bluuebunny/crossref_metadata_2025 huggingface dataset:
Disposition and efficacy of alcuronium in young children undergoing elective surgery
Authors: RAMZAN I.M. , KENEALLY J.P. , GOONETILLEKE P.H.
Published: February 2007

Alcuronium pharmacokinetics and pharmacodynamics were studied in ten patients, aged between two and six years and weighing between 10 and 20 kg, who were undergoing elective surgery. Eight patients received a single dose of alcuronium quaternary base, 0.25 mg·kg−1; two patients required an additional dose after a similar initial dose. Alcuronium concentrations were determined using a specific liquid chromatographic procedure. In all patients, alcuronium plasma concentrations decline in a bi‐exponential fashion with time. Several significant differences were noted when the pharmacokinetic parameters in children were compared with those obtained previously in adults. Young children had shorter mean distribution (5 vs 14 min, P < 0.001) and elimination phase half‐lives (131 vs 199 min, P < 0.05) and a faster clearance from the body when corrected for differences in body weight (2.7 vs 1.4 ml·min−1·kg−1, P < 0.005). Alcuronium volumes of distribution were smaller in children compared with adults in absolute (uncorrected) terms, but no differences were observed when these were expressed relative to body weight. Maximum paralysis achieved in children was similar to that in adults, but was observed to occur more rapidly (4 vs 10 min, P < 0.005). Alcuronium plasma concentrations, at peak paralysis, were not different to those in adults (1.8 vs 1.4 μg·ml−1). Young children eliminate alcuronium more efficiently, but exhibit the same sensitivity to alcuronium during onset of paralysis as adults.
Intravenous sedation for children with Down's syndrome undergoing cardiac catheterization
Authors: RAUTIAINEN PAULA , MERETOJA OLLI A.
Published: February 2007

Down's syndrome is commonly associated with cardiac malformations and sleep related upper airway obstruction. The dose response for ketamine in the presence of an infusion of fentanyl was determined in 28 consecutive children (3–51 months) with Down's syndrome and congenital heart disease during haemodynamic catheterization. The children were premedicated with flunitrazepam orally and glycopyrrolate i.v. Ventilation was continuously monitored with a capnograph. Fentanyl 1 μg·kg−1 and 1 μg·kg−1·h−1 was administered in fixed doses for induction and maintenance of sedation, respectively. The mean induction and maintenance requirements of ketamine were 1.5 ± 0.5 mg·kg−1 and 1.8 ± 0.8 mg·kg−1·h−1, respectively. In infants younger than 6 months, more ketamine was needed for both induction and maintenance than in older children (P < 0.005). Normoventilation without any airway manipulation could be maintained in 15 patients (54%). Respiratory difficulties were frequent: hypoventilation required temporary mask ventilation, insertion of a nasopharyngeal tube or tracheal intubation in two, seven and four children, respectively. Oral flunitrazepam premedication and intravenous sedation with low‐dose fentanyl and ketamine combined with close monitoring of ventilation can be used for cardiac catheterization in children with Down's syndrome. However, the described combination of sedative drugs does not prevent the occurrence of sleep related upper airway obstruction.
Automatic jet ventilation in children anaesthetized by the T‐piece circuit
Authors: BARAKA ANIS , MUALLEM MUSA , CHIDIAC GILBERT , AYYOUB CHAKIB
Published: February 2007

Investigation was carried out in ten children aged between one month and six years, who were anaesthetized by the T‐piece circuit. The volume of the reservoir tubing of the T‐piece was 250 ml. Ventilation was controlled automatically by oxygen jets which were delivered via an injector attached to the reservoir tubing. The oxygen jets were regulated by an electronically‐controlled solenoid valve. The children were ventilated by a tidal volume about 12 ml±kg−1 at a rate of 12‐20 per min depending on their age, while the FGF varied between 3 and 6 l min−1 depending on their body weight. The resulting FIO2 ranged between 0.32 and 0.34 which was expected from the oxygen:nitrous oxide mixture (1:2), denoting no mixing of the oxygen jets with the anaesthetic mixture. The PAco2 was ventilation‐dependent, and ranged between 4±6‐5±3 kPa (35‐41 mmHg). The results suggest that automatic jet ventilation facilitates controlled ventilation in children anaesthetized by the T‐piece circuit, while maintaining the original simplicity of the T‐piece.;
Combined spinal and epidural anaesthesia for inguinal hernia repair in babies
Authors: PEUTRELL J.M. , HUGHES D.G.
Published: February 2007

We describe combined subarachanoid‐epidural anaesthesia for inguinal herniotomy in eight ex‐premature babies less than 47 weeks postconception and one full‐term baby aged 21 weeks who had Pierre‐Robin syndrome. No additional anaesthetic supplements were needed during surgery. Motor block was profound and operating conditions were excellent. One baby had brief self‐limiting bradycardias shortly after lumbar puncture. A second baby with severe bronchopulmonary dysplasia had recurrent oxygen desaturations associated with apnoea during surgery. There were no other intra‐ or postoperative complications. All babies were fed immediately on return to the ward. We conclude that combined subarachnoid‐epidural anaesthesia is a satisfactory technique for anaesthesia for inguinal herniotomy in babies at risk of apnoea after surgery.
A comparison of propofol and chloral hydrate for sedation of young children during magnetic resonance imaging scans*
Authors: BARST SAMUEL M. , MEROLA CRAIG M. , MARKOWITZ AVRAHAM E. , ALBARRACIN CINDY , LEBOWITZ PHILIP W. , BIENKOWSKI ROBERT S.
Published: February 2007

The purpose of this study was to compare the effects of two methods of providing sedation for young children undergoing magnetic resonance imaging (MRI) studies on efficiency of scanner utilization. Thirty‐nine patients were randomized to receive either propofol or chloral hydrate. Age and gender distributions were not significantly different between the groups. Induction time was significantly less for propofol than for chloral hydrate (6 ± 3 min vs 41 ± 9 min; P < 0.0001); and recovery time for propofol was significantly shorter than for chloral hydrate (18 ± 7 min vs 47 ± 28 min; P < 0.0001). Procedure times were not significantly different. Three of 19 patients who received chloral hydrate moved and their scans were interrupted; two of these received propofol. None of the patients in the propofol group moved. Utilization efficiency of the MRI scanner, defined as 100 ± (Procedure Time)/(Induction Time + Procedure Time), was 87 ± 6% for propofol and 45 ± 13% for chloral hydrate. These data demonstrate that propofol sedation allows the MRI scanner to be utilized more efficiently than chloral hydrate sedation.
Comparison of the flow rates of central venous catheters designed for rapid transfusion in infants and small children
Authors: BEEBE DAVID S. , BECK DANIEL , BELANI KUMAR G.
Published: February 2007

Large‐bore Hickman® catheters are useful in infants and small children for the rapid transfusion of blood or fluids into the central circulation. Recently high‐flow plastic sheaths have been developed for the same purpose. We compared the flow rates of normal saline, 5% albumin and packed red blood cells through two sizes of Hickman catheters that have been recommended for major surgery in infants to five sizes of Arrow® plastic sheaths of comparable external diameters, and to 14 and 16 gauge Jelco® catheters. The flow rates of all three solutions through the plastic sheaths and the 14 gauge Jelco catheters were superior to both sizes of Hickman catheters. Shortening the Hickman catheters improved their flow. High‐flow plastic sheaths can provide a useful alternative to Hickman catheters in patients where permanent, large‐bore central venous catheters are not required. Hickman catheters should be shortened as much as safely possible if massive haemorrhage is anticipated.
Aortic aneurysm in a four‐year‐old child with tuberous sclerosis
Authors: TSUKUI ATSUSHI , NOGUCHI RYOHKO , HONDA TADAYUKI , TOBITA TOSHIYUKI , FUKUDA SATORU , SHIMOJI KOKI
Published: February 2007

We present a case of aortic aneurysm in a four‐year‐old child complicated with tuberous sclerosis. We used the same general principles as for adult patients and successfully managed our patient. Our methods included the use of isoflurane plus epidural anaesthesia, dopamine to maintain blood pressure, and induced mild hypothermia to reduce brain metabolism and to prevent spinal cord damage during aortic cross‐clamping. Intensive monitoring including EEG was beneficial to the anaesthetic management.
New regimen for interpleural block in children
Authors: GIAUFRÉ ELISABETH , BRUGUEROLLE BERNARD , RASTELLO CÉLINE , COQUET MICHEL , LOREC ANNE MARIE
Published: February 2007

A new regimen for postoperative analgesia after thoracic surgery is proposed. Eight children received an interpleural infusion using bupivacaine 0.1% in a regimen from 0.5 ml·kg−1·h−1 up to 1 ml·kg−1·h−1, for 48 h according to the pain scores. The plasma levels after 24 h and 48 h were measured as well as the pleural level and in two patients the free fraction of plasma bupivacaine and the plasma PPX (a metabolite of bupivacaine) and one patient the orosomucoid (main plasma protein involved in bupivacaine protein binding) were also measured pre and postoperatively. The results shows the safety of such a regimen, for two days of postoperative analgesia.
Femoral and lateral femoral cutaneous nerve block for muscle biopsies in children
Authors: ROBERT M. MACCANI DO  , DENISE J. WEDEL MD  , AGI MELTON MD  , GERALD A. GRONERT MD
Published: February 2007

Retrospective chart review (1978–1993) of 179 children less than age 18 (10.0 ± 3.8 SD yrs) undergoing muscle biopsy for determination of susceptibility to malignant hyperthermia provided data. One hundred and forty‐six patients received femoral and lateral femoral cutaneous nerve blocks as their primary anaesthetic. We examined age, weight, duration of surgery, time to discharge from hospital, choice and dosage of local anaesthetics, choice and dosage of sedation, postoperative pain medications, and complications. All children receiving this form of anaesthesia remained outpatients. Between 1978 and 1985 procaine (10 mg·kg‐1) with hyaluronidase or 2‐chloroprocaine (12 mg·kg‐1) provided nerve blockade; after 1985, lignocaine (6.8 mg·kg‐1), or a combination of lignocaine or mepivacaine and 2‐chloroprocaine, were the preferred agents. More recently the combination of 2‐chloroprocaine and bupivacaine has been popular. Three patients required admission to the recovery room postoperatively, due to heavy sedation. Forty‐three children (29%) received pain medication during recovery. Femoral and lateral femoral cutaneous block anaesthesia with light to moderate sedation is well tolerated in children undergoing anterior thigh procedures.
Continuous epidural block for pain control in bladder exstrophy: report of a case and description of technique
Authors: ANDREA MESSERI MD  , MASSIMO ROMITI MD  , TIZIANA ANDREUCCETTI MD  , PAOLO BUSONI MD
Published: February 2007

We describe in a neonate an unusual epidural technique for pain control after the surgical correction of bladder exstrophy.
Pharmacokinetics of rectal paracetamol after major surgery in children
Authors: B.J. ANDERSON FANZCA  , G.A. WOOLARD PhD  , N.H.G. HOLFORD FRACP
Published: February 2007

Glycogelatin capsular suppositories containing a paracetamol slurry 40 mg·kg‐1 were given PR to 20 children (12 months‐17 yrs) after major orthopaedic surgery and plasma concentrations of paracetamol measured for up to 18 h. The mean maximum concentration (Cmax) was 0.115 (SD 0.049) mmol·l‐1. Peak concentration occurred (Tmax) at 2.3 (SD 1.2) h. Mean concentration was 0.07 (SD 0.03) mmol·l‐1 at six h. Apparent paracetamol clearance was 5.8 ml·min‐1·kg‐1. The plasma concentration of paracetamol associated with analgesic effectiveness in children is unknown, but antipyretic effects are seen in the range 0.066–0.130 mmol·l‐1. Paracetamol suppositories 40 mg·kg‐1 given perioperatively achieve effective therapeutic antipyretic plasma concentrations within 1–2 h. The timing is coincident with the recovery phase of short duration paediatric surgery. The coefficient of variance of Cmax was 43%. Some individual patients may not achieve a Cmax which is therapeutic.
Observation of early postoperative hypoxaemia in children undergoing elective plastic surgery
Authors: XUE F.S. , HUANG Y.G. , LUO L.K. , DENG X.M. , LIAO X. , TONG S.Y. , LIU Q.H.
Published: February 2007

The incidence, severity and duration of early postoperative hypoxaemia were determined in 420 healthy infants and children undergoing elective plastic surgery. Mean value of preoperative Spo2 was 98.3 ± 0.87%. However, it decreased significantly to 92.7 ± 4.01% immediately following anaesthesia in the postanaesthesia recovery room (PAR) when children breathed room air. Then Spo2 gradually increased to 93.8 ± 4.25% at 10 min, 95.4 ± 3.14% at 30 min, 96.6 ± 2.25% at 60 min, 96.9 ± 1.69% at 120 min, and 97.4 ± 1.55% at 180 min, respectively. The incidence of hypoxaemia and severe hypoxaemia, which were 14.8% and 6.2% respectively on arrival in the PAR, decreased significantly to 6.6% and 1.9%, 30 min later. The hypoxaemia occurred most commonly within 1 h, particularly the first 30 min following anaesthesia. The hypoxaemia was more common and more severe in children undergoing cleft palate repair than other kinds of plastic surgery. A significant correlation was found between low Spo2 levels on admission to the PAR and children's age, fentanyl doses, and the infants’ recovery score.
Laryngeal mask airway for management of a difficult airway and extracorporeal shock wave lithotripsy
Authors: GRONERT BRIAN J.
Published: February 2007

We report successful use of the laryngeal mask airway (LMA) in an eight‐year‐old child with failure to thrive and a known difficult tracheal intubation for ESWL in a mobile lithotripter van.
Total spinal anaesthesia following caudal block with bupivacaine and buprenorphine
Authors: AFSHAN G. , KHAN F.A.
Published: February 2007

This is a case report of an 18‐month‐old 10 kg child who presented for emergency repair of a recurrent diaphragmatic hernia with a history of craniofacial dystosis and was given a caudal block postoperatively with a combination of 4 ml of 0.5% bupivacaine and 2.5 μg·kg−1 buprenorphine made up to a total volume of 10 ml. An inadvertent dural puncture occurred resulting in total spinal block which was managed symptomatically. Block regression started one h later when the respiratory movements became noticeable. Eye opening and hand movements returned 3 h later. The patient's exposure to a large intrathecal dose of buprenorphine did not lead to prolonged respiratory depression. The possibility of a midbrain insult due to a sudden rise in intracranial pressure is also discussed.
Oral midazolam premedication for paediatric day case patients
Authors: CRAY S. H. , DIXON J.L. , HEARD C.M.B. , SELSBY D.S.
Published: February 2007

Forty‐nine children having day‐stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg·kg−1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P<0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P<0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.
Incretins and other peptides in the treatment of diabetes
Authors: Todd J. F. , Bloom S. R.
Published: February 2007

Glucagon‐like peptide‐1 (7‐36) amide (GLP‐1) is a gut hormone, released postprandially, which stimulates insulin secretion and insulin gene expression as well as pancreatic B‐cell growth. Together with glucose‐dependent insulinotropic polypeptide (GIP), it is responsible for the incretin effect which is the augmentation of insulin secretion following oral administration of glucose. Patients with Type 2 diabetes have greatly impaired or absent incretin‐mediated insulin secretion which is mainly as a result of decreased secretion of GLP‐1. However, the insulinotropic action of GLP‐1 is preserved in patients with Type 2 diabetes, and this has encouraged attempts to treat Type 2 diabetic patients with GLP‐1. GLP‐1 also possesses a number of potential advantages over existing agents for the treatment of Type 2 diabetes. In addition to stimulating insulin secretion and promoting pancreatic B‐cell mass, GLP‐1 suppresses glucagon secretion, delays gastric emptying and inhibits food intake. Continuous intravenous and subcutaneous administration significantly improves glycaemic control and causes reductions in both HbA1c and body weight. However, GLP‐1 is metabolized extremely rapidly in the circulation by the enzyme dipeptidyl peptidase IV (DPP‐IV). This is the probable explanation for the short‐lived effect of single doses of native GLP‐1, making it an unlikely glucose‐lowering agent. The DPP‐IV resistant analogue, exenatide, has Food and Drug Administration (FDA) approval for the treatment of Type 2 diabetes and selective DPP‐IV inhibitors are under development. Both approaches have demonstrated remarkable efficacy in animal models and human clinical studies. Both are well tolerated and appear to have advantages over current therapies for Type 2 diabetes, particularly in terms of the effects on pancreatic B‐cell restoration and potential weight loss.
Hospital Performance and Regional Equity
Authors: Forster D. P. , Frost C. E. B.
Published: February 2007

The objective of this article is to see whether or not the attainment of regional equity within the hospital sector has involved any sacrifice in hospital performance.1 For most health services providing medical care free of charge, regional equity is usually an important objective; but when doctors decide who gets into hospital and for how long regional equity may be difficult to achieve in practice. We look at certain indicators of hospital inpatient performance in relation to regional equity within the hospital sector in both England and Wales and Czechoslovakia. The comparison with Czechoslovakia is an interesting one because that country is as much concerned with regional equity in its hospital service as is the United Kingdom (UK). At the same time there have been substantial differences between the two countries in the availability of hospital resources.
Allocating Health Resources
Authors: Lee Kenneth , Ikegami Naoki
Published: February 2007

To clarify the polemics surrounding public and private responsibilities in health care, this article deals with the economic justification for the commitment of public resources. Public health measures do possess the properties of public goods or physical externalities, and yet may not have the sufficient conditions for allocating resources by political procedures. To publicly allocate resources to personal health care can only be justified by the properties of informational externalities, or regard for the humanitarian spillovers. Paradoxically, it is precisely in this latter area that a concern about minimum standards has led to a philosophical commitment to achieving maximum standards. The pursuit of such universal standards in the health sector has been the subject of growing disquiet. This dilemma is best resolved by reorientating the role of government towards an analysis of the costs and benefits of present and projected health practices.
The International Social Security Association after 60 Years
Authors: Leach J. D.
Published: February 2007

The International Social Security Association is marking this year its 60th Anniversary, and this is an appropriate time to consider and evaluate the organization's work. Does the apparatus of Committees, reports and a triennial Assembly justify the cost of participation by members, ultimately borne by contributors or taxpayers? The paper gives a brief history of ISSA and its forerunners, describes the working methods, gives an account of the 22nd Assembly held in 1986 in Montreal, and concludes with an assessment of its efficacy.
“Ask a Policeman”: Community Consultation in Practice
Authors: Savage Stephen P. , Wilson Charles
Published: February 2007

This article examines the development of police‐community consultation arrangements in one large county in southern England: arrangements made under Section 106 of the Police and Criminal Evidence Act 1984. It analyses the various responses of the main parties in the process: the police, the police authority, and the local committees themselves; and considers the extent to which the practice of consultation relates to wider claims for the enhancement of police accountability.

The main conclusions are that, at least in the force area concerned, the predominant conflict was not, as might have been expected, between police representatives and the local community, but rather between the police authority and the local committees, for which they were formally responsible.

In so far as such tensions can occur, the article argues for a more cautious approach to the question of the democratic accountability of the police to the extent that the police authority is to be entrusted with a central role in the reform of the current system of police accountability.
The Privatization of Welfare
Authors: Johnson Norman
Published: February 2007

The different forms of privatization all imply some diminution of the state's role in the provision, financing or regulation of welfare. Privatisation does not simply mean the sale of public assets and greater reliance on private enterprise and competitive markets; it also means the transfer of welfare responsibilities from the state to the voluntary and informal sectors. This is partly an ideological issue, concerning the state's relationship with individual citizens and social groups, and partly a matter of practicalities.

Welfare pluralism implies a less dominant role for the state in the provision (as opposed to the financing and regulation) of welfare services: its major themes are decentralization and participation.

Some doubt is cast on the capacity and the desirability of the informal and voluntary sectors substituting for the state in social service provision. The family is undergoing substantial changes which may reduce its capacity to provide care and, at the same time, the number of dependents is increasing. The voluntary sector is beset with problems of uneven and incomplete coverage, equity, fragmentation and accountability.

The chief consequence of welfare pluralism has been the rapid development of the commercial sector.
Police and Government in the 1990s
Authors: Loveday Barry
Published: February 2007

This article considers the proposals made for reform of local government and the creation of unitary authorities. It considers the relationship between police forces and local government and the introduction of new management structures for police forces. It argues for coterminous police and district authority boundaries, for district police committees and for closer coordination of police and other local services in the development of crime prevention programmes.
Management of HIV/AIDS in the Australian federal system
Authors: Misztal Barbara
Published: February 2007

The purpose of this article is to analyse the effect of the federal structure on public health policy in a crisis situation. Federalism has been one of the most important features of the Australian political system shaping AIDS policy because it has created problems with the coordination of policies and has limited the Commonwealth's capacity to introduce a coherent national monitoring, education, protection, testing and legal framework.

My main point is that in the situation of crisis, there is a tendency to rely on the political will of the centre. The political will of the federal health department, subsumed by conflicts and difficulties, has not lasted long enough to construct a new, more uniform structure (a uniform surveillance, legal and health acts framework). It can be concluded that while political intervention and political will cannot be overestimated as means of overcoming organizational rigidities in an emergency situation, the need for a framework conducive to rapid and coordinated responses is obvious. The lesson from the AIDS epidemic points to the need for more uniform public health legislation, for more uniform system of recording data on HIV and for more uniform civil liberties legislation.
Social Workers as Entrepreneurs
Authors: Yanay Uri
Published: February 2007

Qualified social workers were employed in the newly established Community Service Centers (Matnas) in Israel to take part in efforts to initiate services and define each Matnas' domain. The organizational structure of a Matnas encourages its workers to use their professional skills in making entrepreneurial initiatives: The local board, the untenured, multidisciplinary staff, and the ability to utilize mixed resources, affords the Matnas the flexibility to easily contract ‘in’ and ‘out’ of programs, giving it and its staff a competitive position within the free market of service providers. This structure also permits the establishment of formal and informal contacts with constituents and authorities. This paper presents the case and discusses the role of social workers in innovating service programs.
Social Policies for the Elderly in the Republic of Korea and Japan: A Comparative Perspective*
Authors: Palley Howard A. , Usui Chikako
Published: February 2007

The Republic of Korea (South Korea) and Japan are highly industrialized and modern nations which are both influenced by the Confucian tradition of respect for the elderly and family responsibility for the care of aging parents. In both countries the proportion of the elderly population is increasing. Japan, since the end of World War II, has utilized its government bureaucracy to help develop the social welfare system and to formulate social policies and programs for the elderly. Japan's tradition of samurai Confucianism is congruent with the commitment of the Japanese government to such social development as a matter of national policy. The Republic of Korea has not assigned a comprehensive planning role to its government bureaucracy. Lacking the mix of industrial/post‐industrial infrastructure of Japan and not yet faced with the immediacy of a very large elderly population, the Republic of Korea's government has developed its social policies for the elderly in a more incremental manner, usually emphasizing small scale and piecemeal initiatives. With respect to social support, it has emphasized voluntary family efforts as congruent with the Korean (and Chinese) variant of Confucianism. This paper will compare and contrast these different approaches.
Halfway There? Policy, Politics and Outcomes in Community Care
Authors: Henwood Melanie , Wistow Gerald , Robinson Janice
Published: February 2007

The community care reforms which followed the 1989 White Paper “Caring for People”were apparently focused on addressing the needs of people requiring long‐term care, and on achieving improved outcomes and better quality of life.

The agenda set out by the White Paper was for community care in the next decade and beyond. Half way through this decade, we question the extent to which the objectives of promoting choice and independence for users and carers have been achieved. The paper draws particularly on a programme of monitoring conducted jointly by the Nuffield Institute for Health and the King's Fund, based on national and local focus groups meeting over a two‐year period. It proposes a framework for evaluation which consists of four components: the definition of desired outcomes; specification of service systems necessary to deliver such outcomes; promotion of access to services; and the development of supporting operational policies and resource allocation mechanisms.

This framework offers a substantial step beyond much of the monitoring of the community care reforms which has taken place to date. This has assessed progress largely in terms of the establishment of new systems and processes. We conclude that such changes were essential building blocks for delivering better‐quality community care services, and in the short term it may have been legitimate to view their establishment as proxies for progress towards delivering user‐centred services. However, monitoring and evaluation should now be increasingly oriented towards ensuring that these changes are in fact producing the desired service outputs and urn outcomes. We propose that our framework offers one such way forward.
Measuring the Propensity to Volunteer
Authors: Bales Kevin
Published: February 2007

As charities are expected to take on more and more of the provision of services to the disadvantaged, they will be calling on volunteers to support that work. The use of volunteers means important cost savings when compared to the use of paid service providers, thus giving one advantage to the voluntary sector when bidding in the mixed economy of welfare. Given the potential for increased use of volunteers, questions of motivation and commitment become very important. Volunteers make up a significant proportion of the human resources used to service social needs, yet previous research has not made it clear why and how volunteers come to give so much of themselves. This research demonstrates that there is an underlying Volunteerism–Activism Attitude which can be measured, and which holds within its four dimensions the key motivations for volunteering. Use of the scale measuring this attitude allows prediction of those people who are most likely (and least likely) to volunteer for charity activity. For charities the scale might provide a useful tool in managing the personnel with whom they are now expected to bid in the quasi‐markets of service provision.
Social Policy in a Federal Europe
Authors: Spicker Paul
Published: February 2007

The European Union has a federal structure, in which each citizen is subject to two governments. The position of social policy within the federation is contested, but the EU has gradually developed powers through the extension of its competence, direct intervention in social welfare issues and the push for “convergence”, or agreement on minimum standards. Consistent with its federal nature, the European model of the welfare state is based on convergence, integration of the excluded and social protection through the gradual extension of solidarity. The precise role that the federal government will take on within this is unclear, but it is already having a major impact on social welfare and its influence is likely to increase.
Rhetoric and Reality in European Co‐operation with Third Countries: A Case Study
Authors: Lewando‐Hundt Gillian
Published: February 2007

This case study illustrates the reality of trying to achieve the European Commission objective of fruitful international research co‐operation with Third Countries. The process of responding to an EC research call, preparing a proposal and negotiating a contract are explored with areas of general applicability being highlighted. The case study is drawn from the Avicenne Initiative in the area of health systems research. The difficulties and inequality of access to information, administrative research support and resourcing are explored as both issues for individuals and institutions and also as part of the difficulties of developing south‐north or east‐west research partnerships. The backstage of research is explored in order to highlight issues of discourse, practice and procedure which, if tackled, could provide a more level playing field for researchers from a wide range of institutions and countries.
NEW FARMERS AND NETWORKS: HOW BEGINNING FARMERS BUILD SOCIAL CONNECTIONS IN FRANCE
Authors: MAILFERT KATE
Published: February 2007

A significant number of people are moving ‘back‐to‐the‐land’ in search of a fulfilling lifestyle and self‐defined economic success. But do these ‘neo‐farmers’‘find their bliss’? Experiences are mixed. While some report feeling isolated, others tell stories of rapid integration into local agricultural and social networks. Although the literature is clear that networks play a critical role in providing newcomers to rural areas with support, few studies have addressed the specific experiences of beginning farmers and none has compared the networks of ‘neo‐farmers’ with those of farmers from farming origins. The study reported here examines the ways the personal networks of new farmers with differing backgrounds provide access to farm start‐up resources in France.
E‐SHOPPING VERSUS CITY CENTRE SHOPPING: THE ROLE OF PERCEIVED CITY CENTRE ATTRACTIVENESS
Authors: WELTEVREDEN JESSE W.J. , RIETBERGEN TON VAN
Published: February 2007

The growing number of Internet users and the increasing volume of online sales gives rise to speculation about how e‐shopping will affect shopping centres as we know them. Since shopping centres differ in terms of their appeal to consumers, we expect the impact of e‐shopping on in‐store shopping to decrease with increasing attractiveness of the latter. To test this proposition, we examined how perceived attractiveness of city centres influences the relation between city centre shopping and e‐shopping for 3,200 Internet users in the Netherlands. Results showed that more than 20 per cent of the online buyers made fewer trips to the city centre and also made fewer purchases at city centre stores, due to e‐shopping. However, the higher the perceived attractiveness of the city centre, both in terms of range and convenience of shopping and accessibility, the less Internet users are inclined to shop online and to replace city centre shopping with e‐shopping.
Stress in patients with alopecia areata and vitiligo
Authors: Manolache Liana , Benea Vasile
Published: February 2007

Objective  To study the involvement of stress before the onset/development of alopecia areata and vitiligo.

Patients and method  Forty‐five outpatients with alopecia areata and 32 outpatients with vitiligo were enrolled. The design was a case‐control study (controls had skin diseases unrelated to stress). Stressful events were evaluated using Holmes and Rahe's social readjustment rating scale.

Results  Mean age was around 30 years in both conditions. More than 65% of cases (both alopecia areata and vitiligo) experienced stressful events compared to 22% of controls. The odds ratio was 7.75 for alopecia areata and 6.81 for vitiligo. There was a significant difference in the mean number of stressful events between alopecia areata patients and controls (P = 0.005), and also a significant difference in the number of stressful events between men (P = 0.05) and women (P = 0.001) across these two groups. In the vitiligo group there was a significant difference in the mean number of stressful events between patients and controls only in women (P = 0.02). A potential stressful situation occurred more often in both patient groups. Alopecia areata patients described family problems in 45.6% of patients (especially women), which was statistically significant when compared to controls (P = 0.0004). Personal problems were reported by 35.7% of alopecia areata patients (P = 0.04 compared to controls). Vitiligo patients mentioned personal problems in 47% of cases (one‐third were related to exams) and 31% of cases were related to job/financial problems. Again, this was statistically significant when compared to controls (P = 0.0002).

Conclusions  Stress seems to play an important role in the onset and aggravation of both alopecia areata and vitiligo, mostly with one stressful event before disease onset.
Information processing profiles of internalizing and externalizing behavior problems: evidence from a population‐based sample of preadolescents
Authors: Agnes Brunnekreef J. , De Sonneville Leo M. J. , Althaus Monika , Minderaa Ruud B. , Oldehinkel Albertine J. , Verhulst Frank C. , Ormel Johan
Published: February 2007

Background:  The present study explores the relationships between several information processing capacities and internalizing and externalizing behavior problems in a general population sample of 10‐ to 12‐year olds (N = 2,037 51% girls).

Methods:  Parent‐reported behavior problems as assessed by the Child Behavior Checklist were used to form four groups of children with 1) neither internalizing nor externalizing problems (n = 1,470), 2) only internalizing problems (n = 237), 3) only externalizing problems (n = 182), and 4) both internalizing and externalizing problems (n = 148). These groups were compared on measures of speed and accuracy from the Amsterdam Neuropsychological Tasks program reflecting the efficiency of several input‐, central cognitive‐, and output‐related information processing capacities.

Results:  Children with both internalizing and externalizing problems demonstrated the least efficient performance, followed by children with only externalizing problems, whereas children with only internalizing problems did not differ from children without problems. More specifically, response variability and the ability to maintain and quickly compare information in working memory were found to be related to the severity of problem behavior. The ability to inhibit prepotent responses was related to the type of problem behavior, discriminating between the children with only internalizing problems and only externalizing problems. However, this latter capacity no longer differentiated when controlling for IQ. No differences were found between boys and girls.

Conclusions:  The results suggest that, in general, cognitive processing deficits are more strongly related to the degree than to the type of maladaptive behavior. Furthermore, response variability and working memory may serve as potential markers for identifying high‐risk children and response inhibition as an indicator of the type of maladaptive behavior.
GOALS AND METHODS OF PSYCHOPHYSIOLOGY
Authors: Ax Albert F.
Published: February 2007

The purpose of this essay is to identify the research area of psychophysiology by abstracting the goals and methods from reports which this author believes are properly called psychophysiological. The general goal of psychophysiology is to describe the mechanisms which translate between psychological and physiological systems of the organism. Specific goals are to identify and describe the physiological processes directly relevant to such psychological constructs as drive, motivation, attitude, emotion, and their modification by learning.

Findings include the description by physiological patterns of several emotions, sleep, dreaming, hypnosis, psychiatric and psychosomatic conditions. Principles conceived are individual, stimulus, emotion and attitude specificities and the “law of initial values.”

The progressive theme of psychophysiological method has been to extend measurement to more covert behavior with decreasing interference with the organism. Methods and special problem areas are reviewed under the categories of (a) the stimulus situation, (b) observation (sensors, recorders, signal transformation), and (c) analysis, synthesis, and interpretation. The major unsolved technical problem is the automatic detection of artifact. The chief theoretical problem is to “break the code” by which the organism translates between experience and physiology. The psychophysiological method is seen as having useful application in classification and training for motivational abilities and stress tolerance.

Goal, Method, Application, Translation, Covert, Emotion, Motivation, Attitude, Specificity, Sensor, Recorder, Conversion, Computer, Analysis, Synthesis, Interpretation, Artifact, Learning, Stress‐tolerance. (A. F. Ax)
THE PARTIAL INDEPENDENCE OF SKIN POTENTIAL AND SKIN RESISTANCE FROM SWEATING
Authors: Wilcott R. C.
Published: February 2007

Results of three experiments were as follows:

1. After a 3‐ma DC current of 10‐min duration through the palmar skin, skin potential (SP) basal level is reduced in negativity and the positive wave of the SP response eliminated with no change in sweating (Sw) or skin resistance (SR). This demonstrates that SP basal level and the occurrence of the positive wave are not dependent on Sw or SR.

2. Placing a potential between the SP electrodes to vary SP basal potential will produce variations in response wave form, amplitude and latency. An induced potential comparable to that used in SR recording will produce SP responses of large amplitude. This suggests that the SP and SR represent different aspects of the same physiological processes. The effects of a DC current through the skin and exsanguination can be overcome by varying the SP basal potential. These results further demonstrate that SP responses are a function of SP basal level.

3. After atropinization, SP and SR return to their initial levels faster than Sw. It is concluded that SP and SR are partially produced by a process separate from Sw.

Methodology, Human, Palmar sweating. Skin resistance. Skin potential, Atropine, Cholinergic, Exsanguination, Electrophoresis. (R. C. Wilcott)
SPONTANEOUS HEART RATE AND GSR CHANGES AS RELATED TO MOTOR PERFORMANCE
Authors: Docter Richard F. , Kaswan Jacques W. , Nakamura Charles Y.
Published: February 2007

Spontaneous heart rate changes and spontaneous galvanic skin response (GSR) fluctuations were compared with motor performance on a task said to measure motor impulsivity in two identical experiments. With the use of a total of 64 male college students as subjects, the conclusion drawn from the experiment was that neither of the physiological measures related significantly to impulsive performance. This was true for both a complex motor task and for simple reaction time performance. It is argued that if there is a relationship between spontaneous autonomic activity and motor impulsivity as has been previously reported, the conditions under which this may be demonstrated must be quite specific. The present findings are interpreted as requiring limitations on the generalizability of the relationship previously reported. Heart rate, GSR, Impulsivity, Reaction time. (R. F. Docter)
PSYCHORHYTHMICS: A SPECIAL REVIEW
Authors: Brozek Jonef
Published: February 2007

The purpose was to review systematically recent non‐periodical publications concerned with the behavioral aspects of cyclic phenomena, especially of the “circadian” rhythms, including sleep and wakefulness. The author considers the reports of the international conferences of the Society for Bilogical Rhythms as well as publications in English (rythmic annimal behavior, ibernation, sleep), German (periodicity in psychopathology, vircadian rhythms inman and shift‐work), and Russian (circadian rhythms in annimals). It is suggested that, while the mastery of fire‐making and invention of more modern means of artiticial illuminiation have long liberated man from dependence on the natural sequence of day and night, consderations of space flight put the whole subject of biological rhythms into a new, challenging perspective.
A SIMPLIFIED APPROACH TO PEAK SAMPLING
Authors: Thorne Philip R.
Published: February 2007

A peak sampling circuit useful for displaying such variables as blood pressure, is described. The advantage of simplicity and low cost balances against the disadvantage of holding the signal only for three quarters of a cycle.
MODIFICATION IN AUTONOMICALLY MEDIATED PHYSIOLOGICAL RESPONSES TO COLD PRESSOR BY WORD ASSOCIATIONS
Authors: Mefferd Roy B. , Wieland Betty A.
Published: February 2007

Physiological measures—basal skin resistance (BSR), galvanic skin resistance (GSR), electrocardiogram (EKG), and skin temperatures—were made on 120 consecutive days on 3 male subjects during rest, a 20‐item word association test, recovery, a cold‐pressor test, a combination of cold‐pressor and a second similar word‐association test, and final recovery. Each stimulus alone induced increased sympathetic activity. Ongoing stress (cold pressor) responses, however, were depressed during the word‐association test. Furthermore, the nature, reaction times, and commonalities of the associations were influenced by the stress. The inhibition was not due to order, threshold, adaptation, or conditioning effects.
ELECTRODERMAL RESPONSIVENESS AS RELATED TO PSYCHIATRIC DIAGNOSIS AND PROGNOSIS
Authors: Stern J. A. , Surphlis W. , Koff E.
Published: February 2007

Electrodermal responsiveness as measured by orienting responses to tone stimulation and to a word‐association task was evaluated in a group of schizophrenic patients upon admission to the hospital and after 5 weeks of hospitalization. Two evaluations were conducted, the first based on clinical recovery, the second based on electrodermal responsiveness at time of first testing. Results indicate that patients who demonstrate more rapid habituation at second time of testing have a better hospital discharge record than those who show no change in rate of habituation. Electrodermal responsiveness to the word‐association task at first time of testing was related to such factors as clinical diagnosis, severity of illness, and adequacy of word associations. In general, patients who were most responsive demonstrated less pathology than those who were less responsive at first time of testing.
THE EVALUATION OF AUTONOMIC AND MO TOR COMPONENTS OF THE NONAVOIDANCE CONDITIONED RESPONSE IN THE DOG1
Authors: Dykman Roscoe A. , Mack Robert L. , Ackerman Peggy T.
Published: February 2007

Heart rate (HR), respiratory rate (RR), blood pressure (BP). and motor components of responses to non‐reinforced and reinforced auditory stimuli were studied in six dogs over a period of 20 months. The experiment consisted of several phases: habituation, orienting training, conditioning, extinction, and reconditioning. Differentiated non‐specific motor reactions in four of six dogs developed quickly and before the differentiated specific motor conditioned response (CR) and consistent HR or RR conditioned responses. The form of the gross organismic CR pattern differed in each dog. Yet the animals reliably maintained, in each separate system, their rank‐order positions across experimental phases, suggesting that the CR is determined in part by innate or earlier acquired differences in functioning.
THE RELATION OF AMPLITUDE OF ALPHA RHYTHM TO HEART RATE
Authors: Surwillo Walter W.
Published: February 2007

With heart rate as a criterion measure of arousal, amplitude of alpha rhythm of the electroencephalogram (EEG) was studied in 99 subjects aged 28 to 99 years. The physiological recordings were made while the subjects were performing a simple reaction task. Conditions of the experiment provided a range of arousal states from drowsiness to alertness.

Careful examination of data from each of the 99 cases failed to reveal any evidence of an inverted‐U relationship between alpha amplitude and heart rate scores. It was shown that the method of analysis, which combines observations from different subjects and which was used in a previously reported investigation (Stennett, 1957), is Invalid.