bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes of Hungarian students and nurses to physician assisted suicide
Authors: Fekete S , Osvath P , Jegesy A
Published: July 2002

In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide (PAS) and euthanasia are punishable criminal acts. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, nurses and social science students in Hungary towards PAS, using a twelve item scale: the total number of participants was 242. Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.
The cultural specifity of research ethics—or why ethical debate in France is different
Authors: Maio G
Published: July 2002

In the search for a globally binding ethical minimal consensus in dealing with research on human beings the awareness of the cultural specificity of such questions will be of central importance. France provides a good example of such cultural specificities. Three basic structures of French discussion on research ethics can be enumerated: first the particular weight placed on therapeutic benefit, second a particular accentuation on freedom and voluntarism, and third its lesser attention to the aspect of ability to give consent. The weak emphasis on the ability to give consent is rooted as much in the traditionally paternalistically imbued physician-patient relationship as in the French legal system, in which the doctrine of consent is not given the fundamental position of importance found in the Anglo-Saxon countries. As an important Roman country, a different accentuation in the ethical discussion on research on humans can be recognised, a discussion in which for a long time the right of self determination was less of a criterion for decision than the teleology of medical action. It is precisely this aspect of latent cultural influence in ethical convictions which is of decisive importance for future discussion on research on humans.
Hospital ethics committees in Israel: structure, function and heterogeneity in the setting of statutory ethics committees
Authors: Wenger N S , Golan O , Shalev C , Glick S
Published: July 2002

Objectives:Hospital ethics committees increasingly affect medical care worldwide, yet there has been little evaluation of these bodies. Israel has the distinction of having ethics committees legally required by a Patients' Rights Act. We studied the development of ethics committees in this legal environment.

Design:Cross-sectional national survey of general hospitals to identify all ethics committees and interview of ethics committee chairpersons.

Setting:Israel five years after the passage of the Patients' Rights Act.

Main measurements:Patients' rights and informal ethics committee structure and function.

Results:One-third of general hospitals have an ethics committee, with committees concentrated in larger facilities. Hospitals without committees tended to lack any structure to handle ethics issues. Committees tend to be interdisciplinary and gender-mixed but ethnic mix was poor. Confidentiality is the rule, however, legal liability is a concern. One-third of patients' rights ethics committees never convened and most committees had considered fewer than ten consults. Access to the consultation process and the consultation process itself varied substantially across committees. Some patients' rights ethics committees attempted to solve cases, others only rendered decisions. Informal committees often refused to consider cases within Patients' Rights Act jurisdiction.

Conclusions:Despite statutory requirement, many Israeli patients and clinicians do not have access to ethics committees. The scant volume of cases shows serious discrepancies between practice and Patients' Rights Act regulations, suggesting the need for education or revision of the law. Heterogeneity in committee function demonstrates need for substantial improvement.
A defence of the potential future of value theory
Authors: Marquis D
Published: July 2002

In this issue of the journal Mark Brown has offered a new argument against my potential future of value theory. I argue that even though the premises of this new argument are far more defensible than the premises of his old argument, the new argument does not show that the potential future of value theory of the wrongness of killing is false. If the considerations to which Brown appeals are used, not to show that the potential future of value theory is false, but to show that abortion is morally permissible, they are also unsuccessful. I also argue that Brown's clarified self-represented future of value account and Simon Parsons's account of the wrongness of killing are both subject to major difficulties. Finally, I show, in an appendix, that Brown's assertion that my discussion of his views suffers from major logical errors is false.
Abortion and the value of the future. A reply to: a defence of the potential future of value theory
Authors: Brown M
Published: July 2002

The future like ours argument implies no limitation on abortion rights. The author of the argument concedes that on the intended interpretation, abortion is not shown to be impermissible. The alternative self-represented future interpretation also implies a prochoice view.
GATA3 abnormalities and the phenotypic spectrum of HDR syndrome
Authors: Muroya Koji , Hasegawa Tomonobu , Ito Yoshiya , Nagai Toshiro , Isotani Haruhiko , Iwata Yasuyoshi , Yamamoto Keiichi , Fujimoto Shinji , Seishu Sotofumi , Fukushima Yoshimitsu , Hasegawa Yukihiro , Ogata Tsutomu
Published: July 2002

We report on GATA3 analysis and the phenotypic spectrum in nine Japanese families with the HDR syndrome (hypoparathyroidism, sensorineuraldeafness, andrenal dysplasia) (MIM 146255). Fluorescence in situ hybridisation and microsatellite analyses showed heterozygous gross deletions including GATA3 in four families. Sequence analysis showed heterozygous novel mutations in three families: a missense mutation within the first zinc finger domain at exon 4 (T823A, W275R), an unusual mutation at exon 4 (900insAA plus 901insCCT or C901AACCCT) resulting in a premature stop at codon 357 with loss of the second zinc finger domain, and a nonsense mutation at exon 6 (C1099T, R367X). No GATA3 abnormalities were identified in the remaining two families. The triad of HDR syndrome was variably manifested by patients with GATA3 abnormalities. The results suggest that HDR syndrome is primarily caused by GATA3 haploinsufficiency and is associated with a wide phenotypic spectrum.
Living with and dying from cancer: a humanities special study module
Authors: Kirklin Deborah , Meakin Richard , Singh Surinder , Lloyd Margaret
Published: July 2002

We describe a humanities-based, special studies module (SSM) exploring the impact of cancer on the lives of patients, families and professionals. Literature, film, art and drama provide third year medical undergraduates with vicarious experience of all of these perspectives in a format that has proved highly acceptable to students and tutors. The development, delivery, evaluation and evolution of this humanities-based course are described and we highlight some important elements of course organisation that emerged as being integral to its success.
A Necessary Inhumanity?
Authors: Richardson Ruth
Published: July 2002

It is argued that the phrase “Necessary Inhumanity” more accurately describes the alienation required of doctors in some circumstances, than do modern sanitised coinages such as ‘clinical detachment’. ‘Detachment’ and ‘objectivity’ imply separation, not engagement: creating distance not only from patients, but from the self: the process may well be required, but where it becomes too extreme or prolonged, it can damage everybody, including patients, family members, doctors themselves, and wider society. An awareness of the history of health care in the context of our society might assist self reflection–might help keep initiates in touch with the culture they have been induced to leave and might help them remain humane despite the bruising process of training.
Kafka's uncle: scenes from a world of trust infected by suspicion
Authors: Bamforth Iain
Published: July 2002

What happens when we heed a call? Few writers have been as suspicious of their vocation as Franz Kafka (1883–1924). His story, A Country Doctor, (1919) ostensibly about a night visit to a patient that goes badly wrong, suggests a modern writer's journey to the heart of his work. There he discovers that trust, like the tradition which might sustain him, is blighted. This essay also examines Kafka's attitude to illness and the medical profession, and his close relationship with his uncle, Siegfried Löwy (1867–1942), a country doctor in Moravia.
‘A fragment of the explanation’: the use and abuse of words: Table 1
Authors: Heath Iona
Published: July 2002

This paper explores the normative basis of power in language, story, labels and evidence, and attempts to show how these dimensions of power are used systematically to simplify the reality of exprience, deny ignorance and exclude uncertainty. Through the resulting abuse of words, doctors may often constrain and limit their patients' stories, consigning many of them to stories of failure, and reducing their capacity to celebrate, or even recognise, achievement.
Clinical craft: a lesson from Liverpool
Authors: Gore D M
Published: July 2002

Inspiration in medical humanities can be intense and personal, and does not necessarily require the portrayal of health issues.
A medical perspective on the adventures of Sherlock Holmes
Authors: Reed James
Published: July 2002

The adventures of Sherlock Holmes, although primarily famous as stories of detection of crime, offer a considerable amount to interest the medical reader. There are many medical references in the stories, and the influence of Conan Doyle's medical background is clearly seen in the main characters. Aspects of the stories also reflect Conan Doyle's medical career, and also something of his attitude towards the profession. From Holmes's sayings and accounts of his methods, parallels can be drawn between Holmesian deduction and the diagnostic process. It is concluded, however, that deduction cannot be used as a direct paradigm since medical problems are rarely soluble through a process of logic alone.
Knock: a study in medical cynicism
Authors: Bamforth I
Published: July 2002

French literature has shown an enduring fascination with the social figure of the doctor. In Jules Romains' amusing playKnock(1922), and in its later film version (1951), the doctor as deceiver returns to centrestage with a flourish. Molière's seventeenth-century figures were mostly quacks and mountebanks; Knock is something new: he is a health messiah. By enforcing a mental and social hygiene based on fear, Knock brings a small rural population under his sway. Insouciance is banished by artful consciousness-raising. A society mobilises under the banner of medicine. But who is Dr Knock?
Courses, content, and a student essay in medical humanities
Authors: Grant V J , Jackson A , Suk T
Published: July 2002

Two principled decisions underlay the introduction of the new compulsory medical humanities course. First, it was decided, all lecturers must be trained in the discipline; second, the course content must be relevant to medicine. This paper gives details of the content of eight selective courses. There is also an example of an essay by one of the students, Tiffany Suk. Entitled “Two patients in two rooms with two choices and two ends”, it is a brief analysis and critique of Sylvia Plath's poemsTulipsandContusion. It shows how the student took what she had learned from her course in health psychology to further illuminate the poems. The essay is followed by comments from the lecturer, Anna Jackson, giving the context for the essay and her assessment of it.
Lung function prediction equations derived from healthy South African gold miners
Authors: Hnizdo Eva , Churchyard Gavin , Dowdeswel Rob
Published: July 2002

OBJECTIVES

To estimate lung function prediction equations and to identify appropriate normal reference values for the population of about 250 000 of South African gold miners.

METHODS

Data from a lung function screening programme conducted at a large South African gold mine from 1994 to 1998 were used to estimate the lung function prediction equations. The most reliable period of lung function testing was identified in a previous study of a temporal pattern in reliability, and lung function tests from this period were used. Miners with a history of pulmonary tuberculosis or with radiological abnormalities were excluded from the study. The prediction equations were estimated cross sectionally on 15 772 black and 2752 white miners, and published reference equations that fitted most closely the observed data were identified.

RESULTS

The estimated prediction equations for forced vital capacity (FVC) are as follows: for black men, FVC (l)=− 2.901−0.025×age+4.655×height; and for white men, FVC(l)=−4.407−0.036×age+ 5.940×height. For forced expiratory volume in one second (FEV1) these equations are: for black men, FEV1(l)=−1.654− 0.30×age+3.665×height; and for white men, FEV1(l)= −2.341− 0.038×age+4.314×height. Units are years for age and metres for height. Knudson's and the European Community of Coal and Steel (ECCS) reference values provided the closest fit to the data on lung function of white miners, but the lower limits of normal from the ECCS equations were the closest to the observed one sided lower 95% confidence intervals (95% CIs). For black miners, reference equations that fitted best were derived by Louwet alon asymptomatic black South African men unexposed to occupational dust. There were significant differences between the two groups of miners in the estimated height adjusted mean lung function values for a 40 year old 1.7 m tall man (220 ml (5.2%) for FVC and 110 ml (3.2%) for FEV1); white men had higher FVC and FEV1, but lower FEV1/FVC ratio. The ECCS reference values scaled by a conversion factor of 0.93 for the FVC and 0.95 for the FEV1provided close fits to the data for black miners, but the rate of decline with age was higher than that in the observed data. None of the linear equations provided a good fit for the 20–29 and more than 55 years old age categories.

CONCLUSION

The ECCS and Knudson equations provided the best fit to the data for white miners, whereas the equations by Louwet alestimated on asymptomatic black South African bank workers provided the best fit to the data for black miners. The ECCS reference values scaled by a factor of 0.93 for FVC and by 0.95 for FEV1provided close fits, but the rate of decline with age was higher than that in the data for black miners.
Lung and bladder cancer among workers in a Norwegian aluminium reduction plant
Authors: Romundstad Pål , Haldorsen Tor , Andersen Aage
Published: July 2002

OBJECTIVE

To investigate the relation between exposure to polycyclic aromatic hydrocarbons (PAHs) and the incidence of lung and bladder cancer among aluminium production workers.

METHODS

The cohort comprised 1790 men employed for more than 5 years at a Norwegian aluminium plant contributing 36 587 person-years to the study. Historical exposure to PAHs was estimated by the use of industrial hygiene measurements and by a panel of three people familiar with the industry. Cancer incidence was investigated from 1953 to 1995. The observed cases of cancer among men were compared with expected numbers calculated from national rates for men, and dose-response relations were investigated by internal comparison by Poisson regression with age, period, smoking, and cumulative exposure included in the models. The effect of lagging exposure by 10, 20, and 30 years was also investigated.

RESULT

The present study showed no increased risk of urinary bladder cancer or lung cancer with increasing cumulative exposure to PAHs. No significant changes in risk were found for different lag times.

CONCLUSIONS

Due to the small size of this study, a minor increase in risk could not be excluded.
Investigation of an acute chemical incident: exposure to fluorinated hydrocarbons
Authors: Lyons Ronan A , Wright Dorothy , Fielder Hilary M P , McCabe Michael , Gunneberg Andar , Nash Pam , Routledge Phillip , Rees Huw
Published: July 2002

OBJECTIVES

To assess whether attendance at the site after an incident in a sewer was associated with symptoms in emergency personnel and whether the prevalence of symptoms was associated with estimated levels of exposure to any chemical hazard.

METHODS

Symptoms experienced by people attending an incident involving two dead sewer workers suggested the presence of a chemical hazard, before environmental sampling confirmed any toxic agent. Self reported symptoms, estimated exposures, and biomarkers of exposure for likely agents from all 254 people who attended the incident and a referent occupational group matching the 83 emergency personnel who went to the Accident and Emergency department (A and E) in the first 48 hours were recorded. The prevalence of symptoms and concentrations of creatine phosphokinase in serum of the 83 early patients at A and E were compared with their referent occupational group. In all workers who attended the incident, the trends in symptom prevalences and concentrations of creatine phosphokinase in serum were examined by distance from the site and predefined exposure category.

RESULTS

Among all workers who attended the incident, symptoms of shortness of breath and sore throat were significantly associated with indirect estimates of exposure but not associated with concentrations of creatine phosphokinase. Freon was detected in two blood samples. The early patients at A and E reported more symptoms than their matched reference group and their median concentrations of creatine phosphokinase were higher.

CONCLUSIONS

The association between symptoms and concentrations of creatine phosphokinase with attendance at the site indicated the presence of a continuing hazard at the site and led to extra precautions being taken. Comparison values from the referent occupational group prevented unnecessary medical follow up.
Role of skin prick test and serological measurement of specific IgE in the diagnosis of occupational asthma resulting from exposure to vinyl sulphone reactive dyes
Authors: Park J W , Kim C W , Kim K S , Choi S Y , Kang D B , Ko S H , Won J U , Yang J Y , Hong C-S
Published: July 2002

OBJECTIVES

Some patients with occupational asthma resulting from exposure to reactive dyes have skin reactivity to the causative dyes and specific IgE to reactive dyes have been found in these patients. However, the usefulness of skin prick tests (SPTs) and serological measurement of specific IgE in screening, diagnosis, and monitoring the occupational asthma resulting from exposure to reactive dyes have not yet been assessed. In this study, the clinical validation of SPTs and measurement of specific IgE to vinyl sulphone reactive dyes by enzyme linked immunosorbent assay (ELISA) was evaluated.

METHODS

42 Patients with occupational asthma from reactive dyes (true positive group) were enrolled. In these the causative reactive dye was confirmed by bronchial challenge test. 93 Asymptomatic factory workers with negative challenge to the reactive dye (true negative group) and 16 unexposed controls with negative challenge to the reactive dye were also enrolled. Skin prick tests were done with 10 mg/ml reactive dye in 0.4% phenol/0.9% saline. IgE specific to reactive dye conjugated to human serum albumin (HSA) was measured with enzyme linked immunosorbent assays (ELISAs).

RESULTS

None of the unexposed controls had a positive response to SPTs. The sensitivity (76.2%v53.7%), specificity (91.4%v86.0%), positive predictive value (80.0%v62.9%), and negative predictive value (89.5%v80.8%) of SPTs were higher than those of ELISAs. The mean weal size of reaction to reactive dye was weakly correlated with the ELISA optical density of IgE to reactive dye conjugate in patients with occupational asthma from reactive dyes (n=41,r=0.337, p<0.05). In four patients with occupational asthma from reactive dyes and eight control subjects exposed to reactive dye, IgE specific to reactive dye conjugated to HSA was detected with ELISA even though they showed negative skin reactivity. Six patients completely avoided the reactive dye for a mean (SD) 27.8 (10.3) months, IgE specific to reactive dyes decreased in all six patients (p<0.05) during this time.

CONCLUSIONS

Both SPTs and detection of IgE specific to reactive dye in serum samples could be valuable for screening, diagnosis, and monitoring occupational asthma resulting from exposure to reactive dyes. These two tests would complement each other.
Detection of workers sensitised to high molecular weight allergens: a diagnostic study in laboratory animal workers
Authors: Meijer E , Grobbee D E , Heederik D
Published: July 2002

Objectives: To determine whether results from questionnaires, exposure measurements, and laboratory tests, commonly used in occupational health practice, can predict the presence or absence of sensitisation in workers exposed to high molecular weight (HMW) allergens. The study aims to develop and validate a diagnostic rule to predict sensitisation in laboratory animal workers. The main reason for such research is efficiency.

Methods: Baseline data from 551 laboratory animal workers participating in an ongoing cohort study, bridging a period of 3 years, were used for diagnostic research. Data from 472 workers participating in the study during the first period were used to develop a prediction rule; these workers represented the derivation set. Data from 79 workers, participating during the second period, were used to evaluate the rule's performance—the validation set. Serum samples were analysed for specific immunoglobulin E (IgE) antibodies against common and laboratory animal allergens. Questionnaire items, exposure determinants, IgE serology, skin prick tests (SPTs), and lung function tests were analysed, corresponding to diagnostic investigation, in a multiple logistic regression model. The accuracy of the model was evaluated by receiver operating characteristic (ROC) curve analysis, and by comparison of the predicted and observed prevalences.

Results: Asthmatic symptoms, (work related) allergic symptoms, sex, occupational exposure to rats, and a positive SPT to common allergens, showed the best performance in discriminating workers at high or at low risk of being sensitised.

Conclusion: High and low risk categories for work related sensitisation can be distinguished from simple questionnaire data and SPT results. The method can easily be applied in occupational medical practice and may markedly increase the efficiency of occupational health surveillance in laboratory animal workers as well as other workers exposed to HMW allergens.
Psychomotor performance and subjective symptoms at low level toluene exposure
Authors: Zupanic M , Demes P , Seeber A
Published: July 2002

Objectives: Possible effects of long term occupational exposure to toluene below the level of 100 ppm on psychomotor performance and subjective symptoms were investigated in a cross sectional approach.

Methods: From German rotogravure printing plants 278 male workers, mean age 39.8 years, mean duration of employment 14.9 years, were examined. A mean lifetime weighted average exposure (LWAE) of 45.1 ppm toluene in ambient air was found for 154 exposed workers (rotogravure printing area), with a mean current exposure of 24.7 ppm. The corresponding data for a second group of 124 workers with very low exposure (endprocessing area) had LWAE of 9.3 ppm and a current exposure of 3.3 ppm toluene. Psychomotor performance (steadiness, line tracing, aiming, tapping, and peg board) and subjective symptoms were examined.

Results: No significant differences between the two exposure groups were found by analysis of variance (ANOVA). By stepwise linear regression analyses there were weak associations of LWAE with one performance variable and two symptoms scales, but the results were not significant after correction for the α error. Psychomotor performance was mostly affected by age (maximum explained variance up to 13%), and handedness (up to 9%), whereas subjective symptoms are mostly affected by anxiety (up to 38%).

Conclusions: The weak associations between long term exposure to toluene should be used to indicate further longitudinal investigations. The results of this cross sectional study show no obvious dose response relation for psychomotor functions and subjective symptoms among workers exposed to toluene at a current exposure level of 1–88 ppm.
Permanent pacemaker insertion in a district general hospital: indications, patient characteristics, and complications
Authors: Eltrafi A , Currie P , Silas J H
Published: July 2002

This report reviews the experience of permanent pacemaker insertion in a district general hospital (catchment population of 350 000) and makes a comparison with the national database and other hospitals in the UK.

Methods

The records of all patients receiving a permanent pacemaker in the inclusive period January 1996 to December 1998 were reviewed. Data collected included number of patients paced each year, age, sex, indications, and complications.

Results

In the three years reviewed 200 patients received new permanent pacemakers, a rate of 190 per million population per year, which is similar to the national implantation rate of permanent pacemakers but lower than that of most European countries (see discussion). The majority of patients paced were elderly (75% were above the age of 70 years).

Atrioventricular block (including complete heart block, 45%, and Mobitz type 2 block, 12.5%) was the commonest indication for permanent pacemaker insertion, followed by sick sinus syndrome (25%) and these findings are comparable to those reported previously. However, carotid sinus syndrome was responsible for 16% of the patients paced and this was higher than that reported in the national database (6.5%). Only 1% of the pacemaker modes used was inappropriate and the complication rate was low at 3%.

Conclusions

This report confirms that permanent pacemaker insertion can be effectively and safely provided locally for the increasingly ageing population. The implantation rate both locally and nationally is still much lower than that of some countries in Europe.
Pharyngeal pouch (Zenker's diverticulum)
Authors: Siddiq M A , Sood S , Strachan D
Published: July 2002

Pharyngeal pouches occur most commonly in elderly patients (over 70 years) and typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. The aetiology remains unknown but theories centre upon a structural or physiological abnormality of the cricopharyngeus. A diagnosis is easily established on barium studies. Treatment is surgical via an endoscopic or external cervical approach and should include a cricopharyngeal myotomy. Unfortunately pharyngeal pouch surgery has long been associated with significant morbidity, partly due to the surgery itself and also to the fact that the majority of patients are elderly and often have general medical problems. External approaches are associated with higher complication rates than endoscopic procedures. Recently, treatment by endoscopic stapling diverticulotomy has becoming increasingly popular as it has distinct advantages, although long term results are not yet available. The small risk of developing carcinoma within a pouch that is not excised remains a contentious issue and is an argument for long term follow up or treating the condition by external excision, particularly in younger patients.
Prevalence and correlates of smoking on the roof of the world
Authors: Shah Syed MA , Arif Ahmed A , Delclos George L , Khan Asif R , Khan A
Published: July 2002

OBJECTIVE

To determine the prevalence and correlates of cigarette smoking among adults in high mountain rural areas of northern Pakistan.

DESIGN

Cross sectional survey.

PARTICIPANTS

A sample of 4203 adults (aged 18 years and over) were selected by stratified random sampling from 16 villages.

MAIN OUTCOME MEASURE

Self reported smoking prevalence; age of smoking initiation; daily cigarette consumption and association between current smoking and sociodemographic variables, use of snuff, wine, body mass index, blood pressure, family history of stroke, and hypertension.

RESULTS

614/1406 men (43.7%) and 154/2797 (5.5%) women reported smoking cigarettes. The age standardised prevalence of smoking was 40.5% for men and 6.3% for women. Men were more likely (odds ratio (OR) 6.5, 95% confidence interval (CI) 4.75 to 8.79) to be smokers. Smokers were more likely to use snuff (OR 1.39, 95% CI 1.12 to 1.73), drink wine (OR 3.47, 95% CI 2.81 to 4.29), and were more likely to work as farmers (OR 1.55, 95% CI 1.05 to 2.29) or shopkeepers (OR 2.63, 95% CI 1.67 to 4.14). Individuals with college level education and with desirable body mass index were less likely to smoke (OR 0.55, 95% CI 0.35 to 0.87; OR 0.74, 95% CI 0.57 to 0.96).

CONCLUSION

Cigarette smoking is a major public health problem in this high mountain community of Pakistan, particularly among the male population, the majority of whom begin to smoke quite early in life. A comprehensive tobacco control effort incorporated into the existing community based health infrastructure is needed.
The price of cigarettes in the European Union: Table 1
Authors: Montes Agustín , Villalbí Joan R
Published: July 2002

BACKGROUND

A major factor influencing tobacco use is its price. Fiscal policies on tobacco are a key ingredient of any comprehensive control strategy, as they can be used to raise prices. The European Union (EU) developed directives to ensure some harmonisation of the fiscal pressure on tobacco across its member states.

OBJECTIVES

To provide a simple comparison of tobacco prices in the EU, adjusting for the purchasing power of each currency.

DESIGN

For price comparisons, a 20 units pack of Marlboro was the reference product, and data refer to April 2000. Purchasing power parities (PPP) for each member state currency have been compiled. These are currency conversion rates, which convert to a common currency and equalise the purchasing power of different currencies.

MAIN OUTCOME MEASURES

Nominal prices of a Marlboro pack for each member state, and a price index, estimated taking as reference the EU mean. Adjusted prices and an adjusted price index have been estimated using PPP.

RESULTS

Nominal prices show wide variation, with the cheapest pack in Portugal (59) and the most expensive in the UK (196); the range of variation is three-fold. However, PPP adjusted prices reveal a different distribution. In three countries adjusted prices are outliers, but all other countries make two clusters, one around the average EU index of 100, the other around a lower value of 85.

CONCLUSIONS

These results suggest that fiscal harmonisation policies in the EU do not have an even effect at reducing availability by its impact in price.
State variation in retail promotions and advertising for Marlboro cigarettes
Authors: Slater Sandy , Chaloupka Frank J , Wakefield Melanie
Published: July 2002

BACKGROUND

There is some evidence that tobacco companies marketing efforts undermine the effects of comprehensive tobacco control programmes.

OBJECTIVE

To determine whether point-of-purchase advertising and promotions are more pervasive in states where comprehensive tobacco control programmes are underway.

DESIGN

Cross sectional survey using 1996 data, with merged records of the existence of local tobacco advertising restrictions.

PARTICIPANTS AND SETTING

581 tobacco retail stores located in close proximity to high schools in mainland USA.

MAIN OUTCOME MEASURES

Existence of gift-with-purchase, number of interior advertisements, and exterior store advertisements for Marlboro cigarettes.

RESULTS

After controlling for store type and existence of advertising restrictions, offer of a gift-with-purchase for Marlboro cigarettes was significantly more likely in states with comprehensive tobacco control programmes than those without programmes (odds ratio 2.59, 95% confidence interval 1.57 to 4.26). Although not significant, results show an increase in the number of interior and exterior store advertisements for stores located in states with a comprehensive tobacco control programme than those in other states.

CONCLUSION

Results suggest some point-of-purchase tobacco promotions and advertising are more pervasive in states with comprehensive tobacco control programmes. These efforts are likely to act against the objectives of programmes and need to be accounted for in programme evaluations.
Comparison of plantations and naturally regenerated clearcuts in the Acadian Forest: forest floor bryophyte community and habitat features
Authors: Ross-Davis Amy L , Frego Katherine A
Published: July 2002

To address concern for loss of bryophyte biodiversity within managed forests, we compared community composition and environmental characteristics among three disturbance regimes: (i) naturally regenerated clear-cut forests, (ii) cutover spruce plantations (established on clear-cut forest land), and (iii) afforested field spruce plantations (established on agricultural fields) across a range of ages (19102 years) in the Acadian Forest region of New Brunswick, Canada. Abundances of all forest floor bryophyte species, available substrates, microtopographical features, and tree canopy were measured as percent cover (1 m2) in 26 stands: 12 naturally regenerated clear-cut forests, eight cutover plantations, and six afforested field plantations. Multivariate analyses indicated that both bryophyte community composition and associated environment differed significantly across disturbance regimes, with no strong trends related to time since clearing (i.e., stand age). Spruce plantations were characterized by low substrate diversity and microtopographic and canopy homogeneity. Both plantation types had lower bryophyte species richness, evenness, and diversity (H') relative to naturally regenerated clear-cut forests; cutover plantations had the highest total bryophyte cover. The bryophyte community of plantations was composed of a subset of species found within naturally regenerated clear-cut forests: many liverworts and epixylic mosses were absent, with fewer pioneer species and more perennial stayers (equivalent to K-strategists) than expected.Key words: bryophyte, disturbance regime, substrate, canopy, microtopography, plantation.
Estimating the relative roles of dispersion and predation in generating regional differences in mortality rates of larval radiated shanny (Ulvaria subbifurcata)
Authors: Pepin P , Dower J F , Helbig J A , Leggett W C
Published: July 2002

We followed three patches of larval radiated shanny (Ulvaria subbifurcata) using drogued drifters to assess regional differences in growth and mortality rates. We estimate dispersive losses directly using local surveys of surface currents corrected for the tidally induced divergence caused by the lack of synopticity of our surveys. We also monitored the abundance of juvenile capelin (Mallotus villosus), the major planktivore in the region, using hydroacoustic integration. The pattern of divergenceconvergence showed considerable temporal and spatial variability, which resulted in substantial changes in the inferred biological mortality rates. The net mortality rates appeared to be directly proportional to the local abundance of pelagic fish. As with other patch studies, we are limited in the number of observations we obtained, but the results of this multidisciplinary study do suggest a strong potential for preypredator interactions between larvae and adult planktivorous fish.
Microclimatic and soil moisture responses to gap formation in coastal Douglas-fir forests
Authors: Gray Andrew N , Spies Thomas A , Easter Mark J
Published: July 2002

The effects of gap formation on solar radiation, soil and air temperature, and soil moisture were studied in mature coniferous forests of the Pacific Northwest, U.S.A. Measurements were taken over a 6-year period in closed-canopy areas and recently created gaps in four stands of mature (90140 years) and old-growth (>400 years) Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) forest in the western Cascade Range of central Oregon and southern Washington. Gap sizes ranged from 40 to 2000 m2. Summer solar radiation levels and soil temperatures differed significantly among gap sizes and positions within gaps and were driven primarily by patterns of direct radiation. Nevertheless, effects on air temperature were slight. Soil moisture was more abundant in gaps than in controls, was most abundant in intermediate gap sizes, and tended to decline during the growing season in single-tree gaps and on the north edges of large gaps. However, there was substantial variation in moisture availability within individual gaps, primarily related to the variety of organic substrates present. Moisture in gaps declined over multiple years, likely caused by encroachment of vegetation within and around gaps. Low light levels probably limit filling of natural gaps in these forests, but the variety of microenvironments in large gaps may facilitate diverse plant communities.
Modeling the distance between the molar tooth rows in mammals
Authors: Greaves Walter Stalker
Published: July 2002

The sum of all possible bite forces along a mammalian tooth row is related to the area under the curve when bite force is plotted from one end of the tooth row to the other. Integrating the equation of this plot and dividing by the length of the entire jaw, from joint to incisor, gives the average bite force along the entire jaw (as opposed to along the tooth row). Calculations indicate that for any jaw shape there is only one location for the tooth row relative to the midline of the skull, where the average bite force is maximized; the average force is lower when the tooth row is closer to, or farther from, the midline. In addition, for animals with long narrow jaws, the location where this maximum is realized is relatively closer to the midline than it is for animals with short wide jaws. In many mammals, the distance between the jaw joints (jaw width) often varies between 60 and 80% of the distance from the jaw joints to the incisor (jaw length) in narrow and wide jaws, respectively. Length is measured perpendicular to the resultant force of the jaw muscles. Accepting that average bite force will be maximized, the model predicts that in the longer, narrower jaws the distance between the two molar rows will be approximately half the width of the jaw (and will approach 60% in the shorter, wider jaws).
MOD-2 INDEPENDENCE AND DOMINATION IN GRAPHS
Authors: HALLDÓRSSON MAGNÚS M. , KRATOCHVÍL JAN , TELLE JAN ARNE
Published: July 2002

We develop an O(n3) algorithm for deciding if an n-vertex digraph has a subset of vertices with the property that each vertex of the graph has an even number of arcs into the subset. This algorithm allows us to give a combinatorial interpretation of Gauss-Jordan and Gauss elimination on square boolean matrices. In addition to solving this independence-mod-2 (even) set existence problem we also give efficient algorithms for related domination-mod-2 (odd) set existence problems on digraphs. However, for each of the four combinations of these two properties we show that even though the existence problem on digraphs is tractable, the problems of deciding the existence of a set of size exactly k, larger than k, or smaller than k, are all NP-complete for undirected graphs.
ON GRAPHS WITH LIMITED NUMBER OF P4-PARTNERS
Authors: ROUSSEL FLORIAN , RUSU IRENA , THUILLIER HENRI
Published: July 2002

The study of graphs containing few P4's generated an important number of results related to perfection, recognition, optimization problems (see [12], [15], [8]). We define here a new, larger class of graphs and show that the indicated problems may be efficiently solved on this class too (thus generalizing some of the previous results). Namely, we give a linear time recognition algorithm for this class and we note that the optimization problems concerning the clique number, stability number, chromatic number and clique cover number are solvable in linear time.
ON THE COMPLEXITY OF SOME ADAPTIVE POLLING ALGORITHMS IN GENERAL NETWORKS
Authors: TSE SAVIO S. H. , LAU FRANCIS C. M.
Published: July 2002

We study the problem of adaptive polling in undirected general networks. Polling, also known as broadcast-confirm, consists a propagation round and a feedback round. In adaptive polling, a spanning tree of unknown topology is built dynamically during the propagation round, and feedback messages are free to choose their paths in order to adapt to traffic and fault situations. We study three adaptive polling algorithms and analyze their worst-case communication bit complexities in the propagation round. Then, we prove a lower bound on the worst-case communication bit complexity of Ω(e+n log n) in the propagation round for all algorithms of the same kind as the three algorithms we study, where n is the number of nodes, and e the number of edges. We conclude that the cost introduced into the network due to the running of an adaptive polling algorithm is mild.
CHARACTER FORMULAS FOR COSET N=2 SUPERCONFORMAL THEORIES
Authors: EGUCHI TOHRU , KAWAI TOSHIYA , MIZOGUCHI SHUN’YA , YANG SUNG-KIL
Published: July 2002

Given a hermitian symmetric space G/H×U(1) (HSS) one can interpret the coset model G×G/G with central charge c=0 as the twisted version of N=2 HSS superconformal models. The states with zero conformal weight in c=0 coset theory form an orbit under the action of the Weyl group of G. In N=2 theory these degenerate states under the Weyl group are resolved into the chiral primary states. We argue that the branching functions in c=0 coset theory yield the Witten index in N=2 theory. Then the spectral flow allows us to explicitly calculate the character formulas in N=2 HSS theories.
QUANTUM SUPERGROUPS, LINK POLYNOMIALS AND REPRESENTATION OF THE BRAID GENERATOR
Authors: LINKS J. R. , GOULD M. D. , ZHANG R. B.
Published: July 2002

Unlike the quantum group case, it is shown that the braid generator σ is not always diagonalizable on V ⊗ V, V an irreducible module for a quantum supergroup. Nevertheless a generalization of the Reshetikhin form of the braid generator, obtained previously for quantum groups, is determined corresponding to every finite dimensional standard cyclic module V of a quantum supergroup. This result is applied to obtain a general closed formula for link polynomials arising from standard cyclic modules of a quantum supergroup belonging to a certain class. As explicit examples we determine link polynomials corresponding to the rank 2 symmetric tensor representation of Uq [gl(m|m)] and the defining representation of Uq [osp(2n|2n)].
Continuity of Symplectically Adjoint Maps and the Algebraic Structure of Hadamard Vacuum Representations for Quantum Fields on Curved Spacetime
Authors: Verch Rainer
Published: July 2002

We derive for a pair of operators on a symplectic space which are adjoints of each other with respect to the symplectic form (that is, they are sympletically adjoint) that, if they are bounded for some scalar product on the symplectic space dominating the symplectic form, then they are bounded with respect to a one-parametric family of scalar products canonically associated with the initially given one, among them being its "purification". As a typical example we consider a scalar field on a globally hyperbolic spacetime governed by the Klein–Gordon equation; the classical system is described by a symplectic space and the temporal evolution by symplectomorphisms (which are symplectically adjoint to their inverses). A natural scalar product is that inducing the classical energy norm, and an application of the above result yields that its "purification" induces on the one-particle space of the quantized system a topology which coincides with that given by the two-point functions of quasifree Hadamard states. These findings will be shown to lead to new results concerning the structure of the local (von Neumann) observable-algebras in representations of quasifree Hadamard states of the Klein–Gordon field in an arbitrary globally hyperbolic spacetime, such as local definiteness, local primarity and Haag-duality (and also split- and type III1-properties). A brief review of this circle of notions, as well as of properties of Hadamard states, forms part of the article.
ON CONVERGENCE OF THE FEYNMAN PATH INTEGRAL FORMULATED THROUGH BROKEN LINE PATHS
Authors: ICHINOSE WATARU
Published: July 2002

We study the convergence of the Feynman path integral formulated through broken line paths in nonrelativistic quantum mechanics. The rigorous proof of its convergence had been given little except for special cases for a long time. In the preceding paper the author showed for a class of potentials that this path integral converges and gives the probability amplitude, i.e. the solution of the Schrödinger equation. In the present paper we generalize this result, showing the boundedness theorem on the weighted Sobolev spaces for some integral operators and joining this boundedness theorem to the method in the preceding paper. We note that the result obtained is gauge invariant.
STATISTICAL SIGNIFICANCE OF PERIODICITY AND LOG-PERIODICITY WITH HEAVY-TAILED CORRELATED NOISE
Authors: ZHOU WEI-XING , SORNETTE DIDIER
Published: July 2002

We estimate the probability that random noise, of several plausible standard distributions, creates a false alarm that a periodicity (or log-periodicity) is found in a time series. The solution of this problem is already known for independent Gaussian distributed noise. We investigate more general situations with non-Gaussian correlated noises and present synthetic tests on the detectability and statistical significance of periodic components. A periodic component of a time series is usually detected by some sort of Fourier analysis. Here, we use the Lomb periodogram analysis, which is suitable and outperforms Fourier transforms for unevenly sampled time series. We examine the false-alarm probability of the largest spectral peak of the Lomb periodogram in the presence of power-law distributed noises, of short-range and of long-range fractional-Gaussian noises. Increasing heavy-tailness (respectively correlations describing persistence) tends to decrease (respectively increase) the false-alarm probability of finding a large spurious Lomb peak. Increasing anti-persistence tends to decrease the false-alarm probability. We also study the interplay between heavy-tailness and long-range correlations. In order to fully determine if a Lomb peak signals a genuine rather than a spurious periodicity, one should in principle characterize the Lomb peak height, its width and its relations to other peaks in the complete spectrum. As a step towards this full characterization, we construct the joint-distribution of the frequency position (relative to other peaks) and of the height of the highest peak of the power spectrum. We also provide the distributions of the ratio of the highest Lomb peak to the second highest one. Using the insight obtained by the present statistical study, we re-examine previously reported claims of "log-periodicity" and find that the credibility for log-periodicity in 2D-freely decaying turbulence is weakened while it is strengthened for fracture, for the ion-signature prior to the Kobe earthquake and for financial markets.