High Medium Level Research Articles

Sleep Characteristics in Dance Students Related to Psychological Inflexibility.

Introduction: Dance, as a performance activity, is associated with various problems. Among these challenges, sleep disturbances are notably prevalent. Aims: This study aimed to explore the potential relationship between sleep characteristics-specifically chronotype and subjective sleep quality- and psychological inflexibility in dance students. Methods: This research adopted a cross-sectional design using non-probabilistic sampling. The data were collected in paper format by visiting public conservatories and private academies, and online. One hundred fourteen dance students, with a mean age of 23.87 years, participated in the study. Assessment tools included the Acceptance and Action Questionnaire-II, Pittsburgh Sleep Quality Index, and the Composite Scale of Morningness. Results: The results revealed that 80.7% of all students reported poor sleep quality, compared to 19.3% who reported good sleep quality. Differences emerged in both subjective sleep quality (F(2, 113) = 4.825, P = .010) and chronotype (F(2, 113) = 6.172, P = .003) when students were grouped according to low, medium, or high levels of psychological inflexibility. Those with low inflexibility, as opposed to those with high inflexibility, report better sleep quality, with no differences observed between medium and high inflexibility groups. Students with high-medium levels of psychological inflexibility showed a higher risk (OR = 6.373 times higher) of experiencing poor sleep quality compared to those with low psychological inflexibility. In terms of chronotype, the low inflexibility group is inclined to be more of a morning type than the medium and high inflexibility groups, with no differences between the latter 2 groups. Students categorized as having low inflexibility tend to have a longer history of dancing under the guidance of a teacher and dedicate more hours and days per week to rehearsal. Conclusion: Conservatories can become "healthy spaces." In this regard, sleep hygiene programs and Acceptance and Commitment Therapy interventions can provide guidance to professionals working with dancers in professional companies and conservatories.

A Qualitative Assessment of the Determinants of Faculty Engagement in Internationalization: A Chinese Perspective

Faculty is the key agent for internationalization. This interview-based study explored faculty views about the internationalization understanding, rationales, roles, engagement, and motivation in a research-centric, double-first class university in China. Faculty motivation was analyzed using the lens of the motivation systems theory (MST). The main findings concerning the five main themes emerging from the analysis of documents and interviews of twenty-eight faculty members are as follows. First, Chinese faculty’s understanding, rationales, roles, engagement, and motivation were significantly influenced by the national and university policies. Second, they mainly understood internationalization as activities, openness, and cross-cultural exchange. Third, unlike other countries, Chinese faculty espoused a broader scope of internationalization in their rationales, spanning from personal to university, higher education, China, and world development. Fourth, faculty perceived roles in internationalization included main drivers, role models, liaisons, and coordinators. Fifth, faculty motivation comprised goals, beliefs, and emotions. Faculty, among other goals, aspired to improve teaching content and expand students and self-abilities, yet they had mixed context and capacity beliefs. For example, they appreciated the university and national support for international travel, funding, and research but criticized complex travel procedures and teaching evaluation methods. They also felt concerned about their teaching, research, and communicating in a foreign language with students and international peers, except those with foreign backgrounds and experience. Faculty experienced different emotions when undertaking international activities, for example, joy, interest, and excitement to explore and learn. Finally, there was a high-medium level of faculty engagement in teaching and research than service internationalization (low or no engagement).

Media Use Among Kindergarteners From Low-Income Households During the COVID-19 Shutdown.

This study examines the media use of children from low-income homes during school closings during the COVID-19 pandemic. Caregivers of 151 kindergarteners from low-income homes completed questionnaires as part of a larger study. Caregivers reported how much time children spent watching television/videos and using apps on the most recent weekday and weekend days. Caregivers also reported how their child's current use of media for several different purposes compared with how much the child usually uses media for that purpose. Weekly average media use was 46.3 hours or 6.6 hours per day. Counter to previous research, weekday media use was higher than weekend media use, suggesting that media was likely used as a replacement for time usually spent in school. Caregivers reported increased child media use for positive purposes, such as education and maintaining relationships with family and friends outside of the home, and potentially useful but less socially valued purposes, such as occupying the child's time while caregivers were completing other tasks. Having more children in the household was related to higher media use, and girls used media for maintaining remote relationships more than boys. These findings provide reason for both concern and optimism for the impacts of pandemic closures on low-income children. High levels of media use seem to be prevalent in this population. However, the diverse purposes for media use suggest that caregivers relied on media to supplement children's academic and social growth at a time when school and socializing were not safe in their typical forms.

Factors Influencing Clients’ Commitment to Sustainable Construction Practices

The success of every construction projects largely depends on the level of commitment of the clients. This study examined the factors influencing the level of clients’ commitment to sustainable construction practices in Nigeria. A questionnaire survey was use to collect data from the public and private construction clients on the level of influence of 16 factors extracted from the literature. A total of 182 valid questionnaires were used for analysis. The result revealed that nine factors with weighted average (W) 0.8≤W≤1 have a high level of influence, whereas seven factors with 0.6≤W≤0.8 have a high-medium level of influence on the clients’ commitment. However, the five most influential factors were: client knowledge and awareness, Cost implication and mechanism of financial involvement, economic value and return on investment, end-user/client perception and preference, and health and safety implications. The result further revealed that there is significant difference on how these factors influence the level of commitment of sustainable construction practices of the public and private clients. The study suggested that the disparity was due to the differences in the level of knowledge, awareness, involvement and commitment of the public and private clients to sustainable construction concept. Hence, it is important to optimize the level of knowledge and awareness of the clients, about the cost, benefits/profits, and health and safety implications of sustainable construction practices so as to promote the level of client’s commitment to sustainable construction practices. It recommended for adequate client involvement throughout the sustainable construction life cycle and a sustained awareness campaign, championed by relevant government agencies and professional organizations through different public programs so as to increase the clients’ commitment and desirability to demand for more sustainable construction projects.

Ansätze und Herausforderungen der Implementierung von ESG-Kriterien in Wettbewerben und der unternehmerischen Nachhaltigkeitsbewertung

Zusammenfassung: Awards stellen im Rahmen eines Wettbewerbs aus dem Teilnehmerfeld den Besten heraus. Sie sind damit ein vereinfachtes, meist positives Signal, das die Transparenz verbessern, belohnen und Verbesserungs- und Nachahmeffekte erzielen möchte. Grundlage für die Vergabe eines Nachhaltigkeitsawards an Unternehmen ist deren herausragende Erfüllung von Leitlinien oder vorgegebenen ESG (Environmental, Social, Governance)-Kriterien. Mittels einer Befragung unter 15 Wettbewerben, die sich deutschlandweit an alle Unternehmensbranchen richten, wird in diesem Beitrag dargestellt, welche konkreten Kriterien in die unternehmerischen Nachhaltigkeitsbewertung von Wettbewerben eingehen und welche Herausforderungen damit verbunden sind. Soziale Aspekte, wie Arbeitssicherheit und Menschenrechte, stehen neben ökologischen Aspekten, insbesondere Emissionen und Klimawandel, an vorderer Stelle der Bewertungen. Insgesamt erreichen jedoch nur wenige Wettbewerbe ein gehoben-mittleres Qualitätsniveau mit der gewählten Nachhaltigkeitsbewertung. Die Vergabe bleibt oftmals vage. Vor allem die Transparenz ist sehr verbesserungswürdig. Ein einheitlicher Qualitätsstandard für Nachhaltigkeitswettbewerbe wird empfohlen, dessen Verbindlichkeit und anzulegende Mindestkriterien gilt es weiter auszuloten.

El papel de las relaciones y la satisfacción vital en la percepción de la auto-imagen en una muestra de adolescentes mexicanos

Objetivo: el Trastorno Dismórfico Corporal es una preocupación excesiva por un defecto corporal inexistente o de escasa importancia. El propósito de esta investigación consiste en evaluar el efecto de diferentes tipos de relaciones con el grupo de pares y de la satisfacción con la vida en el desarrollo del Trastorno Dismórfico Corporal en población adolescente. Materiales y métodos: se emplearon técnicas de análisis estructural para evaluar las relaciones entre estudiantes en clase. Los indicadores de centralidad se calcularon analizando diferentes relaciones entre alumnos (n=139) y alumnas (n=274) en 11 salones de clase. Se llevó a cabo una regresión jerárquica, análisis de conglomerados, análisis multivariado y visualización de grafos. Resultados: una baja satisfacción con el cuerpo y con la familia son las principales variables que predicen el desarrollo de este tipo de trastornos somatoformes. Mediante análisis de clúster se identifican dos grupos. El primero presenta niveles medio-altos de satisfacción y un contexto relacional potencialmente conflictivo. El segundo muestra elevada satisfacción y un contexto de relaciones predominantemente positivo. El primer grupo exhibe mayores niveles de Trastorno Dismórfico Corporal en comparación con el segundo. Conclusiones: disponer de una red social positiva actúa como factor de protección ante la aparición de este tipo de trastornos. Otorgar alta importancia al físico y criticar a los demás por su apariencia se relaciona con niveles elevados de Trastorno Dismórfico Corporal.

Vascular and tumor cell expression of VEGFR2 and molecular subtyping: An innovative biomarker approach in bladder cancer.

497 Background: Treatment approaches combining anti-angiogenic therapy with chemotherapy have shown promising clinical results in metastatic bladder cancer (BC). In order to interrogate the potential clinico-pathologic and molecular basis of these findings, we evaluated VEGFR2, vascular density and molecular subtyping in a series of BC patients. Methods: A custom-TMA with primary BC tissues from 117 patients (mean age 71 yrs; range 38-99 yrs; M:F = 83:34) treated at a single institution, was stained and scored (0-3) for CD34 (vascular density) and for VEGFR2 on tumor vessels and cells. CK5/6 and GATA3 IHC was scored by a pathologist to identify main molecular classes of BC. The association between clinico-pathologic variables, VEGFR2, CD34 and molecular subtypes was analyzed by Fisher’s exact test and ANOVA. Univariate and multivariate Cox proportional models were used for survival analysis. Results: Of 112 analyzable BC tissues, 41% were muscle-invasive (MIBC) vs. 56% non-muscle invasive (NMIBC) and 3% undetermined. Compared to NMIBC patients those with MIBC had shorter overall survival (p < 0.001). The main molecular subtypes included basal (11%), mixed baso-luminal (28%) and luminal (61%). Compared to luminal and baso-luminal subtypes, the majority of basal BCs were muscle invasive (p = 0.036). VEGFR2 expression was higher in tumor vessels but variable in tumor cells. 74% of BCs showed high-medium levels of VEGFR2 (scores 3-2) in tumor vessels and 88% had high-medium levels of tumor vascular density. Within basal, luminal and baso-luminal subtypes, 58%, 78% and 71% had high-medium levels of vascular VEGFR2 (p = 0.52), while 83%, 91% and 82% had high-medium levels of tumor vascular density (p = 0.08). Survival analyses showed increasing patient age, higher stage and lower VEGFR2 levels as independent predictors of shorter survival. Conclusions: Given the observed complexity of BC regarding VEGFR2 expression and vascular density across molecular subtypes, further investigation is warranted to understand how the frequent expression of VEGFR2 on tumor vasculature and variable expression in tumor cells relates to the efficacy of anti-angiogenic agents across these subtypes in bladder cancer.

An Exploration of Emotional Intelligence of Doctors:An Empirical Study

In human resource management, Emotional Intelligence (EI) is gaining importance because of its multiple benefits in the workplace. Emotionally intelligent employees are able to manage better emotional work environment. With this view, the present study aims to explore the EI level of doctors of West Bengal. The data are analyzed through Mean, Pearson correlation and Annova. Findings of the study reveal that doctors have high medium level of EI; none of the demographic variables studied in the study related to EI and social awareness is the mostimportant component of doctors EI. Proper training and education programme may help doctors to increase their EI level which will help to improve relation with co-workers, patients, and superior authority.

Knowledge sharing and organizational change in higher education

PurposeOrganizational learning in higher education institutions depends upon the ability of managers and academics to maintain a flow of knowledge across the structural boundaries of the university. This paper aims to understand the boundary conditions that foster or impede the flow of knowledge during organizational change at a large public university.Design/methodology/approachInterview data were collected from 51 academics and 40 managers at the selected university. The analysis focused on two initiatives that managers sought to implement to improve organizational performance.FindingsFor one of these initiatives, managers engaged in knowledge transformation that enabled managers and academics to learn and collaborate across group boundaries. For the other initiative, managers relied on knowledge transfer practices, which failed to establish productive cross-boundary interactions to support organizational learning.Practical/implicationsWhen seeking to implement new initiatives to enhance institutional performance, university managers and academics can view organizational change as a learning process that involves creating and moving knowledge across organizational boundaries. Under conditions of change, the creation and movement of knowledge may require the development of new structures and the use of communications that have a high level of media richness.Originality/valueThis study provides one of the first empirical investigations of knowledge sharing dynamics during organizational change in a higher education setting.

Mapping Social Vulnerability to Air Pollution: A Case Study of the Yangtze River Delta Region, China

Many frequent and severe air pollution incidents have emerged across the vast parts of China recently. The identification of factors and mapping social vulnerability has become extremely necessary for environmental management and sustainable development. However, studies associating social vulnerability with air pollution remain sparse. With reference to research achievements of social vulnerability, this study made a new trial regarding social vulnerability assessment to air pollution. With the projection pursuit cluster (PPC) model, the top three factors contributing to social vulnerability index (SVI) were discovered and SVI and SVI dimensions (susceptibility, exposure, and adaptability) were evaluated. Results revealed that adaptability values are higher than susceptibility and exposure values. SVI is in a poor condition as, for the whole region, most values belong to the high-medium level. High SVI values mainly appear in the northern and the southern ends of study area. SVI in Shanghai is lower than in Jiangsu and Zhejiang provinces. On the scale of prefecture-level city, it can be found that the low-value centers of SVI always occurred in urban core areas. The spatial variation and inequality in social vulnerability provide policy-makers a scientific basis for air pollution prevention and sustainable management.

Life satisfaction in the internet age – Changes in the past decade

Using data from large scale Annual Social Surveys of the CBS in Israel, the current study investigated the impact of internet adoption and internet uses on the life satisfaction of senior citizens (aged 65+), compared to those of working age (ages 20–64) during the decade of 2003–2012. The findings show high-medium levels of life satisfaction – higher in younger age group, compared to the senior citizens. Life satisfaction increased moderately over time among the younger age group, while among the older population it remained stable during the decade under study. Our main conclusion is that internet adoption and digital uses increase life satisfaction, after controlling for socio-demographic variables, sociability and health condition. In addition, internet adoption and digital uses can constitute an important channel for increasing life satisfaction among senior citizens and weaker social groups: people from low economic strata and those suffering from health problems that interfere with day-to-day functioning. Moreover, in contrast to other powerful factors impacting life satisfaction (income, religiosity, sociability and health problems) this factor can be changed with relative ease, if digital literacy becomes one of the important goals in the national agenda.

Optimum Combination of Insulin-Transferrin-Selenium and Fetal Bovine Serum for Culture of Rabbit Articular Chondrocytes in Three-Dimensional Alginate Scaffolds

Fetal bovine serum (FBS) has been reported to affect chondrocyte biosynthesis in monolayer culture. Insulin-Transferrin-Selenium (ITS) was investigated as a partial replacement for FBS during in vitro culture of rabbit articular chondrocytes in three-dimensional alginate scaffold. Chondrocyte-seeded alginate hydrogels were cultured in Dulbecco's modified Eagle's medium plus 10% FBS, 1% ITS plus 2% FBS, 1% ITS plus 4% FBS, or 1% ITS plus 8% FBS. At designed time point, the Chondrocyte-seeded alginate hydrogels were harvested and evaluated with histological staining, immunohistochemistry, and quantitative gene expression analysis. Viable cell density and cell division were also evaluated. Chondrocytes biosynthesis and cell division in 1% ITS with 2% FBS medium were similar to that in medium added with 10% FBS. For a total culture of 3 weeks, phenotypic gene expression in chondrocyte-seeded hydrogels was maintained at high levels in medium with 1% ITS plus 2% FBS, while it was decreased to varying degrees in the other groups. In conclusion, with 1% ITS, medium with 2% FBS could promote chondrocyte biosynthesis and cell division, and prevented cell dedifferentiation in three-dimensional alginate scaffolds.

Stability and Change of Moral Disengagement and Its Impact on Aggression and Violence in Late Adolescence

Stability and change of moral disengagement were examined in a sample of 366 adolescents from ages 14 to 20 years. Four developmental trajectories were identified: (a) nondisengaged group that started with initially low levels followed by an important decline, (b) normative group that started with initially moderate levels followed by a decline, (c) later desister group that started with initially high-medium levels followed by an increase from 14 to 16 years and an even steeper decline from 16 to 20 years, and (d) chronic group that started with and maintained medium-high levels. The results attest that adolescents who maintained higher levels of moral disengagement were more likely to show frequent aggressive and violent acts in late adolescence.

Culture, Children, and Mental Health Treatment: Special Section on the National Stigma Study-Children

Stigma—the prejudice and discrimination linked to individuals with mental illness—has been a mainstay of psychiatric and social science research. Yet a resurgence of academic, policy, and provider interest began in the mid-1990s and culminated in 1999 with the White House Conference on Mental Health and the first-ever Surgeon General’s report on mental illness. Interest has continued, with several programmatic efforts surrounding the recommendations of the President’s New Freedom Commission on Mental Health. As a result, we now have a solid, if not complete, knowledge base about the nature, levels, and correlates of community-based attitudes, beliefs, and behavioral dispositions toward adults with schizophrenia, depression, and addictive disorders. Importantly, no such foundation had existed on the stigma that may accompany the serious emotional disorders that children and adolescents experience or on the attitudinal barriers to and social ramifications of seeking care. Given the high level of media and professional discussion about the rise in children’s use of psychiatric medication, there is a surprising lack of empirical evidence about public perceptions of child and adolescent disorders, the parents and children who experience them, and the need for or reaction to available treatments. In the absence of such data, the tendency is to fall back on what is known about adults’ mental illness and to transfer to our research our own impressions of how cultural subgroups—for example, different racial or ethnic groups or those with more education—think and feel about medical care and the mental health system. Sociologists and other social scientists have long predicted that as modern society became more complex, allowing greater freedom in social interactions, sociodemographic characteristics would be increasingly weak substitutes for cul

Culture, Children, and Mental Health Treatment: Special Section on the National Stigma Study-Children

Stigma—the prejudice and discrimination linked to individuals with mental illness—has been a mainstay of psychiatric and social science research. Yet a resurgence of academic, policy, and provider interest began in the mid-1990s and culminated in 1999 with the White House Conference on Mental Health and the first-ever Surgeon General’s report on mental illness. Interest has continued, with several programmatic efforts surrounding the recommendations of the President’s New Freedom Commission on Mental Health. As a result, we now have a solid, if not complete, knowledge base about the nature, levels, and correlates of community-based attitudes, beliefs, and behavioral dispositions toward adults with schizophrenia, depression, and addictive disorders. Importantly, no such foundation had existed on the stigma that may accompany the serious emotional disorders that children and adolescents experience or on the attitudinal barriers to and social ramifications of seeking care. Given the high level of media and professional discussion about the rise in children’s use of psychiatric medication, there is a surprising lack of empirical evidence about public perceptions of child and adolescent disorders, the parents and children who experience them, and the need for or reaction to available treatments. In the absence of such data, the tendency is to fall back on what is known about adults’ mental illness and to transfer to our research our own impressions of how cultural subgroups—for example, different racial or ethnic groups or those with more education—think and feel about medical care and the mental health system. Sociologists and other social scientists have long predicted that as modern society became more complex, allowing greater freedom in social interactions, sociodemographic characteristics would be increasingly weak substitutes for cul

Financial Exclusion in Rural and Remote New South Wales, Australia: a Geography of Bank Branch Rationalisation, 1981–98

The provision of financial services in rural Australia is a significant public policy issue, reflected in the high level of media and political interest in the recent spate of branch closures. There are, however, many aspects of the current debate regarding the delivery of financial services to rural communities that are, at best, less than ideal and, at worst, erroneous. Using telephone directories for New South Wales, non‐metropolitan bank branch listings for the period 1981 to 1998 were collated. A recategorisation of these data according to the Rural, Remote and Metropolitan Areas classification reveals, amidst a spatial realignment of financial service provision, that rural and remote New South Wales have been disproportionately affected by a relatively recent and concerted withdrawal of services. The research demonstrates that corporate‐level responses to increased competition within the financial system are significantly more important in deciding rural access to banking services than local and regional population trends. Indeed, two‐thirds of rural localities that have lost branches had experienced healthy population growth during the study period. In the wake of the post‐deregulation reconfiguration of the bank branch network, the socio‐economic marginalisation of rural communities is being compounded, a process of ‘financial exclusion’ recognised in other parts of the developed world.

“The Real Royalists”: Folk Performance and Civil Religion at Royal Visits

Introduction In the study of cultures other than our own, high levels of interest (whether positive or negative) are taken as indicators of a culturally significant phenomenon worthy of serious investigation (Ortner 1979). Somewhat surprisingly in our own culture, despite the high levels of media and public interest in the monarchy, has been a distinct lack of academic interest in popular royalism. Since 1953, the year of the present Queen's coronation, the body of specific academic literature generated amounts to little more than a handful of books and a relatively small number of articles. These have been spread over a range of disciplines; for example, anthropology, sociology, history, social psychology and political science. Recent years have seen what may be the start of a more sustained interest in the topic with the publishing of books dealing specifically with the modern monarchy (for example, Hayden 1987; Nairn 1988; Wilson 1989; Billig 1992; Prochaska 1995). Most recently the scale of public mourning for Diana Princess of Wales has produced a flurry of academic work, but whether this develops into a sustained interest in the monarchy remains to be seen. If commentaries on popular monarchy are scarce, then qualitative studies of how people actually interact with the monarchy are very scarce indeed. Humphrey Jennings and Charles Madge have republished the Mass Observation diaries for the Coronation of George VI but, although fascinating, this material is now over sixty years old Jennings and Madge 1987). Michael Billig provides a recent exception, but he is concerned with everyday conversation rather than responses to ceremonial (Billig 1992). Therefore, information on the experience of how the public actually interact with royal ceremonial is seriously lacking. This paper addresses, but does not claim to fill, this gap. Rather, by describing how one particular group of people interact with the monarchy, the aim is to illustrate the richness of the material and in doing so to suggest the value of developing this field of research further. The Royalists The real who are the focus of the paper are people who regularly travel the United Kingdom, to stand for hours, in all weathers, to greet members of the Royal Family during royal visits. Though living in different parts of the country, they have come to know each other through regular attendance at these events. However, the size and composition of the group attending a particular visit varies according to family, employment and financial circumstances, and the time and location of the event. Before I met them, my expectations of what constituted a royalist conformed to a common stereotype of middle-aged, middle-class, married, white and female (cf. Rose and Kavanagh 1976). I found, however, that their ages range from mid-teens to late-sixties, and that are almost as many men as women. The majority of the women are married with older children; the majority of the men are single. Occupations range from a florist (male) to a civil engineer (female), and include a shop keeper, a clerical worker, a secretary, a cook, a postman, a nurse, a teacher, housewives and the retired. The royalists claim that there is no such thing as a typical royalist, we are a very mixed bunch. However, this is not quite the case. Class, religion, political and value orientations provide common factors underlying their surface diversities. Although religion and party politics are not often discussed amongst them, the majority affiliation is towards the Church of England and the Conservative Party. As well as sharing these underlying value orientations, through their occupations they share a predominantly lower-middle-class status. One explanation for this may be that their conditions of employment give them the flexibility to take holiday leave, or time off in lieu of overtime, or to re-organise working hours without loss of income or disruption to colleagues, employers or production. …

Interests in Health Care Technology Assessment (HCTA) and HCTA training needs in eight European countries: Comett-assess

Between mid-1991 and mid-1992, nearly 300 different organisations involved in European health care contributed their views to a survey covering a range of topics relevant to health care technology assessment (HCTA) and economic appraisal of health technologies. Organisations who participated included manufacturers, health care institutions, professional associations, health care reimbursement or funding agencies, academic institutions and policy making agencies in eight European countries. The study was carried out as part of a larger project, COMETT-ASSESS, funded partially by the EC COMETT programme, to design and deliver training in health care technology assessment and socioeconomic evaluation.The survey demonstrates a high level of interest in assessment of health care technologies among European organisations, regardless of the type of organisation. Eight out of ten organisations report high-medium levels of interest in using HCTA in their decision making. A similar proportion report high-medium interest in increasing their general understanding of HCTA, and 2 out of 3 in carrying out assessments.All organisations clearly identify a need to train their staff in HCTA. The two key groups of staff requiring training are managers and clinicians. Manufacturers also report a need to train their marketing staff. The principal reason for training is in order to improve the use staff make of HCTA in their decision-making.This finding indicates that it may not be sufficient for European countries to develop effective HCTA dissemination strategies which improve the flow of information on technology assessment results; decision-makers within the organisations targeted will also need training, if they are to use this information effectively. As well as a need to train decision-makers, organisations also report a need to train their researchers, and to a lesser extent their own trainers.When it comes to the types of technologies which need to be assessed, organisations consistently report that they are interested in assessment of accepted health technologies, as well as new or recently introduced ones. In contrast, to date the major emphasis in many HCTA programmes has been on technologies which are yet to enter the service setting. More thought now needs to be given to developing methodologies for assessing technologies once they have reached the service setting. For this the presence of a skilled and well-trained group of health personnel will also be necessary.Provision of high quality, intensive training will offer quite a challenge in terms of identifying the needs of participants (a process which COMETT-ASSESS has initiated), devising suitable workshop materials and case studies, and designing follow-up materials to reinforce this training.