Risk Communication in The Netherlands: The Monitored Introduction of the EC "Post-Seveso" Directive

Implementation of article 8.1 of the EC-"Seveso" Directive (82/501/EC) is now under way in many countries in Europe. In The Netherlands, the implementation of the Directive started with a carefully monitored introduction of active information provision at two sites (Dordrecht and Elst). This introduction was supported by a multidisciplinary research group. This group helped to develop the risk communication program and also played a role in the evaluation of the program. This paper describes these processes and their evaluation. We will focus on the design of the risk communication programs and the effects of the programs on knowledge and attitudes of the local target groups. This effort and its results clearly started an institutional learning process involving governmental bodies at several organizational levels (local, regional, and national), and industrial organizations (individual firms and organizations of industries). Monitoring the design, the implementation, and the effects of active information provision proves an effective means to gain experience with the implementation of the Seveso Directive and could help to facilitate further implementation.     

Innovation in education: Technological economics

Technological change and innovation are vital parts of the economy. This paper concerns one particular attempt to study both the process of innovation itself and possible means of increasing its effectiveness: Technological Economics. Barriers to innovation, intellectual and organizational, are described from the experience at the University of Stirling.     

An evolving medical leadership position. Tomorrow's Vice President for Medical Affairs

The role of medical leadership in hospitals and health systems is under constant scrutiny and change. The nature of the Vice President for Medical Affairs (VPMA) position and its relationship to leadership in the health care system is explored through a national panel survey conducted recently. The effective VPMA will: be an aggressive manager able to implement change, address strategic planning and quality of care issues; have a high level of integrity; and be a good communicator and problem solver. The results of the research are presented in three sections. The first section describes the background characteristics and compensation of the VPMAs who participated in the survey. The second section focuses on the current role of the VPMA, including duties and responsibilities, job performance barriers and required skills. The final section addresses respondents' perceptions regarding areas for improvement in the role of the VPMA, as well as projections for future changes in this position.     

The Large Sample Distribution of the Weighted Log Rank Statistic Under General Local Alternatives

We derive the large sample distribution of the weighted log rank statistic under a general class of local alternatives in which both the cure rates and the conditional distribution of time to failure among those who fail are assumed to vary in the two treatment arms. The analytic result presented here is important to data analysts who are designing clinical trials for diseases such as non-Hodgkins lymphoma, leukemia and melanoma, where a significant proportion of patients are cured. We present a numerical illustration comparing powers obtained from the analytic result to those obtained from simulations. This revised version was published online in July 2006 with corrections to the Cover Date.