Bringing genetics into primary care: findings from a national evaluation of pilots in England

Objectives: Developments in genetic knowledge and clinical applications are seen as rendering traditional modes of organizing genetics provision increasingly inappropriate. In common with a number of developed world countries the UK has sought to increase the role of primary care in delivering such services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organizational boundaries and professional cultures. This paper presents findings from an evaluation of an English initiative to integrate genetics into 'mainstream' clinical provision in the National Health Service. Methods: Qualitative research in 11 case-study sites focusing on attempts by pilots funded by the initiative to embed knowledge and provision within primary care illustrating barriers faced and the ways in which these were surmounted. Results: Lack of intrinsic interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding. Conclusions: More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized

From the Open Skies proposal of 1955 to the Norstad Plan 1960: a plan too far

A proposal drafted by General Lauris Norstad for the creation of a limited inspection zone in Central Europe and in the Arctic Circle—a proposal that came to be known as the Norstad Plan—evolved out of President Dwight D. Eisenhower's Open Skies proposal. The proposal, based on ideas promoted by Eisenhower's disarmament adviser, Harold Stassen, departed from traditional U.S. disarmament policy. The plan was eventually aborted by West Germany and France, but the document heralded a shift in Eisenhower's disarmament policy. The president was ready to give up the all-or-nothing approach and adopt an incremental approach. To this end, the United States would make concessions that would render U.S. proposals more acceptable to the Soviet Union. The plan adumbrated the conceptual change that paved the way for the Limited Nuclear Test Ban Treaty and the Non-Proliferation Treaty

Knowledge Transfer and Teaching Public Administration: the Academy Model

Since the beginnings of Public Administration in the US and its accompanying education in other parts of the world, government and policy have become more complex. The education in Public Administration created a professional pathway to public service. The addition of education to Public Administration came out of the Progressive Movement in the United States to make knowledge in Public Administration more important in the face of corruption brought on by patronage appointments. When nonprofits became part the US public sector as elsewhere along with nonprofit healthcare, the complexity expanded enormously, requiring professionals to know more in what has become a multidisciplinary field of study. Given the diversity and complexity of the public sector and the need for Public Administration to embrace more knowledge from many disciplines, it stands to reason that an earlier start on the education portion of Public Administration or a pathway would be beneficial. A model of early Public Administration knowledge transfer is described and illustrated below. The Academy described is based on the US career pathways and high school academies as part of the school to work educational movement. The success of the combination of these two areas will also be pointed out in the academy described. Translation of lessons learned from the Acdemy to Europe and Asia are also considered

Blaming the victim, all over again: Waddell and Aylward's biopsychosocial (BPS) model of disability

The biopsychosocial (BPS) model of mental distress, originally conceived by the American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansell Aylward to form the theoretical basis for current UK Government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the Government has sought to reform spending on out-of- work disability benefits. This paper presents a critique of Waddell and Aylward’s model, examining its origins, its claims and the evidence it employs. We will argue that its potential for genuine inter-disciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realized. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements

WTO accession, the changing competitiveness of foreign-financed firms and regional development in Guangdong of southern China

This paper investigates the changing competitiveness of foreign-financed manufacturing firms and its implications for regional development in Guangdong province of southern China in the run-up to World Trade Organization (WTO) accession. It is argued that transnational corporations (TNCs) and some competitive, large-scale, locally-funded firms in Guangdong will triumph after WTO accession. The crowding-out process of small and medium sized enterprises (SMEs) in Guangdong will be accelerated in the near future, as they are competing directly with TNCs, and as their competitive advantages are diminishing, due to bureaucratic red tape and the rigorous enforcement of new government policies. Due to close business linkages with local privately-funded firms, the competitiveness and vitality of foreign-financed enterprises will have profound long term effects on the economic development of Guangdong, before and after WTO accession

Treasure Valley State of the Region Report: A Preliminary View of Performance Indicators

The Treasure Valley State of the Region Report, while preliminary, describes the Boise- Nampa MSA using 49 indicators on social, economic, fiscal and environmental aspects of the region. Comparisons using the indicators are also made with peer regions in the Western United States. The rapid increase in growth in the Treasure Valley warrants a comprehensive look at the region. The Institute of Urban and Regional Planning in the College of Social Sciences and Public Affairs at Boise State University initiated the production of this report to meet this need. This report was assembled by faculty and graduate students in an effort to produce a fact based report using region wide data. It was also assembled as a starting point for understanding some of the issues and opportunities we face now and in the future. Undoubtedly the information in this report will grow and evolve as we develop a region wide system of shared data

The Pauli Equation for Probability Distributions

The "marginal" distributions for measurable coordinate and spin projection is introduced. Then, the analog of the Pauli equation for spin-1/2 particle is obtained for such probability distributions instead of the usual wave functions. That allows a classical-like approach to quantum mechanics. Some illuminating examples are presented.Comment: 14 pages, ReVTe

A Global Hypothesis for Women in Journalism and Mass Communications: The Ratio of Recurrent and Reinforced Residuum

This paper examines the status of women in communications industries and on university faculties. It specifically tests the Ratio of Recurrent and Reinforced Residuum or R3 hypothesis, as developed by Rush in the early 1980s [Rush, Buck & Ogan,1982]. The R3 hypothesis predicts that the percentage of women in the communications industries and on university faculties will follow the ratio residing around 1/4:3/4 or 1/3:2/3 proportion females to males. This paper presents data from a nationwide U.S. survey and compares them to data from global surveys and United Nations reports. The evidence is overwhelming and shows the relevance and validity of the R3 hypothesis across different socio-economic and cultural contexts. The paper argues that the ratio is the outcome of systemic discrimination that operates at multiple levels. The obstacles to achieving equality in the academy as well as media industries are discussed and suggestions for breaking out of the R3 ratio are included.