bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the effect of head and neck position on upper airway anatomy in sedated paediatric patients using Magnetic Resonance Imaging
Authors: SHORTEN G.D. , ARMSTRONG D.C. , ROY W.I. , BROWN L.
Published: February 2007

Upper airway patency can be compromised when children (or adults) receive sedative medication. The study examines the effect of two different positioning techniques (use of the ‘sniff position pillow’ (SPP) and shoulder elevation (SE) on maintenance of upper airway patency using MRI in 21 children sedated with intravenous pentobarbital (5–8 mg·kg‐1). Children positioned on the SPP had a significantly greater degree of atlanto‐occipital extension (P < 0.05), and a significantly greater nasopharyngeal diameter (P < 0.05) than those with shoulder elevation. The degree of atlanto‐occipital extension was not significantly correlated with pharyngeal diameter (R = ‐0.68). No clinical signs of upper airway obstruction were noted and oxygen desaturation did not occur. Both positioning techniques were consistently associated with upper airway patency under the study conditions described. In obligate nose breathers to whom sedative agents are administered, the SPP is more likely to maintain nasopharyngeal patency than shoulder elevation.
Ketamine plus midazolam, a most effective paediatric oral premedicant
Authors: WARNER D.L. , CABARET J. , VELLING D.
Published: February 2007

Healthy children, 1.5 to seven years old, were divided into three groups of 20 each. Group 1 received midazolam 0.5 mg·kg‐1, Group 2, ketamine 6 mg·kg‐1 and Group 3 a mixture of midazolam 0.4 mg·kg‐1+ ketamine 4 mg·kg‐1. Each dose was mixed with atropcne 0.02 mg·kg‐1 plus an equal volume of cherry syrup and was given orally 20 to 30 min prior to surgery. A grade of 1 (asleep, difficult to arouse), 2 (asleep, easily aroused), 3 (awake, calm), 4 (awake, anxious, occasional cry), or 5 (crying, agitated), was assigned at the time of parental separation and again when mask induction was begun. A grade of 1–3 was considered successful. For parental separation, the mixture of ketamine + midazolam was 100% successful, ketamine 90% and midazolam 75%. Successful mask induction for the mixture of ketamine + midazolam was 85%, midazolam 65% and ketamine 42%. This study indicates that a mixture of ketamine + midazolam is the most effective.
Changes in carbon dioxide tension and oxygen saturation during deep sedation for paediatric cardiac catheterization
Authors: FRIESEN ROBERT H. , ALSWANG MARTIN
Published: February 2007

The purpose of this observational study was to determine whether hypercarbia or oxygen desaturation occurred during our current regimens of deep sedation or general anaesthesia of infants and children undergoing cardiac catheterization. Data were gathered prospectively from 50 consecutive infants and children aged 4 months to 12 years undergoing cardiac catheterization. Several anaesthetists used the following regimens, which were not randomized: 1) propofol. 1.5–2.0 mg·kg−1 and fentanyl 1 μg·kg−1 IV over 2 min for induction, followed by propofol infusion of 100–150 μg·kg−1·min−1; 2) fentanyl 2–3 μg·kg−1 and midazolam 0.1–0.2 mg·kg−1 IV over 10–15 min; 3) ketamine 8 mg·kg−1 IM, or 4) same as regimens 1 or 2, plus pancuronium, intubation and controlled ventilation. Regimens 1, 2, and 3 were associated with spontaneous ventilation through the natural airway. End‐tidal carbon dioxide tension (Petco2), Spo2, and respiratory rate were monitored for 60 min. The three regimens employing spontaneous ventilation through the natural airway were associated with both statistically and clinically significant increases in Petco2 and decreases in Spo2. This raises the possibility that acute exacerbation of PAP and PVR may occur in pulmonary hypertensive patients. In contrast, Petco2 and Spo2 did not change significantly from baseline in the controlled ventilation group.
The Bland‐White‐Garland syndrome. Clinical picture and anaesthesiological management
Authors: KLEINSCHMIDT STEFAN , GRUENESS VOLKHARD , MOLTER GERD
Published: February 2007

We report a five‐month‐old infant with an impaired left ventricular ejection fraction as a result of Bland‐White‐Garland‐syndrome (BWGS). Total intravenous anaesthesia with fentanyl and midazolam was used as the anaesthetic technique. After aortic reimplantation of the left coronary artery weaning from cardiopulmonary bypass (CPB) was prolonged and was only successfully managed with high dose noradrenaline, dopamine and dobutamine. Persistent myocardial dysfunction led to prolonged intensive care treatment. Seven months after surgery, left ventricular function and clinical condition have improved significantly.
Spinal anaesthesia in newborns: total and free bupivacaine plasma concentration
Authors: BEAUVOIR C. , ROCHETTE A. , DESCH G , D'ATHIS F.
Published: February 2007

This study was designed to measure total and free bupivacaine (B) after spinal anaesthesia in newborns and to evaluate a possible influence of adrenaline on B absorption. Twenty‐two newborns were randomly allocated to receive either plain B (group 1) or adrenaline added to B (group 2) for spinal anaesthesia. A single blood sample was collected ten min after spinal injection. Total B concentration was found 0.31 ± 0.17 μg±ml−1 in group 1 and 0.25±0.09 μg±ml−1 in group 2. Bound B concentration was 0.27±0.17 μg±ml−1 in group 1 and 0.22±0.09 μg±ml−1 in group 2. No difference was found between the two groups for these parameters. Albumin but not α1‐acid‐glyco‐protein correlated to age and weight, bound B correlated to α1‐acid‐glyco‐protein but not to albumin. Despite the low plasma concentration of binding proteins in newborns, spinal anaesthesia with B does not result in a high level of free drug. Adrenaline does not have any pharmacological advantage in these patients.
Small, flat colorectal cancers in the UK population: an analysis of resected specimens
Authors: Tweedle E. M. , Chaudhri S. , Azadeh B. , Rooney P.S.
Published: February 2007

Objectives To establish the prevalence of small, flat carcinomas in surgically resected colon. To determine whether tumour morphology influences stage at presentation.

Method 1763 surgically resected colorectal cancers from one UK centre excised between 1995 and 2004 were examined. Age 69 years, (42–90), M:F equal. Sixty‐one tumours 20 mm across were identified. Slides were reviewed by a consultant histopathologist and classified using Japanese Research Society Classification, JRSC and TNM staging. Fisher's exact test was used for analysis.

Results In 61 small cancers, 64% (39/61) showed flat morphology and 33% (20/61) polypoid. Two lesions were unclassifiable. Prevalence was 2.2% of all resected colorectal cancers. More T1 tumours at presentation were polypoid, (30% vs. 8%;P = 0.033). T3 tumours were more likely to be flat than polypoid, (49% vs. 20%;P = 0.016). Infiltration into musclaris mucosa occurred in 77% (30/39) flat tumours. Rates of metastases were high in both groups, (30% polypoid vs. 39% flat, not significant).

Conclusions The prevalence of small, flat cancers in resected specimens in the UK concurs with that of Japanese studies. Small, flat cancers should be staged carefully because of high rates of T3/4 disease. The results support the theory of accelerated carcinogenesis in flat cancers.
Prevalence of gestational diabetes mellitus and the effect of weight on measures of insulin secretion and insulin resistance in third‐trimester pregnant rural women residing in the Central Region of Limpopo Province, South Africa
Authors: Mamabolo R. L. , Alberts M. , Levitt N. S. , Delemarre‐van de Waal H. A. , Steyn N. P.
Published: February 2007

Aims  To examine the prevalence of gestational diabetes in third‐trimester pregnant women as well as to assess their insulin secretion and insulin resistance (IR).

Methods  Third‐trimester pregnant women (n = 262) attending antenatal care at local clinics in the central region of the Limpopo Province underwent a 2‐h oral glucose tolerance test (OGTT) with blood collected at 0, 30 and 120 min. Glucose and insulin were measured.

Results  The prevalence of gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM) was 8.8% (7.3% GIGT; 1.5% GDM). Women with GIGT/GDM were significantly older and had more children compared with women with a normal response to the OGTT. Homeostasis model assessment (HOMA)‐IR and fasting insulin were lower in the GIGT/GDM group compared with the normal group, as were measures of insulin secretion (HOMA B‐cell function and insulinogenic index). Furthermore, women with body mass index (BMI) ≥ 30.0 kg/m2 were significantly older and had higher parity, systolic and diastolic blood pressure measurements than those with BMI 25.0–29.9 kg/m2 and BMI < 25.0 kg/m2. However, increased BMI was not associated with an increased risk of GIGT/GDM.

Conclusion  The present study shows that there is a high prevalence of GIGT/GDM, with most women having IGT. The GIGT/GDM present in these women is characterized by increased insulin sensitivity accompanied by reduced pancreatic B‐cell function. Additionally, heavier women appear to have increased first phase insulin secretion, suggesting the presence of insulin resistance.
The Net Resource Distribution of Two Parent Low Income Families: A Regional Comparison*†
Authors: Hemming R. C. L.
Published: February 2007

The purpose of this paper is firstly to investigate the distribution of two parent low income families in England and Wales and Scotland for see to what extent they differ, and secondly to examine the relative importance of certain contributing factors in determining the distributions. From an analysis of Family Expenditure Survey data it is found that although it is difficult to arrive at statistically verifiable conclusions about the nature of the distributions, interesting qualitative observations can be made.
Power and Policy Making
Authors: Webb Adrian
Published: February 2007

POLICY MAKING IN BRITISH GOVERNMENT: AN ANALYSIS OF POWER AND RATIONALITY BY Brian Smith.

COMPARATIVE PUBLIC POLICY: THE POLITICS OF SOCIAL CHOICE IN EUROPE AND AMERICA by Arnold Heidenheimer
Social Support and Government Policy on Services for the Elderly
Authors: Green Stephen , Creese Andrew , Kaufert Joseph
Published: February 2007

Government policy on services for the elderly is to increase the provision of care in the community. This paper examines this policy in relation to informal help received from relatives and friends.

Drawing on the results of a pilot study of 92 people over the age of 75, registered in a group general practice, data are presented on the balance between informal and formal help over a group of activities of daily livhg. The main informal helpers are described with the range of activities for which people in the study were receiving assistance.

Community services are, at present, limited in the help they can provide for people in their own homes. If policies of community care are to be successful, then they must take into account the strengths and weaknesses of informal support. Using the data presented, suggestions are made a bout improvements in services including task specific services not currently provided and the definition of groups at risk of their social support breaking down.
Australia's Social Wage
Authors: Graycar Adam
Published: February 2007

Public Expenditure and Social Policy in Australia By R.B. SCOTTON & HELEN FERBER (eds.)

Poor Policies: Australian Income Security 1972–77 By PATRICIA TULLOCH.
Collaboration between Health and Local Authorities: Why is it necessary?
Authors: Wistow Gerald
Published: February 2007

In contrast with current proposals, collaboration with local government was a dominant factor in the 1974 reorganisation of the NHS. Four categories of such collaboration are identified in this paper: the sharing of services; coordination of service delivery; joint planning; and joint prevention. The need for each is discussed in the context of the reorganisation debate and of subsequent events. In essence, the DHSS case for collaboration — and in particular, its emphasis on joint planning — is seen as both a cause of reorganisation and a consequence of the form which that reorganisation eventually took. Emphasis is placed upon the potential role of collaboration as a vehicle for a preventive health strategy and as an important instrument for the development and implementation of major central government policy objectives. Finally prospects for the continuing evolution of joint working are considered in relation to NHS restructuring. It is concluded that the present government's approach to the structure and management of the NHS is likely to undermine its substantive policy objectives especially in the field of community care.
Special Education: Whose Rhetoric Is It Anyway?
Authors: Hogg James
Published: February 2007

Special Education: Policy, Practices and Social Issues By LEN BARTON AND SALLY TOMLINSON (eds)

Educating Pupils with Special Needs in the Ordinary School By SEAMUS HEGARTY et al.
European Health Care Costs
Authors: Gray Alastair M.
Published: February 2007

The rising cost of health care in Western European countries is now seen by many governments as a problem, and attempts are being made to find a solution by introducing cost‐containment policies.

The author begins by reviewing trends in health care expenditures, and examines some of the underlying reasons for the upward trend.

He then considers some of the more important differences in the organization and financing of Western European health care systems, before surveying the different kinds of cost‐containment policies which are being, and could be, pursued.

The conclusion is that present cost‐containment policies do not take sufficiently into account the underlying reasons for rising costs, and that the criteria for evaluating the success of these policies are inadequate. To be successful, the policies will have to be altered, and the objectives and means of evaluation reconsidered.
Long‐Term Unemployment
Authors: Leaper R. A. B.
Published: February 2007

The author writes from the viewpoint of Chairman of an Area Board of the Manpower Services Commission involved in practical responses to present unemployment and in training programmes for 16 to 18 year olds. He reviews the various interpretations of the nature of unemployment noting that a high level of unemployment is now very general in industrial societies. Training is an important adjunct to employment in a technological and rapidly‐changing society, but of itself it does not solve unemployment. Structural changes are required, many of these uncomfortable to the majority who are in profitable employment. Various partial remedies are reviewed but none of them on its own is found to be a full solution, neither is a reform of income distribution methods found satisfactory. The conclusion is that there are many aspects of unemployment and the solutions to it are complex and many‐facetted.
Preferences for Work Locations Among Social Workers
Authors: Collison Peter , Kennedy John
Published: February 2007

This is a report of a survey conducted in 1975 of students following social work courses in nineteen universities in England and Wales. The respondents were asked to state their preferences for future employment amongst different areas in England and Wales. The results show clear preferences with Devon at the top closely followed by Somerset and North Yorkshire. Most areas with positive scores were counties with substantial rural components but two urban areas were also high in the choice list. The least popular were two densely populated urban areas in the West Midlands and the London boroughs. There are interesting variations amongst these two low scoring groups. Whilst locational preference is only one of the factors determining mobility it is, nevertheless, of some importance.
Social Administration and Policy in Norway
Authors: Salvesen Kaare
Published: February 2007

This is a review by a recently‐retired director in the Norwegian Social Affairs Ministry of Norway's system of administering its social provisions. After a summary of public administration, the social work, social security and health provisions are reviewed. There is a commentary on Labour policies and on housing. The place of non‐governmental organizations completes the over‐view of a country much neglected in British literature.
Rate Capping and Local Government
Authors: McVicar Malcolm , Atkinson Rob
Published: February 2007

This paper argues that rate‐capping was an inevitable product of the government's determination to control both the aggregate expenditure of local government and that of all individual authorities. We set out the background to these developments before going on look in more detail at the mechanics of rate‐capping and its likely effects on the services provided by “capped” authorities. We challenge the rationale underlying rate‐capping, arguing that its motivation is largely political and that to be effective all (or most) authorities will have to be rate‐capped. Finally we examine the resistance being offered by “capped” authorities, their chance of success and the implications for central‐local relations.
Discretion in Welfare Provision
Authors: Williams Rory
Published: February 2007

While discretion has been studied in systems of distribution which are governed by rules, or in those where there is a crucial gatekeeper, there remain many informal and diffuse systems where little is known about the discretion used. An example is the allocation of community services. In such cases, a useful strategy is to analyze the informal rationing system along lines which are discussed, and by this means to identify as discretionary the cases which emerge as anomalous.

Possibilities are outlined for comparing the amount of discretion used and its bias, in areas with different resource levels or degrees of regulation; and the paper concludes with a detailed illustration, drawn from an area study of community services for the elderly, of changes in the use of discretion with increasing pressure on resources.
Health and Social Services Planning
Authors: Wright Jennifer , Sheldon Frances
Published: February 2007

The authors outline joint planning between health and social services since 1974, examining the joint planning meetings of two different types. They identify certain features of small group meetings which could ease joint planning arrangements.
Privatizing Social Services in the U.S.A.
Authors: Weddell Kenneth
Published: February 2007

Governmental and private sector social services organizations have traditionally shared important roles for provision and delivery of social services in the United States. Over the past fifty years, however, a predominant position has developed for the public sector, especially through federal funding for social service programmes. Recent challenges to the prevailing role of public sector dominance have been expressed by the proponents for privatization at a time when decreasing federal funds are made available for social service programmes. The analysis presented here examines the potential and problems associated with the privatization strategies offered through load shedding, limited‐government arrangements, fee charging and competition. As a macro level approach for a comprehensive system of social service provision and delivery, these privatization strategies raise more questions than immediate solutions. A more optimistic view is taken if privatization leads to a more meaningful balance with increased co‐operation between public and private social welfare auspices.
Australian Social Security Appeals
Authors: Horsburgh Michael
Published: February 2007

Early developments in the Australian system of provision for poor people led first to voluntary charitable assistance and then to a more generalized system of social security. A national scheme of old age pensions came in only in 1908; and social assistance schemes, as well as demogrants for defined statuses have gradually spread throughout the Australian Commonwealth. Specific provisions to meet crisis situations remain the responsibility of individual States. There are strong discretionary elements in the whole system. The arrangements for appeals against administrative decisions, and the reviews of these arrangements recently made, are then examined critically.
Local Authorities Unemployment Strategies
Authors: Portwood Derek
Published: February 2007

If a “co‐ordinated strategy to reduce the major problem of unemployment” is needed, as Leaper claimed in previous volume, there remains the question of how to develop such a strategy. Central governmental agencies like the MSC have major programmes, but other consequences of high unemployment have to be dealt with by local authorities. Four case studies of attempts made by local authorities in this regard are then examined. The most prominent features in their strategies are: information giving, training provision, job creation and channelling funding from other agencies or internal co‐ordinated funding. The new strategies have involved changes in management and liaison, in policy review and affirmation.
Last Chance For The Last Refuge
Authors: Jack Raymond
Published: February 2007

The theme of this article is the drastic reduction in residential care for the elderly which has met little opposition from within the health and social services despite the growing population of the very aged. The reasons for this professional compliance are examined and found to lie in a combination of mistaken confidence in community care policies and an uncritical acceptance of influential but largely outdated studies whose findings on the adverse effects of institutional care are seriously questioned by later research.
Working Together Apart
Authors: Macpherson Isobel , McKeganey Neil
Published: February 2007

In this paper we report upon the development and operation of a “street‐level” response to the problems of interprofessional joint working in providing appropriate care for elderly people living in one Scottish city. The “exchange system”, as it was known in the locale, was a mechanism for co‐ordinating the movement of elderly people between the geriatric, psychiatric, and residential services within the city in response to changes in the needs of the individual elderly person, and the needs of service providers. The importance of the scheme stemmed from the fact that it was not imposed on professionals' work, but rather that it developed out of that work.

By focusing on the operation of interprofessional joint working at the street level we draw attention to those complexities involved in such work which are often overlooked in the broad policy statements on joint working which have emerged from government departments, and health and social services agencies. Policy makers and analysts alike have largely ignored the meaning and consequences of joint working at the level of professionals' actual work, and it is this lacuna in the literature that the paper seeks to address. The paper concludes with an appeal to researchers and practitioners to describe any such schemes of whatever nature operating in their own locales. In so doing a corpus of knowledge looking critically at the experience of interservice and interprofessional collaboration at the street level may emerge which would inform broad policy statements.
Rented Housing and Market Rents: A Social Policy Critique
Authors: Ivatts John
Published: February 2007

The private rented sector of the British housing market has been in decline since the beginning of the present century; that decline has continued apace since the end of the Second World War. A proposed solution for the stemming of this demise is the removal of present rent controls and the substitution of free market conditions so that rents find their own market levels. This, so it is argued, would enable landlords to obtain a proper return on their housing investments and lead therefore to an increase in supply and an ending to the present disinvestment from this housing sector.

This article disputes this thesis. In the first place it is argued that “market rent” is a problematic concept and raises complex issues of distributive justice and social policy — which its advocates ignore. Secondly, it is argued that a free market solution is ahistorical in that it takes no account of the past failure in Britain of privately rented housing; and similarly it ignores the complex web of historical circumstances behind its decline — attributing the decline to the single causal factor of rent control. Thirdly, it is suggested that a market solution is sociologically misconceived because it ignores the characteristics and needs of those social groups dependent upon this sector. Finally, on grounds of practicability it is proposed that a free market in rented housing may be quite inappropriate for the rump of housing stock remaining in the private rented sector; and that, given the current social and economic constraints operating in the housing market as a whole, any revival of this sector is unlikely even with enhanced rental inducements.

It is thus concluded that a free market solution is misconceived and would merely serve to impose an ideological straightjacket upon the provision of a basic human need.
Judaism and Social Policy
Authors: Brick Yitzhak
Published: February 2007

The article deals with the connection between Judaism on the one hand and social policy and the development of social services on the other. The article deals with those aspects of Judaism that are specifically related to the foundations of social policy: the nature of interpersonal relationships as well as the relationship between society as an all‐encompassing framework and the individual who is a part of that framework.
Religious belief and social policy: Part I
Authors: Peirce John
Published: February 2007

The nature of religious belief is briefly examined and reference is made to specifically Christian religious belief. The practical expression of this is described as four responses under stereotypical allegorical animals. The difficulties of translating religious belief into practice are alluded to and a plea is entered for a fifth response that distils a number of values from a contemplation of society that will be of relevance to it.
Office of Economic Opportunity: U.S.A.
Authors: Paton C.R.
Published: February 2007

The Office of Economic Opportunity (OEO), was created at the height of Lyndon Johnson's “Great Society” anti‐poverty programmes. It represented a degree of radical activism that reached its culmination in the 89th Congress (1965‐66) and indeed has never been repeated: that Congress was perhaps the only genuinely left‐liberal one this century (outside the New Deal era, at any rate).

The OEO's social policies were tied to a particular theory of public and social administration: that a “rival” federal agency to the existing ones (Health, Education and Welfare, now Health and Human Services; Housing, and Urban Development, et al) could escape their conservative norms. Both at the federal level and in the “field” agencies it spanned to implement its programmes, the new approach to social administration was to by‐pass traditional channels.

This short, illustrative rather than definitive article, examines how such an approach was undermined by both the U.S. political structure and by traditional “politics as usual”. It is but a snapshot of the era. However, it hints at the general problems that such approaches to “by‐passing” traditional agencies and attempting to develop a new autonomy in social reform may have in many countries, especially those with decentralized political structures. For, while decentralized politics provides opportunities as well as barriers to reformers seeking to by‐pass traditional elites (which themselves tend to be decentralized, mirroring political structures), it is suggested here that the balance sheet will tend to be negative from the viewpoint of reformist social administration.
Medical Negligence and Resource Allocation in the NHS
Authors: Bowles Roger , Jones Philip
Published: February 2007

The recent growth in medical malpractice claims and in awards for damages has created concern both amongst doctors and health administrators. Steps which have been taken by the Review Body on Doctors’and Dentists’Remuneration and policy now advocated by the BMA suggest a movement away from the current system of negligence and towards a stricter no‐fault system of liability. Under the current system, medical negligence occurs when doctors have not met the standards of treatment expected by reference to current professional standards. Under a no‐fault system patients would be entitled to compensation for losses which arise from treatment, irrespective of whether negligence had occurred; although the implication is that the amounts of compensation would necessarily be limited. While there are reasons to believe that financial difficulties for doctors and pressures on NHS budgets may be ameliorated by a no‐fault system, there are other criteria against which the current system of negligence should be judged. This article attempts to provide a framework within which a negligence system may be assessed. In particular, attention is drawn to the educative role of a negligence system and to the provision of information which may improve decisions on resource allocation. A critique of the current system of medical negligence in the UK suggests that a package of reforms to improve the system would be better than further movements towards non‐market solutions.
The “Exceptional”United States: First New Nation or Last Welfare State?
Authors: Pierson Christopher
Published: February 2007

The author discusses the American welfare state in the context of Lash and Urry's thesis on ‘disorganized capitalism’. Attention is directed to the claim that the US welfare state has been the laggard of organized capitalism but is becoming the pathbreaker in defining patterns of public welfare provision under an increasingly disorganized capitalism. In this context the US may be “showing the way” to the welfare states of Western Europe. A number of claims about the “exceptional” nature of US development are reviewed and a number of reservations are entered against the “disorganization” thesis as applied to the welfare state. It is suggested that attention should be focussed upon contemporary patterns of welfare state re‐organization rather than dis‐organization.
Caring for mentally disabled people in Scotland
Authors: Titterton Michael
Published: February 2007

Scotland's mental health agencies face a major challenge with the appearance of Caring for People. The arrival of the community care White Paper has coincided with the appearance of renewed concern over hospital inpatient provision and over the perceived lack of progress in the development of community care. This article examines some of the differences which arise from the construction of community care policy in Scotland and some of the evidence available for assessing the present state of care in the community for the younger mentally disabled. It is found that some 630,000 adults under the age of 65 (or 19% of all adults in this age group) are suffering from some form of mental disability, some 22% of whom are in severe need of care. 93% of this group are located in the community. Problems for carers are created by the presence of significant shortfalls in resources and by the balance of care which exists in Scotland.
Support Groups for Mentally Ill People
Authors: Pymn Bridget
Published: February 2007

This paper outlines demand levels for day care for the mentally ill and explores the contribution that support groups can make within the package of care. It outlines costings and results of one particular experimental low cost venture which involved public and voluntary sector cooperation.
Developing Models for Day Services
Authors: Shaw Ian , Williamson Howard , Parry‐Langdon Nina
Published: February 2007

This paper reports an evaluation of a rural activity project for people with learning difficulties. The project is situated in (but not a regular part of) an agriculture college. Both statutory and voluntary interests are represented in the management of the scheme, which is funded by the All Wales Strategy for the Mentally Handicapped through the local authority.

Despite the widespread presence of ideas about normalization and carer participation, key stakeholders in the project appeared to draw on various aspects of three different models in describing, assessing and participating in the work of the scheme: a training for work model, a personal and social growth model, and an education for life model.

We explore the question of whether such contrasting views can be tolerated in a single project, and their implications for policy and practice decisions. Each model has its distinctive consequences for project aims, selection, programme planning, staffing requirements, future development objectives and desirable project outcomes. The debate has implications for the way in which policies of normalization are operationalized in and beyond the field of learning difficulties.
Collective Decision‐Making: the Analytic Hierarchy Process
Authors: Rabinowitz Jonathan
Published: February 2007

Analytic Hierarchy Process (AHP) is a method to improve decision making whose application here is to complex environments. “A.H.P.” involves structuring a decision into a hierarchy, determining relative priorities for the elements in the hierarchy, and combining the numbers into overall weights estimating each decision outcome. The need for decision aids such as AHP, is supported by the literature, which suggests that even experts can contend with only limited amounts of information and tend to arrive at decisions in a simple fashion. AHP allows for using more information to make decisions in more complex ways. This leads to more coherent decisions. In the case presented AHP helped a committee make resource allocation decisions in an urban renewal project in Israel. The example highlights the usefulness of AHP in group settings. Areas of disagreement were easily identified and discussed. This diffused much of the tension typical of these proceedings.
Needs as Claims
Authors: Spicker Paul
Published: February 2007

People “need” things if they will suffer negative effects without them. Needs are based in problems, but they are not only problems; they have to be understood in terms of a relationship between functional problems and resources. Needs are a form of claim made against services.

The concept of “need” is not decisive in the allocation of resources, and this paper argues that the concept has to be understood as a form of claim‐language. Once needs are understood in terms of claims, many of the apparent difficulties in conceptualizing the issues dissolve; the main conflicts are between different types of claims, rather than contested definitions of need. Similarly, the establishment of priorities between greater and lesser needs depends on the strength of the claim which the needs present, and the context in which services operate, rather than on intrinsic comparisons between different levels of need.

It follows that need is often not the sole, or even the primary, determinant of the legitimacy of a claim. Greater needs only have priority over lesser ones if they also constitute a claim of a different, and stronger, kind.
The Criminal Justice System and the Politics of Scrutiny
Authors: Spencer Jon
Published: February 2007

The criminal justice system remains largely untouched by over a decade of scrutiny and restructuring of public services by consecutive Conservative administrations. This is despite the system's lack of accountability, absence of clear objectives, prolific unfettered spending patterns, and discrepancies in its treatment of suspects and offenders at all stages of the prosecution process as witnessed by regular and embarrassing “mishaps”.

This paper explains the apparent contradictions in the New Right's social policy agenda showing how the overtly Thatcheritepolicies of “law and order” with its own brand of moral authoritarianism continues to immunize and protect the professional players on the criminal justice stage from the policies of scrutiny and consequent change. Ironically, it is argued, criminal justice and penal policy is one area of social policy where the machinery of appraisal, audit and management by objectives would be highly beneficial.

Paul Wilding provided stimulating and helpful comments on the first draft of this paper and Howard Parker helped me to keep the contradictions of the system as the theme of the paper.
Implications of Subsidiarity for the Care of Older People in Germany
Authors: Tester Susan
Published: February 2007

This paper examines definitions and origins of the principle of subsidiarity and its application to welfare systems of the Federal Republic of Germany (FRG) with particular reference to the care of older people. The German corporatist welfare system is influenced by conservative views about status relations and Catholic teachings on family responsibilities. Since unification of Germany in 1990 new care systems based on the principle of subsidiarity have been imposed in eastern Germany. The FRG's social insurance system based on entitlement benefits those fully employed, while women and marginalized groups with low status in the labour market are poorly covered by insurance and may have to rely on stigmatizing means‐tested social welfare based on subsidiarity. Access to pluralist, fragmented care services depends on eligibility for funding through insurance or social welfare or else on ability to pay. Social care is poorly developed because of the emphasis on insurance and the medical model as well as on the principles of subsidiarity and self help which place an explicit duty on the family, mainly women, to care.
The Burden of Risk: Who Dies Because of Cars?
Authors: Erskine Angus
Published: February 2007

This article argues that those interested in social policy should by definition be interested in issues of transport policy. It analyses data on road traffic fatalities and suggests, in the light of this evidence, that those who benefit least from the motor vehicle seem disproportionately likely, given their relative exposure to the risk, to die in road traffic accidents.
COMPUTER IDENTIFICATION AND MEASURMENT OF CARDIAC CYCLIC ACITVITY
Authors: Welford Norman T. , Lacey Beatrice C. , Peckham Cyril
Published: February 2007

Heart rate was recorded on a SETAR (Serial Event Timer and Recorder) This gave a digital reading on punched paper tape for each R‐R interval. A computer program for the analysis of cyclic cardiac activity, which identifies the troughs and peaks in a series of heart beats, is described. These readings are cast into frequency distributions, as are differences between successive troughs and peaks, both in terms of amplitude and elapsed time.
AN INVESTIGATION OF THE VARIABILITY IN REPEATED IN PSYCHOPHYSIOLOGICAL MEASUREMENTS IN TRANQUILIZED MENTAL PATIENTS
Authors: Acker Charles W.
Published: February 2007

This study was undertaken to determine those changes which take place in a number of psychophysiological measures as a function of time and repetition of experimental sessions.

Eight male chronic schizophrenic patients served as subjects. They were seen twice weekly for a total of 12 30‐min sessions, during which continuous polygraph recordings and blood pressures at 3‐min intervals were obtained. Variables analyzed for this study were blood pressure, heart and respiration rates, skin conductance, finger pulse volume, and muscle tension. The data were treated by analysis of variance for between‐session (days) and within‐session (intervals) effects.

The hypothesis of decreasing activation was sustained only for heart rate. No other variable showed systematic changes associated with successive test sessions.

Auxiliary data suggests that the variables which reflect adaptation effects depend upon the laboratory, subject population, and frequency of measurement. It is concluded that except for the particular variable which shows a session‐to‐session adaptation effect, individual variability and measurement error remain as the major sources of test‐retest unreliability in the variables and population studied.
AN INSTRUMENT FOR SIGNALING HEART RATE TO I NRESTRAINED HUM AN SUBJECIS
Authors: Brown Clinton C. , Thorne Philip R.
Published: February 2007

The circuit described represents a relatively simple and economical solution to the problem of presenting to the human S his heart rate data in the form of an auditory signal. The requirements of portability, low cost, and long‐term unattended operation have been met. In addition, portions of the circuit have additional uses in the general area of psychophysiological instrumentation.
ON THE SCORING OF HEART RATE: REPLY TO CRITICISMS
Authors: Galbrecht Charles R. , Dykman Roscoe A.
Published: February 2007

Lang and Hnatiow, who derived a measure of heart rate (HR) response different from that employed by Dykman, Reese, Galbrecht, and Thomasson, reported better evidence of HR adaptation to serially presented tones than did Dykman et al. The former authors found no habituation when Dykman's procedure for scoring HR responses was applied to their data. When Dykman's HR records were rescored by Lang's method, both measures yielded adaptation curves.

McDonald, Johnson, and Hord, who employed a measure of HR response similar to that of Lang and Hnatiow, noted that alert Ss adapted in HR, while drowsy (by electroencephalogram (EEG) activity) Ss failed to adapt. They said that HR adaptation results of Dykman et al. may have been influenced by inadequate control for arousal level of Ss. However, the most drowsy Ss (judged by behavioral notes) in Dykman's study provided good evidence of HR adaptation by both McDonald's and Dykman's measures.

These discrepancies in results are believed to depend mainly upon differences in experimental procedures rather than upon methods of scoring or arousal level.
PHYSIOLOGICAL CONCOMITANTS OF PSYCHOLOGICAL DIFFERENTIATION
Authors: Courter R.J. , Wattenomaker R.A. , Ax A. F.
Published: February 2007

Thirty‐two male college students who scored above 50 (standard score) on the Closure Flexibility (CF) test were designated field independent (FI), and eight who scored below 50 were designated field dependent (FD). It was found that FI subjects were able to discriminate between the conditioned tone (CS) and the un‐reinforced generalization tones by the amplitude of their GSR significantly better (p < 0.01) than were FD persons. Although it cannot be asserted with certainty that this relationship is dependent on the autonomic response system, there is tentative support for this position. It seems probable that even the FD subjects could distinguish between the two most different pitched tones; yet they failed to make this distinction by their GSR responses. This lack of differentiation by the FD subject appears to be a function of a less well‐differentiated autonomic nervous system. This study demonstrates that the stimulus generalization gradient involves an interaction between the cognitive style of the organism and the impinging stimuli, not merely the quantitative physical characteristics of the stimuli.
A RE‐ANALYSIS OF GSR CONDITIONING
Authors: Mcdonald David G. , Johnson Laverne C.
Published: February 2007

Lockhart and Grings (1963) have suggested that a previous analysis of galvanic skin response (GSR) conditioning by Stewart, Stern, Winokur, and Fredman (1961) failed to establish its major point since it neglected to include a pseudoconditioning control for sensitization effects. In the present paper an experiment is reported in which this control was included, and it was found that the initial report of Stewart et al. was supported. That is, there was significant evidence of a conditional anticipatory GSR which was not due to sensitization effects.
THE B/GSR MODULE: A COMBINED RECORDING TO PRESENT BASE SKIN RESISTANCE AND GALVANIC SKIN REFLEX ACTIVITY PATTERNS
Authors: Simons David G. , Perez Robert E.
Published: February 2007

A base skin resistance galvanic skin reflex (B/GSR) module combined BSR and GSR activity into a 1‐channel recording. Three identical modules were used to record 3 sites simultaneously on a series of normal subjects. Electrode sites included bilateral palmar locations and a location just beneath the medial malleolus. The GSR amplification factor was a fixed value of 3.0. The units provided a generally satisfactory combined record of BSR and reflex activity. The BSR and GSR patterns observed simultaneously from 3 sites consistently showed very similar changes. Four distinct B/GSR activity patterns were identified.
NEURAL TIMING MECHANISMS, CONDITIONING, AND THE CS‐UCS INTERVAL
Authors: Prescott James W.
Published: February 2007

The history of GSR Classical conditioning studies on the optimal CS‐UCS interval has been evaluated in the context of the phenomena of internal inhibition of delay HD, an effect of delayed reinforcement. It was concluded from this review that nearly all GSR studies concerned with this theoretical issue lack validity since responses to stimulus onset orienting and unconditioned responses and not delayed conditioned responses have been the subject of measurement. The existence of an “optimal” CS‐UCS interval is questionable, however, and appropriate experimental methodology is suggested for the solution of this problem.

The role of temporal processes in classical conditioning has been emphasized and the concept of “precision” in neural timing mechanisms mediating delayed CRs has been advanced. It is suggested that the neural temporal properties of the conditioning process have greater heuristic value than the intensity properties of the conditioned response.
SURVEY OF PRACTICE IN ELECTRODERMAL MEASUREMENT
Authors: Tursky Bernard , O'Connell Donald N.
Published: February 2007

This paper is a report on the results of a survey on electrodermal recording procedures. A detailed questionnaire was sent to more than two hundred members of the Psychophysiological Society. The results indicate a wide disagreement among investigators in most phases of the recording process. This indicates a lack of standardization in one of the most used of physiological measures.
THE EFFECTS OF THREAT OF SHOCK ON HEART RATE FOR SUBJECTS WHO DIFFER IN MANIFEST ANXIETY AND FEAR OF SHOCK
Authors: Hodges W. F. , Spielberger C. D.
Published: February 2007

Although there is growing consensus that psychophysiological response to stress is in part a function of the Ss’ definition of the situation, many investigators continue to ignore individual differences in Ss’ interpretation of stressor situations. In this study, high (HA) and low (LA) anxiety Ss were run in Threat of Shock and No Threat Conditions. The Threat Condition produced a significant mean increase in heart rate (HR) as compared to the No Threat Condition, but there was no difference in the HR response of HA and LA Ss to threat of shock. However, Ss who reported moderate to extreme fear of shock two months prior to the experiment responded with greater HR acceleration than Ss who reported little or no fear. These findings were discussed in terms of a conceptualization of “anxiety” which distinguishes between anxiety as a transitory state of the organism and as a relatively permanent personality trait. It was concluded that Ss’“cognitive appraisal” of an experimental situation was an important determinant of psychophysiological responses to stress.