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This article offers for inspection the proposition that the adversarial evidence-based litigation process is unsuitable for resolving custody cases in general and relocation cases in particular. It analyzes the leading cases from New York, Massachusetts, California, England, Canada, and Australia. It reaches a conclusion that no jurisdiction has devised a legal standard or formula that enables a judge to predict the future best interest of a child if that child is allowed to relocate with one parent away from the other. For this reason, the court has a duty to offer as sophisticated and friendly a settlement process and atmosphere as possible. However, knowing that judges will still be required to resolve these difficult cases because they often seem impervious to settlement, the article offers thirty-six factors that a court should consider in all move-away cases. By relying on each of these factors that is relevant to the case, the parents will have an understanding of why the decision was made the way it was and it will also allow for effective appellate review. [ABSTRACT FROM AUTHOR]

To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors. This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics. Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes. We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey. The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation. We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover. [ABSTRACT FROM AUTHOR]

Introduction Collabo RATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate Collabo RATE scores and response rates across multiple clinical settings with varied patient populations. Method All adult patients at three United States primary care practices were eligible to complete Collabo RATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications. Mixed-effects logistic regression evaluated the impact of site, clinician, patient age and patient gender on the Collabo RATE score. Results While Collabo RATE score increased only slightly with increasing patient age ( OR 1.018, 95% CI 1.014-1.021), female patient gender was associated with significantly higher Collabo RATE scores ( OR 1.224, 95% CI 1.073-1.397). Clinician also predicts Collabo RATE score (random effect variance 0.146). Site-specific factors such as clinical workflow and checkout procedures play a key role in successful in-clinic implementation and are significantly related to Collabo RATE scores, with Site 3 scoring significantly higher than Site 1 ( OR 1.759, 95% CI 1.216 to 2.545) or Site 2 (z=−2.71, 95% CI −1.114 to −0.178). Discussion This study demonstrates that Collabo RATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. [ABSTRACT FROM AUTHOR]

Although we know a great deal about the percentage of youth who drink alcohol, we know very little about the specific brands they choose to drink. This information gap needs to be addressed if public health officials are to develop more effective interventions. Unfortunately, there are no national youth surveys that collect data on alcohol brand consumption. In this paper, we describe the development and pilot testing of what we believe to be the first comprehensive, Internet-based youth survey of brand-specific alcohol use. We used online advertising in 3 U.S. cities to recruit a convenience sample of 241 respondents, ages 16 to 18 years. We used Craigslist, a network of online communities that features local classified advertisements, to recruit the sample. We used SurveyGizmo, an online software program for designing Internet surveys, collecting data, and performing basic analysis, to survey these respondents about their brand-specific alcohol consumption patterns. The survey instrument assessed each respondent's 30-day drinking history, including the frequency of consumption for each alcohol brand. Using Internet survey technology, we were able to collect information on 366 brands and still have respondents complete the instrument quickly and easily. The total number of brands consumed in the past 30 days ranged from 1 to 18, with a median of 4 brands. The top 5 brands consumed were beer brands, as were eleven of the top 15 brands. The remaining 4 brands in the top 15 included 3 brands of flavored alcoholic beverages and 1 brand of mixed drink. Among the top 15 alcohol brands consumed during heavy drinking episodes were 8 brands of beer, 4 brands of flavored alcoholic beverages, 2 brands of wine, and 1 brand of mixed drink. This pilot study helps establish the feasibility of including brand-specific questions on federal or other national youth alcohol surveys. [ABSTRACT FROM AUTHOR]

Many local governments are adopting inclusionary zoning (IZ) as a means of producing affordable housing without direct public subsidies. In this paper, panel data on IZ in the San Francisco metropolitan area and suburban Boston are used to analyse how much affordable housing the programmes produce and how IZ affects the prices and production of market-rate housing. The amount of affordable housing produced under IZ has been modest and depends primarily on how long IZ has been in place. Results from suburban Boston suggest that IZ has contributed to increased housing prices and lower rates of production during periods of regional house price appreciation. In the San Francisco area, IZ also appears to increase housing prices in times of regional price appreciation, but to decrease prices during cooler regional markets. There is no evidence of a statistically significant effect of IZ on new housing development in the Bay Area. [ABSTRACT FROM PUBLISHER]

ulrich c.m., taylor c., soeken k., o'donnell p., farrar a., danis m. & grady c. (2010) Everyday ethics: ethical issues and stress in nursing practice. Journal of Advanced Nursing 66(11), 2510-2519. Aim. This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. Results. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. [ABSTRACT FROM AUTHOR]

Problem: Over the past several decades, inclusionary zoning (IZ) has become an increasingly popular, but sometimes controversial, local means of producing affordable housing without direct public subsidy. The conversation about IZ has thus far largely ignored variations in the structure of IZ policies, although these variations can impact the amount of affordable housing produced and the effects of IZ on production and prices of market rate housing. Purpose: We provide a detailed comparison of the ways in which IZ programs have been structured in the San Francisco and Washington metropolitan areas and in suburban Boston. Methods: We create a unique dataset on IZ in these three regions by combining original data collected from several previous surveys. We use these data to compare the prevalence, structure, and affordable housing output of local IZ programs. Results and conclusions: In the San Francisco Bay Area, IZ programs tend to be mandatory and apply broadly across locations and structure types, while including cost offsets and alternatives to onsite construction. In the Washington, DC, area, most IZ programs are also mandatory, but have broader exemptions for small developments and low-density housing. IZ programs in the Boston suburbs exhibit the most heterogeneity. They are more likely to be voluntary and to apply only to a narrow range of developments, such as multifamily housing, or within certain zoning districts. The amount of affordable housing produced under IZ varies considerably, both within and across the regions. There is some evidence that IZ programs that grant density bonuses and exempt smaller projects produce more affordable housing. Takeaway for practice: Although variation in IZ program structures makes it hard to predict effectiveness, IZ's adaptability to local circumstances makes it a particularly attractive policy tool. IZ programs can easily be tailored to accommodate specific policy goals, housing market conditions, and residents' preferences, as well as variations in state or local regulatory and political environments. Research support: This article is adapted from a longer working paper written with financial support from the Center for Housing Policy, the research affiliate of the National Housing Conference. [ABSTRACT FROM AUTHOR]

A curriculum unit for middle school Earth Science called “What's on Your Plate?” was designed. The unit was implemented in several middle and high school classrooms in California and Massachusetts. In the first implementation, the total number of students who participated was 1100. The unit was designed with two main pedagogical principles: make thinking visible, and help students learn from one another; both were derived from an inquiry-based framework. With these two main pedagogical principles as a larger guiding framework, we designed the curriculum to provide students with rich, iterative model-based activities for students to both learn with and provide criteria for them to critique their peers' work from the opposite coast. The goal here was to influence students' understanding of the domain as well as their understanding of the nature of models in science by engaging them in an authentic context in which they constructed and reasoned with models, as well as critiqued the models of their peers. Data from 15 classrooms is described both in terms of the gains students made of their understanding of the nature of models as measured by pencil and paper survey administered both before and after the unit. In addition, a small subset of students' data is shown to illustrate advances in students' understanding of models. Lastly, we show how students with more sophisticated epistemologies of models are better able to further their content understanding as compared to students with less sophisticated epistemologies of models. [ABSTRACT FROM AUTHOR]

This section offers updates related to civic affairs in the U.S. as of June 1994. There has been a civic journalism boom in the country as evidenced by an increase in the number of papers and broadcasters that have adopted community debates. A formal organization is being established by Los Angeles County, California to support money-making ventures. A decision was made by the Massachusetts Department of Social Services (DSS) to privatize its revenue-generating operation to recover lost federal reimbursement dollars.

Despite more than 30 years of public health programs to reduce tobacco use, smoking is still the leading preventable cause of death in the United States. In response to this continuing epidemic, voters in California (1988), Massachusetts (1992), Arizona (1994), and Oregon (19%) approved ballot initiatives that established state- wide tobacco control programs funded by cigarette excise tax revenues. Evaluating these innovative public health interventions is important, both to improve existing programs and to guide other states in developing and implementing similar interventions. In this paper we describe the methods being used to evaluate the statewide anti-tobacco campaigns in California and Massachusetts, and review the findings of process and outcome evaluations of both programs. Our review suggests that both programs have had a substantial impact on the public `s health by reducing cigarette consumption and stimulating the development of policies to reduce environmental tobacco smoke exposure. However, it does not appear that either program has reduced smoking initiation among adolescents. Our evaluation suggests three problems in pm gram implementation that future anti-tobacco campaigns must avoid in order to produce long-term, sustained effects: (1) the gradual erosion of program funding by the state legislatures and governors; (2) the lack of a consistent, supportive constituency within state government and (3) inconsistency in campaign themes, messages, and programs. We conclude by offering recommendations to correct these problems so that state- wide cigarette-tax -funded anti-tobacco campaigns can realize their potential to become one of the most effective public health interventions available. [ABSTRACT FROM AUTHOR]

This narrative-based paper provides a first-person account of the early history of telepathology (1985–2000) by the field's inventor, Ronald S. Weinstein, M. D. During the 1980s, Dr. Weinstein, a Massachusetts General Hospital-trained pathologist, was director of the Central Pathology Laboratory (CPL) for the National Cancer Institute-funded National Bladder Cancer Project, located at Rush Medical College in Chicago, IL. The CPL did post therapy revalidations of surgical pathology and cytopathology diagnoses before outcomes of the completed clinical trials were published. The CPL reported that interobserver variability was invalidating inclusion of dozens of treated bladder cancer patients in published reports on treatment outcomes. This problem seemed ripe for a technology-assisted solution. In an effort to solve the interobserver variability problem, Dr. Weinstein devised a novel solution, dynamic-robotic telepathology, that would potentially enable CPL uropathologists to consult on distant uropathology cases in real-time before their assignment to urinary bladder cancer, tumor stage, and grade-specific clinical trials. During the same period, universities were ramping up their support for faculty entrepreneurism and creating in-house technology transfer organizations. Dr. Weinstein recognized telepathology as a potential growth industry. He and his sister, Beth Newburger, were a successful brother–sister entrepreneur team. Their PC-based education software business, OWLCAT™, had just been acquired by Digital Research Inc., a leading software company, located in California. With funding from the COMSAT Corporation, a publically traded satellite communications company, the Weinstein-Newburger team brought the earliest dynamic-robotic telepathology systems to market. Dynamic-robotic telepathology became a dominant telepathology technology in the late 1990s. Dr. Weinstein, a serial entrepreneur, continued to innovate and, with a team of optical scientists at The University of Arizona's College of Optical Sciences, developed the first sub-1-min whole-slide imaging system, the DMetrix DX-40 scanner, in the early 2000s. [ABSTRACT FROM AUTHOR]