This research addresses one of the most pressing and controversial issues facing child welfare policymakers and practitioners today: the dramatic overrepresentation of Indigenous families in North American public child welfare systems. Effective, inclusive education is one necessary component of efforts to reduce such disparities. Yet recruiting students from various cultural communities to the field and educating white social work students and professionals to practice in culturally responsive ways are ongoing challenges. In this ethnography, we examine an apparently successful model of inclusive education: the Center for Regional and Tribal Child Welfare Studies (the Center) at the University of Minnesota, Duluth, School of Social Work. For over a decade, the Center has graduated Indigenous and non-Indigenous child welfare workers with MSWs now practicing within tribal communities, as well as provided continuing education for child welfare professionals. At the Center, Indigenous scholars and social workers, tribal leaders and their allies design and sustain a model of honoring and integrating Indigenous worldviews with Western social work. Experiential learningengaging the "heart and head"is a cornerstone of the Center's educational practices. Students and professional colleagues are approached with a "good heart" as "relatives" with positive intentions. They learn about the spirituality, language, culture and history of Indigenous people. The strengths-based curriculum also includes challenging content on the legacy of genocide and historical trauma on Indigenous families and communities, as well as contemporary laws and policies such as the Indian Child Welfare Act. The educational worldview and practices of the Center provide understanding for social work, generally, and child welfare, specifically, that supports effective practice and policy within diverse communities. work educational models and practices, as well as child welfare systems. It promises to provide understanding for social work, generally, and child welfare, specifically, that will contribute to effective practice and policy within our diverse communities; and create collaborations to reduce system barriers to equitable practice.

This paper traces the emergence of coastal management in the late twentieth century and assesses the social and spatial implications of the new Integrated Coastal Management (ICM) philosophy that guides national regulatory programs worldwide. A review of the epistemology of ICM reveals its link to the United Nations marine regulatory regime (the Law of the Sea) and the sustainable development paradigm embraced at the 1992 United Nations Conference on Environment and Development. I suggest that the resulting regulatory regime facilitates the opening of coastal zones worldwide to aggressive state and global capital investment. By promoting the overhaul of existing social and spatial organization in coastal zones and by asserting the primacy of resource access for modern economic interests, ICM may introduce more rather than less social conflict and ecological degradation. To illustrate this dynamic, I examine the case of coral reef management in general, and in the context of the Sri Lankan ICM program.

Physician education in the United States must change to meet the primary care needs of a rapidly transforming health care delivery system. Yet medical schools continue to produce a disproportionate number of hospital-based specialists through a high-cost, time-intensive educational model. In response, the American Osteopathic Association and the American Association of Colleges of Osteopathic Medicine established a blue-ribbon commission to recommend changes needed to prepare primary care physicians for the evolving system. The commission recommends that medical schools, in collaboration with their graduate medical education partners, create a new education model that is based on achievement of competencies without a prescribed number of months of study and incorporates the knowledge and skills needed for a twenty-first-century primary care practice. The course of study would occur within a longitudinal clinical training environment that allows for seamless transition from medical school through residency training.

Community health centers (CHCs), a principal source of primary care for over 24 million patients, provide high-quality affordable care for medically underserved and lower-income populations in urban and rural communities. The authors propose that CHCs can assume an important role in the quest for health care reform by serving substantially more Medicaid patients. Major expansion of CHCs, powered by mega teaching health centers (THCs) in partnership with regional academic medical centers (AMCs) or teaching hospitals, could increase Medicaid beneficiaries' access to cost-effective care. The authors propose that this CHC expansion could be instrumental in limiting the added cost of Medicaid expansion via the Affordable Care Act (ACA) or subsequent legislation. Nevertheless, expansion cannot succeed without developing this CHC-AMC partnership both (1) to fuel the currently deficient primary care provider workforce pipeline, which now greatly limits expansion of CHCs; and (2) to provide more CHC-affiliated community outreach sites to enhance access to care. The authors describe the current status of Medicaid and CHCs, plus the evolution and vulnerability of current THCs. They also explain multiple features of a mega THC demonstration project designed to test this new paradigm for Medicaid cost control. The authors contend that the demonstration's potential for success in controlling costs could provide help to preserve the viability of current and future expanded state Medicaid programs, despite a potential ultimate decrease in federal funding over time. Thus, the authors believe that the new AMC-CHC partnership paradigm they propose could potentially facilitate bipartisan support for repairing the ACA.