bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetics of alcuronium in children with acyanotic and cyanotic cardiac disease undergoing cardiopulmonary bypass surgery
Authors: WEEKES L.M. , KENEALLY J.P. , GOONETILLEKE P.H. , RAMZAN I.M.
Published: February 2007

The aim of this study was to determine the pharmacokinetic parameters for alcuronium in children with cyanotic or acyanotic congenital cardiac disease undergoing cardiopulmonary bypass surgery and to compare these parameters with previously reported values in children and adults with normal cardiac function. Seven children with acyanotic disease and seven with cyanotic disease were studied. Alcuronium (base) was administered in an initial dosage of 0.25 mg·kg−1 with additional doses as needed to maintain paralysis. Using time averaged data, cyanotic children had lower mean clearance, elimination half‐life and volume of distribution at steady state than the acyanotic children; none of these differences was, however, statistically significant. In this study, children with acyanotic and cyanotic cardiac disease undergoing bypass, had a diminished clearance (P < 0.05) and a smaller volume of distribution (P < 0.05) than normal children and a shorter elimination half‐life (P < 0.05) than adults. Onset of cardiopulmonary bypass caused an immediate marked decrease in alcuronium plasma concentrations which remained low in the acyanotic children at the completion of bypass.
Intraoperative hyperthermia in a paediatric patient with cystinosis
Authors: PURDAY JONATHAN P. , MONTGOMERY CAROLYNE J. , BLACKSTOCK DEREK
Published: February 2007

Cystinosis is a rare autosomal recessive inherited disorder of amino acid metabolism. Little is known of the affects of general anaesthesia on the disease (Tobias 1993) and complications relating to anaesthesia have not been previously reported. Infantile cystinosis presents as progressive renal failure and the Fanconi syndrome and metabolic bone disease often develop. We describe the case of a child who presented with signs of apparent malignant hyperthermia (MH) under general anaesthesia and was treated with dantrolene. During a repeat ‘trigger‐free’ general anaesthetic he developed a fever which responded to paracetamol. The metabolic effects of cystinosis and its similarity to MH will be discussed.
Compartment syndrome in a child occurring after femoral artery cannulation
Authors: SELBY IAN R. , DAROWSKI MARK J.
Published: February 2007

Compartment syndromes have not been reported in association with femoral artery cannulation for invasive blood pressure monitoring in children. We report a case that presented atypically in a child admitted in extremis due to small bowel obstruction and who had a 20 G femoral arterial cannula sited during resuscitation. The compartment syndrome was diagnosed after repeated measurements of compartment pressures.
A comparison of 4.5% human albumin solution and Haemaccel in neonates undergoing major surgery
Authors: STODDART P.A. , RICH P. , SURY M.R.J.
Published: February 2007

In a randomized blinded study we compared two colloid solutions in 30 neonates undergoing major surgery. Fifteen neonates received 4.5% Human albumin solution (HAS) (mean volume 25.6 ml·kg−1, SD 9.5) and the others received Haemaccel (Hoechst) (24.9 ml·kg−1, SD 10). Pre and postoperative plasma albumin and haemoglobin concentrations and plasma colloid osmotic pressures (COP) were compared. In the group given Haemaccel there was an appreciable and statistically significant decrease in the mean plasma albumin concentration from 34.27 to 28.27 g·l−1 (mean difference 6, CI 3.38 to 8.62) and the mean COP decreased significantly from 22.2 to 19.9 mmHg (mean difference 2.3, CI 0.3 to 4.5). In the HAS group there was no significant change in either the plasma albumin concentration or COP. There was a small but significant decrease in the mean haemoglobin concentration from 15.92 to 14.35 g·dl−1 (mean difference 1.56, CI 0.57 to 2.55) after HAS. We conclude that HAS is the superior colloid for volume replacement in neonates undergoing surgery.
Regional variations in skin perfusion and skin thickness may contribute to varying efficacy of topical, local anaesthetics in neonates
Authors: LARSSON BJÖRN A. , NORMAN MIKAEL , BJERRING PETER , EGEKVIST HENRIK , LAGERCRANTZ HUGO , OLSSON GUNNAR L.
Published: February 2007

The national Swedish screening programme for inborn errors of metabolism includes blood sampling from all neonates. Heel lancing has hitherto been the method of choice for these screening tests. Studies have recently been done to find out whether the use of EMLA can alleviate pain caused by heel lancing. EMLA had little, if any (1, 2) effect when applied to the heel of full term babies. Similar results were reported concerning preterm infants (3, 4). Other authors have found that differences in skin thickness or in skin blood perfusion may influence the effect of EMLA (5, 6). The aim of this study was to establish whether differences in skin thickness or in skin blood perfusion were present in three regions: the forehead, the dorsum of the hand and the heel. Ten healthy full term neonates were included in the study on skin perfusion. Measurements were made with a laser Doppler flux meter. Twenty‐seven healthy full term neonates were included for measurements of skin thickness using a high frequency B‐mode ultrasonic meter. The heel skin perfusion was two to three times higher than the skin perfusion at the dorsum of the hand and at the forehead but there was no significant difference when comparing skin thickness of the heel with the dorsum of the hand and the forehead. A rapid clearance of a topically applied local anaesthetic, due to high cutaneous blood flow, may explain why EMLA seems to be of little value when it is applied to the neonatal heel.
Behavioural changes and children's memories after intravenous, inhalation and rectal induction of anaesthesia
Authors: KOTINIEMI LEENA H. , RYHÄNEN PAULI T.
Published: February 2007

Ninety two‐to‐seven‐year‐old children admitted for routine day case ENT operations were randomly allocated to have either intravenous thiopentone (group I), halothane inhalation (group II) or rectal methohexitone (group III) for anaesthesia induction. Using a postoperative questionnaire, the parents evaluated the changes in the child's behaviour one day, one week and one month after the operation. Problematic changes were detected in 17 (59%) children in group I, 14 (50%) in group II and 17 (58%) in group III (NS). Although the children in group II behaved most calmly during the induction they had significantly more negative memories of the induction of anaesthesia (six children in group II vs two in group I and one in group III) and of the hospital in general (17 in group II vs 11 in group I and eight in group III) than children in the other groups. Judging from memories of young children, intravenous and rectal inductions are less distressing to them than inhalational induction.
Craniodiaphyseal dysplasia; another cause of difficult intubation
Authors: APPLEBY J.N. , BINGHAM R.M.
Published: February 2007

A nine‐year‐old boy with craniodiaphyseal dysplasia (CDD) presented for mandibular reduction. Patients with CDD present problems to the anaesthetist, specifically difficulties with airway management and tracheal intubation. This child was managed using laryngeal mask airway (LMA) guided fibreoptic intubation. Spontaneous respiration was maintained throughout intubation, following which ventilation was controlled and anaesthesia was provided using nitrous oxide, isoflurane and fentanyl. The perioperative management is described.
The incidence of minor sequelae following anaesthesia in children
Authors: SELBY I.R. , RIGG J.D. , FARAGHER B. , MORGAN R.J. , WATT T.C. , MORRIS P.
Published: February 2007

A survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight‐month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).
Influence of acute alcohol ingestion on the hormonal responses to modest hypoglycaemia in patients with Type 1 diabetes
Authors: Kerr D. , Cheyne E. , Thomas P. , Sherwin R.
Published: February 2007

Aims  To determine whether mild alcohol intoxication (45–50 mg/dl) influences counterregulatory hormone responses to moderate hypoglycaemia (2.8 mmol/l) in patients with Type 1 diabetes.

Methods  Seventeen subjects (14 male, age range 21–46 years) with Type 1 diabetes underwent four hyperinsulinaemic glucose clamps: euglycaemia with placebo; euglycaemia with alcohol (0.4 g/kg); hypoglycaemia (2.8 mmol/l for 65 min) with placebo; and hypoglycaemia (2.8 mmol/l for 65 min) with alcohol (0.4 g/kg). Arterialized venous blood samples were taken for measurement of insulin and counterregulatory hormones.

Results  During hypoglycaemia, peak growth hormone concentrations were significantly lower after alcohol compared with placebo (14.3 ± 2.9 vs. 25.9 ± 3.4 µg/l, P < 0.001) associated with reduced insulin sensitivity in both hypoglycaemia and euglycaemia studies.

Conclusions  We found an attenuated growth hormone response to hypoglycaemia associated with mild alcohol intoxication. Although this may potentially contribute to impaired recovery of glucose after hypoglycaemia in patients with Type 1 diabetes, it appears to be offset by a reduction in insulin action.
Common polymorphisms of the PAI1 gene do not play a major role in the development of diabetic nephropathy in Type 1 diabetes
Authors: Martin R. J. L. , Savage D. A. , Patterson C. C. , Brady H. R. , Maxwell A. P.
Published: February 2007

Aim  Plasminogen activator inhibitor 1 (PAI1) plays a key role in the regulation of extracellular matrix (ECM) degradation. The PAI1 gene is therefore an excellent candidate gene for diabetic nephropathy. The aim of this study was to employ gene resequencing to identify common DNA polymorphisms in the PAI1 gene, and subsequently assess haplotype tagged single nucleotide polymorphisms (htSNPs) using a case control design.

Methods  All nine exons, exon–intron boundaries, introns 1, 4 and 7 and approximately 3 kb upstream and 5 kb downstream of the PAI1 gene were screened for DNA polymorphisms in 15 case and 15 control subjects using WAVE® denaturing high‐performance liquid chromatography technology and confirmed by DNA sequencing. Polymorphisms were genotyped in 86 healthy individuals using direct sequencing and haplotype tagged single nucleotide polymorphisms (htSNPs) identified. Genotyping of the htSNPs was performed in 583 Type 1 diabetic patients (222 with nephropathy, 361 without nephropathy) using Pyrosequencing.

Results  Twenty‐one polymorphisms with a minor allele frequency (MAF) > 1% were identified; 14 had a MAF ≥ 10%. Five htSNPs [c.‐1968_69insG, c.43 G→A (Ala15Thr), c.1092‐105 A→G, c.*1737 G→A, c.*3711 C→T] were identified. Haplotype frequencies were similar in case and control groups (likelihood ratio χ2 test, P = 0.66).

Conclusion  It is unlikely that common polymorphisms of the PAI1 gene strongly influence susceptibility to diabetic nephropathy in the White Type 1 diabetic population.
INTERNATIONAL TAX COMPETITION AND DOUBLE TAXATION
Authors: Ida Tomoya
Published: February 2007

This paper examines international tax competition, with respect to both corporate income tax rates and tax rules for double taxation. Unlike existing studies, this study assumes that governments set non‐discriminatory tax rates on domestic‐ and foreign‐sourced corporate income and can choose no tax allowance as the tax rule. Consequently, the Nash equilibrium outcomes contradict the intuition underlying previous studies: no tax allowance is chosen as the tax rule where world economic welfare can be maximized. A capital‐exporting country gains whereas a capital‐importing country loses, compared to the case where there is a tax allowance of any kind.
On Confounding, Prediction and Efficiency in the Analysis of Longitudinal and Cross‐sectional Clustered Data
Authors: VANSTEELANDT STIJN
Published: February 2007

Abstract. In the analysis of clustered and/or longitudinal data, it is usually desirable to ignore covariate information for other cluster members as well as future covariate information when predicting outcome for a given subject at a given time. This can be accomplished through con‐ditional mean models which merely condition on the considered subject's covariate history at each time.Pepe & Anderson (Commun. Stat. Simul. Comput. 23, 1994, 939) have shown that ordinary generalized estimating equations may yield biased estimates for the parameters in such models, but that valid inferences can be guaranteed by using a diagonal working covariance matrix in the equations. In this paper, we provide insight into the nature of this problem by uncovering substantive data‐generating mechanisms under which such biases will result. We then propose a class of asymptotically unbiased estimators for the parameters indexing the suggested conditional mean models. In addition, we provide a representation for the efficient estimator in our class, which attains the semi‐parametric efficiency bound under the model, along with an efficient algorithm for calculating it. This algorithm is easy to apply and may realize major efficiency improvements as demonstrated through simulation studies. The results suggest ways to improve the efficiency of inverse‐probability‐of‐treatment estimators which adjust for time‐varying confounding, and are used to estimate the effect of discontinuing highly active anti‐retroviral therapy (HAART) on viral load in HIV‐infected patients.
Writing the history of welfare
Authors: Gladstone D. E.
Published: February 2007

Social Reform in England 1780–1880 By JOHN ROACH.

Before the Welfare State: Social Administration in early industrial Britain By URSULA HENRIQUES.
The Role of Social Marketing in Influencing Consumer Behaviour
Authors: Scrivens Ellie
Published: February 2007

Commercial marketers have turned their attention to the social welfare sector and are considering ways in which marketing techniques can be used to promote service use, improvements in life‐style, and changing public attitudes. This paper examines the concept of what is termed “social marketing”, and looks at the difficulties it faces, and finally discusses the need for social policy analysts to become more aware of the uses of and the issues relating to the increased use of social marketing by governments.
Management and the Health District
Authors: Beesley M. E.
Published: February 2007

This article is by a member of a district health authority in the London Area, and is stimulated by Haywood's paper in our last issue. It examines the most recent developments in health service management in implementation of the Griffiths Report.
Unemployment and Labour Market Policies: Some Lessons from West Germany
Authors: Hallett Graham
Published: February 2007

The author points out that West Germany has had low inflation, high industrial efficiency, and good vocational training, but has not escaped rising levels of unemployment. After an analysis of employment trends in Germany since 1945 there is a review of varying government policies in public expenditure and in dealing with unemployment. The author relates demographic trends to employment patterns, and refers to such phenomena as the “dormant labour force”, concluding that unemployment will remain high. He reviews the effects of social security benefits and of job creation schemes. He concludes that none of the well‐known remedies for unemployment have proved effective in themselves but that short‐term job creation schemes are very much a “second‐best”. He concludes that industrial efficiency — though essential — is not enough in itself and that conquering inflation or providing youth training are shown by the German example to be only a partial help and not a solution to improving employment prospects.
The Council on Tribunals
Authors: Sayers Michael
Published: February 2007

The origins of the Council and its remit are examined starting with the Franks Committee Report in 1957. The Council's monitoring of the work of tribunals has insured their greater efficiency and more effective use by aggrieved citizens. The growth of tribunals and increase of the number of cases heard by them means that the Council has an expanded role and one essential to safeguard the interests of aggrieved citizens.
Women and Underachievement at Work: A Study of the Internal Labour Market of the Civil Service
Authors: Bagilole Barbara
Published: February 2007

This article describes some of the major results of a study1 which examines the complex problem of women's underachievement in paid work. Through an investigation of female clerical staff and their experience of one major Civil Service department, an analysis is made of the internal organization and processes and their effect on women's promotion success. The conclusion is that the internal labour market of the Civil Service is structured to men's conventional employment patterns and both formal and informal factors combine to keep the majority of women at a disadvantage in paid work. The very few women who do achieve have to accept and adopt conventionally male characteristics in both their work situation and their family life.
Leisure Policy in France and the Reduction of Social Inequalities
Authors: Hantrais Linda
Published: February 2007

In contemporary French society, despite extensive government intervention over the past half centuv, differential access to free time and to leisure facilities, together with differences in attitudes towards participation in cultural activities, remain good indicators of the social inequalities associated with gender, age, educational training, socio‐occupational status and regional origins. Thejndings from recent government‐sponsored national surueys and from other smaller scale empirical research highlight some of the most salient cultural inequalities persisting in leisure behaviour in France today. The evidence suggests that gender deferences, while still acting as one of the main discriminators in leisure behaviour, are most meaningful when considered in relation to age, correlated in turn with the level of educational attainment, family circumstances and socio‐occupational status. A survey of the leisure policies pursued ly successive French governments in the post‐war period demonstrates how the state has intervened increasingly with the overt objective of reducing social inequalities and breaking down the traditional cultural and economic barriers affecting access to leisure.
Yugoslav Social Policy
Authors: Milosavljević Milosav
Published: February 2007

Yugoslavia provides an interesting example of a decentralized system of policy‐making which implies the abolition of the state's main role in economic and social affairs. Self‐management is the basic principle of the socio‐political system in Yugoslavia. It involves all levels, processes and fields of social relationships from working organizations (enterprises) and local communities to the communes, republics and Federation. The implications of this system of socio‐political organization for social policy and provision are examined.
The “Three Worlds” of Human Services
Authors: Sugarman Barry
Published: February 2007

The “three worlds” referred to in this article are the three environments in which human services are delivered: the public, private non‐profit, and private for‐profit sectors. This article analyses the situation of human services in the USA, while suggesting that the arrival of privatization in other western industrial societies makes it relevant there too.

After defining each of the three environments, an attempt is made to generalize about broad differences in management behaviour that tend to result from the different kinds of pressures inherent in each of the three worlds. Relationships between the three worlds are discussed, with special reference to the field of alcoholism treatment services.
The Why Work? Syndrome
Authors: Mansfield Malcolm
Published: February 2007

This article is an examination of the relationship between the level of welfare benefits and the motivation to work in modern capitalism. The idea that capitalism cannot produce the industrial discipline it requires given welfare benefits above “subsistence” is shown to be untrue. Non‐pecuniary inducements to work centred on the Job Centre can replace low‐level benefits but only under strictly‐defined conditions. The article goes on to examine what happens when Job Centres do not fulfil their disciplinary role.
Patients First — Reality or Rhetoric?
Authors: Williamson Valerie
Published: February 2007

This paper will argue that the NHS, despite its aspirations to provide a universal service of excellence, has not been historically very responsive to the consumers it serves. Under the present Government this attitude has ostensibly changed. “Patients First” has become a catch phrase both nationally and at the local level in Brighton Health District. A recent CHC survey of consumers' rections to service revealed however that many elderly patients were not consulted in any meaningful way about their needs on discharge from hospital. Why does the reality of consumerism not match the rhetoric? A number of potentially explanatory factors are identified and their relevance evaluated in the context of Brighton CHC's research. It is suggested that the currently fashionable consumerism represents a different concept from active participation which would necessarily involve a fundamental realignment of the NHS.
Transition Shock and the Relocation of People from Mental Handicap Hospitals and Hostels
Authors: Booth Tim , Simons Ken , Booth Wendy
Published: February 2007

The process of deinstitutionalisation has been gathering momentum in Britain and the United States since the mid‐1970s. A discussion of these trends provides the background to an examination of “transition shock” as it affects people relocated from mental handicap institutions. The paper explores the theoretical underpinnings of the concept of transition shock and links them to the findings of a follow‐up study of the behavioural consequences of relocation.
Destinations of Social Administration Graduates
Authors: Leaper R. A. B.
Published: February 2007

Recently emphasis has been laid on the demands which the changing needs of society place on university studies. An examination of the relevance of Social Policy and Administration studies to employment demands is timely. This article is based on an examination of data obtained from the Universities Statistical Records, on the results of a survey of responses from graduates at Exeter University from 1972 to 1986, and on two recently published reviews of S.P.A. in universities. The appeal of courses to applicants, personal career motivations, field work experience and the structure of the courses are in turn examined for their influence on ultimate employment destinations. Discontinuities of classification in the available statistics of university courses make comparisons over time problematic. In general first degrees in S.P.A. are shown to have wide employment acceptability, a declining relationship with immediate employment in social work, a high level of adaptability to the needs of an economy affected by technological change, and a good educational basis for specialised post‐graduate professional qualifications.
Defining Community Care: realities and myths
Authors: Higgins Joan
Published: February 2007

This article looks critically at the concept of community care and argues that it is unhelpful and redundant. It makes three main points: first, that many care settings have elements of institutional and so‐called community care and that there is no clear dichotomy between the two. Second, it is argued that the real distinction is not between the institution and the community but is between the institution and home. Community care is not provided by anonymous, altruistic others but comes from specific individuals (usually women) in domiciliary settings. The concept and definition of “home” are briefly discussed and it is suggested that most care is delivered either in a home, from home or at home. The third argument is that careful individual assessment is required to ensure that dependent people are not offered housing or residential solutions when what they need (and want) is care and services.
What Can We Afford For the National Health Service?
Authors: Pritchard Colin
Published: February 2007

The annual Gross Domestic Product (GDP) is here used as astandardmeasure against which to compare expenditure on Health & Welfare and Defence budgets, between Conservative and Labour governments and the four largest EC countries 1973/4‐1993/4.

An analysis of Mrs Thatcher's governments’ expenditure shows that proportionately less GDP went to General Government Expenditure (GGE) than all the other European Community countries. Mrs Thatcher's first government maintained the unprecedented level of GDP devoted to Health reached in 1978/79, but successive administrations began to reduce, and, plan further reductions of GDP for the NHS. Relative decreases of GDP were also found in relation to expenditure on Social Security, Housing, and Personal Social Services and Defence.

The governments of France, Germany and Italy provided more of their GDP to health than Britain, whilst at the same time we spent more on Defence and Law & Order & Public Safety. This raises the question: what can we afford for the NHS?

A review of demographic changes shows that the British infant and elderly population, who are associated with demands for health, were proportionately more numerous than in France, Germany and Italy. This suggests the need for more UK health expenditure if Britain is to meet current and future needs.
Social Policy and European Union
Authors: Weale Albert
Published: February 2007

What social policy developments may be reasonably expected from the European Union? Three possible positions on this question are developed: a market liberal view; a progressive liberal view; and an institutionalist view. None of these positions is obviously the correct one, and in each case a mixture of pragmatic and principled criticisms can be developed. However, it is argued that the progressive liberal position strikes an ethically acceptable balance of competing considerations.
A Disaster Foretold? The Case of the Personal Pension
Authors: Waine Barbara
Published: February 2007

With the creation of the State Earnings Related Pension Scheme (SERPS) in 1975, pensions policy in the UK was characterized by a consensus between the Labour and Conservative parties. By the mid 1980s, under the influence of New Right ideas, the Conservatives had broken with this consensus. Conservative pensions policy now centred on the ideological objectives of promoting individual property ownership and pension provision “independent”of the State. Such objectives were central to the creation of personal pensions under the 1986 Social Security Act. This article examines the political background to the emergence of this policy and seeks to evaluate how far the stated aims have been achieved. It does this by analysing the current controversy over methods of selling personal pensions and by looking at statistical evidence on the incomes of individuals who have taken out personal pensions. The argument concludes that personal pensions have been, predominantly, taken out by groups with low incomes, and the combination of low contributions and transaction costs threatens to lead to inadequate pension provision; such problems are likely to be particularly marked for women. In turn this conclusion, when set in the context of the tax regime applying to personal pensions, raises further doubts over the extent to which “independent”pension provision is likely to be achieved.
The Recognition of Wifely Labour by Welfare States
Authors: Shaver Sheila , Bradshaw Jonathan
Published: February 2007

This article is concerned with questions about the amount of support given by welfare states towards the maintenance of a wife engaged in housework and child care. It compares the value of the support supplied by the tax/benefit packages of 15 countries. The article defines support for wifely labour as the difference between the net disposable income of a single person and a couple with the same earnings. In analysing the data, three models are used: the “traditional” model where the wife is economically dependent on her husband; the “modern” model where the wife remains outside the labour market while she has young children; and the “dual breadwinner” model where the mother of young children is in full‐ or part‐time employment. Much of the analysis is concerned with patterns of social policy in which support for wives is associated with support for children. While the evidence shows that welfare states do provide support to wives, both with and without young children and engaged in paid as well as unpaid work, the levels of support vary greatly between welfare states. The variations are not associated with the generally discussed categorizations of welfare state types.
Money Isn't Everything. Fiscal Policy and Family Policy in the Child Support Act
Authors: Clarke Karen , Craig Gary , Glendinning Caroline
Published: February 2007

One of the explicit aims of the 1991 Child Support Act is to ensure that parents honour their financial obligations towards their natural children to a greater extent than they have hitherto. An equally important underlying objective is that of reducing the costs to the state of supporting lone parents. This paper examines the extent to which these two objectives are compatible within the framework of the Child Support Act through an examination of the impact of the Act's implementation on lone mothers and their children. It presents some of the key findings of a study of lone mothers on means‐tested benefits, interviewed almost one year after the implementation of the Act. The paper concludes that the Act is failing to meet its stated aim of increasing the extent to which parents honour their financial obligations to children, because of an excessively narrow conception of the ways in which financial obligations are met combined with too strong an emphasis on maximizing savings in state expenditure on lone parents. The implementation of the Child Support Act, far from enhancing the welfare of children in lone parent families, has brought with it considerable financial and emotional costs for children and their mothers.
Poverty, Deregulation of the Labour Market and Benefit Fraud
Authors: Evason Eileen , Woods Robert
Published: February 2007

This paper presents the results of a focus groups exercise conducted in Belfast. The research explored the interaction of cuts and adjustments in the benefit system, deregulation of the labour market and increases in rents in the public sector. The results of the research suggest that these policies in combination have had the unanticipated consequence of making working while claiming benefit more attractive, and that the measures announced in the 1994 budget to encourage claimants to take low paid work are unlikely to have any significant effect.
A Taxonomy of the Dimensions of Accreditation Systems
Authors: Scrivens Ellie
Published: February 2007

Unlike those in the USA, Canada and Australia, the UK National Health Service has no single dominant accreditation system. The Department of Health and the NHS Executive commissioned Keele University to study the organization and processes of accreditation and the potential impact of the introduction of a national accreditation system into the NHS. This paper discusses the policy questions involved in the construction of accreditation systems.
A Social‐symbiotic Approach? EU Industrial Policy and the Pharmaceutical Industry in the EU
Authors: Earl‐Slater Alan
Published: February 2007

The purpose of this paper is to develop the debate about a symbiotic approach to industrial policy with respect to the pharmaceutical industry in the EU. The EU has an increasingly important role to play in European markets but it seems, at best, to be following a fragmented industrial strategy. There is a real and growing danger that this strategy becomes worse for everyone than no strategy at all. Thus the EU can either go for a comprehensive and comprehensible strategy or let the industry fend for itself amongst disparate health care systems amongst member states. Alternatively it can continue to stumble along with a pastiche of policies. There are signs of some debate about a more holistic approach to industry. In the European Union for example DG (Directorate General) V and DG III produced a communication arguing that “the [European Union] Community policy in favour of the pharmaceutical industry must take notice of [the] twofold context of public health and social security” (Com(93)718:3).

This paper identifies current fragments of EU pharmaceutical industrial policy and indicates what a social‐symbiotic approach is. Whether or not the industry in the EU continues to decline with respect to the industry elsewhere Asia and America in particular, the sick people of the EU will still need medication: a symbiotic approach to industrial policy can help stem the relative decline in the EU and indeed could reverse it.
The Devils in the Detail: Some Reflections on Contracting for Social Care by Voluntary Organizations
Authors: Deakin Nicholas
Published: February 2007

This paper explores the political origins and the process of introduction of the community care policy in the United Kingdom. The particular concerns of voluntary organizations in the face of the new responsibilities conferred upon them by legislation and their expectations of likely outcomes are examined. Evidence from a recent research study undertaken as part of the ESRC's Contracts and Competition Programme is then employed to draw up a preliminary balance sheet of the actual experience of voluntary bodies, their role in the operation of community care policy and their changing relationships with other agencies and the users of services.
“An Inner Group of Willing People”: Volunteering in a Religious Context
Authors: Harris Margaret
Published: February 2007

In the age of “welfare pluralism”, volunteers are attracting increasing attention from academics and policy‐makers. This paper focuses on volunteering in the context of religious congregations. It is found to be similar in some ways to that in secular organizations but there are also significant differences including the impact of religious values on motivation, the fact that congregational volunteers are also “members”, and the special relationship with clergy. It is concluded that congregational volunteers can be important constituents of the “mixed economy of care”and “civil society”. However, long‐term care may be provided better by institutions which are less dependent on individual enthusiams.
Leading Article: Community Care as an Alternative to State Welfare
Authors: Marsland David
Published: February 2007

This paper challenges prevailing notions of community and community care. It exposes some of the confusions associated with current thinking and offers a more realistic interpretation, drawing upon the roots of the idea of community. By this standard, genuine community care is to be regarded as an alternative to state welfare, which it might serve to replace or complement.
The Role of Housing Managers in the Implementation of Community Care
Authors: Cunningham Rosie , Spencer Sheila
Published: February 2007

This article will outline the response of housing management to the implementation of community care policy in the North East. It will locate housing's role within the broader development of community care policy, and briefly review the reasons for housing's relatively late arrival as a key partner, alongside social services and health, in the planning and delivery of services. Using information gathered from interviews with housing professionals, part‐time housing students, voluntary organizations, and workers within health and social services, it outlines and evaluates five main factors which appear to be affecting the successful integration of housing management into the process of planning and delivering community care services in the North East.
Confidentiality and Media Attention: A Discussion Concerning Denial and Public Education
Authors: Schellenberg Dennis H.
Published: February 2007

The article presents the beginning of a discussion on how the doctrine of confidentiality may have been misapplied in the area of children's protective services. It asks the reader to consider who the client is in these cases and, having answered that question, asks what is the professional responsibility? The whole discussion is linked to the difficulties in dealing with media attention in these cases and offers some experience in the form of case examples.

Woven in to the matrix of the above discussion is a clinical and public educational discussion. Preserving confidentiality in its traditional sense can contribute to a preservation of the family secret, namely, child abuse. In that way, a child protection agency can actually be contributing to the maintenance of abuse patterns in a family. Also, with no capacity to speak professionally about specific abuse, the public education impact is diminished.
Social Protection in Greece: A Brief Glimpse of a Welfare State
Authors: Petmesidou Maria
Published: February 2007

This paper examines the delayed development of the welfare state in Greece and its restructuring since the early 1990s. The emphasis is on factors, such as the rapid shift from pre‐Fordist to post‐Fordist socio‐economic structures, the weak development of contractual relationships and a solidaristic culture, and the extensive reproduction of a statist/clientelist form of social organization strongly linked to a high degree of social fragmentation and a particularistic appropriation of welfare benefits and services, which have hindered the full maturation of social citizenship in Greek society up to now.

An expensive trend of social protection in conjunction with some major law reforms in the early 1980s contributed to the development of a “weak form” of universalism. These trends were soon overturned, however, well before Greek society could develop a welfare state, under the pressure of a serious fiscal crisis, low economic growth, increasing international competition, significant demographic changes and a fragile social consensus.

Thus, the national health care system has hardly succeeded in establishing universal coverage, the social insurance system has remained highly fragmented and dualist, while policy measures for tackling increasing unemployment, hardship and poverty have been rudimentary. These have caused serious deadlocks and a deep institutional crisis. For this crisis to be overcome, it is essential that a new social balance promoting social solidarity is achieved in the country, while a reinvigorated Social Europe can help enormously in this direction.
THE COLLEGE CHASE: HIGHER EDUCATION AND URBAN ENTREPRENEURIALISM IN ISRAEL
Authors: ROSEN GILLAD , RAZIN ERAN
Published: February 2007

Local government initiative to attract colleges, in spite of being formally excluded from the higher education system, is shown to represent urban entrepreneurialism, in which strategies undertaken – reactive or proactive, competition or co‐operation, and means of support – are influenced by location. However, such decentralised forms of local governance do not indicate a diminishing role of the central state, but rather reshape regulation – decisions reflecting greater pluralism, becoming more exposed to external pressures for market‐oriented initiatives in high demand locations, and for publicly supported colleges in less attractive locations. Local entrepreneurialism is particularly influential at the intra‐regional level, but saturation could emphasise the need to move from local entrepreneurialism to competitive regionalism.
‘INFORMATION HINTERLAND’– A BASE FOR FINANCIAL CENTRE DEVELOPMENT: THE CASE OF BEIJING VERSUS SHANGHAI IN CHINA
Authors: WANG DANNY TAN , ZHAO SIMON XIAOBIN , WANG DONGGEN
Published: February 2007

This paper examines the role of ‘information hinterland’ as a determinant to financial agglomeration and financial centre development. The concept is then applied to investigate the potentials of Beijing and Shanghai in becoming financial centres in China. Specifically, the information hinterlands of the two cities are identified in two steps: first, the boundaries of the hinterlands are demarcated on the basis of distance, intensity of transport connection and interactions in terms of migration. Second, the intensity of information from the hinterland is assessed in terms of business information, policy information and the seats of multinational headquarters. Results of the analysis and their implications are discussed.
Christianity and rural community literacy practices in Uganda
Authors: Openjuru George Ladaah , Lyster Elda
Published: February 2007

In this article, we examine how Christianity provides the impetus for local literacy practices in a rural community in Uganda. These Christian literacy practices form a central part of the literacy activities of the community and are manifested in a variety of contexts from public to private, using a wide variety of readily available religious texts in the community. Through examination of Christian literacy practices, the authors suggest that ethnographic research has the potential to generate information that can be used to enhance literacy learning in rural community life.
Failure to thrive? The community literacy strand of the Additive Bilingual Project at an Eastern Cape Community School, South Africa
Authors: Hunt George
Published: February 2007

This paper discusses an attempt to establish community literacy procedures in an Eastern Cape community school. The school hosts the Additive Bilingual Education (ABLE) project, a cooperation between UK and South African universities and the school trust. The community literacy strand of the project encourages family members to contribute oral texts in Xhosa to the school (for example, ntsomi or traditional stories, biographies and procedural texts such as recipes). These are then turned into print and electronic text through shared writing, and act as reading resources through paired reading, a cross‐age peer‐tutoring procedure. This is an attempt to deal with the shortage of reading material in Xhosa, while at the same time enhancing community involvement in the school by producing ‘culturally relevant’ materials. In discussing the problems I encountered in attempting to establish these procedures, I seek to link factors operating at the micro level of school practicalities and community attitudes with those operating at the macro level of national policy and international cooperation.
Physiological Linguistics, and Some Implications Regarding Disciplinary Autonomy and Unification
Authors: EPSTEIN SAMUEL D.
Published: February 2007

Abstract:  Chomsky’s current Biolinguistic (Minimalist) methodology is shown to comport with what might be called ‘established’ aspects of biological method, thereby raising, in the biolinguistic domain, issues concerning biological autonomy from the physical sciences. At least current irreducibility of biology, including biolinguistics, stems in at least some cases from the very nature of what I will claim is physiological, or inter‐organ/inter‐component, macro‐levels of explanation which play a new and central explanatory role in Chomsky’s inter‐componential (interface‐based) explanation of certain (anatomical) properties of the syntactic component of Universal Grammar. Under this new mode of explanation, certain physiological functions of cognitive mental organs are hypothesized, in an attempt to explain aspects of their internal anatomy. Thus, the internal anatomy of the syntactic component exhibits features that enable it to effectively interface with (i.e. function in a coordinated fashion with) other ‘adjacent’ organs, such as the Conceptual‐Intensional (C‐I) (‘meaning’) system and the Sensory‐ Motor (SM) (‘sound’) system. These two interface systems take as their inputs the assembled outputs of the syntactic component and, as a result of the very syntactic structure imposed by the syntax (as opposed to countless imaginable alternatives) are then able to assign their (linearized) sound and (compositional) meaning interpretations. If this is an accurate characterization, Chomsky’s long‐standing postulation of mental organs, and I will argue, the advancement of new hypotheses concerning physiological inter‐organ functions, has attained in current biolinguistic Minimalist method a significant unification with foundational aspects of physiological explanation in other areas of biology.
Probable Migraine in the United States: Results Of The American Migraine Prevalence and Prevention (AMPP) Study
Authors: Silberstein S , Loder E , Diamond S , Reed ML , Bigal ME , Lipton RB
Published: February 2007

Probable migraine (PM) is a prevalent migraine subtype fulfilling all but one criterion for migraine with or without aura. The aims of this study were: (i) to describe the epidemiology, medical recognition and patterns of treatment for PM in the USA; (ii) to compare the patterns of preventive PM treatment in the population with expert panel guidelines for preventive treatment. A validated self-administered headache questionnaire was mailed to a random sample of 120 000 US households. Subjects were classified as PM according to the second edition of the International Classification of Headache Disorders (ICHD-2). The questionnaire also assessed patterns of migraine treatment. Guidelines for preventive medication use were developed by a panel of headache experts, who used headache frequency and impairment to assess the need for preventive therapy and the gap between current and ideal use. Our sample consisted of 162 576 individuals aged ≥12 years. The 1-year period prevalence of PM was 4.5% (3.9% in men and 5.1% in women). In women and men, prevalence was higher in middle life, between the ages of 30 and 59 years. The prevalence of PM was significantly higher in African-Americans than in Whites (female 7.4% vs. 4.8%; male 4.8% vs. 3.7%) and inversely related to household income. During their headaches, most (48.2%) had at least some impairment, while 22.1% were severely disabled. The vast majority (97%) of PM sufferers used acute treatments, although 71% usually treated with over-the-counter medication. Most PM sufferers (52.8%) never used a migraine-preventive treatment and only 7.9% were currently using preventive medication. According to the expert panel guidelines, prevention should be offered (16.9%) or considered (11.5%) for 28.4% of the PM sufferers in the survey. We conclude that PM is a frequent, undertreated, sometimes disabling disorder. It has an epidemiological profile similar to migraine. In contrast to migraine, which is less prevalent in African-Americans than in Whites, PM is more prevalent in African-Americans than in Whites. In the USA, many with PM do not receive adequate treatment.