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Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Crim. 177 ye

erläutert von C. Keller, Königl. Preuß. Geheimen Justiz-Rath, Mitglied des General-Auditoriats ; Volltext // Exemplar mit der Signatur: Augsburg, Staats- und Stadtbibliothek -- Stw 5092

In this paper we propose a culture-based health promotion/disease prevention intervention model. This model, which is family-based, incorporates a life course perspective, which involves the identification of individual developmental milestones, and incorporates aspects of culture that have been widely used across cultures to influence behavior and mark important developmental transitions. Central among those cultural traits is the ritual, or rite of passage, which, for millennia, has been used to teach the skills associated with developmental task mastery and move individuals, and their families, through life stages so that they reach certain developmental milestones. Family rituals, such as eating dinner together, can serve as powerful leverage points to support health behavior change, and serve as unique intervention delivery strategies that not only influence behavior, but further strengthen families.

OBJECTIVES: To explore differences in urban versus rural lifetime excess risk of cancer from five specific contaminants found in food and beverages. METHODS: Probable contaminant intake is estimated using Monte Carlo simulations of contaminant concentrations in combination with dietary patterns. Contaminant concentrations for arsenic, benzene, lead, polychlorinated biphenyls (PCBs) and tetrachloroethylene (PERC) were derived from government dietary studies. The dietary patterns of 34 944 Canadians from 10 provinces were available from Health Canada's Canadian Community Health Survey, Cycle 2.2, Nutrition (2004). Associated lifetime excess cancer risk (LECR) was subsequently calculated from the results of the simulations. RESULTS: In the calculation of LECR from food and beverages for the five selected substances, two (lead and PERC) were shown to have excess risk below 10 per million; whereas for the remaining three (arsenic, benzene and PCBs), it was shown that at least 50% of the population were above 10 per million excess cancers. Arsenic residues, ingested via rice and rice cereal, registered the greatest disparity between urban and rural intake, with LECR per million levels well above 1000 per million at the upper bound. The majority of PCBs ingestion comes from meat, with values slightly higher for urban populations and LECR per million estimates between 50 and 400. Drinking water is the primary contributor of benzene intake in both urban and rural populations, with LECR per million estimates of 35 extra cancers in the top 1% of sampled population. CONCLUSION: Overall, there are few disparities between urban and rural lifetime excess cancer risk from contaminants found in food and beverages. Estimates could be improved with more complete Canadian dietary intake and concentration data in support of detailed exposure assessments in estimating LECR.

BACKGROUND: Getting research into policy and practice in healthcare is a recognised, world-wide concern. As an attempt to bridge the gap between research and practice, research funders are requesting more interdisciplinary and collaborative research, while actual experiences of such processes have been less studied. Accordingly, the purpose of this study was to gain more knowledge on the interdisciplinary, collaborative and partnership research process by investigating researchers' experiences of and approaches to the process, based on their participation in an inventive national research programme. The programme aimed to boost collaborative and partnership research and build learning structures, while improving ways to lead, manage and develop practices in Swedish health and social services. METHODS: Interviews conducted with project leaders and/or lead researchers and documentation from 20 projects were analysed using directed and conventional content analysis. RESULTS: Collaborative approaches were achieved by design, e.g. action research, or by involving practitioners from several levels of the healthcare system in various parts of the research process. The use of dual roles as researcher/clinician or practitioner/PhD student or the use of education designed especially for practitioners or 'student researchers' were other approaches. The collaborative process constituted the area for the main lessons learned as well as the main problems. Difficulties concerned handling complexity and conflicts between different expectations and demands in the practitioner's and researcher's contexts, and dealing with human resource issues and group interactions when forming collaborative and interdisciplinary research teams. The handling of such challenges required time, resources, knowledge, interactive learning and skilled project management. CONCLUSIONS: Collaborative approaches are important in the study of complex phenomena. Results from this study show that allocated time, arenas for interactions and skills in project management and communication are needed during research collaboration to ensure support and build trust and understanding with involved practitioners at several levels in the healthcare system. For researchers, dealing with this complexity takes time and energy from the scientific process. For practitioners, this puts demands on understanding a research process and how it fits with on-going organisational agendas and activities and allocating time. Some of the identified factors may be overlooked by funders and involved stakeholders when designing, performing and evaluating interdisciplinary, collaborative and partnership research.

Through an examination of the implementation of the 1996 Personal Responsibility and Work Opportunity Act in the state of Mississippi, we explore the adequacy of traditional two‐actor principal‐agent theory. Using this as our lens, we suggest that the choices made by Mississippi in the area of welfare reform to privatize much of the work and to add several layers to the existing principal‐agent relationship substantially reduced accountability and the effectiveness of the monitoring systems. We conclude that not only is traditional principal‐agent theory an insufficient tool for understanding the complex interrelationship between democratic actors in this particular case, the decisions of the state of Mississippi to complicate the principal‐actor relationship through privatization also undermined the reform effort itself in ways that may have general implications for other like‐minded efforts in other policy areas.There are those who are undermining what we are trying to achieve ...—Bud Henry, Director of Economic Assistance, Mississippi Department of Human Services