Keeping people alive— The implications for planning

Current and future developments of medical techniques, especially those concerned with resuscitation and intensive care, will result in more people living much longer in the future. Their treatment and care will be very expensive, and this will require consideration of priorities. In this article some ethical attitudes are suggested, and a number of practical planning measures to anticipate some of the inevitable problems are proposed.     

The use of multiple scenarios by U.S. industrial companies

A growing number of firms have responded to the ‘unpredictable future’ by developing ways to measure their proposed strategies against several plausible alternative futures. Probably the most widely used of these techniques is multiple (or alternative) scenario analysis (MSA).Survey results indicate that approximately 150 of the Fortune ‘1000’ industrials now use MSA in their formal planning processes. Most have begun using MSA within the last 3 or 4 years. Furthermore, a number of other companies are considering its use. Survey results also show that firms do not follow the relatively rigorous procedures as suggested in the literature. Also, MSA seems to be most successful when management is both knowledgable and involved with scenarios from the beginning.     

The etiology of low back pain in military helicopter aviators: prevention and treatment

Low back pain (LPB) is a major health problem among military rotary-wing aircrews worldwide. In order to define the etiology and propose remedies to LBP in helicopter aviators a review and critique of the literature was conducted. In-flight sitting posture and vibration generated by the aircraft were identified as high risk factors for LBP. Consequently, researchers recommended ergonomic modifications to the crew stations. The efficacy of these technical interventions has not been proven. As well, these design changes are not financially practical. Following an in depth kinesiological analysis of the physical demands of this type of flying, and preliminary experimentation, an alternative aeromedical approach focusing on the aircrew rather than the craft is presented. The authors propose a set of flight-specific exercises that might effectively deal with this problem. A thorough testing of this approach is envisioned.     

Informal Care Intensity and Caregiver Drug Utilization

Providing informal care has negative health consequences for informal caregivers. If these health consequences increase drug utilization among caregivers, estimates of health care savings from informal care—mainly realized through reductions in utilization among care recipients—should consider the increased drug costs incurred by informal caregivers. This paper evaluates whether more intensive informal caregivers have higher drug utilization than less intensive caregivers, controlling for initial health status and other factors. We find that informal care intensity is associated with higher drug consumption. An increase of 10% of total informal care per day is associated with a 0.7% increase in drugs. The small magnitudes indicate that, in this application, it is not important to consider caregiver drug utilization when quantifying the net savings to the health care system of informal care. For individual caregivers, such as those who take multiple drugs per month and/or have no drug coverage, the increase in drug utilization associated with intensive caregiving is likely to be costly.     

“Order through Fluctuation”: An Evolutionary Epistemology for Human Systems**

Most approaches to systems theory, group theory and family theory suffer from two major inadequacies. First, they are heavily oriented toward structure (e.g. structure of the system) as opposed to process. Second, because of this bias, such theories overemphasize stability at the expense of change and transformation. In contrast, Ilya Prigogine's concept of “order through fluctuation” demonstrates how systems suddenly organize themselves and, equally suddenly, make discontinuous shifts from one coherent order to another. As a paradigm, “order through fluctuation” constitutes a basic nonequilibrium ordering principle that governs the forming and unforming of systems at all levels.     

The Role of Technology on Young Adolescent Development: Implications for Policy, Research and Practice

This National Science Foundation funded qualitative study highlights unique features of adolescent technology use and its impact on the developmental maturational processes of early adolescence. One hundred twenty-eight 13- and 14-year-old students were interviewed about their information technology (IT) use. The most salient feature of the interview data is that the students perceived technology as integral to all aspects of their everyday life experience. In particular, they understood the necessity of using technology for the development of their cognitive/academic skills, and they spoke about the need to have technology skills for their future careers. They also seemed to understand how IT helped them develop psychosocially, especially in the areas of communication and relationship development. Throughout the interviews, these young adolescents expressed pleasure and pride in their self-reported high level of technoliteracy. Their voices can help expand our understanding of adolescent development in the digital age, and suggest implications for policy, practice, and research.