Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation

While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.     

Medicare and Amyloid PET Imaging: The Battle Over Evidence

We examine a recent dispute regarding the Centers for Medicare and Medicaid Services’ (CMS) refusal to unconditionally pay for amyloid positron emission tomography (PET) imaging for Medicare beneficiaries being assessed for Alzheimer’s disease. CMS will only pay for amyloid PET imaging when patients are enrolled in clinical trials that meet certain criteria. The dispute reflects CMS’s willingness in certain circumstances to require effectiveness evidence that differs from the Food and Drug Administration’s standard for pre-market approval of a medical intervention and reveals how stakeholders with differing perspectives about evidentiary standards have played a role in attempting to shape the Medicare program’s coverage policies.     

How volunteerism inhibits mobilization: a case study of shelter animal advocates

This paper presents an analysis of how volunteerism can neutralize impulses for mobilization. An ethnographic case study of shelter animal advocates, or individuals promoting shelter reform to ensure that companion animals impounded at animal shelters receive proper medical and behavioral care and are given opportunity for adoption, illuminates a specific set of mechanisms that explain why they have not engaged in collective action such as protest. The findings speak to the complex debate about the relationship between volunteerism, political engagement, and social change by identifying five processes that undercut shelter animal advocates’ capacity to act collectively in protest of how the shelter is run: (1) periods of grievance interruption; (2) exposure to the target’s institutional narratives; (3) relational ties to the target; (4) conflict avoidance; and (5) maintenance of identity as volunteers.     

Alternative Methods for Computing the Sensitivity of Complex Surveillance Systems

Stochastic scenario trees are a new and popular method by which surveillance systems can be analyzed to demonstrate freedom from pests and disease. For multiple component systems—such as a combination of a serological survey and systematically collected observations—it can be difficult to represent the complete system in a tree because many branches are required to represent complex conditional relationships. Here we show that many of the branches of some scenario trees have identical outcomes and are therefore redundant. We demonstrate how to prune branches and derive compact representations of scenario trees using matrix algebra and Bayesian belief networks. The Bayesian network representation is particularly useful for calculation and exposition. It therefore provides a firm basis for arguing disease freedom in international forums.     

从职业病防治看我国集体合同制度的不足与完善

职业病防治法的规定已经较落后,应当对其进行修改,扩大职业病的范围,同时为集体合同约定职业病条款预留空间。改革职业病的管理体制,积极完善工会组织,充分利用行业集体合同、区域集体合同和专项集体合同等现有机制,通过集体协商,引导劳动者和用人单位通过集体合同解决职业病防治问题,无论对于合同双方主体还是对于整个社会都是有益的。     

清末奉天万国鼠疫研究会考论

奉天万国鼠疫研究会是在清政府应对1910年末到1911年初东北三省鼠疫过程中,认识到亟须向国外学习先进的防控经验的前提下召开的。会议由中国倡议并主办,共有来自12个国家的34位正式代表参加。从1911年4月3日（三月初五日）至4月28日（三月三十日）在奉天（今沈阳）召开,其间共举行大会24次,形成决议45项,确定了许多国际通行的防疫准则,为此后的国际防疫合作奠定了基础;同时,这次国际会议也大大推动了中国近代公共防疫事业的发展。奉天万国鼠疫研究会是由清政府主办的中国近代史上第一次国际学术会议。     

祈愿类俗赋举要(一)

俗赋除了具有铺写、用韵、虚拟等赋体特征之外,又兼有浅近、诙谐、实用等的俗文学性质。依俗赋的特质,可将其分为祈愿、诙谐、故事寓言、隐语、认知、铺叙、论辩等类。祈愿类俗赋有驱傩辞、上梁文、撒帐辞等民俗应用文。祈愿类的俗赋含有基层民众的生活愿望,表现出铺排的文学效果,兼具有民俗研究与文学欣赏的价值。     

The Cost of Compensating Asbestos Victims Under the Occupational Disease Compensation Act of 1983

The potentially huge financial liability due to asbestos product suits and the resulting filings for reorganization in bankruptcy by Manville, UNR Industries, Inc., and Amatex, has become a major public policy concern. In response to the problem several bills have been introduced in the Congress to provide compensation for asbestos (and other occupational disease) victims. This paper estimates the cost of compensating asbestos victims under the provisions of the "Occupational Disease Compensation Act of 1983," introduced by Congressman George Miller. Utilizing fatality projections from studies by Enterline, Selikoff, and Walker, and assumptions regarding likely claims filing and success rates, duration and degree of disability, and medical expenses, first year costs for this legislation are estimated to range from a low of $131 million to a high of $ billion. Present value cost estimates at a 2% real discount rate range from $3 billion to $56 billion. The paper also estimates the impact of possible modifications to the compensation provisions of the legislation. Reducing medical payments by the amount received from medicare would lower costs by 3-4%. Providing survivors with a 3-year lump sum benefit rather than a 5-year lump sum payment would save 20-25% as would offsetting the 5-year lump sum by expected social security old age and disability benefits. Combining all of these changes would reduce costs by almost 50%.     

黄芩甙护肤霜的研制和应用

介绍利用中草药黄芩提取物黄芩甙制成水包油型护肤霜,其各项理化指标符合QB/T1857—93标准。临床应用结果表明,该护肤霜对黄褐斑、色素沉着、痤疮、皮肤粗糙、干裂疗效显著。     

江泽民关于卫生预防的思想探讨

江泽民同志非常重视卫生预防工作,对此作过详细阐述,学习和研究江泽民同志的卫生预防思想,有利于促进我国卫生事业的发展。从"预防为主"是我国卫生工作的基本方针之一、预防工作的重点、预防工作的举措等方面对江泽民的卫生预防思想进行了初步探讨。