few relapses or best with those who have none at all. Although it may be very helpful in avoiding relapses, it may be less helpful in dealing with them when they do occur.

problems of the representativeness of the sample, of generalizing to Gamblers Anonymous as a whole, and of arguing from associations to causes are discussed. A general picture of the organization as a whole is presented.     

Genetic Diversity of Invasive Species in the Great Lakes Versus Their Eurasian Source Populations: Insights for Risk Analysis

Combining DNA variation data and risk assessment procedures offers important diagnostic and monitoring tools for evaluating the relative success of exotic species invasions. Risk assessment may allow us to understand how the numbers of founding individuals, genetic variants, population sources, and introduction events affect successful establishment and spread. This is particularly important in habitats that are "hotbeds" for invasive species--such as the North American Great Lakes. This study compares genetic variability and its application to risk assessment within and among three Eurasian groups and five species that successfully invaded the Great Lakes during the mid 1980s through early 1990s; including zebra and quagga mussels, round and tubenose gobies, and the ruffe. DNA sequences are compared from exotic and native populations in order to evaluate the role of genetic diversity in invasions. Close relatives are also examined, since they often invade in concert and several are saline tolerant and are likely to spread to North American estuaries. Results show that very high genetic diversity characterizes the invasions of all five species, indicating that they were founded by very large numbers of propagules and underwent no founder effects. Genetic evidence points to multiple invasion sources for both dreissenid and goby species, which appears related to especially rapid spread and widespread colonization success in a variety of habitats. In contrast, results show that the ruffe population in the Great Lakes originated from a single founding population source from the Elbe River drainage. Both the Great Lakes and the Elbe River populations of ruffe have similar genetic diversity levels--showing no founder effect, as in the other invasive species. In conclusion, high genetic variability, large numbers of founders, and multiple founding sources likely significantly contribute to the risk of an exotic species introduction's success and persistence.     

Children's computer usage: are they at risk of developing repetitive strain injury?

The purpose of this study was to determine the average time school children spend on computers and electronic games, the positions they assume, and any associated discomfort related to their use. A twenty three-point questionnaire was distributed to 476 children in first to eighth grade from three parochial schools in one of the New York City boroughs. The findings of this study suggest that children use the computer and electronic games differently than adults and that more boys than girls engage in electronic game playing. Results clearly indicated that children are experiencing discomfort from the use of computers or electronic games, and that the discomfort is largely concentrated in the neck region. Occupational therapy could be instrumental in terms of educating the children, their parents/guardians, and their teachers on proper body mechanics, applications of ergonomically suited workstations, and the use of rest/stretch breaks while engaged in computing and electronic game playing.     

The Children's Aid Society community schools: a full-service partnership model

In 1989, the Children's Aid Society (CAS) created an unprecedented partnership with the New York City Board of Education by developing a comprehensive response to the pressing needs of children and families in the northern Manhattan neighborhood of Washington Heights. After three years of careful planning, CAS and the New York City public schools opened the first community school at Intermediate School 218, offering a full array of supports, services, and learning opportunities. Adding, on average, one partnership school per year and remaining very flexible in adapting its model to the individual needs of each community, CAS now has thirteen community schools around New York City. The model's flexibility is seen also in the success of its national and international adaptation-an intentional part of CAS's work.