Underutilized Strategy Research Articles

Improving Corporate Environmental Performance: Encouraging Sustainable Commerce Through Regulatory and Other Governmental Action

Improving Corporate Environmental Performance: Encouraging Sustainable Commerce Through Regulatory and Other Governmental Action

Divergent reactions on racemic mixtures

Methods that furnish enantioenriched products are crucial in modern organic synthesis. An underutilized strategy to arrive at enantioenriched products is to perform divergent reactions on racemic mixtures, where each enantiomer of the starting material reacts with a single chiral reagent to furnish two separable, non-enantiomeric products that are enantioenriched. Stereodivergent, regiodivergent and structurally divergent reactions on racemic mixtures are discussed in this tutorial review.

Body Weight and Weight Loss: Are Health Messages Reaching Their Target?

To investigate lay peoples' knowledge of health risks of overweight, accuracy of self-perception of body weight and perceived benefits of weight loss. A nine item questionnaire was administered to a cross sectional survey of adults in metropolitan shopping centres, height and weight were measured. Two hundred and nine (57% female) adults completed the survey. Thirty eight percent had a healthy BMI (18.5-24.9), 38% were overweight (BMI 25-29.9) and a further 22% were obese (BMI > 30). However only 46% perceived themselves 'overweight', 50% considered themselves 'just about right' and 4% considered themselves 'underweight'. Of those with a BMI of 25 or greater 28% considered their weight 'just about right'. Over 80% thought 'being overweight' was 'likely' or 'very likely' to be a risk factor for cardiovascular disease, hypertension, diabetes and stroke; however 20% of overweight or obese individuals did not think their health would improve if they lost weight. A significant proportion of overweight or obese individuals do not accurately perceive their body weight and do not recognise the health advantages of weight loss despite recognising excess body weight as a risk factor for chronic diseases. Increasing the awareness of an individual's BMI and promoting the benefits of modest weight loss maybe two underutilized strategies for population level weight control.

In search of innovation: A national qualitative analysis of child welfare recruitment and retention efforts

This national qualitative study explores recruitment and retention strategies within state child welfare agencies and the perceived effectiveness of these strategies. The study includes a national review of 50 state child welfare websites, and qualitative interviews with 18 individuals in 13 states. The findings highlight agencies' identification and investment of similar types of recruitment and retention efforts; yet agencies still grapple with elevated turnover rates despite continued efforts. This article comprehensively explored national utilized and underutilized strategies that have been employed to help alleviate child welfare recruitment and retention challenges. Further, mechanisms for overcoming and promoting innovation to understand the effectiveness of child welfare recruitment and retention strategies are addressed.

Prevalence and Correlates of Hepatitis C among Injection Drug Users: The Significance of Duration of Use, Incarceration, and Race/Ethnicity

The study examined associations between Hepatitis C (HCV) seropositivity and a lifetime history of jail or correctional facility incarceration among injection drug users. The sample consisted of 351 injection drug users recruited in inner-city neighborhoods of Baltimore. Multiple logistic regressions were fit to assess associations between HCV seropositivity and a lifetime history of incarceration for the total sample and stratified by race. Analyses demonstrated HCV nearly two times greater for whites than African Americans. In addition, HCV was 2.6 times greater in participants incarcerated in correctional facilities and HCV was 7.4 times greater in participants reporting more than 5 years of injection drug use compared to participants reporting less than 1 year of injection drug use. The study findings suggest that incorporating systematic HCV screening, prevention, and treatment programs within correctional systems represents a vital yet underutilized strategy to reduce HCV transmission in society as a whole.

Teaching Elementary Accounting To Non-Accounting Majors

A central recurring theme in business education is the optimal strategy for improving introductory accounting, the gateway subject of business education. For many students, especially non-accounting majors, who are required to take introductory accounting as a requirement of the curriculum, introductory accounting has become a major obstacle for achieving their goal of obtaining undergraduate degree in business. This paper reviews a variety of common but underutilized strategies for presenting learning opportunities to non-accounting majors in their first accounting course. Effective teaching methodologies that will promote active learning to help non-accounting majors develop interest in accounting and enhance their critical thinking skills in the acquisition of accounting knowledge are explored. Included in this review are discussions about the adjustments that can be made relative to class size and individuality in the early pre-course stages. Teaching strategies such as the use of remedial modules, case studies, hands-on student participation opportunities, within or separate from the classroom lecture, mini-quizzes, and mnemonics are discussed. Guidance is offered to accounting academics who wish to fulfill their responsibility to students in the most difficult, rule-dominated, math-oriented, and consequently, high risk course of introductory accounting.

Case Study: A Strategic Research Methodology

This research reviews the literature on case study as a strategic qualitative research methodology. Although case studies have been criticised by some authors as lacking scientific rigour and do not address generalizability, this research, however, reiterated its appropriateness when dealing with a process or a complex real-life activities in great-depth. Case study has been commonly used in social science fields like sociology, industrial relations and anthropology eventhough generally was considered an underutilized strategy. Hence, this research explained the general concept of a case study, strengths and weaknesses of using this method knowing that theoretically case is exciting and data rich. Based on a study of four organizations and the researcher’s own experience, this article described matters on how case study was undertaken, gaining excess to those organizations and the systematic process of data collection and triangulation (multiple techniques). It was noted that combining multiple techniques for elicitng data in case study research actually strengthens and confirmed results.

Front‐Line Staff Perspectives on Opportunities for Improving the Safety and Efficiency of Hospital Work Systems

To contrast the safety-related concerns raised by front-line staff about hospital work systems (operational failures) with national patient safety initiatives. Primary data included 1,732 staff-identified operational failures at 20 U.S. hospitals from 2004 to 2006. Senior managers observed front-line staff and facilitated open discussion meetings with employees about their patient safety concerns. Hospitals submitted data on the operational failures identified through managers' interactions with front-line workers. Data were analyzed for type of failure and frequency of occurrence. Recommendations from staff were compared with recommendations from national initiatives. The two most frequent categories of operational failures, equipment/supplies and facility issues, posed safety risks and diminished staff efficiency, but have not been priorities in national initiatives. Our study suggests an underutilized strategy for improving patient safety and staff efficiency: leveraging front-line staff experiences with work systems to identify and address operational failures. In contrast to the perceived tradeoff between safety and efficiency, fixing operational failures can yield benefits for both. Thus, prioritizing improvement of work systems in general, rather than focusing more narrowly on specific clinical conditions, can increase safety and efficiency of hospitals.

Funding for continuing medical education

We are pleased that academic detailing was mentioned as an underutilized strategy in a recent CMAJ editorial on continuing medical education.[1][1] Academic detailing programs presently exist in 6 provinces. These programs have formed the Canadian Academic Detailing Collaboration to share expertise

Student involvement and empowerment in quality assurance in distance education in South Africa

This article attempts to explore why and how student involvement is a necessary, but under-developed and under-utilised strategy for enhancing quality distance education in South Africa. Any critical analysis of education in South Africa needs to consider the historical and current social contexts, and in this case the analysis needs to explain the circumstances and social forces responsible for the timing, method and approach in which quality assurance in higher education, and specifically distance higher education in South Africa developed. The article then focuses on why the distance education sector places such a premium on quality assurance and why quality assurance in distance education rely on learner involvement and empowerment as a way of building the new democracy.

Prevalence and correlates of hepatitis A among adult drug users: The significance of incarceration and race/ethnicity

This report examines associations between hepatitis A virus (HAV) infection prevalence and a history of incarceration in jail or a correctional facility among a population of drug users in Baltimore stratified by African American and white racial/ethnic status. The study sample consisted of 509 non-injection and injection drug users recruited from inner-city neighborhoods of the Baltimore metropolitan region. The baseline prevalence of HAV infection was 36.9% ( N = 188). One-fourth (25.5%) of the sample reported no lifetime history of incarceration, 44.6% reported incarceration in a local jail in their lifetime, and 29.9% reported incarceration in a correctional facility in their lifetime. In the multivariate logistic analysis, HAV infection prevalence was higher for whites (44.3%) [adjusted odds ratio (AOR) = 2.3, 95% CI = 1.5–3.5] when compared to African Americans (30.5%) adjusting for gender, age, and education. In the analysis stratified by race/ethnicity, as anticipated, jail incarceration and correctional facility incarceration were each independently associated with elevated HAV prevalence among white drug users. African American drug users with a high school diploma had significantly lower HAV infection prevalence when compared to African American drug users who did not graduate from high school. Heightened HAV prevalence among white drug users compared to African American drug users is noteworthy given the opposite association of HAV infection prevalence and these two racial/ethnic groups in the general population. Since millions of incarcerated drug users in the US return to society each year, the results suggest that incorporating systematic HAV screening, prevention, and treatment programs within correctional systems represents a vital yet underutilized strategy to reduce HAV transmission in society as a whole.

Psychological Research With Administrative Data Sets: An Underutilized Strategy for Mental Health Services Research.

A key element in the identity of professional psychologists is their commitment to base practice on the best knowledge available about a problem being tackled. Although administrative data (e.g., records of provider billing and procedures) can often shed light on the dark areas of the complex U.S. health care system, psychologists make notably little use of them. Experience teaches that decisions must often be made despite the absence of "gold standard" knowledge from the well-designed, controlled studies learned in graduate school. Increased involvement of psychologists in work using administrative data can improve service provision but requires that psychologists adopt unaccustomed approaches to research. The authors discuss administrative data's strengths and limitations, recent progress made in using them, how psychologists can acquire and use low-cost information from administrative data, and examples of questions that can be answered.

Non-Invasive Stool DNA Testing Leads to Increased Screening Adherence in an Asymptomatic Population

Purpose: Colorectal cancer (CRC) is the leading cause of cancer deaths in the U.S. among non-smokers, with an estimated 57,000 deaths in 2004. Screening is a cost-effective yet underutilized strategy for reducing both colorectal cancer mortality and incidence due to poor patient acceptance. It was previously shown that non-invasive stool-based DNA screening was perceived by patients to have a number of advantages over fecal occult blood testing (FOBT) and colonoscopy, suggesting that stool-based DNA testing might be a preferred strategy for routine CRC screening (Am J Prev Med 2005; 28 (2)). The primary objective of this study was to assess patient acceptance of stool-based DNA testing in a community-based setting. Methods: Stool-based DNA screening has been commercially available (PreGen-Plus™) in the U.S. since August 2003. The manufacturer, Lab Corp®, requests patient feedback on pre-paid business reply cards (BRCs). Data are tallied centrally. Results: Data from the first 1145 BRCs tallied were as follows: 91–94% found it easy/very easy to pick up and drop off sample collection materials, 87% found it easy/very easy to collect a stool sample and 92% said they would be likely/very likely to perform the test again if recommended by their physicians. Importantly, 52% of patients screened with stool-based DNA testing had never been screened for CRC in the past. Among those who had been previously screened, 52% reported that they had been screened with FOBT. Conclusions: CRC screening using stool-based DNA testing appears to be very acceptable to patients. Moreover, given that more than half of subjects had never been screened before, stool-based DNA testing may be an effective way to draw more people into the CRC screening system, thereby increasing the likelihood of detecting more CRCs at an earlier, more curable stage. And, given a high likelihood of re-use, stool DNA screening may be an effective way to retain people in an ongoing screening program.Table: Patient Perceptions of Stool DNA Testing

Preserving cardiac function in the hypertensive patient: why renal parameters hold the key

The relationship between cardiovascular and renal pathologies is well recognized in advanced nephropathy and heart failure, but in early disease it has received less attention. Consequently, microalbuminuria screening and interventions that treat early nephropathy remain under-utilized cardioprotective strategies in the hypertensive patient. Agents that delay the progression of renal disease are likely to be cardioprotective by lessening the systemic consequences of renal dysfunction and may have additional cardioprotective effects by exerting beneficial effects on endothelia elsewhere in the body and within the heart. A critical driving factor within both renal and wider cardiovascular pathologies is overactivation of the renin-angiotensin-aldosterone system (RAAS). Accordingly, RAAS-directed antihypertensive agents including both angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have been demonstrated to have renoprotective effects. In major prospective trials, two ARBs, losartan and irbesartan, have been demonstrated to be renoprotective in patients with frank proteinuria, and one ARB, irbesartan, has been shown to have renoprotective properties in patients with microalbuminuria. For patients with incipient or frank renal dysfunction, an aggressive RAAS-based approach to hypertension management, combining potent blood pressure control with proven renoprotection, may therefore constitute a key component of therapy targeted towards long-term cardioprotection.

Do treatment process factors mediate the relationship between type A-type B and outcome in 12-Step oriented substance abuse treatment?

One underutilized strategy for enhancing treatment research is to examine intervening factors that link client characteristics to endpoint outcomes. This study tested the hypothesis that Type B substance abusers would demonstrate difficulties engaging in the treatment process, and that these problems would mediate their poorer outcomes. Longitudinal naturalistic study. Two intensive 12-Step substance abuse treatment programs. A sample of 115 men and women seeking treatment. Empirical clustering techniques were used to divide the sample, and the link between type, process factors, and 12-month outcomes was examined. Hypotheses were not supported. Type Bs did not demonstrate difficulties with the treatment process, but had greater problems sustaining gains posttreatment. Contrary to prediction, Type Bs were better matched to self-help affiliation than Type As. Findings argue for a more optimistic perspective on treating Type Bs, and for the utility of Type A-Type B in informing treatment research.

Strategies in the treatment of penicillin-resistant Streptococcus pneumoniae.

The epidemiology, resistance mechanisms, susceptibility testing, treatment, prevention, and clinical importance of penicillin-resistant Streptococcus pneumoniae (PRSP) infection are discussed. PRSP is an established presence in the United States, with some geographic areas reporting decreased susceptibility in up to half of isolates. The mechanism of resistance to beta-lactam antibiotics in S. pneumoniae is genetic changes resulting in decreased binding of drug to the bacterial cell wall. Emerging PRSP strains have necessitated testing as a tool in selecting drugs for treating life-threatening infections. Opinions differ on how to treat these infections empirically. Non-life-threatening infections, such as otitis media, are still often treated successfully with amoxicillin, amoxicillin-clavulanate potassium, or a third-generation cephalosporin. Currently recommended initial treatment of pneumococcal pneumonia in otherwise healthy patients requiring hospitalization consists of cefuroxime, ceftriaxone, or cefotaxime; some authors continue to emphasize injectable penicillin. Once the mainstay of empirical treatment of pneumococcal meningitis, penicillin has largely been abandoned in favor of cefotaxime or ceftriaxone. Vaccination remains an underutilized strategy in atrisk populations. The clinical importance of penicillin resistance among pneumococci is still uncertain. Changing patterns in the susceptibility of S. pneumoniae to penicillin make selection of appropriate therapy increasingly difficult. Key considerations are the site of infection and the level of resistance.

Observations on Science and Management

Academic scientists are neither environmental managers nor environmental policymakers, but they have important roles to play in both arenas. To play these roles effectively, they must participate as colleagues with managers and policymakers in the management and policy-making processes on a recurrent basis and be fully engaged at critical junctures. Since many scientists—particularly the most active researchers—neither understand nor track the management and policy- making processes, they need mechanisms to involve them efficiently and effectively. These must be institutional mechanisms. Institutional mechanisms for involvement increase effectiveness, reduce time commitments, and provide protective cover for participants. These may be important attributes, particularly for untenured professors. Institutional mechanisms also enhance the probability of involving not only our best natural scientists and engineers, but scholars from other fields, such as the social sciences, who can play equaUy important roles. Institutional mechanisms legitimize the time spent by managers and policymakers away from what may be perceived as more pressing issues. A model borrowed from psychotherapy, the holding environment, is a useful institutional model to promote adaptive work by scholars and environmental managers and policy makers. The model has been adopted by the New England Aquarium and adapted as its Aquatic Forum. It is now being refined and evaluated. Scientific consensus among experts and scenario planning are two powerful and underutilized strategies for involving scientists in environmental management and policy-making. Their application is dependent upon creating and sustaining an environment appropriate for creative exploration, discovery, and problem solving. Such environments are nurturing and low risk, and enjoy the benefits of skilled facilitators to ensure that all voices are heard, that all messages are evaluated, and that results are synthesized into forms appropriate for decision-making. The holding environment meets all of these criteria

Out of the Ivory Tower: the value of collaborative research.

Collaboration is an underutilized strategy for combining the strengths and perspective of home health care professionals in service and academic settings. This paper explores the importance of collaborative research strategies, focusing on the role of the unique talents, resources, and perspectives offered by each health professional to the research process. Finally, personal, professional and organizational barriers to collaboration are examined in order to alert would-be researcher collaborators to obstacles they are likely to encounter. When both the strengths of and obstacles to collaborative research are anticipated, collaboration can encourage research that is relevant to the needs and experiences of both home health service providers and academicians.

The Life Review

Summary This paper explores reflection upon the past and the potential it may hold for the systemic family practitioner. Reminiscence is viewed to be an underutilized and underinvestigated strategy for intervention with the elderly and their families. The paper includes a list of benefits for the therapist, as well as individuals and families involved in the counseling process. Systemic family therapy should make effective use of reflection upon past events in order to develop positive understanding of the complex role experience plays in avoidance of repeating past mistakes and the creation of future success.

Individual Learning in Construction Projects: Professions and their Approaches

New materials, use of sophisticated technologies and increased customer demands, in combination with growing competition among construction companies, have led to a high organizational boundaries. The results indicate that personal networks are the most common source of learning for all professions. While clients, architects, and designers also engage in reading and attending courses, site managers and workers are less engaged in these activities. Experimenting and organizing for learning appear to be underutilized strategies by all professions. This leads to the conclusion that attempts to increase learning have to address the differences in learning behaviours of the various groups. Further, focus on experimenting and organizing for learning is a possibility to change the learning behaviour from learning as a consequence of problems to learning for future improvement.degree of specialization. For successful integration of the different professional specialists, there is a need for shared learning between project co-workers. Based on twenty eight interviews in six different Swedish construction projects, this paper illustrates strategies for individual and shared learning, among different actors and across various