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The proper management of hazardous wastes is an issue facing many communities, necessitating greater citizen involvement in the decision-making process. The study explored the effectiveness of two methods of presenting information concerning hazardous waste management alternatives. Two, one-day workshops, attended by community leaders, were held. Each workshop day was considered a treatment group. The two workshops, an on-site visit and a simulated (slide) site visit, were compared using pretest, posttest, and follow-up attitude and comprehension questionnaires. For the most part, no significant differences were found between the two treatment groups. However, significant differences in the attitudes held by those in technical and non-technical occupations were found.

Background The scale-up of HIV Counselling and Testing (HCT) in South Africa to 4500 public health facilities and the service's provision in mobile and non-medical sites was aimed at increasing HCT uptake. However, some people still have never had an HIV test. Objective An HCT survey was carried out to ascertain barriers and facilitators for HIV testing in South Africa. Methods A cross-sectional survey of 67 HCT-offering health facilities in 8 South African provinces was undertaken. Individuals (n = 489) who had not tested for HIV on the day of the site visit were interviewed on awareness of HCT services, HIV testing history and barriers to HIV testing. Frequencies were run to describe the sample characteristics, barriers and facilitators to HIV testing. Bivariate and multivariate logistic regression was used to identify the association between never tested for HIV with socio-demographics, awareness of HCT services and type of HCT facilities. Results In all 18.1% participants never had an HIV test. Major barriers to HCT uptake comprise being scared of finding out one's HIV test result or what people may say, shyness or embarrassment, avoidance of divulging personal information to health workers and fear of death. In multivariate analysis the age group 55 years and older, and not being recommended to have an HIV test were associated with never had an HIV test. Potential facilitators for HIV testing include community or household HIV testing, providing incentives for those who test for HIV, mandatory HIV testing and disclosure of HIV status by those who test HIV positive. Conclusion The benefits of HCT which include the reduction of HIV transmission, the availability of HIV care and treatment needs to be emphasized to enhance HCT uptake. Health workers also need to recommend HCT to all individuals attending health facilities offering this service.

Background Endemic health care-associated safety problems, including health care-associated infection, account for substantial morbidity and mortality. We outline a regional No Preventable Harms campaign to reduce these safety problems and describe the initial results from the first initiative focusing on catheter-associated urinary tract infection (CAUTI) prevention. Methods We formed a think tank composed of multidisciplinary experts from within a 7-hospital Midwestern Veterans Affairs network to identify hospital-acquired conditions that had strong evidence on how to prevent the harm and outcome data that could be easily collected to evaluate improvement efforts. The first initiative of this campaign focused on CAUTI prevention. Quantitative data on CAUTI rates and qualitative data from site visit interviews were used to evaluate the initiative. Results Quantitative data showed a significant reduction in CAUTI rates per 1,000 catheter days for nonintensive care units across the region (2.4 preinitiative and 0.8 postinitiative; P = .001), but no improvement in the intensive care unit rate (1.4 preinitiative and 2.1 postinitiative; P = .16). Themes that emerged from our qualitative data highlight the need for considering local context and the importance of communication when developing and implementing regional initiatives. Conclusions A regional collaborative can be a valuable strategy for addressing important endemic patient safety problems.

This article is based on the authors' observations on health care delivery and problems during a three-day site visit to rural Mississippi in February, 1976. During the trip, sponsored by the George Washington University Health Staff Seminar, they visited the following health clinics and facilities: Jackson-Hinds Comprehensive Health Center, Jackson and Utica, Miss; Central Maternal and Pediatric Clinic, Jackson; Milton Olive Clinic, Lexington; County Health Improvement Pmgram, Holmes County; Tchula Clinic, Tchula; and Delta Community Hospital, Mound Bayou

The Postapplication Phase should be the easiest part of the application process but in reality it is the most difficult of all for some applicants; it is the phase during which the initiative is entirely in the hands of the funding organization, and all the applicant can do is stand and wait. The urge to “do something” during this period is irresistible for some and they rush about telephoning friends who might be influential, checking on date, time, and place of review committee meetings, or bombarding the program officer with questions about the status of the application and the possibilities of its being approved. No one knows for certain whether this does or does not help because no study has been done—at least no well-publicized one—to indicate that such activities affect the outcome of a proposal one way or another. Not that it matters very much; individuals who are disposed to take action during a waiting period will not be deterred by statistical evidence that it doesn’t help, because it helps them. They are constitutionally unable to await the results of any pending decision in which they have a stake. But it is useful to understand exactly what the process is and especially to know the estimated time lag between the date a proposal is submitted and the date an announcement of awards can be expected.

The Yucca Mountain region was used by Owens Valley Paiute, Western Shoshone, and Southern Paiute people for thousands of years. The area contains numerous plants, animals, and sacred resources traditionally used by these people. This report presents the location and interpretation of Native American cultural resources on or near Yucca Mountain, Nevada. This work built upon the archaeological reconnaissance and identifications of cultural resources by the Desert Research Institute. Interpretations provided by Native American Indian people are not intended to refute other scientific studies, such as botanical, wildlife, and archaeological studies. Rather, they provide additional hypotheses for future studies, and they provide a more complete cultural understanding of the Yucca Mountain area. Representatives of sixteen American Indian tribes identified the cultural value of these resources as part of a consultation relationship with the U.S. Department of Energy (DOE). This interim report is to be used to review research procedures and findings regarding (1) initial consultation with the sixteen tribes, (2) in -depth interviews with tribal elders, and (3) findings from the first on -site visit with representatives of the sixteen tribes.

A regular coordination meeting, the seventh in a quarterly series, was held of the ''methane production'' group of the Fuels from Biomass Systems Branch, U.S. Department of Energy. The meeting was held in Seattle, Washington in order to site visit the Monroe, Washington anaerobic digester facility operated by Ecotope Group, Inc. In addition, progress reports were presented from all contractors. A list of attendees, the working schedule, and the progress reports and special topical reports presented are included in the following. Separate abstracts were prepared for the progress and special topical reports.

The scientific direction of the work in this grant is unchanged and the 12 research projects in the three major categories represent only minor modification from the proposed work given at site visit. Adjustment was necessary in keeping with the award and to accommodate the resignation of Dr. S. John Gatley who took a position at the Brookhaven National Laboratories. Significant progress is being made in each scientific area with principal responsibility in radiochemistry now assumed by J. Mukherjee and S. Murphy, both of whom have contributed major advances in their areas of fluorination of receptor ligands for studies of the dopaminergic system and approaches to studies of the glutamate type II receptors, respectively. C.T. Chen's work in quantitative method approaches to image integration and analysis continues to receive national and international attention. Similar attention is being given to J. Metz and H. deWit with their work on the effects of drugs of dependency on mood and regional brain metabolism. Resource development in the overall program has been substantial. An equipment grant totaling $350,000 was awarded to the Frank Center for Image Analysis of the FMI by the W.M. Keck Foundation through The University of Chicago/Argonne National Laboratory Center formore » Imaging Science for purchasing computer systems for graphic display, visualization of 2D and 3D image data, and fast computation. We have purchased nine VAXstations, five DECstations, two SUN/SPARCstations, one AT T Pixel Machine system, and the associated communication links for networking. These systems are currently being installed and tested. This facility will provide added computation capabilities for and facilitate the development of the research projects. 39 refs., 4 figs.« less

This report is intended to provide responsible DOE authorities with the professional observations and recommendations resulting from this firm's technical assistance in evaluating an accidental release of solvent refined coal (SRC) processed liquids at the SRC Pilot Plant, Ft. Lewis, Washington. The spill occurred during the night of December 19-20, 1979 at the facility operated for DOE by the Pittsburgh and Midway Coal Mining Company. The site visit on January 29, 1980 was made by DOE's staff member, Mr. John Abrahams, and this firm's representative, Mr. ALvin F. Meyer, Jr., P.E., President. In brief, the spill of approximately 2300 gallons of SRC processed liquids was caused by human failure. Compounding the circumstances was the presence of a bleeder valve which was inexplicably left open. Additional factors contributing to the episode were the fact that the operation was conducted at night, and the presence of steam and noise which obscured, at least partially, the possibility of detecting the spill occurrence. After operating personnel discovered the spill, the plant management of Pittsburg and Midway Coal Mining Company were informed. It was decided that environmental surveys and measurements would be undertaken to detect any possible contamination. Subsequent to the site visit, additional informationmore » was provided by Pittsburg and Midway Coal Mining Company, and by Hqs. ASFE Program officials. Analysis of the available data to date (February 22, 1980) indicates that no off site (SRC Plant boundaries) environmental contamination has occurred. A need exists for close further study and evaluation.« less

This report identified human engineering discrepancies (HEDs) in Callaway-1. It was found that overall the systems reviewed were designed to permit effective and efficient operator actions. The applicant's proposed resolutions of the HEDs are acceptable to the Human Factors Engineering Branch (HFEB) staff. Because of the large number of systems not available for evaluation during the HFEB site visit, a second visit will be required. (DLC)

Three staff members from Oak Ridge National Laboratory (ORNL) participated in a site visit to US Antarctic Program (USAP) facilities at McMurdo Station, Amundsen-Scott South Pole Station, and remote field and support sites. Interviews were conducted with National Science Foundation, Navy, and ITT/Antarctic Services staff responsible for environmental management functions. The ORNL team visited all facilities at McMurdo Station, three remote field camps, a Navy refueling facility, South Pole Station, and Scott Base (a New Zealand installation). In general, the team found that environmental impacts of the USAP are minor for the Antarctic continent as a whole. Improvements for the handling and disposal of solid wastes and the discharge of wastewaters that have been initiated should help minimize environmental impacts of USAP activities. The information collected during the site visit will be used in a draft supplemental environmental impact statement on the USAP to be published for public review in June 1990.

This section contains edited copies of site-visit and other reports prepared by CCAWG members. Some of the hand-out materials prepared by DOE contractors and others are included (without explication) to permit readers the construction of a coherent picture of work in progress.

Before going on to the site, it is first necessary to be quite clear as to: (a) The client’s brief, the area of floor space required and how it can be disposed about the site, whether in single-storey or multistorey building. (b) The exact location and boundaries of the site. (c) The objectives of the site visit. To return to the office and find some important piece of information missing can waste considerable time and money. It is also necessary to have ready to hand all the equipment needed to carry out the survey. Check lists are valuable for both equipment and objectives. Such lists can be designed so that the information obtained can be written in on site, and will thus serve as a permanent record.

Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

A public archaeology programme was initiated at the Fern Avenue site (an early nineteenth century Adelaide jam factory) as an integral part of the archaeological investigations conducted between March 2000 and November 2000. One component of the public archaeology programme was an archaeological education programme for primary and early secondary aged school children. The primary school component of the programme provided 583 inner-city primary aged school children (aged between 7 and 11) with a classroom introduction to archaeology followed by practical on-site experience. This paper focuses on the outcomes of the primary school class-based teaching. Analysis of the children's written schoolroom answers has enabled a basic evaluation of the students' overarching perceptions relating to Australian archaeology. In general, this study suggested that the primary aged school children involved in the programme understood that archaeology involved 'investigating the past' and 'excavation'. However, comprehension beyond these fundamentals was limited ? especially in terms of more specific knowledge, such as an understanding that Australian archaeology comprised the major disciplines Aboriginal, historical or maritime. Although the children's initial understanding of archaeology was limited, it held a high level of appeal. The base interest generated by archaeology was used to teach the fundamentals, whilst the site visit compounded and enhanced most of the students' awareness of the discipline, creating a memorable experience for all involved.

Citizens in contemporary societies are encountering more and more issues that are somehow related to science and technology. Therefore, science and technology education plays an important role in providing students with the knowledge and the competences they need in their life. The research and development project discussed in this chapter focuses specifically on scientific literacy. It is considered as a crucial element of multiple literacies required in modern life. These proficiencies are often referred to in terms such as information literacy, media literacy, environmental literacy, political literacy, computer literacy etc. (see e.g., Lankshear & Knobel, 2003). In order to enhance student scientific literacy the authors introduce a model of industry site visit for lower secondary school science education as a form of out-of-school learning. The potential of the site visit and other learning activities connected to it are discussed in the frameworks of scientific literacy, motivation and interest. The site visit and the activities, such as the use of ICT in reading and writing, are scrutinised with regard to the specified educational goals. The analysis of the motivational aspects of the site visit is based on self-determination theory. Self-determined learning could occur when an activity at a site is considered by a learner to be interesting, enjoyable, or personally valuable. Furthermore, the site visit offers role models which are critical for students’ choice of advanced studies and careers in science. Some empirical results on both cognitive and affective learning outcomes, as well as challenges that were encountered are presented on the basis of first design and evaluation cycle.

In the Council Meeting of the XIJIth International Congress of Nephrology (ICN) in Madrid, Spain, I was unexpectedly nominated as President-Elect of the International Society of Nephrology. It was one of the highest honors in my professional career and I accepted this important responsibility of the Society. I say "unexpectedly" because I was informed that I was to be a candidate only a few weeks prior to the Congress, and thus I was not prepared for the role. However, due to my commitments as a member of the Scientific Program Committee for the TCN in Tokyo 1990, the 1993 ICN in Jerusalem, and the 1995 ICN in Madrid, I have learned a great deal and have gained insights into the history, activities, and organizational structure of this distinguished Society. These interactions and involvement in the activities of the Society have helped me become acclimated to the job in a timely manner. Over the last two years, under the able and enthusiastic leadership of President Robert W. Schrier, together with the absolutely effective executive offices of Vice-President Thomas E. Andreoli, Secretary General Jan Weening, and Treasurer C. Craig Tisher, the Society has increased its membership, in part through the introduction of a new membership policy for nephrologists in "currently economically handicapped countries." This new policy will enable many nephrologists in such countries to have easier access to current actions in education, training, and the state-ofthe-art technologies in nephrology. Moreover, it will enable the Society's activities to be disseminated into wider areas throughout the world. We all hope more nephrologists worldwide will join the Society to contribute to the prevention and care of patients suffering from renal diseases. One of the many important activities which has contributed greatly to the dissemination of the missions of the Society has been the Commission for Global Advancement of Nephrology, co-chaired by Drs. Barry M. Brenner and John H. Dirks. Under their superb leadership the Commission has reached various parts of "currently economically handicapped countries" of the world by sending "site visit" teams which interacted effectively with national societies and local nephrologists and assisted organizing nephrology courses by sending faculty and funds that enabled young nephrologists in some of these countries to come to such courses. I became a part of those missions by serving as Chair of the Asian Pacific Subcommittee of the Commission. I believe that the Society should continue this Commission on an even greater scale in the coming years. The principal philosophy behind launching such a Commission is our understanding that any international scientific society should try to meet the needs of

There has been much discussion in the recent statistical literature concerning the optimal manner for a consulting statistician to operate within a larger organization. Marquardt (1979) described the "total involvement" approach, involving a statistician from conceptualization of a project to the final report; Finney (1982) discussed the questions a statistician should ask for effective consulting; and Bishop, Peterson, and Tragser (1982) argued that a statistician's most substantive contributions are made during the planning stages of a study. McCulloch et al. (1982) described a program for training statistical consultants, and Hunter (1981) discussed the roles a statistician may assume. A statistician consulting in a geographically dispersed organization will encounter difficulties similar to those of a statistician consulting in-house. The typical obstacles encountered through in-house consulting are greatly exaggerated, however, when consulting with clients at distant sites. Similarly, the skills needed to be an effective consultant at a distance are generally the same as those required for inhouse consultation, but some must be enhanced for effective consultation at a distance. In this article we present, from our experience, some of the problems that become exaggerated when consulting at a distance, some of the skills that must also be exaggerated to produce effective consulting in this situation, some features we have found useful in long-distance consultation, and some recommendations for the classroom, which may help prepare students for consulting by telephone. As with in-house consulting, visits to experimental sites are an important aspect for effective statistical consultation (e.g., Hahn 1984). A statistician consulting with distant field sites has a different involvement in a site visit, however, than does a statistician consulting in-house. Hahn stated that the major mode of communication between experimenter and statistician should be face to face. A statistician consulting in-house is available for face-to-face communication as needed by the experimenter, in addition to visiting the experimental site. For a statistician consulting with distant sites, a site visit frequently represents the only opportunity for face-to-face consultation across a span of months or years. Thus a visit to a distant site is a "temporary" resource, and the statistician must expect to have his or her talents exploited to the fullest. Consulting relationships must be established and developed in a relatively short span of time; current projects must be reviewed and future projects anticipated; and the statistician must learn the purposes and constraints under which the field station is operating. An in-house site visit generally does not need to accomplish as much. When consulting with an in-house experimental site, if something more needs to be done, the statistician and experimenter can always meet again later. When consulting with a distant site, however, the statistician will have to accomplish anything left undone over the telephone, since another visit may not be feasible in the near future. Therefore, a statistician visiting a distant site must expect much longer and more intensive consulting sessions than would be usual for in-house visits. Such visits to distant field sites usually require far more mental and physical stamina than would be expected in-house, and a statistician unwilling to meet the demands will not produce a successful site visit. Ideally, a statistician should be able to make a site visit at the start of every major project. This is rarely accomplished, even for in-house situations; but visits to distant projects are accomplished far less frequently than nearby or in-house projects. In practice, it may be fortunate if a statistician ever visits a particular field site, let alone at the start of each project. Consequently, most statistical consulting in a widely dispersed organization is done by telephone. A statistician in a central location must therefore sharpen the skills that allow consultations over the telephone to be as effective as possible. When consulting over the telephone, the statistician must not only receive and assimilate complicated information but be able to convey complex ideas in a manner that is useful to the person in the field. In the absence of face-to-face communication, the difficulty of this task is greatly magnified. Possibly the most essential element for effective consultation by telephone is the ability to understand the situation quickly (objectives, study design, data structure, etc.). The statistician needs to ask precise questions that are *Richard Engeman is a Statistician, and William Dusenberry is a Statistician and Chief of the Section of Technical Services, both at the Denver Wildlife Research Center, U.S. Fish and Wildlife Service, Bldg. 16, Denver Federal Center, Denver, CO 80225. The authors thank Dave Otis, John Oldemeyer, and anonymous referees for their helpful reviews.

THE IMPACT of Cicely Saunders, OBE, FRCP, director of St Christopher's Hospice, London (Sydenham), on the care of the dying patient is persuasive. After Dr Saunders had lectured at St Luke's Hospital Center, a Hospice Committee was established at St Luke's to consider the introduction of similar concepts within the framework of a university general hospital. Two members of the committee and I were invited to St Christopher's for an in-depth site visit in order to assist the committee in its deliberations. I believe this report is factually correct, although it reflects my own intense positive involvement with a committee hospice staff. First Impressions Although I arrived with an initial resistance to continual contact with the dying patient, the actual experience was quite different from what I had expected. Instead of a terminal care or "death house" environment with cachectic, narcotized, bedridden, depressed patients, I found an active community of