How a Washington Lobbyist Gives Lawmakers Free Trips Despite the Ban on Lobbyist-Funded Travel

A group of Washington lobbyists led by Richard Kessler under the umbrella of the Ripon Educational Fund and the Ripon Society has spent millions of dollars taking lawmakers to European capitals and U.S. resorts, thereby skirting congressional ethics rules that forbid registered lobbyists from paying for congressional travel.Kessler, head of Kessler Business Services, has kept a lower profile than many better-known Washington lobbyists, such as admitted felon Jack Abramoff. Few have questioned the more than $1 million in free travel that lawmakers have reported receiving from groups and companies Kessler appears to control or influence. All told, Kessler-influenced groups and companies are responsible for providing 6 percent of the$17.6 million lawmakers have reported receiving in free travel from private companies and organizations from 2000 to mid-2005, Public Citizen estimates.By funneling travel money through the Ripon Educational Fund and the Ripon Society, his parent company, Century Business Services, and his lobbying clients, Kessler has apparently made it possible for lawmakers to accept free trips to European capitals and U.S. resorts without violating ethics rules. It is legal for lawmakers to take trips paid for by private companies and organizations

Transcutaneous electrical nerve stimulation for cancer pain in adults.

Background Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown. Objectives The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. Search strategy We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases (11/04/08). Selection criteria Only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults were included. Data collection and analysis The search strategy identified 37 possible published studies which were divided between two pairs of review authors that decided on study selection. A study eligibility form was used to screen each abstract and where study eligibility could not be determined from the abstract, the full paper was obtained and assessed by one pair of review authors. A standardised data extraction sheet was used to collect information on the studies and the quality of the studies was assessed independently by two review authors using the validated five-point Oxford Quality Scale. Final scores were discussed and agreed between all four review authors. The small sample sizes and differences in patient study populations of the two included studies prevented meta-analysis. Main results Only two RCTs met the eligibility criteria (64 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered. Authors' conclusions The results of this systematic review are inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults

CanWalk: study protocol for a randomized feasibility trial of a walking intervention for people with recurrent or metastatic cancer

Increasing numbers of people in the UK are living with recurrent or metastatic cancer, many of whom experience reduced quality of life resulting from the physical and psychosocial consequences of cancer and its treatment. While drug treatments are important at alleviating some symptoms, there is increasing evidence of the benefits of exercise in enhancing quality of life and health outcomes. Walking is an inexpensive and accessible form of exercise. To our knowledge, no studies have investigated whether a walking intervention is sufficient to enhance quality of life and alleviate symptoms in people with recurrent or metastatic cancer across a range of tumor types. This paper describes the CanWalk study protocol, which aims to assess the feasibility and acceptability of undertaking a randomized controlled trial of a community-based walking program to enhance quality of life and well-being in people with recurrent or metastatic cancer

Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk

Background: Depression can be debilitating, as well as a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and entrapment that ensue from experiencing oneself to be of lower rank than others. This study aims to review the literature investigating the relationship between self-perceptions of social rank and depressive symptoms or suicidal ideation/behaviour. Methods: A keyword search of three psychological and medical databases was completed (Psychinfo, Medline, Web of Knowledge). Studies were quality assessed using established criteria. Results: An initial 1290 records were identified. After application of inclusion and exclusion criteria, 70 remained measuring depressive symptoms (n = 68), self-harm (n = 3) and suicidal ideation (n = 3). The main measures assessing social rank were the social comparison scale (SCS; n = 32) and subjective social status (SSS, n = 32), with six additional papers including another measure of social rank. In univariate analyses, as perceptions of social rank decreased, depressive symptoms (and suicidal ideation/self-harm) increased. Multivariate analyses indicated that social rank may act as a psychosocial mechanism to explain the relationship between social factors (in particular socio-economic status) and depressive symptoms. Additionally, psychological variables, such as rumination or self-esteem, may mediate or moderate the relationship between social rank and depressive or suicidal symptoms. Limitations: Study quality was variable and 89% of studies were cross-sectional. Conclusions: Although more prospective research is required, this review highlights the importance of understanding an individual's perception of their social position compared to others as it may lead to an enhanced understanding of the aetiology of depressive disorders

Survey of University of California Academics\u27 Attitudes Regarding the Impact of Escaped Horticultural Introductions on Wildlands

In order to investigate whether there were differences in attitudes and perceptions within the University of California regarding the impact of introduced ornamental plants, we conducted a survey of academics with assignments in natural resource programs or ornamental horticulture. In general, the ornamental horticulture academics did not view the problem of invasive species as severely as the natural resource academics, but the both groups recognize that non-native landscape ornamentals now occur and can affect California\u27s wildlands. These data can be used to provide training to academics on this issue and help facilitate discussion between the different groups

The Use of a Non-Point Source Pollution Self-Assessment for Greenhouse and Nursery Operators in California

Water quality rules adopted in 2001 in San Diego, California, created new requirements for greenhouse and plant nursery growers to manage surface run-off that could potentially affect drinking water, recreational locations, and wildlife habitat. A Run-off and Non-Point Source Pollution Self-Assessment for Greenhouse and Container Nurseries was developed as a series of worksheets that translated technical information for growers to meet legal requirements, maintain their property value, and enhance the quality of their environment. Self-assessment results determined a need for additional training on run-off management and prevention pollution through more site-specific fertilization and pest management techniques based on routine monitoring

Increase Employee Engagement by Using the Finding Joy at Work Framework to Identify and Remedy Items that Remove Joy from our Work Life

Improving engagement scores within MaineHealth Corporate has been a focus for a number of years. The most recent data has shown a marked improvement from 2014 to 2017, moving us to the 49th percentile, but the MaineHealth goal is to bring us to the 75th percentile so there is still work to be done. The Institute for Healthcare Improvement offers training in “Finding and Creating Joy at Work”, a framework for identifying “pebbles in your shoes” that detract from your joy at work, finding and addressing the underlying root causes. We would like to use that framework to find and alleviate things that remove joy in our daily work lives in our department, therefore improving engagement and happiness at work