Robert H Fletcher
Biographic Data
| ID | 3584498 |
|---|---|
| NAME | Robert H Fletcher |
| GIVEN NAMES | Robert H |
| FAMILY NAME | Fletcher |
| SIGNATURE | FLETCHER R H |
| AFFILIATIONS | University of North Carolina at Chapel Hill |
| VERIFIED | No |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 25 |
| AUTHOR COUNT | 23 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1889 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Cash for conservation? Integrating basic income support into biodiversity and climate finance
This article outlines the idea of a Basic Income for Nature and Climate (BINC) as a novel mechanism for funding biodiversity conservation and climate change mitigation activities. This proposal responds to two important empirical developments. The first concerns growing discussions around cash transfer programs and universal basic income within international development discussions. While these are increasingly implemented or piloted, they do not…
From Green to Black
Within political ecology research, a dominant focus on the hard physicality of the world limits engagement with how events taking place on land mediate and are mediated by other material spaces like the atmosphere. This paper engages with burgeoning research on the extraction-conservation nexus to highlight how the clearly demarcated land-based boundaries on which nexus thinking relies limit an awareness of how processes of conservation and extra…
A global conservation basic income to safeguard biodiversity
Biodiversity conservation supporting a global sustainability transformation must be inclusive, equitable, just and embrace plural values. The conservation basic income (CBI), a proposed unconditional cash transfer to individuals residing in important conservation areas, is a potentially powerful mechanism for facilitating this radical shift in conservation. This analysis provides comprehensive projections for potential gross costs of global CBI u…
Fortress tourism
This paper examines the role of tourism in promoting peace around transboundary protected areas (TBPA) in conflict-affected regions through a case study of the Virunga TBPA straddling the Democratic Republic of Congo, Rwanda and Uganda. Also praised as ‘peace parks’, TBPAs embody the rationale that stimulating a tourism economy in shared conservation spaces will provide incentives for formerly antagonistic states and actors to cooperate. Virunga …
Neoliberal Conservation
Neoliberal conservation describes a dynamic wherein prominent organizations around the world concerned with biodiversity protection have increasingly adopted strategies and mechanisms that seek to reconcile conservation with economic development by harnessing economic markets as putative mechanisms for financing nature conservation. Since the turn of the millennium, a vibrant discussion around this topic has arisen across anthropology, geography,…
Colorectal cancer screening
Which is better policy, to prevent colorectal cancer from arising or to detect it early once present? This question, long simmering in the background, was forced to a boil when two major US clinical practice guidelines, released within months of each other, reached opposite conclusions. Some countries have agencies that issue single, national clinical guidelines. Examples are the National Institute for Health and Clinical Excellence (NICE) in the…
Personalized Screening for Colorectal Cancer
From the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts. Reprints: Robert H. Fletcher, MD, MSc, 208 Boulder Bluff Trail, Chapel Hill, NC 27516. E-mail: [email protected]
Systematic Review
Cancer Prevention Among Working Class, Multiethnic Adults
Objectives. We analyzed outcomes from a study that examined social-contextual factors in cancer prevention interventions for working class, multiethnic populations. Methods. Ten community health centers were randomized to intervention or to control. Patients who resided in low-income, multiethnic neighborhoods were eligible; the intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity…
The Fairness and Effectiveness of Stroke Care in Health Maintenance Organizations
Department of Ambulatory Care and Prevention; Harvard Medical School and Harvard Pilgrim Health Care; Boston, Massachusetts From the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts. Address correspondence to: Robert H. Fletcher, MD, MSc, Professor, Department of Ambulatory Care and Prevention, Suite 200, 126 Brookline Avenue, Boston, MA 02215. E-mail: [email protected]
Accuracy of women's self-report of their last Pap smear
We compared interview data and physician records on when women last had a Pap smear in a sample of 98 rural Black women. We found 20 per cent of women could not accurately report on whether a Pap smear had been done within three years (sensitivity = 0.95, specificity = 0.47). Source of gynecological care and perceived barriers to obtaining a Pap smear but not education were associated with inaccurate reports. Self-report may be a misleading measu…
The Treatment of Patients with Asthma by Specialists and Generalists
The authors investigated possible differences between specialists and generalists in the intensity with which they treat patients with asthma by studying the care of 283 patients between the ages of six and 40 provided by 13 allergists and 40 randomly selected physicians in two primary care specialties: pediatrics and family practice. After excluding patients with more than one physician, allergists' patients were nearly identical to primary care…
Social Security Disability Determinations
Social Security spends $135 million yearly, contracting with physicians to provide consultative examinations for disability applicants. However, little is known about who these physicians are or how they view the determination of impairment. We surveyed a random sample of 153 physicians from North Carolina who performed consultative examinations for the North Carolina Disability Determinations Agency in 1983 (the consultative group), and a random…
The Impact of Echocardiographic Results on Treatment Decisions for Patients Suspected of Mitral Valve Prolapse
Although echocardiography is frequently ordered in ambulatory settings for patients suspected of mitral valve prolapse (MVP), its impact on their subsequent management is unknown. We studied the relationship between the results of echocardiography for outpatients suspected of MVP, and two frequent medical decisions: treatment with beta blockers and the recommendation of antibiotic prophylaxis to prevent bacterial endocarditis. A medical record au…
The Application of Official Policy
In 1977, the American Heart Association recommended that patients with mitral valve prolapse (MVP) and mitral insufficiency receive antibiotic prophylaxis prior to procedures that place them at risk for bacterial endocarditis. To study how clinicians conformed to this recommendation, the authors selected 126 patients with MVP admitted to a University Medical Center in 1978, the year following the official policy. Overall, only 47 patients (37%) h…
Measuring the Continuity and Coordination of Medical Care in a System Involving Multiple Providers
Patients often receive medical care from many different providers. Consequently, the various episodes of care may not be integrated into a meaningful whole, and the quality of care may suffer. Before this possibility can be evaluated, it is necessary to develop a measure of the integrating process. The authors studied the continuity and coordination of care for 197 patients attending the General Medicine Practice within a large teaching hospital.…
Patients?? Priorities for Medical Care
Relatively little research has been done on the importance patients attach to various aspects of their medical care when their options are constrained. We studied priorities for care among 225 patients attending the medical clinics of a university teaching hospital. Eight attributes of medical care were considered: continuity, coordination, comprehensiveness, availability, convenience, cost, expertise, and compassion. Priorities were established …
Free Grass to Fences
Journal Article Free Grass to Fences: The Montana Cattle Range Story. By Robert H. Fletcher. (New York: University Publishers, Inc., for the Historical Society of Montana, 1960. xx + 233 pp. Illustrations and map. $12.00.) Get access Lola M. Homsher Lola M. Homsher Wyoming State Archives and Historical Department Search for other works by this author on: Oxford Academic Google Scholar Journal of American History, Volume 48, Issue 2, September 196…
Columns of Infamy
Scopelism1
Ministères de la marine et de l‘ Instruction publique. Mission scientifique du Cap Horn. 1882–1883
Den östgrönlandske Expedition, udfört i Havene 1883–'5, under Ledelse af G. Holm. Kjöbenhavn
A Quarterly Bibliography of Anthropologic Literature
Accuracy of women's self-report of their last Pap smear
We compared interview data and physician records on when women last had a Pap smear in a sample of 98 rural Black women. We found 20 per cent of women could not accurately report on whether a Pap smear had been done within three years (sensitivity = 0.95, specificity = 0.47). Source of gynecological care and perceived barriers to obtaining a Pap smear but not education were associated with inaccurate reports. Self-report may be a misleading measu…
Cancer Prevention Among Working Class, Multiethnic Adults
Objectives. We analyzed outcomes from a study that examined social-contextual factors in cancer prevention interventions for working class, multiethnic populations. Methods. Ten community health centers were randomized to intervention or to control. Patients who resided in low-income, multiethnic neighborhoods were eligible; the intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity…
From Green to Black
Within political ecology research, a dominant focus on the hard physicality of the world limits engagement with how events taking place on land mediate and are mediated by other material spaces like the atmosphere. This paper engages with burgeoning research on the extraction-conservation nexus to highlight how the clearly demarcated land-based boundaries on which nexus thinking relies limit an awareness of how processes of conservation and extra…
Free Grass to Fences
Journal Article Free Grass to Fences: The Montana Cattle Range Story. By Robert H. Fletcher. (New York: University Publishers, Inc., for the Historical Society of Montana, 1960. xx + 233 pp. Illustrations and map. $12.00.) Get access Lola M. Homsher Lola M. Homsher Wyoming State Archives and Historical Department Search for other works by this author on: Oxford Academic Google Scholar Journal of American History, Volume 48, Issue 2, September 196…
A global conservation basic income to safeguard biodiversity
Biodiversity conservation supporting a global sustainability transformation must be inclusive, equitable, just and embrace plural values. The conservation basic income (CBI), a proposed unconditional cash transfer to individuals residing in important conservation areas, is a potentially powerful mechanism for facilitating this radical shift in conservation. This analysis provides comprehensive projections for potential gross costs of global CBI u…
Scopelism1
Den östgrönlandske Expedition, udfört i Havene 1883–'5, under Ledelse af G. Holm. Kjöbenhavn
A Quarterly Bibliography of Anthropologic Literature
Ministères de la marine et de l‘ Instruction publique. Mission scientifique du Cap Horn. 1882–1883
Scopelism1
Columns of Infamy
Free Grass to Fences
Journal Article Free Grass to Fences: The Montana Cattle Range Story. By Robert H. Fletcher. (New York: University Publishers, Inc., for the Historical Society of Montana, 1960. xx + 233 pp. Illustrations and map. $12.00.) Get access Lola M. Homsher Lola M. Homsher Wyoming State Archives and Historical Department Search for other works by this author on: Oxford Academic Google Scholar Journal of American History, Volume 48, Issue 2, September 196…
Patients?? Priorities for Medical Care
Relatively little research has been done on the importance patients attach to various aspects of their medical care when their options are constrained. We studied priorities for care among 225 patients attending the medical clinics of a university teaching hospital. Eight attributes of medical care were considered: continuity, coordination, comprehensiveness, availability, convenience, cost, expertise, and compassion. Priorities were established …
Measuring the Continuity and Coordination of Medical Care in a System Involving Multiple Providers
Patients often receive medical care from many different providers. Consequently, the various episodes of care may not be integrated into a meaningful whole, and the quality of care may suffer. Before this possibility can be evaluated, it is necessary to develop a measure of the integrating process. The authors studied the continuity and coordination of care for 197 patients attending the General Medicine Practice within a large teaching hospital.…
The Application of Official Policy
In 1977, the American Heart Association recommended that patients with mitral valve prolapse (MVP) and mitral insufficiency receive antibiotic prophylaxis prior to procedures that place them at risk for bacterial endocarditis. To study how clinicians conformed to this recommendation, the authors selected 126 patients with MVP admitted to a University Medical Center in 1978, the year following the official policy. Overall, only 47 patients (37%) h…
Social Security Disability Determinations
Social Security spends $135 million yearly, contracting with physicians to provide consultative examinations for disability applicants. However, little is known about who these physicians are or how they view the determination of impairment. We surveyed a random sample of 153 physicians from North Carolina who performed consultative examinations for the North Carolina Disability Determinations Agency in 1983 (the consultative group), and a random…
The Impact of Echocardiographic Results on Treatment Decisions for Patients Suspected of Mitral Valve Prolapse
Although echocardiography is frequently ordered in ambulatory settings for patients suspected of mitral valve prolapse (MVP), its impact on their subsequent management is unknown. We studied the relationship between the results of echocardiography for outpatients suspected of MVP, and two frequent medical decisions: treatment with beta blockers and the recommendation of antibiotic prophylaxis to prevent bacterial endocarditis. A medical record au…
Accuracy of women's self-report of their last Pap smear
We compared interview data and physician records on when women last had a Pap smear in a sample of 98 rural Black women. We found 20 per cent of women could not accurately report on whether a Pap smear had been done within three years (sensitivity = 0.95, specificity = 0.47). Source of gynecological care and perceived barriers to obtaining a Pap smear but not education were associated with inaccurate reports. Self-report may be a misleading measu…
The Treatment of Patients with Asthma by Specialists and Generalists
The authors investigated possible differences between specialists and generalists in the intensity with which they treat patients with asthma by studying the care of 283 patients between the ages of six and 40 provided by 13 allergists and 40 randomly selected physicians in two primary care specialties: pediatrics and family practice. After excluding patients with more than one physician, allergists' patients were nearly identical to primary care…
The Fairness and Effectiveness of Stroke Care in Health Maintenance Organizations
Department of Ambulatory Care and Prevention; Harvard Medical School and Harvard Pilgrim Health Care; Boston, Massachusetts From the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts. Address correspondence to: Robert H. Fletcher, MD, MSc, Professor, Department of Ambulatory Care and Prevention, Suite 200, 126 Brookline Avenue, Boston, MA 02215. E-mail: [email protected]
Systematic Review
Cancer Prevention Among Working Class, Multiethnic Adults
Objectives. We analyzed outcomes from a study that examined social-contextual factors in cancer prevention interventions for working class, multiethnic populations. Methods. Ten community health centers were randomized to intervention or to control. Patients who resided in low-income, multiethnic neighborhoods were eligible; the intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity…
Personalized Screening for Colorectal Cancer
From the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts. Reprints: Robert H. Fletcher, MD, MSc, 208 Boulder Bluff Trail, Chapel Hill, NC 27516. E-mail: [email protected]
Colorectal cancer screening
Which is better policy, to prevent colorectal cancer from arising or to detect it early once present? This question, long simmering in the background, was forced to a boil when two major US clinical practice guidelines, released within months of each other, reached opposite conclusions. Some countries have agencies that issue single, national clinical guidelines. Examples are the National Institute for Health and Clinical Excellence (NICE) in the…
Neoliberal Conservation
Neoliberal conservation describes a dynamic wherein prominent organizations around the world concerned with biodiversity protection have increasingly adopted strategies and mechanisms that seek to reconcile conservation with economic development by harnessing economic markets as putative mechanisms for financing nature conservation. Since the turn of the millennium, a vibrant discussion around this topic has arisen across anthropology, geography,…
Fortress tourism
This paper examines the role of tourism in promoting peace around transboundary protected areas (TBPA) in conflict-affected regions through a case study of the Virunga TBPA straddling the Democratic Republic of Congo, Rwanda and Uganda. Also praised as ‘peace parks’, TBPAs embody the rationale that stimulating a tourism economy in shared conservation spaces will provide incentives for formerly antagonistic states and actors to cooperate. Virunga …
A global conservation basic income to safeguard biodiversity
Biodiversity conservation supporting a global sustainability transformation must be inclusive, equitable, just and embrace plural values. The conservation basic income (CBI), a proposed unconditional cash transfer to individuals residing in important conservation areas, is a potentially powerful mechanism for facilitating this radical shift in conservation. This analysis provides comprehensive projections for potential gross costs of global CBI u…
From Green to Black
Within political ecology research, a dominant focus on the hard physicality of the world limits engagement with how events taking place on land mediate and are mediated by other material spaces like the atmosphere. This paper engages with burgeoning research on the extraction-conservation nexus to highlight how the clearly demarcated land-based boundaries on which nexus thinking relies limit an awareness of how processes of conservation and extra…
Cash for conservation? Integrating basic income support into biodiversity and climate finance
This article outlines the idea of a Basic Income for Nature and Climate (BINC) as a novel mechanism for funding biodiversity conservation and climate change mitigation activities. This proposal responds to two important empirical developments. The first concerns growing discussions around cash transfer programs and universal basic income within international development discussions. While these are increasingly implemented or piloted, they do not…
Medicine (9 works) · Political science (7 works) · Computer Science (6 works) · History (6 works) · Library science (6 works) · Family medicine (5 works) · Internal Medicine (5 works) · Internal Medicine (5 works) · Citation (4 works) · Economics (4 works)