BACKGROUND:Randomized controlled trials have demonstrated that fecal occult blood testing (FOBT) reduces colorectal cancer (CRC) mortality. However, patient compliance with FOBT is low and this is one of the major barriers to CRC screening.

The failure of a breastfeeding promotion effort to take root is traced to lack of administrative support and its consequences. For example, although staff training sessions were held, they were not mandatory and attendance was poor. There was no supervisory reprimand for staff who did not implement breastfeeding policies and practices. The program followed the steps for instituting change but failed and the lessons of its failure suggest that administrative backing is particularly important.

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When pharmaceutical companies market their products to, and through, healthcare professionals in hospitals and private practice, healthcare professionals face ethical dilemmas in their practice and their organizations. Pharmaceutical companies target nurse practitioners with prescribing privileges. The author describes the ethical dilemma faced by healthcare professionals when friendly salespeople offer tempting gifts. The article outlines cultural responses to gift giving and ethical issues surrounding healthcare professionals' responses to pharmaceutical marketing strategies. Nurse administrators need to acknowledge a growing threat to nursing integrity. Nurse administrators have the power to make and enforce ethical policies that prevent proprietary influences from clouding nursing judgment and contributing to the escalating costs of prescription medications.

In-service program development requires that the individual offering it be familiar with needs assessment techniques and program planning. In order to provide a program appropriate to the audience's needs, the presenter needs first to identify and set goals for the program, identify objectives relevant to the participants' needs, outline the material to be presented, and select the most appropriate presentation methodologies and ways of evaluating the program. This discussion includes examples and sample assessment forms that are specific to a breastfeeding program.