Council on Environmental Quality

PURPOSE/OBJECTIVE: Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes. RESULTS: = 0.54) revealed they moderately preferred nondisabled people-they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability). CONCLUSIONS/IMPLICATIONS: This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Summary ‘The British Ecological Society aims to promote the science of ecology through research and to use the findings of such research to educate the public and influence policy decisions which involve ecological matters .’ Yet, how successful have we been in influencing UK and EU environmental policy? Many scientists hold to the ‘deficit model’ of turning science into policy, the view that if only politicians are told what the science reveals, ‘correct’ policies will automatically follow. Nothing could be further from the truth. Politicians have all kinds of reasons, some valid, some less valid, not to adopt what often seem to us to be common sense policies to protect the environment. Here, I explore some of the successes and failures of ecologists to influence UK and European environmental policy, using acid deposition, the collapse of global marine fisheries, GM crops and climate change, carbon dioxide and ocean acidification as examples. I briefly review the extensive literature (largely ignored by natural scientists) on what social scientists have to say about evidence‐based policy‐making (or the lack of it) and why it often appears to be so difficult to persuade politicians to adopt sound environmental policies. Synthesis and applications. Ecologists can, and do, influence government policy on the environment, but often via complex and iterative interactions that can be painfully slow, and may require fundamental changes in politicians’ belief systems, values and norms.

Isoprene and a variety of other reactive hydrocarbons are released in large quantities by vegetation in forested regions and are thought to participate in the NO x ‐catalyzed production of ozone, a serious air quality problem in North America and Europe [ National Research Council , 1991]. The determination of the fraction of O 3 formed from anthropogenic NO x and biogenic hydrocarbons (BHC) is a crucial step in the formulation of effective control strategies. Peroxymethacrylic nitric anhydride (MPAN, CH 2 C(CH 3 )C(O)OONO 2 ) is formed almost entirely from the atmospheric oxidation of isoprene in the presence of NO x and is an excellent indicator of recent ozone production from isoprene and therefore biogenic hydrocarbons. Measurements are presented here of MPAN, peroxyacetic nitric anhydride (PAN, CH 3 C(O)OONO 2 ), peroxypropionic nitric anhydride (PPN, CH 3 CH 2 C(O)OONO 2 ) and ozone from separate data sets acquired during the 1994 and 1995 Nashville intensive studies of the Southern Oxidant Study. It was found that PAN, a general product of HC‐NO x photochemistry, could be well represented as a simple linear combination of contributions from BHC and anthropogenic hydrocarbon (AHC) chemistries as indicated by MPAN and PPN, respectively. The PAN:MPAN ratios found to be characteristic of BHC‐dominated chemistry ranged from 6 to 10. The PAN:PPN ratios found to be characteristic of AHC‐dominated chemistry ranged from 5.8 to 7.4. These BHC and AHC attributions were used to estimate the contributions of anthropogenic and biogenic hydrocarbons to regional tropospheric ozone production, and substantial BHC‐O 3 (50–60 ppbv) was estimated in cases where high NO x from power plants was present in areas of high BHC emission. This estimation method provides direct evidence of significant photochemical ozone production from the oxidation of biogenic hydrocarbons in the presence of NO x .

Abstract To adapt to climate change and ensure food security, major interventions are required to transform current patterns and practices of food production, distribution and consumption. The scientific community has an essential role to play in informing concurrent, strategic investments to establish climate-resilient agricultural production systems, minimize greenhouse gas emissions, make efficient use of resources, develop low-waste supply chains, ensure adequate nutrition, encourage healthy eating choices and develop a global knowledge system for sustainability. This paper outlines scientific contributions that will be essential to the seven policy recommendations for achieving food security in the context of climate change put forward by the Commission on Sustainable Agriculture and Climate Change. These include improved understanding of agriculture’s vulnerability to climate change, food price dynamics, food waste and consumption patterns and monitoring technologies as well as multidisciplinary investigation of regionally appropriate responses to climate change and food security challenges.

Disabled people, amidst political and social gains, continue to experience discrimination in multiple areas. Understanding how such discrimination, named here as ableism, operates is important and may require studying perspectives of people who do not claim a disability identity. Ableism may be expressed in a number of ways, and examining how a particular group, in this case siblings of disabled people, understand and value disability may contribute to overall understandings about how ableism works. Thus, the purpose of this study is to explore relationships between siblings of disabled people's broad societal understandings of disability and their attitudes towards it. In order to tease out this relationship further we have also examined factors that impact how people define disability. Using both social psychological and sociological approaches, we have contextualized individual attitudes as providing additional new information about social meanings of disability, and set this study's results against the larger backdrops of debates over meanings of disability within Disability Studies. In our research, participants revealed complex understandings of disability, but most often defined disability as preventing or slowing action, as an atypical function, a lack of independence, and as a socially constructed obstacle. Participants' unconscious (implicit) disability attitudes significantly related to their understandings of disability as lacking independence, impairment, and/or in relation to the norm, and their conscious (explicit) disability attitudes. Moreover, longer employment in a disability-related industry was correlated with defining disability as a general difference, rather than as slowing or limiting of tasks.

A committee of the Health Council of the Netherlands prepared a report on the definition and treatment of dyslexia at the request of the Minister of Health, Welfare, and Sport (see Note). The Health Council, as charged by the Health Act, is to inform the government on the state of science with respect to public health issues. The Council is entirely funded by the government but otherwise completely independent (an independence guaranteed by law). The committee was formed to answer questions regarding the provisions and funds needed for the treatment of persons with dyslexia, neuropsychological treatment modalities, in particular, and the role of speech and language therapists. Definitive decision making about reimbursement by the Dutch National Health Service for treatment by speech and language therapists in cases of dyslexia was on hold, pending the committee's report. Specific attention was requested for the following aspects: the definition of dyslexia (the characteristic symptoms of this category of developmental language disabilities); the consequences of the proposed definition for indication and treatment; the appropriate methods of treatment; the involvement of several possible professionals (e.g., neuropsychologist, remedial teacher, speech and language therapist), as well as the role of the neurologist during and in relation to the treatment process; and those situations in which treatment should be the responsibility of the health care system. This article summarizes the committee's considerations and conclusions on these different aspects.

Direct Support Professionals (DSPs) are the "backbone" of long term services and supports (LTSS) in the United States ( Bogenschutz, Hewitt, Nord, & Hepperlen, 2014 , p. 317). This study examined the relationship between DSPs and people with intellectual and developmental disabilities' (IDD) quality of life. To do so, we utilized Personal Outcome Measures® interviews from over 1,300 people with IDD to examine the impact DSP change has at individual and organizational levels. We found DSP continuity is central to quality of life of people, including human security, community, relationships, choice, and goals. States cannot continue to provide near-poverty level reimbursement rates for DSPs and still ensure quality of life.

Regional planning bodies would implement coordinated, ecosystem-based approaches to coastal and marine spatial planning.

In 1993, The Council on Quality and Leadership in Supports for People With Disabilities (The Council) developed a person-centered outcome assessment instrument, Personal Outcome Measures (1997). The Council has maintained a database (N = 3,630) of Personal Outcome Measures interviews conducted during accreditation reviews. Our purpose in this article is to report findings on (a) the relationships between and among the Personal Outcome Measures (The Council, 1997) and patterns of individual outcome attainment and (b) to examine the impact of characteristic variables (disability, organizational size, residential type, or source of program funding) on the individual attainment of personal outcomes. Alternatives are suggested for examining the dimensions of both quality of service and quality of life for people with disabilities.

An extensive survey was conducted of all the air pollution indices that are presently utilized or are available. The data were obtained from a literature review; from telephone discussions with personnel in State, local, and Provincial air pollution control agencies; and from material received from these agencies. Of the 55 metropolitan air pollution control agencies surveyed in the United States, 35 used some form of daily air pollution index. These indices were so varied that it was necessary to develop a system to classify indices according to four criteria: (1) number of variables, (2) calculation method, (3) calculation mode, and (4) descriptor categories reported with the index. Using the classification system, 14 basically different index types were identified. With two minor exceptions, it was found that no two indices were exactly the same. The survey results and agency comments were used to identify the general structural characteristics and criteria for a candidate uniform air pollution index.

Telehealth use rapidly expanded during the COVID-19 pandemic. Understanding if, and how, persons with disabilities (PWDS) used telehealth during the pandemic is vital to assuring that this evolving and increasingly common form of health care is equitably developed and delivered to avoid reproducing the health disparities PWDS already face. Our aim was to explore the use of telehealth among PWDS during the pandemic. We conducted a weighted secondary analysis of United States Census Bureau data (April-July 2021) from 38,512 (unweighted) PWDS. Our findings revealed 39.8% of PWDS used telehealth during the second year of the pandemic, ranging from 34.5% of persons with hearing disabilities to 43.3% of persons with mobility disabilities. There were also differences in telehealth use based on sociodemographics. Telehealth promises to open doors to more equitable health care access for many PWDS, but only if access barriers are removed.

Measuring performance is increasingly important in not‐for‐profit and public sector organisations from those as large as the US federal government to the smallest volunteer group. Human resource metrics are the most relevant – spanning function, operations and strategy. Function measures include employee efficiency and effectiveness (turnover, sick leave, insurance and recruitment costs, for example). Operational measures include specifics like revenue per employee, as well as broad measures of effectiveness that link management to performance and returns on investment. Future‐oriented strategic measures match capability against anticipated need, and are increasingly a key part of core planning activities. Barriers to effective measurement include fear (of retribution, variation and loss of control). Data may be gathered using top‐down or bottom‐up approaches. Issues to be considered when implementing a metrics methodology include linking outputs to outcomes, data quality, leading vs lagging indicators, indicator maturity, and imperfection.

Background. Muslim communities tend to hold more negative attitudes toward organ donation than other communities. These views, in part, reflect the diverse views of Islamic scholars who debate the conditions under which donation and transplantation is morally licit. In December 2018, the Fiqh Council of North America (FCNA) weighed in on the US context of donation and transplantation through an Islamic ethico-legal verdict ( fatwa ). Methods. Between 2016 and 2018, FCNA members engaged in multidisciplinary research using conventions of collective Islamic moral deliberation. They examined rulings on organ donation and transplantation issued by Islamic jurists and juridical councils abroad, convened with organ donation and transplantation professionals and stakeholders including families and patients, and consulted medical and bioethics experts. Results. FCNA judges organ donation to be morally permissible from the perspective of Islamic law and ethics, subject to several conditions. These include first-person authorization, that donation occur either while living or after circulatory declaration of death, harm to the donor is minimized, reproductive organs are not donated, among others. Organ transplantation, in general, was also deemed licit. Conclusions. FCNA’s verdict uniquely addresses American contexts and has several clinical practice implications. By sharing their perspective with academic and professional stakeholders, the council aims to provide nuanced guidance for assisting Muslims in making informed choices regarding these procedures and further societal dialogue on the ethics and practices of donation and transplantation.

The influence of sunlight on bacterioplankton production [I4C-leucine (Leu) and 3Hthyrnidine (TdR) incorporation; changes in cell abundances] and O2 consumption was investigated in a shallow subtropical coral reef located near Key Largo, Florida, USA. Quartz (light) and opaque (dark) glass biological oxygen demand (BOD) bottles containing 0.8 pm filtered reef water amended wlth C, N and P were incubated in situ and exposed to natural variations in solar radiation over a 48 h period. Photoinhibition of Leu and TdR incorporation was observed at all depths during both daylight periods. Photoinhibition of bacterial production decreased with depth and was significantly higher during the first day of exposure. Bacterial abundances also decreased during daylight periods particularly during the second day of exposure. Leu and TdR incorporation rates and bacterial abundances exhibited recovery during periods of darkness. Light treatment bacterial O2 consumption was inhibited at all depths during Day 1 but enhanced relative to dark treatments at all depths during Day 2. Estimates of light treatment bacterial gross growth efficiencies (GGE) determined during the evening of Day 1 were similar to dark treatment estimates. Light treatment GGE determined during Day 2, however, were lower than dark treatments but increased with depth. Recovery of bacterial production and respiration during the second day of exposure suggested photoinduced selection for light tolerant cells and/or physiological adaptation to ambient light reglmes occurred over the duration of exposure. The results of this experiment suggested that solar radiation may have a significant effect on bacterial metabol~sm in this shallow euphotic marine ecosystem.

As subminimum wage is a prominent and problematic issue affecting the lives of many people with disabilities in United States, and as it is linked to discrimination, the aim of this study was to explore how prejudice impacts the use of special wage certificates and subminimum wage across the United States. Since in the United States employment discrimination has historically been tied to racism and sexism, in addition to ableism, we also were interested in exploring how those factors may impact the use of special wage certificates. To do so, we analyzed data about the use of special wage certificates around the United States, and prejudice data from 4.70 million people. Our findings revealed significant links between subminimum wage and not only ableism, but also racism. Subminimum wage practices are discriminatory and help normalize oppression.

BACKGROUND: Despite the ability to and interest in work, people with disabilities are employed at significantly lower rates than nondisabled people. Employment disparities highlight persistent social and cultural stereotypes that equate disability with unemployability. OBJECTIVE: The aim of this study was to explore the relationship between employment of people with disabilities and disability prejudice in the United States. This study had the following research question: how does disability prejudice impact state disability employment rates? METHODS: To explore these questions, we used secondary data about state disability employment (2016), as well as disability prejudice data from 270,000 nondisabled people residing in all 50 states and the District of Columbia. RESULTS: Findings from this study revealed states with higher disability prejudice scores have lower disability employment rates, suggesting employment disparities are intertwined with disability prejudice. CONCLUSIONS: Cultures and systems must be rid of harmful disability stereotypes to ensure people with disabilities can truly partake in their human and civil rights.

Public demand for safer care has catapulted the healthcare industry's efforts to understand relationships between patient safety and hospital performance. This study explored linkages between staff perceptions of safety culture (SC) and ongoing measures of hospital nursing unit-based structures, care processes, and adverse patient outcomes. Relationships between nursing-sensitive measures of hospital performance and SC were explored at the unit-level from 9 California hospitals and 37 nursing units. SC perceptions were measured 6 months prior to collection of nursing metrics and relationships between the two sets of data were explored using correlational and regression analyses. Significant relationships were found with reported falls and process measures for fall prevention. Multiple associations were identified with SC and the structure of care delivery: skill mix, staff turnover, and workload intensity demonstrated significant relationships with SC, explaining 22-45% of the variance. SC was an important factor to understand in the quest to advance safe patient care. These findings have affordability and care quality implications for hospital leadership. When senior leaders prioritized a safety culture, patient outcomes may have improved with less staff turnover and more productivity. A business case could be made for investing in patient safety systems to provide reliably safe care.

Transportation is the most frequently reported problem for people with disabilities. While some people with disabilities have difficulty with limited or no public transportation systems, others have trouble with inaccessible infrastructures and systems. In addition, people with intellectual and developmental disabilities (IDD) often have trouble with many of the skills that navigating transportation requires. Although accessible transportation is crucial for independent living, Medicaid only requires states cover nonemergency medical transportation and does not require transportation related to other aspects necessary for community living such as accessing work, errands, or recreational activities. The purpose of this article is to examine Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers, the largest provider of long-term services and supports for people with IDD, to see how transportation is provided for people with IDD. Our examination of 99 waivers for FY 2013 revealed 58 waivers provided transportation-specific services and 71 waivers provided transportation within another service. The majority of waivers provided transportation for people with IDD through these two means; however, this transportation was often limited to very specific purposes. From our findings, it appears transportation services for people with IDD in waivers need to be expanded to support community access and integration.

(1994). CUMULATIVE EFFECTS ASSESSMENT: A TOOL FOR SUSTAINABLE DEVELOPMENT. Impact Assessment: Vol. 12, No. 3, pp. 319-331.

Direct support professional (DSP) turnover significantly impacts both human service providers and people with intellectual and developmental disabilities (IDD). This study explored how DSP turnover impacts people with IDD's health and safety. We analyzed secondary data regarding DSP turnover and health and safety (i.e., emergency room visits, incidents of abuse and neglect, injuries, and behavioral events) from a random sample of 251 people with IDD. Findings revealed, regardless of their support needs, people who experienced DSP turnover had more emergency room visits, experienced more instances of abuse and neglect, and had more injuries than people who did not experience DSP turnover. Our findings suggest extended tenure of DSPs can help promote the health and safety of people with IDD.