Front-row Seat Research Articles

Reflections on Aspects of Medical Progress 1944-2008 - Part 1: The Launch of a Journey Lasting 65 Years: Personal Observations Made from a Front-Row Seat at the Greatest Show on Earth

Reflections on Aspects of Medical Progress 1944-2008 - Part 1: The Launch of a Journey Lasting 65 Years: Personal Observations Made from a Front-Row Seat at the Greatest Show on Earth - Volume 36 Issue 1

The Express-Lane Edit: Making Editing Useful for Adolescents

Editing is a powerful tool for writers, but are our methods of teaching it really demonstrating that power for young adolescents? The author, frustrated with students’ inability to edit, blames his own approach and, beginning with a grocery store epiphany, works to develop a more effective system. Elements of his successful approach include time to celebrate what is right with writing and the incorporation of effective, research-based instruction. Anderson offers a front row seat to “the express-lane edit” in action in his sixth-grade classroom.

The Greatest Show on Earth: A Study of the Red Cross' Front Row Seat at the Stage of Theresienstadt

During World War II, the concentration camp Theresienstadt in the northern section of Czecholslovakia played an integral role in the Nazis' schemes of international propaganda. The camp became a model city for the period of six hours while International Red Cross delegates visited on June 23, 1944 in order to prepare reports to be disseminated to the public addressing concerns at the inner workings of the camps behind Nazi front lines. To date, no overwhelming synthesis of the events precluding and proceeding the day period of deception labeled the Embellishment has been construed. I attempt to collect all details of the Embellishment, even its inception, in order to produce a more total understanding of life within the camp during this period and to create a setting conducive to visualization of the play itself. The paper in many ways also seeks to understand reasons for the Red Cross' positive outlook on the concentration camp despite worldwide concern and site-specific evidence to the contrary. In the second half of the paper, I examine why the Red Cross accepted the Embellishment to such a high degree, citing Red Cross justifications as well as the single report printed on the visit written by the Swiss representative Maurice Rossel. In sum, the Embellishment created a moment of suspended time that vastly impacted members of the concentration camp and the outside world, so that even today one may be shocked at the colossal undertaking of playacting which occurred in Czechoslovakia's rural plains.

Conspiracy Theory: Lessons for Leaders from Two Centuries of School Reform

If school leaders are to bring about successful reform, they must thwart the forces that have conspired against it since the 19th century. Mr. Nehring identifies six conspirators--destructive tendencies so deeply embedded in our culture that they often operate unnoticed--and offers practical suggestions for rooting them out. ********** GENERALLY, I am not an alarmist, but my research into the history of American school reform has led me to believe that there is something of a conspiracy against thoughtful schooling that is deeply embedded in our culture. I have come to believe also that by understanding the sources of this conspiracy, we might marshal the resources necessary to create and sustain thoughtful schools. During my years as an educator, I have been fortunate to work in a leadership role in the start-up of three small public high schools. These experiences have given me a front-row seat in the theater of school reform. I have also spoken with hundreds, perhaps thousands, of like-minded school reformers about our related efforts, and what strikes me is how similar the challenges are across demographics and across geographic locales. And so, I have been led to ask, What is the source, the common source, of all these challenges? In recent years I have gone after this question in a focused way through research that blends history and contemporary experience. Driven by a hunch that these common challenges to thoughtful school practice are culturally embedded, I have attempted to connect the dots between the problems faced by school reformers today and the problems faced by school reformers fifty, a hundred, and even two hundred years ago. If the same problems that we face today surface across the historical record, then it's reasonable to conclude that they are somehow embedded in the culture. In exploring carefully selected cases of school reformers from the 19th and 20th centuries and comparing their experiences with contemporary efforts, I have come across several themes. From these themes and from the experiences of school reformers across generations, I have developed some practical strategies for school leaders as we face these cultural conspirators in our own schools and districts. Before moving on to the conspirators themselves, of which there are six, let me explain why I use the term conspirator. Okay, it's catchy, I admit. But beyond that, these culturally embedded tendencies, like conspirators, are hidden in plain sight. You will probably not be surprised by them when you see what they are. You will surely recognize most, if not all, of them. And yet, despite their visibility, we tend to look right past them without recognizing their destructive impact on our schools. A second reason that the term applies is that, like conspirators everywhere, these tendencies work together--in this case, to tear good schools apart. Their combined impact is much greater than their individual effect. A third and final reason is that, once we're aware of the identity of the conspirators, we will probably conclude, as all good conspiracy theorists do, They're everywhere! Kidding aside, it is important to understand that these tendencies, because they are culturally rooted, can surface anywhere in our school practice. To the extent that we are products of our own culture, they reside in our own hearts and minds. Whenever we are inclined to point out these tendencies in others with whom we work, we would do well to ask where we find these same traits in ourselves. On to the conspirators. I have identified six that appear in both historical and contemporary records. As you learn about each one, consider the places in your own school setting where you see it at work. After identifying all six conspirators, we will examine the experiences of two representative school reformers from an earlier generation and consider some practical lessons for school leaders today. …

APA President Urges Support For Single-Payer Insurance System

APA President Urges Support For Single-Payer Insurance System

Science For Life: A Conversation With Nobel Laureate David Baltimore

As a man with equal interests in science and science policy, David Baltimore has been at the forefront of many of the important debates that have shaped science since the 1970s. Very much engaged in the initial discussions about the use of recombinant DNA technology, Baltimore had a front-row seat as the biotechnology industry developed. He was also a major player in the decision that resulted in funding of the Human Genome Project by the National Institutes of Health (NIH). Baltimore discusses biotechnology, science education, and the need for a strong dialogue among scientists and scholars in the health policy community.

A Front Row Seat: A Phenomenological Investigation of Learning Disabilities

Based on prior research and theory, we propose a conceptual definition of instructional communication that is holistic, transactional, expansive, and assessable. Second, we extend instructional communication research to test this definition by engaging students with learning disabilities (SWLDs) in interviews and focus groups, employing a phenomenological methodology. Specifically, 21 college SWLDs reflected on their lived experience and shared their perceptions of competent and incompetent instructor communication. Important connections between the proposed definition of instructional communication competence and the ten emergent themes that resulted from phenomenological description and reduction confirm that the proposed definition is valid conceptually and operationally, at least as represented by this study. The central metaphorical interpretation that emerged from this study ‘being in a front row seat’ recognizes not only the interest, involvement, and desire for inclusion by SWLDs, but also the need for teacher instructional communication competence with respect to this population. Future research should test this definition in other communication contexts beyond the classroom and should take into account the diversity of learning disabilities students may manifest.

Health Action AIDS Campaign

Health Action AIDS Campaign

Medicare Reform???s Impact on Long-Term Care

In late June of last year, both the House and the Senate passed the most meaningful Medicare reform legislation since Medicare’s inception in 1965. As luck would have it, this occurred just days before I joined Centers for Medicare and Medicaid Services (CMS) as a Health Policy Scholar. This role provided me not only a front row seat, but a place on the playing field as CMS works to operationalized the Medicare Modernization Act of 2003 (MMA). It is this perspective of MMA with attention to its impact on long-term care (LTC) residents and providers that I analyze here. To start, there will be two major points of impact felt by LTC as a result of MMA: pharmaceutical access and the expanded role of managed care. Pharmaceutical access became a major issue for LTC when, in the concluding hours of this legislation, the pharmacy benefit was moved from Medicaid to Medicare significantly affecting the dually eligible beneficiary. “Dually eligible” refers to those Medicare beneficiaries who have full Medicaid benefits, including fairly unlimited pharmaceutical access. As a result, the vast majority of LTC residents will be forced from the Medicaid pharmacy benefit to the new Medicare Part D pharmacy benefit, which starts in 2006. This program will be offered through private risk-taking prescription drug plans (PDP) that can either operate within fee-for-service Medicare or as part of a Medicare managed care program. It is important to realize that LTC to the federal government is very different than what most of us involved in senior care think; LTC is only nursing facilities and not assisted living or other nonnursing home settings. As a result, all of these nonnursing home settings are instead considered in the same manner as any communitydwelling senior with no special consideration given despite their increased needs. The second point of impact will be felt by the addition of specialized Medicare Advantage (MA) plans. Medicare Advantage is the new term for all Medicare managed care programs, which all include managed Medicare plans such as Medicare Choice organizations as well as Preferred Provider Organizations (PPO). New types of MA plans now available as a result of MMA are specialized MA plans. Specialized MA plans offer the opportunity to expand managed care into nursing homes in a way not previously available. This is the result of allowing managed care plans to focus solely on institutionalized seniors within a particular facility rather than having to serve the entire population in a large geographic region.

Medicare Reform's Impact on Long-Term Care

In late June of last year, both the House and the Senate passed the most meaningful Medicare reform legislation since Medicare’s inception in 1965. As luck would have it, this occurred just days before I joined Centers for Medicare and Medicaid Services (CMS) as a Health Policy Scholar. This role provided me not only a front row seat, but a place on the playing field as CMS works to operationalized the Medicare Modernization Act of 2003 (MMA). It is this perspective of MMA with attention to its impact on long-term care (LTC) residents and providers that I analyze here. To start, there will be two major points of impact felt by LTC as a result of MMA: pharmaceutical access and the expanded role of managed care. Pharmaceutical access became a major issue for LTC when, in the concluding hours of this legislation, the pharmacy benefit was moved from Medicaid to Medicare significantly affecting the dually eligible beneficiary. “Dually eligible” refers to those Medicare beneficiaries who have full Medicaid benefits, including fairly unlimited pharmaceutical access. As a result, the vast majority of LTC residents will be forced from the Medicaid pharmacy benefit to the new Medicare Part D pharmacy benefit, which starts in 2006. This program will be offered through private risk-taking prescription drug plans (PDP) that can either operate within fee-for-service Medicare or as part of a Medicare managed care program. It is important to realize that LTC to the federal government is very different than what most of us involved in senior care think; LTC is only nursing facilities and not assisted living or other nonnursing home settings. As a result, all of these nonnursing home settings are instead considered in the same manner as any communitydwelling senior with no special consideration given despite their increased needs. The second point of impact will be felt by the addition of specialized Medicare Advantage (MA) plans. Medicare Advantage is the new term for all Medicare managed care programs, which all include managed Medicare plans such as Medicare Choice organizations as well as Preferred Provider Organizations (PPO). New types of MA plans now available as a result of MMA are specialized MA plans. Specialized MA plans offer the opportunity to expand managed care into nursing homes in a way not previously available. This is the result of allowing managed care plans to focus solely on institutionalized seniors within a particular facility rather than having to serve the entire population in a large geographic region.

Building consensus on divisive issues: a case study of the Yukon wolf management team

This article presents a case study of a successful effort to reach agreement on one of the most intractable environmental issues of our time: wolf management. This case is unusual in several ways. In this case, the members of the negotiating team were ordinary citizens rather than leaders of organized groups. This team was given an unusually high level of authority to write the plan as they saw fit; the agency pledged to implement “whatever they came up with.” The agency convened the process, but agency personnel were not members of the team and attended only when they were invited. The team members were able to reach agreement on this tough issue even though polar opposites were at the table—one who felt that wolves are a “spiritual essence” and another who felt that, as he put it, “wolves, coyotes, and cockroaches have a lot in common”. They produced a detailed plan that addressed all the issues in just 5 months. Another unusual aspect of this effort is that the final agreement does not list the team members. They explained that they wanted their plan to “stand alone” and be judged based on what it said, not on who was involved. However, just after their agreement was completed, a new, pro-wolf control government was elected that refused to endorse the plan. While the government gave various reasons for not ratifying the plan, more and more diverse interest groups came out in support for both the plan and the process that created it. Eventually, overwhelming public support forced the government to sign and implement the plan as written. This demonstrates that, while it is important for a team to seek the sanction of decision-makers, it is perhaps even more important for the general public to see the effort and the final agreement as fair. Strong support from a broad spectrum of the public can help win the necessary political support. In addition to discussing the unorthodox aspects of this consensus-building effort, this article also attempts to give the reader a front row seat to this process by using the informants' own words—words rich in detail, brimming with color and spoken straight from the heart. Certainly their experience dispels any notion that such efforts are simply a matter of following a recipe. During the process, members of the negotiating team experienced the entire gamut of emotions—anger, defeat, humor and, finally, a genuine sense of pride. As team member Patty Denison put it, “We showed that a random group of people could work together and do something truly monumental.”

Lunatics and Anarchists: Political Homicide in Chicago

As a former member of the Chicago police department, a practicing Chicago attorney and longtime member of the Chicago City Council, I am intrigued by homicide in Chicago. The colorful mayhem and peculiar prairie personality of Chicago provides us with no lack of curious cases and characters on which to focus our investigations. Over the past three decades I have had a front row seat from which to observe that home grown Chicago phenomenon known as political suicide. I am sure you too can recall those fascinating episodes of local politics in which notable Chicago politicians have crashed and burned. Often we can identify the telltale wounds that have resulted as largely being self-inflicted. You might remember the surprise snowstorm in early 1979 during the tenure of Chicago Mayor Michael Bilandic. Many Chicagoans found themselves trapped by the blizzard-like conditions and were enraged at the weather. Chiding Mayor Bilandic for not being fast enough to remove the snow, the storm became the vehicle for the Mayor's ousting during the election that ironically followed on the heels of the storm.

Customer service [in e-business

When you're in business, it's good to have customers, but do you have customer service in mind when you're developing technology for an e-business Web site? If not, you should, because the place where your work and the customers' experience comes together is where you can make it easy-or hard for customers to do business at a site. If you can understand customer intentions at an e-business site, you can factor them into technology choices and mechanisms that support them. Is it easy for a single-minded customer to find and buy a product, or for a holistic-minded user to do a combination of browsing, learning and shopping? While the marketing people decide what goes on a site and the content developers create the look-and-feel, the front-row seat for data mining is with the technical staff who know what information is available in log files, what profiling can be dynamically processed in the background and indexed into the dynamic generation of HTML, and what performance can be expected from the servers and network to support customer service and make e-business interaction productive.

Réorientation du goût à Florence et à Paris

Reorientation of Taste in Florence and Paris, Francis Haskel. More than anyone else, Francis Haskell (1928-2000) made art an object of history by showing the variations of its contents and frontiers under the influence of changes in taste, the rediscoveries of forgotten artists, and reconstructions and deconstructions of artistic hierarchies. More than anyone, he included philanthropists and critics, collectors and museums, exhibits and the market in the history of art. More than anyone else, he gave a front-row seat to images in general and to works of art in particular as far as historic sources are concerned. More than anyone else he contributed to breaking down the walls between the history of art and history and drew them together. Familiar to anyone studying the history of Europe of the first modernity, Haskell's work is perhaps less familiar to 20th century specialists. Yet he was very interested in this period, not only in his early publications but also in his later major books. In homage to this great historian who disappeared prematurely, we are publishing a chapter of his last and unfinished book : The Ephemeral Museum : Art Exhibitions and their Significance. He shows the interest of a study of artistic events such as temporary exhibits for the ideological history of the 20th century.

Bulgarians Sue CERN for Leniency

In cash-strapped Bulgaria, scientists are wondering whether a ticket for a front-row seat in high-energy physics is worth the price: Membership dues in CERN, the European particle physics lab, nearly equal the country's entire budget for competitive research grants. Faced with that grim statistic and a plea for leniency from Bulgaria's government, CERN's governing council is considering slashing the country's membership dues for the next 2 years.

Front Row Seat at the Revolution

When Internet service provider AOL announced it would acquire media conglomerate Time-Warner, Dave Pell, publisher of Davenetics, an online news service for Web professionals, crowed, “The people who still (even to this day) think the net is just about hype are wrong. The debate is over. We are lucky enough to have a front row seat at this revolution.” Our culture is in the process of changing its whole definition of words like media and publishing. Commercial publishing giants now flow into new forms at dizzying speed. We hear a lot about a new “internet Darwinism”, with predictions that only a few large “electronic content providers” will survive. This talk raises troubling questions for small journal publishers like the Seismological Society of America (SSA). SSA leaders have faced electronic publishing with considerable vision and foresight. If it is difficult for commercial publishers to plan an electronic future, it is even more difficult for nonprofit scholarly societies. Venture capital is not available to fund expensive mistakes. Although I still occasionally hear from a Society member that it is “trivial and straightforward” to publish on the Web, most now …

Front row seat on life.

Front row seat on life.

S/M, and: The Libertine (review)

Reviewed by: S/M, and: The Libertine Elizabeth J. Montgomery S/M. By Mary Zimmerman. Lookingglass Theatre Company, Steppenwolf Studio Theatre, Chicago. 9 February 1996. The Libertine. By Stephen Jeffreys. Steppenwolf Theatre, Chicago. 13 March 1996. Click for larger view View full resolution Figure 1. Elizabeth Barry (Martha Plimpton) and John Milmot, Second Earl of Rochester (John Malkovich) in the Steppenwolf Theatre Company’s production of Stephen Jeffrey’s The Libertine, directed by Terry Johnson. Photo: Michael Brosilow. Click for larger view View full resolution Figure 2. The Marquis de Sade (Andrew White) with the Servant Girl (Meredith Zinner) in the Lookingglass Theatre Company’s production of S/M, written and directed by Mary Zimmerman. Photo: Mary Zimmerman. Within a two month period, the Steppenwolf Theatre’s two stages have served up two contemporary interpretations of notorious sexual renegades. Restoration England’s John Wilmot, Second Earl of Rochester, and revolutionary France’s Marquis de Sade share a reputation for outrageous sexual conduct. Both men were deeply involved with the historical events of their times; Rochester played an important role in Charles II’s restoration court while Sade was enmeshed in the events and aftermath of the storming of the Bastille and the French Revolution. It is these two men’s shared passion for the theatre, however, rather than their roles in history that emerges most strikingly from the Chicago productions of S/M and The Libertine. Both S/M and The Libertine assert the importance of theatricality as an epistemology: for both Sade and Rochester, theatre provides a truer, richer form of existence than “real life.” S/M uses an exploration of the lives of Sade and Sacher-Masoch in order to create a theatre piece which interrogates the concepts of performance and of “history”; despite its reliance on historical evidence (letters, journals), S/M ultimately relinquishes any claim to historical authenticity or completeness in favor of an exploration of the idea of performing, in the words of the play’s subtitle, a “dream biography.” In contrast, The Libertine relentlessly pursues the character of Rochester, using his fascination with the theatre as a way of understanding the man, of performing his biography as definitively as possible. Mary Zimmerman’s growing reputation as a skillful author/adapter rests on her creation of engaging theatre from unlikely and often unwieldy textual sources, in recent years including critically-acclaimed adaptations of such unlikely sources as 1001 Arabian Nights, the Chinese novel Journey to the West, and Leonardo DaVinci’s notebooks. In S/M, Zimmerman eschews narrative story-telling, instead creating a series of vignettes and vivid stage images drawn both from Sade and Sacher-Masoch’s lives and from their literary works. Although the play features scenes depicting both Sade and Sacher-Masoch, Sade’s story dominates the production. Staged in a studio space, the set is comprised mainly of the bare space delineated by a rectangle of three tiers of scaffolding, each holding a single row of chairs. Actors drag on various props and stage pieces when appropriate—a large table, a miniature stage—but the mise en scène is created primarily through the effects generated by lighting and the actor’s costumed bodies. The unique set places each spectator in a front-row seat, highlighting the voyeurism inherent in watching the theatre, while simultaneously creating multiple perspectives from which to watch the action. S/M blurs the boundaries between actor and character immediately as actors visibly move props and costumes on and around the scaffolding before the “action” of the play begins. All the actors in this production enacted multiple roles, disrupting any easy identification with individual characters. Even the Marquis de Sade, the piece’s core presence, remains something of a cipher, never fully psychologized. In an early scene, two young girls search for the Marquis de Sade in the dictionary. To their disappointment, the girls find only the short entry: French pervert. The play unfolds in part as coda and rebuttal to the paucity of this definition, displaying scene after scene from Sade’s life, from letters by and about him, from his own plays. Sade ultimately emerges as complex and enigmatic, a man who resists characterization. The...

Life‐story fee contracts: When may a criminal defendant demand ineffective counsel?

One glance through the more recent bestseller lists and television schedules reveals the American public's obsessive interest in stories involving bizarre criminal acts, such as the Amy Fisher case, the prosecution of the Menendez brothers, the Lorena Bobbit trial, and the attack on figure skater Nancy Kerrigan.(1) Presently, the public's thirst for sensational crime is being quenched by the Simpson murder case, as the book publishing industry is cranking out truckloads of O.J. Books(2) and television stations are providing not only a front row seat to the trial but a daily rehashing of the events regarding the case. So who profits from these sensational crime stories? Obviously, the book publishing and television industries reap benefits. But what about the defendants--and their attorneys? In the Simpson case, for example, the most notable individual to profit from the murders of Nicole Brown Simpson and Ronald Goldman is Simpson himself. While in jail waiting for his trial to begin, Simpson teamed with Lawrence Schiller to write a book(3) explaining his side of the story, thus giving the defendant a one-sided word with the world without the unpleasantness of cross-examination.(4) Though his book provides him with a voice, more importantly, it fills O.J.'s coffers for his legal defence. Simpson, who hired a dream team of attorneys to represent him,(5) is spending approximately $60,000 a week in legal fees.(6) Although Simpson was worth more than a few million dollars before being jailed in June of 1994,(7) he is using the proceeds from his book(8) to staunch [the] checking-account hemorrhage(9) that has resulted from retaining the highly expensive and talented counsel. Arguably, Simpson is able to afford his legal defense dream team as a result of the book publishing and television industries' attempt to satisfy the American public's insatiable thirst for sensational crime. As a general rule, at any time before or during the criminal proceedings, a criminal defendant may sell his or her life-story rights directly to a literary or television agency and use the proceeds to finance his or her defense.(10) Clearly, Simpson has capitalized on this rule. Problems arise, however, when an indigent criminal defendant retains private counsel by means of a contract that grants the attorney the publication rights and potential profits to the defendant's life-story in lieu of attorneys' fees. These types of contracts create a potential conflict of interest between the attorney's financial interests and the attorney's professional responsibility to his or her clients. For example, in United States v. Hearst,(11) Patricia Hearst was arrested for bank robbery, and she was represented by F. Lee Bailey at trial. During the course of the proceedings, Bailey contracted to write a book about the trial, thus raising questions of potential or actual conflict of interest. Hearst was convicted, and she immediately appealed, claiming that Bailey's book contract created a conflict of interest that deprived her of her sixth amendment right to the assistance of counsel. Hearst charged that Bailey (1) failed to seek a continuance, so public interest would not cool and competing authors would not get the jump on him; (2) failed to seek a change of venue, because publicity would be maximized by a trial in San Francisco, a media center; and (3) put her on the witness stand, so her story would go on the public record and he would not be constrained by the attorney-client confidentiality rules. As the Hearst case illustrates, an attorney operating under a publication rights fee contract may be tempted to subordinate the interests of the client to his or her own anticipatory gain because the only compensation the attorney will receive will come from the commercial exploitation of the defendant's life-story. The attorney's financial stake in the literary contract might cause the attorney to hold a lengthy and sensational trial at any price; to create as much trial publicity as possible; and, as a result, to increase the financial potential of the acquired publication rights and the personal monetary benefits flowing therefrom. …

Australia's role in HIV prevention in the developing world

A scientist with the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales in Sydney, Australia, addresses the fact that Australians working in the area of HIV infection have been very successful in prevention, treatment, and care. In the early 1980s, a bipartisan political decision was made to foster an effective partnership between HIV-infected communities, health care providers, and governments. HIV-infected communities included sex workers, prisoners, Aboriginal people, and high profile gay community activists. These three different groups succeeded in forming such a partnership, as reflected in the fact that the annual number of new HIV cases is down to 500 from a peak of 3000 in 1984. A key method used to contain HIV infection was needle-and-syringe exchange programs and continuing access to needles to prevent HIV transmission in the injecting drug community. Even though Australia has all this experience and success, it had a backseat role in ushering in the UNAIDS program because Australia did not contribute a significant share of the agency's relatively small budget (US$100 million/year). If Australia were to give just 10%, it would acquire a front row seat along with the Netherlands, Sweden, Belgium, France, and the UK. These nations have the greatest say as to where UNAIDS funds go. The Australian international aid organization has recently received an increase in funds, $110 million for 4 years to spend on four areas, one of which is HIV/AIDS. Australia has just allocated $25 million for a 5-year program for HIV/STD (sexually transmitted disease) prevention in Indonesia. This money would have been able to buy Australia a leading role in UNAIDS. Australians need to reassess their priorities. Australians can help their neighbors in the Asia-Pacific region move away from their denial of HIV to HIV prevention and care. They can conduct clinical trials of shorter and more user-friendly regimens of antiviral drugs that may lead to reduced perinatal transmission and research on microbicides. They can prevent tuberculosis and introduce manageable methods of securing safe blood supplies and mass screening.