bluuebunny/crossref_metadata_2025 huggingface dataset:
Competitive strategy in remanufacturing and the impact of take‐back laws
Authors: Webster Scott , Mitra Supriya
Published: January 2007

This paper examines the impact of take‐back laws within a manufacturer/remanufacturer competitive framework. Take‐back laws require that firms take responsibility for the collection/disposal costs of their products. We consider two alternative implementations of take‐back laws that are distinguished by the degree of control that the manufacturer has on returns sold to the remanufacturer. In one implementation, known as collective WEEE take‐back, the manufacturer has no control over returns sold to the remanufacturer. The other implementation, known as individual WEEE take‐back, gives complete control to the manufacturer.

We develop a general two‐period model to investigate questions of interest to policy‐makers in government and managers in industry. Our results suggest that, in some settings, enactment of collective WEEE take‐back will result in higher manufacturer and remanufacturer profits while simultaneously spurring remanufacturing activity and reducing the tax burden on society. A negative effect is higher consumer prices in the market. In other settings, we find that collective WEEE take‐back introduces a structural change to the industry—creating an environment where remanufacturing becomes profitable when it is not profitable without a take‐back law. With respect to individual WEEE take‐back, we find that the manufacturer often benefits from allowing the remanufacturer to enter the market, though from a government policy‐maker perspective, there are clear risks of monopolistic behavior.
A new OSL chronology for dust accumulation in the last 130,000 yr for the Chinese Loess Plateau
Authors: Lu Y.C. , Wang X.L. , Wintle A.G.
Published: January 2007

A sensitivity-corrected Multiple Aliquot Regenerative-dose protocol has been developed for fine-grained quartz OSL dating of Chinese loess. Its reliability has been assessed on the basis of the methodology and by dating reference samples of known age close to the transition from the last interglacial paleosol (S1) to the last glacial loess (L1), which corresponds to the Marine Oxygen Isotope Stage (MIS) 5/4 transition. On the basis of the fine-grained quartz OSL-age estimates for 33 loess samples from the upper part of the Luochuan profile, a detailed chronostratigraphy of continuous dust accumulation in the past 130 ka has been proposed. Changes in the accumulation rate occurred during the last glacial period (MIS 4 to MIS 2); unexpectedly, high accumulation rates were found in the weakly developed L1–2(S)paleosol of the last interstadial (MIS 3), rather than in the classic L1–1and L1–3loess of the cold–dry glacial condition (MIS 2 and 4). The OSL ages show some disagreement with the previous numerical chronology for the loess–paleosol sequence based on correlation of variations in grain size with sedimentation rate; the latter method resulted in an almost constant accumulation rate from 72 to 12 ka.
Century-scale variability in late-summer rainfall events recorded over seven centuries in subannually laminated lacustrine sediments, White Pass, British Columbia
Authors: Cockburn Jaclyn M.H. , Lamoureux Scott F.
Published: January 2007

Formation of annually laminated sediments in Summit Lake, White Pass, British Columbia is controlled by runoff generated by snowpack and glacier melt and major rainfall events. The 700-yr varve record is divided into two subannual series (early and late) based on sedimentological criteria and sedimentary structures within each varve. A comparison of recent subannual laminae with nearby meteorological records supports the interpretation they are formed by river discharge events generated by major snow and glacier melt events and large late-summer rainfall events. A significant correlation exists between the late subannual thickness series and the size of the largest rainfall events in late summer. The long record indicates there was an abrupt increase in the thickness and frequency of major rainfall-induced sedimentary events at the end of the seventeenth century. In addition, the frequency of laminae generated by early runoff events also increased. However, early subannual varve thickness component remains statistically the same as the thickness prior to the end of the seventeenth century. This suggests the change in varve thickness at this time is due to increases in major late-summer rainfall frequency rather than increased sediment availability caused by regional Little Ice Age glacier advances.
Teenage mothers and their infants: new findings on the home environment
Authors: King Timothy , Fullard William
Published: January 2007

This study is belived to be the first of its kind using standardized instruments to assess adolescent mothers' skills in parenting their infants. It was designed to answer first, how do teenage mothers compare with normal mothers and their parenting skills and, second, are there predicts able individual differences in parenting skills as a function of age racep socio‐economic status, knowledge of child development, place of residencer and amount of time spent away from the child?
Leaving home, and the adolescent family therapist
Authors: Kraemer Sebastian
Published: January 2007

Serious psychiatric problems of adolescence can be viewed as breakdowns at the prospect of adulthood, when “leaving home” begins to have real meaning, wherever the young person actually lives. Most young people seem to cope well enough with this process, but crises develop in those families where the growing child senses that it is too soon to grow up and leave, in case the parents could not survive in the “empty nest”. I describe how a therapist gradually develops such a point of view, and end with the case of “Jean” who broke down at the age of 15.
A cross‐cultural study of adolescent self‐concept
Authors: Olowu A.A.
Published: January 2007

A culture‐fair scale that was specifically developed to compare six selfconcept areas of English and Nigerian (Yoruba) adolescents was utilized in a sample of 686 adolescents. This consisted of 314 white English and 372 Yoruba adolescents whose ages ranged between 14·9 and 10·70 years. The English adolescents were found to have significantly more positive self‐concept on most of the 24 scales. The observed results were explained in the light of the sociocultural environments of the two groups of adolescents.
EFFECT OF COMBINING ORGANIC RESIDUES WITH MINJINGU PHOSPHATE ROCK ON SORPTION AND AVAILABILITY OF PHOSPHORUS AND MAIZE PRODUCTION IN ACID SOILS OF WESTERN KENYA
Authors: KIFUKO M. N. , OTHIENO C. O. , OKALEBO J. R. , KIMENYE L. N. , NDUNG'U K. W. , KIPKOECH A. K.
Published: January 2007

Experiments were conducted in both the greenhouse and the field on highly weathered (Orthic Ferralsol) soils to evaluate the effect of combining on-farm organic residues (chicken manure, farmyard manure, sugar bagasse) with Minjingu phosphate rock (MPR) on soil pH, extractable (available) and sorbed phosphorus (P), and to assess the cost benefit for maize production. The greenhouse study results indicated that, in the first eight weeks of incubation, soil pH increased linearly with increase in MPR rates and decreased thereafter. The available P also increased linearly. Chicken manure and sugar bagasse were most and least effective respectively in reducing P sorption, while there was a significant negative relationship between P adsorption maxima and extractable P. The field experiment data showed that the available P values increased significantly above the control in all the treatments where MPR and organic materials were applied separately or combined. Treatment effects on Langmuir sorption maxima (Smax) in the field were variable. An increase in Smax with an increase in MPR rates was noted. However, there was a positive relationship between Smax and available P (r = 0.52 to 0.69), suggesting the diversity of factors affecting the complex nature of P dynamics under field conditions. MPR applied alone in the first season gave a significant residual positive effect on maize grain yield for two additional seasons. The economic analysis revealed that a single application of chicken manure (2 t ha−1) combined with MPR at 60 kg P ha−1 gave the highest incremental net benefit equivalent to US$ 657 ha−1 during the three maize cropping seasons.
ON-FARM WHEAT TRIALS IN BANGLADESH: A STUDY TO REDUCE PERCEIVED CONSTRAINTS TO YIELD IN TRADITIONAL WHEAT AREAS AND SOUTHERN LANDS THAT REMAIN FALLOW DURING THE DRY SEASON
Authors: RAWSON H. M. , GOMEZ-MACPHERSON H. , HOSSAIN A. B. S. , SAIFUZZAMAN M. , RASHID H. , SUFIAN M. A. , SAMAD M. A. , SARKER A. Z. , AHMED F. , TALUKDER Z. I. , RAHMAN MOZNUR , SIDDIQUE M. M. A. B. , HOSSAIN I. , AMIN M.
Published: January 2007

This research set out to find ways to increase wheat production in Bangladesh. The approaches were (1) to increase the area planted to wheat, concentrating on developing a suitable management system for the very hot, often saline and hitherto largely untested fallow lands of the south; and (2) to increase economic and sustainable yield of wheat in the traditional rice-wheat zones. Five mechanized reduced tillage and planting systems were compared. They were used to enable 200 co-operating farmers at 11 locations to plant on time and avoid the reduction in yield that accompanies delays, found in this study to average 2 % d−1. Methods that placed seeds in rows were zero tillage, full or strip surface shallow till, and raised beds. A partially mechanized version of the traditional manual system called New Conventional, in which seeds and fertilizers were broadcast, was also tested. Farmers' wheat yields averaged more than 3.5 t ha−1 for the two seasons of the study. Farmers in the untested lands averaged more than 2.5 t ha−1 on their farms, well above the 0.5 t ha−1 needed to cover all costs and equal to normal production levels in traditional wheat areas. Surprisingly, full and strip till did not produce higher yields overall than New Conventional in either season. Reasons for the lack of difference are discussed in relation to other aspects of management and variation between the farmers themselves. Farmers had varying opinions and mixed success with zero till and beds. The economic consequences to farmers of using the different systems are also discussed with the suggestion that the low-tech New Conventional method will be preferable for novice wheat farmers in the historically fallow lands where the study indicated potential production is 1 million tonnes.
“Half God, half man”: Kazantzakis, Scorsese, and The Last Temptation
Authors: Holderness Graham
Published: January 2007

You may have heard of the Blessed Mountain.It is the highest mountain in our world.Should you reach the summit you would have only one desire,and that to descend and be with those who dwell in the deepest valley.That is why it is called the Blessed Mountain.Kahlil Gibran, Sand and Foam
Some New Letters of Popes Urban II and Paschal II
Authors: BRETT MARTIN
Published: January 2007

The ancient library of the canons of St Peter at the Vatican contained two copies of the Panormia, an immensely successful canon law collection attributed to Ivo of Chartres.1 Neither was part of the legacy of Cardinal Giordano Orsini (d. 1438), and they may well have been at St Peter's since the later twelfth century when they were written. In spite of the many losses the library suffered, both survive, as MS G 19 and MS G 19bis.2
Missionary Education, Religion and Knowledge in India, c.1880–1915
Authors: BELLENOIT HAYDEN J. A.
Published: January 2007

Christian missionaries were some of the most influential actors in colonial India. Yet they only began working recently in relation to larger British influence in the subcontinent. Originally banned from the territories of the East India Company for fears of upsetting Indian religious sensibilities, they were allowed to operate after 1843 in parallel with a rising Utilitarian and evangelist fervour in Britain and within particular Company circles; the latter often blurred the distinctions between ‘moral improvement’, civilisation and Christianity. Missionaries were influential in the debate over sati and the subsequent outlaw of its practice. Protestant encounters with Hinduism and Islam were defined by the rhetoric of ‘heathen’ and ‘unbelievers’, as missionaries derided the ‘idolatry’ of Hinduism and ‘bigotry’ of Islam. Some of the first mission schools established were in the Bombay Presidency, Bengal and the Punjab. During this period missionaries ascribed utility to the corpus of western scholarship as an ally against Indian religions. They hoped to ‘prove’ their falsehoods. The primary way to do this was through western education, arguing that western scholarship was saturated with Christian morals and that such ethoses would transform Indians accordingly. This was a period when the symmetry between Christianity and western scholarship was championed by missionaries such as John Murdoch and Alexander Duff. After the Indian Mutiny (1857–8), missionaries were held in check (at least officially) by the colonial state as a means of avoiding upsetting Indian religious sensibilities. Yet, ironically, in northern India missionaries came to be relied upon by a cash-strapped Education Department. They came to dominate education and were credited with doing much to push the frontiers of western pedagogy in their efforts to propagate their faith.
Terribly Severe Though Mercifully Short: The Episode of the 1918 Influenza in British Malaya
Authors: LIEW KAI KHIUN
Published: January 2007

The influenza epidemic swept through our midst in September and October, unhappily with fatal consequences to a number of friends in the Tamil community. We are glad to say that though terribly severe while it lasted, its duration was mercifully short. On the other hand, the great news that the armistice has been signed filled us with unaccustomed joy.
The Court of Wards in a Princely State: Bank Robber or Babysitter?
Authors: COHEN BENJAMIN B.
Published: January 2007

Scholarship on institutional history rarely brings the academe to a heightened state of excitement. However, when institutions cross spans of time and place while intersecting with multiple cultural identities and levels of power, things can become more captivating. An ideal institution for examination of this very process is the Court of Wards. Originally devised in Tudor England, the Court was later brought to India by members of the East India Company and put into wide use throughout the subcontinent. In India, its purpose was to shelter child heirs and their estates, eventually returning heir and estate to autonomy when ruling age was reached. However, while the Court in England and in India has received some critical review, we can extend its investigation one step further by examining its use in the ‘other India’, that of the princely states. How did this administrative unit become adopted and adapted to some of India's 560 princely states? To what degree were the Court and its administrators able to rectify an inherent tension within the Court's purpose? It was largely designed to protect child heirs and their estates, and return them in due time. But, in a princely state, in some circumstances, the ultimate ‘owner’ of any land was the chief prince. Did the Court mediate between the wishes of the ruling prince and his (or her) smaller ‘little kings?’ In short, to what extent was the Court of Wards at times a babysitter, and at other times a bank robber?
Commercial World of Mancherji Khurshedji and the Dutch East India Company: A Study of Mutual Relationships
Authors: NADRI GHULAM AHMAD
Published: January 2007

On April 1st 1768, a Parsi servant of Mancherji Khurshedji, a merchant and -broker of the Dutch Company, came to Surat to whom another Parsi servant of Dhanjishah, a merchant under the English protection, asked wherefrom he came and without any further argument he inflicted a blow with his fist to the first mentioned who then fell down and meanwhile he gave him a slap, then the defender inflicted two pricks with his knife to the offender, many people witnessed this fight, and the Parsi who still had the knife in his hand, was attacked with bamboos with such force that the knife fell from his hand, he was further beaten up till he fell down.
Slavery, Sexuality and House Churches: A Reassessment of Colossians 3.18–4.1 in Light of New Research on the Roman Family
Authors: MACDONALD MARGARET Y.
Published: January 2007

The instructions to slaves and masters in the Colossian Haustafel have long raised questions about their concrete meaning for their intended audience. Drawing principally on recent research on the Roman family, but also on other texts, inscriptions and imagery, this article seeks to show that the implications of the household code for the sexual treatment of slaves must have varied widely. Important factors included the believing or non-believing nature of each household and the complexity of familial arrangements generally. Ultimately, Colossians appears implicitly to recognise a degree of honour in the case of slaves, a view that may sometimes have led to greater respect for familial/sexual boundaries than was otherwise usual.
The Question of Interest Group Influence
Authors: DÜR ANDREAS , DE BIÈVRE DIRK
Published: January 2007

Interest groups are a major channel through which citizens can express their opinions to decision-makers. Their participation in policymaking may improve decision-making processes by supporting policies that are in line with citizen preferences and blocking policies that solely reflect the interests of the governing elite. At the same time, however, intense interest group pressures may make it difficult for policy-makers to implement the most efficient policies since such policies often impose costs on parts of the public. Competition among interest groups over the distribution of economic gains may also slow down the rate of economic growth (Olson 1982). Finally, if some groups constantly win, interest group politics may undermine the legitimacy of electorally accountable decision making in a democracy.
Lobbying Success in the United States and the European Union
Authors: MAHONEY CHRISTINE
Published: January 2007

Scholars have avoided studying interest group influence because of the difficulty operationalising the concept. The research presented here introduces a new way of measuring lobbying success and lays out a model of its determinants. To understand why interest groups sometimes succeed and at other times fail, we must consider the institutional structure of the political system within which the advocates are operating; the characteristics of the issue at hand; and finally the characteristics of the interest group itself and their lobbying strategy. I test these factors with original data based on interviews with 149 advocates in Washington D.C. and Brussels active on a random sample of 47 policy issues. From the results, issue context emerges as a much more important determinant of lobbying success than institutional differences. The institutional differences that do emerge suggest that direct elections coupled with private campaign finance lead to winner-take-all outcomes biased in favour of wealthier business interests, while the lack of these institutional characteristics leads to more balanced policy compromises with more advocates achieving some of their policy goals.
Advocacy Coalitions and the Internationalization of Public Health Policies
Authors: PRINCEN SEBASTIAAN
Published: January 2007

This article looks at the impact of multilevel governance structures on state-society relations. It contends that rather than focusing on relations between state actors and societal actors, it is more useful to look at shifts between competing advocacy coalitions in a given issue area. It argues that the impact of multilevel governance structures on domestic advocacy coalitions depends on the political opportunity structure provided at the international level, the types of policy outputs international institutions can deliver, and the extent to which members of an advocacy coalition have the organizational capacities to be active at the international level. These factors are explored in two cases of public health policy: anti-smoking policy and alcoholism policy. Moreover, both cases show that multilevel governance structures offer better opportunities for challengers than for defenders of the domestic status quo.
High-speed navigation of unmanned ground vehicles on uneven terrain using potential fields
Authors: Shimoda Shingo , Kuroda Yoji , Iagnemma Karl
Published: January 2007

Many applications require unmanned ground vehicles (UGVs) to travel at high speeds on sloped, natural terrain. In this paper, a potential field-based method is proposed for UGV navigation in such scenarios. In the proposed approach, a potential field is generated in the two-dimensional “trajectory space” of the UGV path curvature and longitudinal velocity. In contrast to traditional potential field methods, dynamic constraints and the effect of changing terrain conditions can be easily expressed in the proposed framework. A maneuver is chosen within a set of performance bounds, based on the local potential field gradient. It is shown that the proposed method is subject to local maxima problems, rather than local minima. A simple randomization technique is proposed to address this problem. Simulation and experimental results show that the proposed method can successfully navigate a small UGV between predefined waypoints at speeds up to 7.0 m/s, while avoiding static hazards. Further, vehicle curvature and velocity are controlled during vehicle motion to avoid rollover and excessive side slip. The method is computationally efficient, and thus suitable for onboard real-time implementation.
Development of an image-guided robotic system for surgical positioning and drilling
Authors: Tseng Ching-Shiow , Huang Chiao-Chi , Chen Chen-San
Published: January 2007

This study develops a novel image-guided robotic system that can be used to position biopsy needles or drill fixation holes. After the patient has received a CT-scan, the registration of the image, localizer (patient), and robot frames will be done by finding the optimum transformation matrix among the image and localizer coordinates of the fiducial markers and the DRFs mounted on the robot. Then, surgical paths planned on the computer displayed images can be transformed to the robot frame, and the robot is thus capable to move surgical tools to the preplanned location. The positioning error is about 2 mm and the orientation error is about 0.23°.
Velocity space approach to motion planning of nonholonomic systems
Authors: Duleba Ignacy , Khefifi Wissem
Published: January 2007

In this paper, a velocity space method of motion planning for nonholonomic systems is presented. This method, based on Lie algebraic principles and locally around consecutive current states, plans a motion towards a goal. It is effective as most of the computations can be carried out analytically. This method is illustrated on the unicycle robot and the inverted pendulum.
Real-time motion planning for robot manipulators in unknown environments using infrared sensors
Authors: Wang Shuguo , Bao Jin , Fu Yili
Published: January 2007

This paper deals with sensor-based motion planning method for a robot arm manipulator operating among unknown obstacles of arbitrary shape. It can be applied to online collision avoidance with no prior knowledge of the obstacles. Infrared sensors are used to build a description of the robot's surroundings. This approach is based on the configuration space but the construction of the C-obstacle surface is avoided. The point automation is confined on some planes with square grids in the C-space. A path-searching algorithm based on square grids is used to guide the automation maneuvering around the C-obstacles on the selected planes. To avoid the construction of the C-obstacle surface, the robot geometry model is expanded, and the static collision detection method is used. Hence, the computation time is reduced and the algorithm can work in real time. The effectiveness of the proposed method is verified by a series of experiments.
A novel PID control parameters tuning approach for robot manipulators mounted on oscillatory bases
Authors: Lin J. , Huang Z.-Z.
Published: January 2007

This research focuses on the issue of dynamic modeling and controlling a robotic manipulator attached to a compliant base. Such a system is known under the name macro–micro system, characterized by the number of control actuators being less than the number of state variables. The equations of motion for a two-link planar elbow arm mounted on an oscillatory base has been presented in this investigation. In order to study the sensitivity of tuning the PID parameters to achieve the desired performance, the Grey relational analysis has first been proposed. Therefore, the aim of this work is to apply Grey theory to optimize parameters for partial states feedback of a PID controller for such a structure. The experimental results of the proposed methodology also show that it is technically and economically feasible to develop a low-cost, reliable, automatic, less time-consuming controller for robotics mounted on oscillatory bases.
An integrated agent-based software architecture for mobile and manipulator systems
Authors: Nebot Patricio , Cervera Enric
Published: January 2007

Mobile manipulation involves the most important key issue in robotics: integration. While hardware integration seems to be nearly solved due to the increasing dominance of PC-compatible systems, software integration is still a challenge, since a lot of issues arise with the variety of operating systems, device drivers, application libraries, and programming languages which need to be merged in any real-world robotic system. This paper presents a software architecture, which seamlessly integrates robot arms, mobile bases, vision systems and sensing devices, in a distributed, homogeneous agent framework. Based on the Java platform, the agent-based architecture allows great flexibility in the integration of components, and provides a simple yet extensible and powerful software layer to develop further mobile manipulating environments. Detailed software issues, as well as preliminary results are shown, which pave the way towards the development of network-ready applications involving mobile and manipulating artifacts.
Mapping the integration of social and ethical issues in health technology assessment
Authors: Lehoux Pascale , Williams-Jones Bryn
Published: January 2007

Background:Since its inception, the field of health technology assessment (HTA) has stressed the need for consideration of ethical and social issues. However, few concepts or analytic tools have been developed, and because of the complexity of the endeavor and a lack of integration of work already produced, such concepts remain difficult to apply in HTA.

Objectives:Through a descriptive “map” of concepts, tools, and processes, we summarize the most tangible efforts on the part of HTA producers to address social and ethical issues.

Methods:A literature review and content analysis of HTA reports in the Centre for Reviews and Dissemination database enables a synthesis of the reflections on, initiatives around, and gaps in knowledge related to the integration of social and ethical issues in HTA.

Results:We examine: (i) the aim of integrating ethical and social issues in HTA, (ii) the theoretical approaches used, (iii) the methods and processes applied, and (iv) the implications for HTA producers. We highlight two levels at which social and ethical issues can be considered: throughout the production process of HTA reports and as part of the organizational structure of HTA agencies.

Conclusions:Given the profound societal changes that occur in relation to healthcare technology development, HTA producers have a responsibility to inform and enlighten technology-related public and policy debates. Fulfilling this role, though, requires that socioethical dimensions of technologyandHTA are made explicit.
Primary data collection in health technology assessment
Authors: McIsaac Michelle L. , Goeree Ron , Brophy James M.
Published: January 2007

This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.
Economic evaluations of leukemia: A review of the literature
Authors: Kasteng Frida , Sobocki Patrik , Svedman Christer , Lundkvist Jonas
Published: January 2007

Objectives:Leukemia, together with lymphoma and multiple myeloma, are hematological malignancies, malignancies of the blood-forming organs. There are four major types of leukemia: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). There is a growing amount of literature of the health economic aspects of leukemia. However, no comprehensive review is yet performed on the health economic evidence for the disease. Hence, our aim was to review and analyze the existing literature on economic evaluations of the different types of leukemia.

Methods:A systematic literature search used electronic databases to identify published cost analyses and economic evaluations of leukemia treatments. After reviewing all identified studies, sixty studies were considered relevant for the purpose of the review.

Results:The identified studies were published after 1990, with a few exceptions. Many of the identified economic evaluations in leukemia, particularly for ALL and AML, may be defined as cost-minimization analyses, where only the costs of different treatment strategies are compared. In CML, a new treatment, imatinib, was introduced in 2001 and several cost-effectiveness analyses have since then been conducted comparing imatinib with previous first line treatments.

Conclusions:This review indicates that there is a shortage of cost-effectiveness information in leukemia. The introduction of new therapies will stress the need for new economic evaluations in this group of diseases. More information about the total costs, that is, including indirect costs, and quality of life effects would be valuable in future evaluations in leukemia.
Effectiveness and safety of endoscopic thoracic sympathectomy for excessive sweating and facial blushing: A systematic review
Authors: Malmivaara Antti , Kuukasjärvi Pekka , Autti-Ramo Ilona , Kovanen Niina , Mäkelä Marjukka
Published: January 2007

Objectives:Despite controversies, endoscopic thoracic sympathectomy (ETS) has been used as a treatment for excessive sweating of hands and face and for facial blushing. This study aims to evaluate the effectiveness of ETS for the current indications in a systematic review.

Methods:Controlled clinical trials and cohort studies with more than 100 patients were included. Abstracts were searched from MEDLINE and CCTR from 1966 to June 2004. Two reviewers extracted the data and assessed study quality. Data on effectiveness and safety were synthesized qualitatively.

Results:We did not find any controlled clinical trials. Fifteen prospective studies were included. The internal and external quality of these studies were poor overall. Follow-up was commonly less than 2 years, during which time excessive sweating and facial blushing seemed to decrease among most patients. Immediate complications related to thoracoscopy occurred in up to 10 percent of patients. Compensatory sweating below breast level was reported in up to 90 percent of the patients. Other common side effects included dryness of face and hands, gustatory sweating, and neuralgic pain. Several other less common side effects were reported.

Conclusions:The evidence of the effectiveness of ETS is weak due to a lack of randomized trials. The intervention leads to severe immediate complications in some of the patients, and to persistent side-effects for many of the patients.
Telemedicine in pediatric and perinatal cardiology: Economic evaluation of a service in English hospitals
Authors: Dowie Robin , Mistry Hema , Young Tracey A. , Weatherburn Gwyn C. , Gardiner Helena M. , Rigby Michael , Rowlinson Giselle V. , Franklin Rodney C. G.
Published: January 2007

Objectives:Pediatric cardiology has an expanding role in fetal and pediatric screening. The aims of this study were to observe how district hospitals use a pediatric telecardiology service, and to compare the costs and outcomes of patients referred to specialists by means of this service or conventionally.

Methods:A telemedicine service was set up between a pediatric cardiac center in London and four district hospitals for referrals of second trimester women, newborn babies, and older children. Clinicians in each hospital decided on the role for their service. Clinical events were audited prospectively and costed, and patient surveys were conducted.

Results:The hospitals differed in their selection of patient groups for the service. In all, 117 telemedicine patients were compared with 387 patients seen in London or in outreach clinics. Patients selected for telemedicine were generally healthier. For all patients, the mean cost for the initial consultation was £411 for tele-referrals and £277 for conventional referrals, a nonsignificant difference. Teleconsultations for women and children were significantly more expensive because of technology costs, whereas for babies, ambulance transfers were much more costly. After 6-months follow-up, the difference between referral methods for all patients was nonsignificant (telemedicine, £3,350; conventional referrals, £2,172), and nonsignificant within the patient groups.

Conclusions:Telemedicine was perceived by cardiologists, district clinicians, and families as reliable and efficient. The equivocal 6-month cost results indicate that investment in the technology is warranted to enhance pediatric and perinatal cardiology services.
Cost-effectiveness analysis of prenatal diagnosis intervention for Down's syndrome in China
Authors: Chen Yingyao , Qian Xu , Li Jun , Zhang Jie , Chu Annie , Schweitzer Stuart O.
Published: January 2007

Objectives: The cost-effectiveness of prenatal diagnosis intervention for Down's syndrome (DS) in China was assessed and evidence-based information for policy makers and providers is presented.

Methods: Based on field surveys in four selected cities in China and a literature review, the economic evaluation of prenatal diagnosis for DS from a societal perspective is conducted by cost-effectiveness analysis.

Results: In current clinical practice, for a cohort of 10,000 pregnant women, the strategy that delivers karyotyping by chorionic villus sampling (CVS) or amniocentesis (AC) only to those pregnant women 35 years of age and older (maternal age screening strategy) can detect .67 DS births. The strategy that offers the diagnostic test after maternal serum screening with α-fetoprotein and human chorionic gonadotrophin (maternal serum screening strategy) can detect 1.41 DS births. The cost per prevented DS birth by the maternal age screening strategy and maternal serum screening strategy is US$13,091 and US$56,048, respectively. Sensitivity analysis shows that the maternal serum screening strategy can be cost-effective if uptake rate of CVS or AC for patients with positive serum tests increase while the cost of serum screening decreases.

Conclusions: Although, in general, serum screening has been found to be more cost-effective than maternal age screening, this appears not to be the case in China. The reasons appear to be low uptake rate of the maternal serum strategy, low uptake rate of CVS or AC, and the high price of serum screening. Our findings are that health system factors concerning technology utilization are important determinants of the technology's efficiency.
Frederick Mosteller (1916–2006): Mentoring, A Memoir
Authors: Hedley-Whyte John
Published: January 2007

Frederick Mosteller was born in Clarksburg, West Virginia, at the time of the birth of medical technology assessment (10). During a long academic career at Harvard, he, probably more than any other person, contributed to techniques of assessment of therapy and outcome (6;14;29). Much of his seminal writing was published in theInternational Journal of Technology Assessment in Health Care(1;3;8;12;16;17;19;21–23).
Bare interiors
Authors: DEASY MARTIN
Published: January 2007

Opera is a genre that prizes interior expression. How then does it cope with characters who are defined by reticence and inscrutability? Donizetti's 1837 opera Roberto Devereux thematises these issues – a reflection, in part, of the nineteenth century's growing anxieties over public self-expression. Engaging with contemporary 1830s criticism, this article focuses on two numbers in the work that were identified as problematic by early audiences, arguing that their perceived failure is a consequence of the work's inventive depiction of its characters' vacant subjectivities. Donizetti's opera can be seen to stretch primo Ottocento operatic conventions to their limits, in the process undoing the traditional correspondence between interior expression and self-definition.
On parachutes of optimum shape in a subsonic gas flow
Authors: MAKLAKOV D. V. , ELIZAROV A. M. , SHARIPOV R. R.
Published: January 2007

In this paper the problem of finding the impermeable parachute of optimum shape in a subsonic gas flow has been solved. The effects of compressibility have been taken into account out by making use of ideas of Chaplygin's approximate method. A formula for the drag coefficient has been deduced and by comparison with exact solutions it has been demonstrated that for bluff bodies its related error is no more than 0.5% for any Mach number at infinity less than unity. On the basis of the formula a functional for the drag force has been constructed and its global maximum has been found analytically. It has been shown that the optimum shape is slightly affected by compressibility.
OBSTETRIC MANAGEMENT OF TEENAGE PREGNANCY
Authors: MYERS JENNY E , HEAZELL ALEXANDER EP , JONES REBECCA L , BAKER PHILIP N
Published: January 2007

Adolescent pregnancy rates in the United Kingdom remain the highest in Western Europe. Interestingly, throughout most of Western Europe teenage birth rates fell during the 1970s, 80s and 90s, but in the United Kingdom rates have remained high. An increasing incidence has also been noted, with 49.9 births per 1,000 women under 18 in 2001 and 52.8 live births per 1,000 women in 2002.
G-7 INFLATION FORECASTS: RANDOM WALK, PHILLIPS CURVE OR WHAT ELSE?
Authors: CANOVA FABIO
Published: January 2007

This paper compares the forecasting performance of some leading models of inflation for G-7 countries. We show that bivariate and trivariate models suggested by economic theory or statistical analysis are not much better than univariate ones. Phillips curve specifications fit well into this class. Improvements in both the MSE of the forecasts and turning point prediction are obtained with time-varying coefficients models, which exploit international interdependencies. The performance of the latter class of models is stable throughout the 1990s.
EDITOR'S ANNOUNCEMENT: THE NEW SUPPLEMENTS SERIES
Authors: Barnett William A.
Published: January 2007

Beginning in 2007, this journal will publish a new series of supplements for special issues. This new supplements series is intended to remove some special issues from the regular-issues space budget and thereby help to avoid the crowding-out problem that had previously resulted from having special issues replace regular issues. Because of the rapid growth of excellent special issues proposals, we expect the number of supplements to be published per year to grow rapidly. Initially our objective is to publish one or two such supplement issues each year. The supplement will be published “when ready.” The initial space budget for the annual supplement is 144 printed pages, plus or minus 20% to accommodate the variance in special issue sizes. Hence all special issues must be of length within the following range of printed page: 115–173.
Emerging Technologies: Systems Biology
Authors: Srivastava Ranjan , Varner Jeffrey
Published: January 2007

The field of systems biology is based on the paradigm that the whole is greater than the sum of the parts. Through a combination of high‐throughput experiments analyzing “‐omic” scale phenomenon and the development of new computational techniques and algorithms, it is now feasible to study biological systems in a way that was previously not possible. During the 232nd National Meeting of the American Chemical Society, a session devoted to the emerging technology of Systems Biology was held. A number of talks on a wide variety of subjects covering cell signaling, network regulation and analysis, novel experimental procedures, synthetic biology, and metabolic flux analysis were presented. All of these approaches shared the common theme of using a systems biology approach to aid in the understanding of fundamental biology, with an eye toward applications for the benefit of society.
Die Bedeutung der Interferenzresistenz für Altersunterschiede in komplexen Gedächtnisspannenaufgaben
Authors: Titz Cora , Behrendt Jörg , Menge Uwe , Hasselhorn Marcus
Published: January 2007

Zusammenfassung: Dem Hemmungsdefizit-Modell zufolge beruhen im Alter verringerte Leistungen in komplexen Spannenaufgaben auf einer nachlassenden Interferenzresistenz. In einer Studie mit je 64 jungen (19-33 Jahre) und älteren Erwachsenen (58-80 Jahre) wurden altersbezogene Unterschiede in der Arbeitsgedächtnisleistung, gemessen über komplexe Spannenaufgaben, jedoch nicht von verschiedenen Interferenzmanipulationen moderiert. So hatte es keinen Einfluss, ob Items mit oder ohne Distraktoren dargeboten wurden (coaktive Interferenzen), ob bei Darbietung langer Sequenzen bereits viel oder wenig Material verarbeitet wurde (proaktive Interferenzen), oder ob zwischen Verarbeitung und Speicherung eine hohe oder geringe Interferenz bestand (Sätze verifizieren und Wort merken, vs. Matheaufgaben lösen und Wort merken). Stattdessen erwiesen sich eher Unterschiede in Geschwindigkeitsmaßen und der prozessualen Kapazität der phonologischen Schleife als zentral in Zusammenhang mit Altersdifferenzen in der komplexen Spanne.
Integration von Angehörigen in Seniorenheime
Authors: Gsottschneider Anna , Baumann Urs , Messer Randolf
Published: January 2007

Zusammenfassung: Studienziel war es, zu untersuchen, welche Leistungen Angehörige stationär versorgter alter Menschen tatsächlich erbringen bzw. zu welchen Hilfestellungen sie theoretisch bereit wären. Methodik: In einem Interview wurden 40 Angehörige von BewohnerInnen dreier Seniorenheime in der Stadt Salzburg bezüglich tatsächlich erbrachter und hypothetisch vorstellbarer Unterstützung bei diversen Aufgaben im Rahmen der Versorgung der SeniorInnen befragt. Ebenso wurden Befürchtungen sowie erwartete Gegenleistungen erfasst. Ergebnisse: Es zeigte sich, dass das Ausmaß der familiären Unterstützung stark von der spezifischen Aufgabe abhing, wobei körperlich anstrengende und zeitintensive Tätigkeiten eher an das Heimpersonal abgegeben wurden und die familiäre Beteiligung bei den Aufgaben geringer war, die mit einem Eindringen in die Intimsphäre des/der Seniors/in assoziiert waren. Bei einer hypothetischen Frage unter idealisierten Bedingungen ergab sich eine große familiäre Unterstützungsbereitschaft. Die Angehörigen befürchteten hinsichtlich der Mitarbeit vor allem Einschränkungen in verschiedenen Lebensbereichen. Bezüglich einer adäquaten Gegenleistung polarisierten die Meinungen der ProbandInnen zwischen einer finanziellen Abgeltung und keiner monetären Gegenleistung.
Körperbeschwerden und Gesundheitsangst in der Primärmedizin
Authors: Benedikt Gertraud , Schulmeister Elke , Sattel Heribert , Schäfert Rainer , Sauer Nina , Herzog Wolfgang , Henningsen Peter
Published: January 2007

Zusammenfassung. Patienten mit erhöhter Gesundheitsangst verursachen erhebliche Kosten für das Gesundheitssystem. Die durchgeführten medizinischen Untersuchungen und Behandlungen sind häufig unangemessen, denn in etwa der Hälfte der Fälle liegt den Krankheitsbefürchtungen keine organische Erkrankung zugrunde. Im Rahmen der kontrollierten cluster-randomisierten Studie FUNKTIONAL wurden in 29 Hausarztpraxen bei 1751 Patienten systematisch Gesundheitsangst (Whiteley-7), körperliche und psychische Symptome (PHQ-D) sowie die ärztliche Einschätzung des Hausarztes erfasst. Es fand sich eine verstärkte psychische und globale Funktionsbeeinträchtigung bei Patienten mit erhöhter Gesundheitsangst, die auf Patient- und Arztseite angegeben wird. Psychosoziale Faktoren werden vom Behandler häufiger als für die Erkrankung relevant betrachtet, wenn Patienten erhöhte Gesundheitsangst zeigen. Die Erkennung und Reduktion von Gesundheitsangst in der Allgemeinarztpraxis stellt sich also als relevanter Behandlungsaspekt dar, auch wenn keine hypochondrische Erkrankung im engeren Sinne vorliegt.
Dissoziative Psychopathologie bei somatoformen Störungen
Authors: Grabe Hans J. , Freyberger Harald J. , Spitzer Carsten
Published: January 2007

Zusammenfassung. In der vorliegenden Arbeit wird die Frage empirisch untersucht, inwieweit dissoziative Symptomatik mit somatoformen Störungen assoziiert ist. Hierzu wurden n = 497 Patienten mit affektiven Störungen (F3), Angststörungen und Anpassungsstörungen (F4), dissoziativen Störungen (F44) sowie somatoformen Störungen (F45) mit der Symptom-Check-Liste (SCL-90-R) und dem Fragebogen zu Dissoziativen Symptomen (FDS) untersucht. Es zeigte sich bei Patienten mit somatoformen Störungen eine hohe Ausprägung dissoziativer Psychopathologie und pseudoneurologischer Symptome, die sogar auf dem Niveau der Dissoziation bei Patienten mit dissoziativen Störungen lag. Unabhängig von Alter, Geschlecht und Diagnosengruppen bestanden zwischen Dissoziation und klassischen pseudoneurologischen Symptomen wie Taubheitsgefühlen, Kloßgefühl und Schweregefühlen in Armen und Beinen, aber auch zu Kopfschmerzen, signifikante Assoziationen. Die mögliche therapeutische und klassifikatorische Implikation dieser Ergebnisse wird diskutiert.
Selbst- und Fremdeinschätzungen der Therapiemotivation als Prädiktoren von Behandlungsabbrüchen in der stationären Psychotherapie
Authors: Klauer Thomas , Maibaum Frauke , Schneider Wolfgang
Published: January 2007

Zusammenfassung. In den meisten Studien irregulärer Entlassungen aus der stationären Psychotherapie wurden soziodemographische und klinische Variablen als Prädiktoren des Behandlungsabbruchs untersucht. Die vorliegende Studie ging der Frage nach, ob Charakteristika der individuellen Behandlungsmotivation (z. B. Leidensdruck; sekundärer Krankheitsgewinn; Behandlungserwartungen; erfasst über Selbst- und Fremdberichte) zusätzliche Varianz in Abbruchraten erklären können. Eine Stichprobe von insgesamt 402 stationären Psychotherapie-Patienten wurde bei Erstinterview und Aufnahme mit einem Fragebogenverfahren (FMP) und einem klinischen Rating-System (OPD) untersucht. Zur Vorhersage irregulärer Entlassungen über die gesamte Behandlungszeit sowie früher Therapieabbrüche vor dem zehnten Behandlungstag wurden hierarchische logistische Regressionsanalysen eingesetzt. Die Befunde zeigen zunächst, dass das Vorhandensein einer Partnerschaft der beste Prädiktor für Behandlungsabbrüche unter den betrachteten soziodemographischen Variablen war. Motivationale Patientenmerkmale konnten zusätzlich zur Aufklärung von Varianz im Abbruchrisiko beitragen. Die Bedeutung einer standardisierten Erfassung von Merkmalen der Therapiemotivation für eine frühe Identifikation potenzieller Therapieabbrecher wird unterstrichen.