A new industrial order for physicians: a talk with Jeff C. Goldsmith, PhD. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed Jeff C. Goldsmith, PhD, President of Health Futures, Inc. on October 12, 1999 to discuss how the Internet will affect health care delivery in the millennium. One of the most profound changes that he sees is how the relationship between physicians and patients will be altered. Empowered consumers are where the real revolution is happening--a trend sometimes overlooked by physicians. Goldsmith says, "The key thing physicians have missed is that the patient is in charge of the process.... The Internet has enabled patients to aggregate their collective experience across disease entities." But there is too much information. "It is almost universally acknowledged by patients and physicians that there is a terrible quality problem. Getting from information to knowledge is a huge commercial opportunity for somebody." He doesn't think that people have put enough emphasis on the collective learning part of this new technology.     

Business leadership as a spiritual discipline

What motivates organizational leaders in their search for spirituality? They seek to integrate their inner journey with their day-to-day professional roles. This article describes how a course in spirituality for executives has provided tools to analyze and clarify intentions, avoid the traps of excessive greed and power, and make decisions that are both compassionate and effective. André L. Delbecq, DBA, the Thomas J. and Kathleen L. McCarthy Professor at the Leavey School of Business at Santa Clara University in California, offers seminars in spirituality for organizational leadership through the MBA program and the Center for Executive Development. Delbecq is the first to admit his surprise at the number of executives who have repeatedly asked for courses in spirituality. He talks about how his seminars have helped CEOs and other top executives achieve greater effectiveness in leading organizations.     

Assessment of Airborne Exposure to Trihalomethanes from Tap Water in Residential Showers and Baths

This study evaluates airborne concentrations of common trihalomethane (THM) compounds in bathrooms during showering and bathing in homes supplied with chlorinated tap water. Three homes in an urban area were selected, each having three bedrooms, a full bath, and approximately 1,000 square feet of living area. THMs were concurrently measured in tap water and air in the shower/bath enclosure and the bathroom vanity area using Summa canisters. Chloroform (TCM), bromodichloromethane (BDCM), and chlorodibromomethane (CDBM) were quantified using U.S. Environmental Protection Agency (EPA) Method TO-14. Air samples were collected prior to, during, and after the water-use event for 16 shower and 7 bath events. Flow rate and temperature were measured, but not controlled. The increase in average airborne concentration (+/- standard error) during showers (expressed as microg/m3 in shower enclosure or bathroom air per microg/L in water) was 3.3+/-0.4 for TCM, 1.8+/-0.3 for BDCM, and 0.5+/-0.1 for CDBM (n = 12), and during baths was 1.2+/-0.4 for TCM, 0.59+/-0.21 for BDCM, and 0.15+/-0.05 for CDBM (n = 4). The relative contribution of each chemical to the airborne concentrations was consistent for all shower and bath events, with apparent release of TCM > BDCM > CDBM. The results are therefore consistent with their relative concentration in tap water and their vapor pressures. When the shower findings for TCM are normalized for water concentration, flow rate, shower volume, and duration, the average exposure concentrations in these urban residences are about 30% lower than those reported by other investigators using EPA analytical methods. This difference is likely attributable primarily to greater air exchange rates in residential shower/bath stalls compared to more "airtight" laboratory shower chambers. This appears to be the first field study to thoroughly evaluate THM exposures from residential showers and baths, and can be used to validate previously published models of tap water volatile chemical transfer to indoor air.     

Intergenerational and International Discounting

A discount rate for the consumption of future generations is typically composed of two parts. One is a "pure" time preference for immediate over postponed consumption, the other a declining marginal utility as consumption increases. The costs of greenhouse abatement, however, for at least the first 50 years, will be borne by the developed countries; the benefits will accrue to the presently undeveloped. Pure time preference always relates to one's own consumption; it has no relevance here. Consumption transfers over time will be from richer to poorer, from lower to higher marginal utility. It is a foreign aid program and it ought to have to compete with more direct foreign aid, which can benefit the very poor rather than their much-better-off descendants.     

IntroductionExposing Misinformation Concerning Child Sexual Abuse and Adult Survivors

This article introduces a special volume on misinformation about child sexual abuse. Despite extensive research findings on the long-term effects and consequences of child sexual abuse, misinformation on this topic is widespread. Several forces have worked to support and disseminate this erroneous information. Because it is difficult to comprehend the horror of sexual crimes against children, society's denial and disbelief have often unwittingly supported the agendas of those who want to discount or minimize the impact of these crimes. The media has also contributed to the aura of skepticism surrounding claims of sexual abuse and its mental health impact, and has reported favorably on controversial and unproven claims such as the “false memory syndrome.” In the hope of countering misinformation and thus raising the level of discourse to the engagement of real scientific issues, a number of well known and respected researchers and clinicians examine various facets of the problem.     

Effectiveness of an educational intervention to increase knowledge and reduce use of risky behaviors associated with cumulative trauma in office workers

OBJECTIVE: This pilot project assessed the effectiveness of an intervention to increase knowledge and reduce risky behaviors related to cumulative trauma disorders (CTD) in office workers. STUDY DESIGN: All 124 employees from the administrative offices of a health maintenance organization were invited to participate. Subjects were followed across time using an identification number. Data were collected via questionnaire in June 1994 (pretest1) (N=84), August 1994 (pretest II) (N= 63) and September 1995 (posttest) (N=40). The yearlong intervention focused on functional activities to prevent CTD. RESULTS: of chi-square analyses for the 40 subjects who completed all surveys indicated this intervention significantly increased overall knowledge of CTD (p =.002). Significant changes in self-reported hand/wrist (p =.016) and neck/shoulder (p =.003) posture were also found. CONCLUSIONS: This study is a first step in identifying effective educational interventions to increase knowledge and reduce risk factors related to CTD in office workers.     

Culture as a barrier to rural women's entrepreneurship: experience from Zimbabwe

This article identifies the important issues addressed by programs and projects that are aimed at promoting women's equality through entrepreneurship and suggests several actions for future focus of gender programs and training. Culture was seen as a barrier to the self-confident and autonomous economic activities of women in Zimbabwe. Likewise, structural barriers such as lack of marketable skills, time and ability to travel, land and assets, education, and position as primary family providers all compounded to the problem of entrepreneurship among women. Establishment of policy approaches for women like vocational skills training augmented by training in business skills and marketing, however, are insufficient since it failed to discuss and transfer behavioral skills necessary to make one an entrepreneur. To conclude, programs must be designed to empower personal skills and self-awareness, as well as address the constraints to entrepreneurship, and macroeconomic policy change.     

Technology and social interaction: the emergence of 'workplace studies'

Despite the substantial body of literature concerned with the ways in which digital media are transforming contemporary society and institutional life, we have relatively little understanding of the ways in which new technologies feature in day to day organizational conduct and interaction. There is however a growing corpus of empirical research which places the situated and contingent character of new technologies at the heart of the analytic agenda, but as yet, these studies are relatively little known within sociology. They include ethnographies of command and control centres, financial institutions, the news media, and the construction industry. They address the ways in which tools and technologies, ranging from paper documents through to complex multimedia systems, feature in work and collaboration. In this paper, we discuss these so-called 'workplace studies' and consider their implications for our understanding of organizational conduct, social interaction and new technology.     

Happy alone? Sad young men in East Asian gay cinema

This essay chooses as its texts three films representing contemporary gay male subjects from each of the "three" China's: HK, Taiwan, and the Mainland. Relocating the homoerotic image of the "sad young man," a trope popular from Hollywood rebellion films of the 1950s and 1960s, to contemporary China, I discuss how this masculine icon has been transformed from one of heroic rebellion to one of existential isolation. Indeed, as the politics of both the outmoded Confucian family and fractured Chinese nationhood intersect, what the sad young (gay) man rebels against is a political fluctuation which is no longer fixed; as the young man's opposition is no longer fixed, so too does he become alienated even from his own rebellious cause.