Community Health Centers in an Era of Health System Reform and Economic Downturn: Prospects and Challenges

Reviews 2008 legislation reauthorizing community health centers and the factors affecting their role as providers for the uninsured, publicly insured, and underinsured. Outlines health centers' patient mix, quality of care, revenues, and challenges

Creativity and dysfunction in strategic processes : the case of scenario planning

This paper attempts to open up a new line of enquiry into the dysfunctions of creativity within strategic processes. Generally, the impact and results of introducing creativity (and innovation) into organisational life are perceived to be wholesome and beneficial. But recent research in the area of organisational psychology has documented a ‘dark’ side to its introduction, e.g., low employee morale, stress, theft, sabotage, destructive conflict. Learning from this work and shifting the domain to strategic management, this paper focuses on scenario planning—a strategy process widely regarded by participants and facilitators as creative and innovative in structure, content and output. First, the creative credentials of the process are established with reference to the literature and definitions from the creative and cultural industries. Second, the process is deconstructed into activities and each is examined for the extent of its embedded creativity. Third, informed by case evidence, four dysfunctions of the scenario planning process are conjectured: creativity layered on fantasy; heightened expectations and confusion; pride and passion; and creativity leading to excess. The paper concludes by suggesting four options for handling these potential dysfunctional effects and, in the light of the dialogue presented, re-interprets the definition of scenario planning presented earlier in the text

Assessing the Need for On-Site Eye Care Professionals in Community Health Centers

Poor vision health severely impacts school and work performance, quality of life, and life expectancy, and results in billions of dollars in medical expenditures each year. While eye and vision problems are often associated with age, low income and racial and ethnic minorities also have elevated risk of eye problems. Federally-funded community health centers, which are mandated to provide comprehensive primary care in underserved communities, are often the only option to improve vision health for low-income residents. With respect to certain chronic conditions, health centers are able to provide high quality care that meets or exceeds national benchmarks despite limited financial resources, a shortage of primary care providers, and greater health care demands. What is not well known, is the extent to which health centers are able to provide on-site professional vision care. Our analysis found that seven out of 10 health centers do not staff on-site eye care professionals to provide comprehensive eye exams. Rather, many health centers rely on referral arrangements with local optometrists and ophthalmologists for such services. Major barriers to providing on-site comprehensive eye care services include the inability to afford necessary space/equipment and the perceived lack of reimbursement or inadequate reimbursement from Medicaid, Medicare and private insurers. Health centers indicated also that they also need assistance in developing a business plan, designing space, and developing an inventory of eye care equipment. While the lack of health insurance coverage, differences in Medicaid coverage and benefits across states, and inadequate reimbursements are likely to limit capacity and access to vision care professionals, another challenge may be patient’s general lack of understanding about the need for routine eye exams. Therefore, strategies to improve access to vision care must go beyond developing financial incentives and restoring eye care professionals for eligible placements in underserved communities, to include education about the importance of routine eye care exams

Vision Exams for Children Prior to Entering School

Children\u27s vision problems are very common, affecting nearly 15 million children. Early screening and detection are essential in treating eye disorders in children. This fact sheet discusses statistical data associated with Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) of vision/eye conditions, and provides recommendations from the National Commission on Vision and Health

Political Attitudes Develop Independently of Personality Traits

The primary assumption within the recent personality and political orientations literature is that personality traits cause people to develop political attitudes. In contrast, research relying on traditional psychological and developmental theories suggests the relationship between most personality dimensions and political orientations are either not significant or weak. Research from behavioral genetics suggests the covariance between personality and political preferences is not causal, but due to a common, latent genetic factor that mutually influences both. The contradictory assumptions and findings from these research streams have yet to be resolved. This is in part due to the reliance on cross-sectional data and the lack of longitudinal genetically informative data. Here, using two independent longitudinal genetically informative samples, we examine the joint development of personality traits and attitude dimensions to explore the underlying causal mechanisms that drive the relationship between these features and provide a first step in resolving the causal question. We find change in personality over a ten-year period does not predict change in political attitudes, which does not support a causal relationship between personality traits and political attitudes as is frequently assumed. Rather, political attitudes are often more stable than the key personality traits assumed to be predicting them. Finally, the results from our genetic models find that no additional variance is accounted for by the causal pathway from personality traits to political attitudes. Our findings remain consistent with the original construction of the five-factor model of personality and developmental theories on attitude formation, but challenge recent work in this area

New England Coral Canyons and Seamounts

Just 150 miles off the coast of Cape Cod lie some of our country's greatest marine treasures. Hidden beneath thousands of feet of ocean, where the continental shelf drops off to the pitch-black abyss of the deep Atlantic Ocean, five massive canyons plunge down, some deeper than the Grand Canyon. Just beyond these canyons, four extinct underwater volcanoes – called seamounts – rise as high as 7,700 feet above the ocean floor, higher than any mountain east of the Rockies and the only such seamounts in U.S. Atlantic waters. The plunging walls and deep floors of the canyons and the towering slopes of the seamounts are alive with vivid coldwater corals of otherworldly beauty – some the size of small trees and centuries, if not thousands of years, old. These corals, together with other structure-forming fauna including sponges and anemones, form a foundation for vibrant deep-sea ecosystems, providing food, spawning habitat, and shelter for an array of fish and invertebrate species. The varied habitats and strong and complex currents of the canyons and seamounts also support significant and diverse concentrations of marine life throughout the water column. These deep-sea biodiversity hotspots are sites of active scientific exploration, investigations and discovery. The canyons and seamounts proposed for designation represent tremendous opportunities for further scientific exploration and education around deep-sea ecosystems. Importantly, these remote and relatively pristine areas function as a scientific reference site, giving researchers the chance to advance our understanding of undisturbed nature in a world otherwise transformed by humans. In recognition of this area's value, 141 eminent ocean scientists from 84 research institutions, along with the three major New England Aquaria and 226 accredited aquaria from around the world, have urged robust long-term protections for these "particularly outstanding examples" of New England's canyons and seamounts