bluuebunny/crossref_metadata_2025 huggingface dataset:
How Should We Define Value in Cancer Care?
Authors: Ramsey Scott , Schickedanz Adam
Published: March 2010

This paper aims to construct a definition of value in cancer care and to argue for the application of that definition in our evaluation of care for cancer patients.
Therapy for Advanced Stage Cancer: What Do Patients Want and Expect? A Patient Advocate's Perspective
Authors: Erwin Robert L.
Published: March 2010

The author examines how value in cancer care can mean different things at different times during the course of a patient's illness, from providing health and a normal life to providing a good quality of life in the time remaining.
The Role of the U.S. Food and Drug Administration Review Process: Clinical Trial Endpoints in Oncology
Authors: McKee Amy E. , Farrell Ann T. , Pazdur Richard , Woodcock Janet
Published: March 2010

The U.S. Food and Drug Administration grants marketing approval for drug products based on a comprehensive review of safety and efficacy data. The clinical trial endpoints that have been used to support approval in the oncology setting have evolved over the last 30 years commensurate with an improved understanding of the natural history of cancers and the mechanisms of action of drugs. Overall survival is the gold standard for a registration trial designed to gain marketing approval; however, additional endpoints have been used in the approval of oncology drugs. Advantages of specific endpoints are discussed, including the accuracy of an endpoint's measurement and its relation to clinical benefit. Surrogate endpoints may be acceptable for “accelerated” approval, with a sponsor commitment to provide evidence of clinical benefit in a subsequent trial.
Beyond Costs and Benefits: Understanding How Patients Make Health Care Decisions
Authors: Ubel Peter A.
Published: March 2010

Many medical decisions are “preference sensitive,” where the best choice depends on the values a specific patient places on relevant outcomes. For example, a decision may require a patient to make a trade-off between a small increase in chance for survival and a large out-of-pocket expense. In such situations, patients need to understand the costs and benefits of the health care alternative, in order to decide the best course of action. However, findings from decision science research have demonstrated that people's decisions are often influenced not only by their perceptions of these costs and benefits, but also by subtle contextual factors that trigger intuitive and emotional decision processes. In this article, I describe some of these contextual factors, and lay out the challenges these factors raise for clinicians' efforts to help their patients make informed decisions.
Concrete Options and Ideas for Increasing Value in Oncology Care: The View from One Trench
Authors: Smith Thomas J. , Hillner Bruce E.
Published: March 2010

In the U.S., medical oncology as a profession is wrestling with conflicting and often unrealistic clinical and financial expectations. Office-based practitioners face an environment of low reimbursement for cognitive care, high but declining reimbursement for chemotherapy and supportive care, and high income expectations of oncology professionals. As a field, there has been little incentive to assess or improve the quality of cancer care. Current incentives are often misaligned to reward doing the most aggressive and expensive actions, as long as patients are satisfied, because this leads to the highest return to the practice. Some consequences include U.S. cancer treatment costs that are twice that of any other nation with no or minimal differences in survival, late referrals (if at all) to hospice, and 14%–20% of patients receiving chemotherapy within 14 days of their death when it is highly likely to harm and cause complications. This pattern of care may lead to a significant risk for stress and burnout, as well as being economically unsustainable.

Systematic change to reward value requires realignment of incentives to provide episode-based care free from incentives to give expensive chemotherapy or supportive care drugs without good evidence, and an external board to determine appropriate patterns of care. The only ways to reduce the cost of care are to reduce either the amount of care or the cost of care, and either has dramatic consequences in a field that has been built on high expectations. These actions will likely control costs, but in the short term will cause significant distress among patients, families, and health care practitioners.
Of Value: A Discussion of Cost, Communication, and Evidence to Improve Cancer Care
Authors: Schickedanz Adam
Published: March 2010

The U.S. spends far more per person than any other country in the world in treating cancer, without demonstrably superior results. Though the pursuit and pace of innovation in oncology are perhaps unmatched and promise great benefit for cancer patients, this explosion of innovation has been accompanied by dramatic increases in cost, often without significant increases in patient survival. These trends have led to a growing interest in addressing value—understood as treatment benefits or quality weighed against economic cost—in cancer care. In February 2009, the Institute of Medicine convened a group of experts with diverse perspectives, including those of clinical oncology, patient advocacy, the insurance industry, pharmaceutical manufacturing, health economics, and bioethics, to identify challenges to value in cancer care, suggest potential solutions, and discuss what value entails in oncology. This article presents many of the ideas that emerged from this symposium, including ways to correct misaligned economic incentives, improve clinical communication, and generate evidence to promote value in cancer care.
On numerical solver selection and related uncertainty terminology
Authors: Claeys Petra , van Griensven Ann , Benedetti Lorenzo , De Baets Bernard , Vanrolleghem Peter A.
Published: March 2010

Mathematical models provide insight into numerous biological, physical and chemical systems. They can be used in process design, optimisation, control and decision support, as acknowledged in many different fields of scientific research. Mathematical models do not always yield reliable results and uncertainty should be taken into account. At present, it is possible to identify some factors contributing to uncertainty, and the awareness of the necessity of uncertainty assessment is rising. In the fields of Environmental Modelling and Computational Fluid Dynamics, for instance, terminology related to uncertainty exists and is generally accepted. However, the uncertainty due to the choice of the numerical solver and its settings used to compute the solution of the models did not receive much attention in the past. A motivating example on the existence and effect of numerical uncertainty is provided and clearly shows that we can no longer ignore it. This paper introduces a new terminology to support communication about uncertainty caused by numerical solvers, so that scientists become perceptive to it.
The impact of diurnal water use patterns, demand management and rainwater tanks on water supply network design
Authors: Lucas S. A. , Coombes P. J. , Sharma A. K.
Published: March 2010

The traditional use of long-term average consumption records and “peak factors” to determine water network design criteria does not account for allotment-scale diurnal water use patterns which impact upon the dynamics of water distribution systems. The diversity of allotment-scale diurnal water use patterns directly impacts on network dynamics. Demand management and rainwater tanks are likely to impact upon the diurnal patterns of water flows in a water supply network. Results presented in this study suggest that rainwater tanks with mains water trickle top-up produce diurnal “mains water” use patterns different to “household” water use patterns, and when simulated correctly, significantly reduced peak hour “mains water” demand. This outcome impacts upon water supply network design criteria and provided opportunities to offset water infrastructure costs. There is a need to investigate diurnal mains water use patterns resulting from source control measures, such as demand management and rainwater tanks, on peak hour mains water demand in water supply distribution systems and their impact on network design criteria.
Development of a rapid screening method for the detection of pathogenic Escherichia coli using a combination of Colilert® Quanti-Trays/2000 and PCR
Authors: Omar K. B. , Potgieter N. , Barnard T. G.
Published: March 2010

The use of culture based methods for the detection of Escherichia coli (E. coli) only gives information on the occurrence of E. coli and not pathogenicity of the organisms detected. To detect the both indicator and diarrhoeagenic E. coli (DEC) a method was developed using the Colilert® Quanti-Tray/2000 system and polymerase chain reaction (PCR). A total of 619 samples were collected from springs (33), boreholes (24), taps (5), rivers (36), streams (8), domestic storage containers (253), raw sewage (1), final effluents (5), stool (149), soil (5) and toilet seat swab (100) samples from various provinces in South Africa. E. coli was enumerated using the Colilert® Quanti-Tray's/2000 and DNA extracted from E. coli positive wells and used as template for a multiplex-PCR targeting genes specific to entero-pathogenic- (EPEC), entero-haemorrhagic- (EHEC), entero-invasive- (EIEC), entero-toxigenic (ETEC) and entero-aggregative E. coli (EAEC). The internal control was detected in 99% of positive E. coli samples. EAEC was detected in 17%, EIEC in 4%, ETEC in 11%, EHEC in 9% and EPEC in 21% of the E. coli positive samples. It is shown that this method can be used for the detection of DEC from a wide range of samples enriched with Colilert® Quanti-Tray's/2000.
Diffusion and perfusion magnetic resonance imaging in evaluation of primary glial brain tumors
Authors: Stosic-Opincal T.L. , Macvanski M.V. , Gavrilovic S.S. , Gavrilov M.S. , Damjanovic D.S. , Vasic B.D. , Grujicic D.M.
Published: March 2010

Introduction: Diffusion (DWI) and perfusion (PWI) imaging can give important data about physiological characteristics of tissue, which complete morphologic findings from conventional MRI. The aim of this study is to estimate the value of these MRI technics in evaluation of primary glial brain tumors. Materials and methods: The significance of DWI and PWI in differentiation of histologically proven low- and high-grade gliomas was estimated in 48 patient with diagnosed brain gliomas. ADC and rCBV values were compared by application of Mann-Whitney test, and logistic regression analysis was used to determine which of these two parameters contributed the most in increasing the diagnostic accuracy, ia. its sensitivity, specificity and predictive velues. ROC curves were constructed to determine threshold values for differentiation of low- from highgrade lesions. Results: Statistical significance were showed between mean values of rCBV for low-grade (0,82) and high-grade (5,32) gliomas, which was not found for values of ADC parameters. Threshold rCBV value of 1,23 was determinated for discrimination between low- and high-grade gliomas with a sensitivity of 83,2% and a specificity of 77,5%. Conclusion: Conventional MRI combined with PWI increases the accuracy in determination of glioma grade.
Delayed MDCT in preoperative analysis of the hypopharingeal postcricoid caarcinomas
Authors: Ivanovic A. , Masulovic D. , Saranovic Dj. , Djuric-Stefanovic A. , Lazic Lj. , Sabljak P. , Pesko P.
Published: March 2010

Introduction. Determination of borders of the postcricoid tumors is of great significance during preoperative analysis, because it can be of considerable influence on operative treatment and its planning. Therefore, exact demarcation, delineation and opacification of tumor zone on CT analysis is crucial. Material and method. Late CT scan delay of 150 sec and slow vein flow of contrast agents of 1ml/sec is radiological method of choice in preoperative evaluation of carcinoma of the post-cricoid region. For our purposes we used modern MSCT Light Speed GE 64, with slice thick of 2,5mm (retro recon of 0,625) with software postprocesing. Results and discussion. In our study, we have detaily analyzed 25 patients with clinically proved carcinoma of hypopharynx, of which 8 had the hardest form of tumor. Control group were patients to whom CT scan was done by standard protocol and CT time scan of 50 sec. With all 8 of them, scanned by protocol of delay time of 150 sec, was proved a statistically important validity of interpretation and demarcation of tumors. Conclusion. Delay time on CT scanning is proved to be efficient protocol for visualization of neck soft tissues which includes the walls of hypopharynx.
Low dose CT protocol: Capability for early detection of lung carcinoma
Authors: Stojanovic S. , Petrovic K. , Andjelic D. , Njagulj V. , Krsmanovic A. , Boban N.
Published: March 2010

Lung carcinoma is the most common cause of death among men who died from cancer; also, among women, the incidence of this disease is on the increase. Use of multislice computed tomography (MSCT) has enhanced detection capability for pulmonary nodules. Nowadays, low radiation dose CT technique (LDCT) increases interest in lung cancer screening. This study is a part of the project whose aim is early diagnosis and well-timed treatment of lung carcinoma. Participants in this screening were above the age of 40, both smokers and non-smokers, who have undergone MSCT examination of lungs following low-dose protocol (LDCT). In the first ten months of the study, 375 volunteers have been examined. Overall number of detected nodules was 361; and 303 of these nodules have been characterized as non-calcificated. 95 participants (24.27%) had at least one non-calcificated nodule. 17 patients were referred to pulmologist and for further clinical evaluation. LDCT significantly increases detection of small, non-calcificated pulmonary nodules, and, therefore, gives higher opportunity to detect early lung carcinoma.
Diagnosis of breast cancer in women age 40 and younger: Mammography and breast ultrasound
Authors: Milosevic Z. , Karapandzic-Plesinac V. , Jovicevic A. , Vukovic V. , Vucicevic J. , Pavlovic T. , Borojevic N.
Published: March 2010

Breast cancer is the leading cause of mortality among women aged 25 to 44 years in Serbia. The purpose of this study was to determine basic clinical and radiological features of breast cancer in young women. 93 women aged 31,0+3,5 years with breast cancer were identified. The analysis included clinical characteristics (TNM classification) and radiological features (mammography and breast ultrasound). 53,8% of the patients had locoregional disease. The mean diameter of breast cancer was 2,6+6 cm. Carcinoma in situ was found in 2,2%. Mammography was performed in 25,8% of the patients and breast ultrasound in 68,8%. The results of our study indicate that the diagnosis of breast cancer in young women is late, in the stage with palpable breast tumor and lymph node metastases. Mammography or breast ultrasound are not routinely used. The implementation of algorithms for breast cancer detection and diagnosis in young women helps in earlier detection of breast cancer and consequently improves outcomes.
Kompjuterizovana tomografija u postoperativnom pracenju bolesnika posle Whipple-ove operacijeprikaz karakteristicnih CT nalaza
Authors: Djuric-Stefanovic A. , Masulovic D. , Saranovic Dj. , Ivanovic A. , Stevic R. , Kostic J. , Randic K. , Mladenovic M.
Published: March 2010

We presented the postoperative CT findings of patients after the Whipple's operation (cephalic pancreaticoduodenectomy), performed for the pancreatic head cancer, or ampullary carcinoma. Technique of the Whipple's operation is described, and normal and pathological postoperative CT findings, which are characteristic for the immediate (early) and delayed (late) follow-up period, are presented. In addition, difficulties in differentiation of afferent jejunal loop from the recurrent tumor by CT are discussed, and references from the literature about the possibilities of successful visualization of the afferent jejunal loop are cited. Possible locations and CT appearances of the tumor recurrences are presented. An overview of the literature is provided.
Magnetic resonance cholangiopancreatography: Diagnostic significance in malignant diseases of bile and pancreatic ducts
Authors: Maksimovic R.M. , Milenkovic R.D. , Kratovac-Dunjic M.S. , Lilic G.B. , Masulovic D.M. , Banko B.A. , Milicevic M.
Published: March 2010

Magnetic resonance cholangiopancreatography (MR CP) is a relatively new, noninvasive method in patients with pancreaticobiliary diseases, which is comparable to invasive endoscopic retrograde cholangiopancreatography (ERCP). One of the most common indications for MRCP is malignant obstruction of the bile and pancreatic ducts. Standard imaging protocol includes routine abdominal study followed by a sequence for MRCP adapted to each of the patients and site of the malignant process. MRCP is a simple to perform, does not exposure the patients to radiation, requires no anesthesia, is less operator dependent and allows better visualization of ducts proximal to an obstruction. Thus, during one examination only, it is possible to assess not only pancreaticobiliary system but also abdominal structures, which increases diagnostic value of MR and is therefore, optimal method in evaluation of these patients. .
The future of transcatheter antitumor therapy
Authors: Masulovic D. , Milicevic M. , Stevic R. , Sagic D. , Saranovic Dj. , Lazic Lj. , Maksimovic R. , Randic K.
Published: March 2010

Transcatheter antitumor therapy very quickly accepted during the last decade and their importance in the treatment of oncology patients will be increasing. By improvement of new targeted agents, which can be given intraarterial or systemic, efficiency of transcatheteric therapeutic approaches can be drastically increased. Numerous clinical trials (study phase I / II / III) relating to the synergy of two antitumor therapeutic approaches are already in progress. Preliminary results of these trials are already very encouraging. Further improvement in the development of specific therapeutics antitumor drugs and systemic applications will be a big step in the quest for medication against malignant tumors.
Precision TACE in therapy of primary malignant tumors of liver/hepatocellular carcinoma (HCC)
Authors: Bojanovic A. , Bosnjakovic P. , Stojanovic M. , Markovic M. , Mrvic M. , Radic S. , Radovanovic Z.
Published: March 2010

AIM: Hepatocellular carcinoma is one of the most frequent malignant tumors in general and most common liver malignancy. Aim of this study was to determine the therapeutic effect of chemoembolization with microspheres charged with doxorubicin in HHC patients. MATERIAL AND METHODS: During for period of four-year (November 2005- November 2009) at Institute of radiology CC Ni transarterial chemoembolization procedures (precision TACE) was performed on 27 patients. There were 17 male and 10 female patients with average age of 62 years. Total number of 64 TACE interventions were done in total, minimally one, maximally 6 per patient. HCC was patohystologically verified in all patients included in this study. After selective catheterization of tumor feeding artery, followed by application of microspheres a follow-up study with evaluation of therapeutic effects was conducted. RESULTS: Patients were enrolled in the study and followed four years in total. The therapy effects were estimated according to RECIST criteria. CONCLUSION: Precision TACE represents effective and controlled method for application of chemotherapeutic agencies with reduced systemic toxicity. Our preliminary results show increased therapeutic efficacy, diminished mortality and subsequently prolonged survival rate and improved quality of life in patients with HCC.
A refined way of solving reactor point kinetics equations for imposed reactivity insertions
Authors: Ganapol Barry
Published: March 2010

We apply the concept of convergence acceleration, also known as extrapolation, to find the solution of the reactor kinetics equations (RKEs). The method features simplicity in that an approximate finite difference formulation is constructed and converged to high accuracy from knowledge of the error term. Through the Romberg extrapolation, we demonstrate its high accuracy for a variety of imposed reactivity insertions found in the literature. The unique feature of the proposed algorithm, called RKE/R(omberg), is that no special attention is given to the stiffness of the RKEs. Finally, because of its simplicity and accuracy, the RKE/R algorithm is arguably the most efficient numerical solution of the RKEs developed to date.
A fast, primary-interaction Monte Carlo methodology for determination of total efficiency of cylindrical scintillation gamma-ray detectors
Authors: Rehman Shakeel , Mirza Sikander , Mirza Nasir
Published: March 2010

A primary-interaction based Monte Carlo algorithm has been developed for determination of the total efficiency of cylindrical scintillation g-ray detectors. This methodology has been implemented in a Matlab based computer program BPIMC. For point isotropic sources at axial locations with respect to the detector axis, excellent agreement has been found between the predictions of the BPIMC code with the corresponding results obtained by using hybrid Monte Carlo as well as by experimental measurements over a wide range of g-ray energy values. For off-axis located point sources, the comparison of the BPIMC predictions with the corresponding results obtained by direct calculations as well as by conventional Monte Carlo schemes shows good agreement validating the proposed algorithm. Using the BPIMC program, the energy dependent detector efficiency has been found to approach an asymptotic profile by increasing either thickness or diameter of scintillator while keeping the other fixed. The variation of energy dependent total efficiency of a 3'x3' NaI(Tl) scintillator with axial distance has been studied using the BPIMC code. About two orders of magnitude change in detector efficiency has been observed for zero to 50 cm variation in the axial distance. For small values of axial separation, a similar large variation has also been observed in total efficiency for 137Cs as well as for 60Co sources by increasing the axial-offset from zero to 50 cm.
The Early Childhood Educator in a Critical Learning Community: Towards Sustainable Change
Authors: Van Keulen Anke
Published: March 2010

The action research project Sustainable Change in a Critical Learning Community was conducted in the Netherlands (2007–08) to improve quality in early childhood by enhancement of critical reflection at all levels in early childhood organisations: educators individually and collectively, pedagogical leaders and coaches, and (middle) management. The complex reality in which professionals in early childhood organisations operate demands a reflective attitude to knowledge and practice, but in order to achieve this, participants at every level in the institution have to be involved. Bureau MUTANT conducted this action research project in cooperation with four childcare-providing organisations. MUTANT is a small independent agency that supports professionals and institutions in early childhood, welfare and health care with innovative methods, training and consultation. Respect for diversity — with regard to ethnicity, social background and gender — is a key issue in all actions. With the results of this action research, MUTANT wishes to answer questions and worries in childcare organisations in the Netherlands and to fill a gap in the professionalisation of individuals and teams. The final target is to enhance the quality of educators and thus the quality of childcare organisations, a quality based on democratic principles such as furtherance of social change, social justice and democratic values.
Critiquing Child-Centred Pedagogy to Bring Children and Early Childhood Educators into the Centre of a Democratic Pedagogy
Authors: Langford Rachel
Published: March 2010

Child-centred pedagogy is both an enduring approach and a revered concept in Western-based teacher preparation. This article weaves together major critiques of child-centred pedagogy that draw on critical feminist, postmodernist and post-structural theories. These critiques have particular relevance for conceptualizing what it can mean to be, and what it takes to become, an early childhood professional. The construct of the female early childhood professional is particularly important with the current intensification of the teacher as a technician and the increasing numbers in the workforce from racialized groups who may face social inequities. The construction of the individualized child and its parallel denial of the influences of gender, ethnicity and class on who a child becomes are equally important. Drawing upon the work of reconceptualist scholars, some preliminary ways will be proposed in which we can theorize and reconstruct children and early childhood professionals at the centre of a pedagogy that is a democratic space for all.
Issues in and Challenges to Professionalism in Africa's Cultural Settings
Authors: Nsamenang A. Bame
Published: March 2010

This article explores critical issues linked to early child development (ECD) professionalism in African childhood contexts in the light of rights-based consideration. Against the backdrop of acculturation being a reality in Africa, it accepts professionalism as a ‘good thing’ for ECD programmes in Africa. The article sketches a portrait of childhoods in African cultural settings and points to sensitive aspects of African child development that would require keen sensitivity from professionalization agendas. In particular, the article recognizes children in their changing families and hybridized cultural circumstances as social agents and ‘natural’ stakeholders of ECD professionalism. It reviews evidence that reveals African children as accredited contributors from an early age to their own developmental learning. Accordingly, African youngsters should be enlisted as partners to ECD professionalism in order to give them and their families participative spaces and a respectful voice in all ECD efforts. Given the coexistence of three ECD heritages in African families and communities today from Eastern, Western and indigenous African sources, a ‘blended approach’ is perhaps the most appropriate route to take towards ECD professionalism.
From ‘Marginality’ to ‘Mainstream’: A Narrative of Early Childhood Professionalism in Bangladesh
Authors: Islam Zahirul
Published: March 2010

Early childhood as a professional field with its concern for the young child has gained a distinctive perspective in Bangladesh. The prevailing thoughts and practices of this field, derived from a modern scientific paradigm, are a continuation of the trend that was introduced through colonization. The prime concern of practitioners is that children are marginal, therefore they need to be placed in the mainstream. Then, it is claimed, children will become the holders of rights, privileged and affluent. This article argues that this approach does not reveal knowledge of young children's situation ‘as it really is’. Rather, it provides twisted understandings of young children. Drawing on a postmodern perspective, the article proposes an alternative paradigm of efficient professionalism that is respectful of ‘little narratives' — local voices, diversity and the child's perspective — which is appropriate to the Bangladesh context and embraces openness. In order to make professional practices decolonized, this paradigm dismantles the colonial trend, challenges the professional approach's claim to be a transcendent form of knowledge and initiates the trend of understanding children in terms of their own circumstances.
Conflicting Discourses of Private Nursery Entrepreneurs in KwaZulu-Natal, South Africa
Authors: Ebrahim Hasina Banu
Published: March 2010

The South African government has adopted a poverty-targeted approach to provisioning in early care and education. This approach prioritises public funding for vulnerable and disadvantaged children. Given the need to address past imbalances and the context of limited financial resources, the private sector has been given an increased role in financing and delivering early care and education. To date, little attention has been paid to how private providers configure their services. This article seeks to address the gap. Through the analysis of the discourses of private entrepreneurs and their staff in two early childhood centres in urban KwaZulu-Natal, it is argued that the business approach in early care and education, with the focus on parents as customers, is narrow and limiting. It marginalises access for young children from disadvantaged groups and downplays the diversity that characterises young children's lives in South Africa.
Towards the Re-Emergence of a Critical Ecology of the Early Childhood Profession in New Zealand
Authors: Dalli Carmen
Published: March 2010

A 10-year strategic plan for early childhood education introduced by the New Zealand Ministry of Education in 2002 included policies to create a teacher-led early childhood profession by 2012. This article reviews the provisions of the strategic plan and argues that it emerged from a critical ecology of the early childhood profession with a history of advocacy and strategy. The article marks out new challenges to the implementation of the strategic plan as it draws close to its end date in a changed political context and a time of economic constraint. It is argued that the challenges call for the re-emergence of a critical ecology of the profession that responds to the current context.
Promoting Early Childhood Teacher Professionalism in the Australian Context: The Place of Resistance
Authors: Fenech Marianne , Sumsion Jennifer , Shepherd Wendy
Published: March 2010

The early childhood education (ECE) sector in Australia is marked by a habitus where ‘professionalism’ is confined to objective, technical practices. The authos suggest that this is a diminished view of professionalism, and one that compromises high-quality ECE. This article is concerned with how teacher professionalism can be re-imagined and practised within an ECE setting in ways that uphold children's rights and interests and emancipate early childhood teachers from technical, deprofessionalising constraints. Through a case study of professionalism in a reputable high-quality long-day-care centre in Sydney, Australia, the article extends thinking about teacher activism and promotes resistance-based professionalism as one way of producing an alternative habitus about quality ECE and the integral role early childhood teachers play in such provision.
Fetal Akinesia Deformation Sequence and Neuroaxonal Dystrophy without PLA2G6 Mutation
Authors: Rakheja Dinesh , Uddin Naseem , Mitui Midori , Cope-Yokoyama Sandy , Hogan Robert N. , Burns Dennis K.
Published: March 2010

We present autopsy findings of a stillborn female infant at 20 to 21 weeks' gestation with neuroaxonal dystrophy. External examination showed features of fetal akinesia deformation sequence. Internal examination showed hypoplasia of the cerebellum, corpus callosum, and optic nerves, as well as nuclear cataracts. Light and electron microscopic examinations showed widespread axonal spheroids in the central and peripheral nervous systems. Gene sequencing failed to reveal PLA2G6 mutations, indicating that fetal neuroaxonal dystrophy presenting as fetal akinesia deformation sequence is genetically distinct from infantile neuroaxonal dystrophy and related disorders. In addition, placental examination showed α-fetoprotein–positive, eosinophilic, globular inclusions in the cytoplasm of a few villous macrophages. The significance of this novel histologic finding is unclear.
Defect entropies and enthalpies in BaF2
Authors: Katsika-Tsigourakou Vassiliki , Skordas Efthimios
Published: March 2010

Various experimental techniques have revealed that the predominant intrinsic point defects in BaF2 are anion Frenkel defects. Their formation, enthalpy and entropy, as well as the corresponding parameters for the fluorine vacancy and fluorine interstitial motion have been determined. In addition, low temperature dielectric relaxation measurements in BaF2doped with uranium leads to the parameters τ0, E in the Arrhenius relation τ = τ0 exp(E/k B T) for the relaxation time τ. For the relaxation peak associated with a single tetravalent uranium, the migration entropy deduced from the pre-exponential factor τ0 is smaller than the anion Frenkel defect formation entropy by almost two orders of magnitude. We show that, despite their great variation, the defect entropies and enthalpies are interconnected through a model based on anharmonic properties of the bulk material which have been recently studied by employing density-functional theory and density-functional perturbation theory.
Anal HPV infection in Slovenian men who have sex with men
Authors: Milošević Miloš , Poljak Mario , Mlakar Boštjan
Published: March 2010

Anal human papillomavirus (HPV) infection commonly affects men who have sex with men (MSM) and is associated with the development of anal cancer, with the highest prevalence in MSM who are positive for human immunodeficiency virus (HIV). The purpose of this study was to determine the prevalence of anal HPV infection and genotype distribution in Slovenian MSM and its correlation with behavioral patterns in order to predict the possible impact of quadrivalent HPV vaccine in this population. To our knowledge, this is the first study of prevalence and genotype distribution of anal HPV infection in MSM from any of the Eastern European countries. The study included 136 MSM who visited two outpatient offices from January 2007 through December 2008. All participants were clinically examined and tested for HIV, and anal swabs were taken for HPV testing. The results showed a high prevalence of anal HPV infection in both HIV-negative (75%) and HIV-positive (95%) MSM. Promiscuity and use of “poppers” (alkyl nitrites taken for recreational purposes through direct inhalation) were clearly associated with a higher prevalence of anal HPV infection. The four most common HPV genotypes were 6, 11, 16, and 18. The prevalence of anal HPV infection in Slovenian MSM is higher in comparison with other studies. Quadrivalent HPV vaccine could have great potential in this population.
Diagnostic validity of the care dependency scale as a screening tool for pressure ulcer and fall risks in Dutch and German hospitals
Authors: Mertens Elke , Dassen Theo , Scheufele Ramona , Halfens Ruud , Tannen Antje
Published: March 2010

Pressure ulcers and falls are frequent adverse events with negative impacts for hospital patients. Guidelines recommend risk assessment as the first step in prevention. Care dependency correlates with falls and pressure ulcers and the Care Dependency Scale showed a diagnostic validity comparable to that of specific risk assessment tools. The aim of this study was to establish a simple and valid screening index for the risk of falls and pressure ulcers in hospitals by using the Care Dependency Scale and to evaluate this index within two validation samples from different countries. Quantitative, cross-sectional data from two German surveys and one Dutch survey were analysed. A total of 305 Dutch and German hospitals with 21,880 patients took part. The diagnostic validity of the Care Dependency Scale was evaluated by computing receiver operator characteristics curves, the areas under the curves, sensitivity, specificity and positive and negative predictive values.The Scale demonstrated a good diagnostic validity for pressure ulcer risk screening in Dutch and German hospitals. The diagnostic validity regarding the risk for falls was satisfying in Germany and moderate in the Netherlands. Using the Care Dependency Scale for risk screening could reduce the necessity of further assessment by more than a half.
Sonographic criteria for fine-needle aspiration cytology in a korean female population undergoing thyroid ultrasound screening
Authors: Kim Seung Ja , Moon Woo Kyung , Cho Nariya
Published: March 2010

Background: Thyroid sonography is commonly used as a screening procedure resulting in finding of innumerable benign nodules. It would be necessary to apply strict sonographic criteria for incidentally detected thyroid nodules to avoid unnecessary invasive procedures or further examinations.

Purpose: To prospectively evaluate the incidence of diverse thyroid lesions including thyroid cancer detected during thyroid ultrasound (US), and to establish the diagnostic value of sonographic criteria for thyroid nodules.

Material and Methods: During 2 years, 2250 patients visited the breast clinic for a breast US examination. In 2079 of these women (mean age 42.6 years, age range 15–77 years) without a history of previous thyroid surgery or thyroid abnormalities, thyroid screening with US was performed as well. The overall findings of all thyroid lesions detected during thyroid US were recorded. Fine-needle aspiration (FNA) was performed for all suspicious thyroid lesions and some with probably benign findings. The sonographic features of 113 aspirated nodules were analyzed and classified as either positive or negative findings. Sonographic classifications were correlated with the histological findings. The diagnostic index was calculated for individual sonographic criteria.

Results: Of the 2079 patients, 1209 patients (58%) had normal findings. Abnormal findings (42%) included thyroid cancer ( n=53, 2.5%), solid nodules except for thyroid cancer ( n=300, 14.4%), mixed echoic nodules ( n=112, 5.4%), cysts ( n=294, 14%), thyroiditis features without thyroid nodules ( n=106, 5.1%), and parenchymal calcifications ( n=5, 0.2%). Of 113 aspirated nodules, 80 nodules were classified as positive and 33 nodules as negative according to the sonographic criteria in a retrospective analysis. Of 80 lesions classified as positive, 51 lesions were malignant. Of 33 lesions classified as negative, 2 lesions were malignant. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 96.2%, 51.7%, 63.8%, 93.9%, and 72.6%, respectively.

Conclusion: Thyroid abnormalities were detected in 42% of all screened women. The use of the sonographic criteria showed excellent diagnostic performance for FNA and could be useful to provide practitioners with an objective tool to decide whether to perform a biopsy or not.
Changes in Legislative Support for the Governor's Program Over Time
Authors: HALL THAD E.
Published: March 2010

Abstract This study examines changes in legislative support for the governor's legislative agenda in Georgia during the governor's first term in office (1991–94). I analyze the factors that led legislators to support the governor's agenda, as well as how the level of support changed between election years and off‐years. I use multivariate OLS models of gubernatorial support to determine how support varied (1) between the parties, (2) between factions within parties, and (3) over time. I find that there was wide variation in support among factions in the majority party and that support varied widely between election years and off‐years.
Defending the Institutional Status Quo: Communist Leadership of the Second Russian State Duma, 1996–99
Authors: CHAISTY PAUL
Published: March 2010

The 1995 Russian parliamentary elections returned a State Duma dominated by an alliance of the Communist Party (CPRF) and the Agrarian (APG) and Popular Power (PP) groupings, whose combined number fell just four votes short of an overall majority. Such a powerful voting bloc might have been expected to undo the power‐sharing principles on which the First Duma (1994–95) operated. Rather than challenge the status quo, however, the CPRF defended it on several occasions. In this paper, I argue that existing arrangements held benefits for the CPRF and its leftist allies. In the absence of a stable, disciplined majority, the Duma's rules gave leftist deputies the incentives and flexibility to organize collectively.
The Electoral Consequences of Party Switching by Incumbent Members of Congress, 1947–2000
Authors: GROSE CHRISTIAN R. , YOSHINAKA ANTOINE
Published: March 2010

What are the electoral consequences of switching parties for incumbent members of Congress? Do incumbents who switch fare better or worse after their switch? Aldrich (1995) and Aldrich and Bianco (1992) present a model of party affiliation for all candidates. We empirically extend this model for incumbent legislators who have switched parties. Specifically, we look at the universe of incumbent representatives who have run for Congress under more than one party label since World War II. We find that the primary and general election vote shares for party switchers are not as high after the switch as before. Additionally, we learn that party switching causes the primaries in the switcher's party and in the the opposing party (the switcher's “old” party) to become more competitive in the short run. Over the long run, however, primaries in the switcher's new party are less competitive than those in the old party before the switch.
Subnational Determinants of National Multipartism in Latin America
Authors: MORENO ERIKA
Published: March 2010

Recent research points to the importance of subnational elections as variables shaping the national party system in federal states (Jones 1997b; Mainwaring and Shugart 1997; Samuels 2000). I propose that the effects of subnational elections are not limited to federal states but instead can be seen throughout the region. This paper examines the impacts of gubernatorial elections across eighteen Latin American countries during the most recent democratic period. The analysis suggests that intermediate subnational elections do exert an influence on national party systems, whether the state is federal or not, and particularly influence how many parties are elected to a legislature's lower house.
Tactical and Contextual Determinants of U.S. Senators' Approval Ratings
Authors: SCHAFFNER BRIAN F. , SCHILLER WENDY J. , SELLERS PATRICK J.
Published: March 2010

This paper focuses on U.S. senators and their home‐state approval ratings from 1981 to 1997. We examine these ratings to assess the relative impacts of tactical factors, such as the senators' bill sponsorship and media activity, and contextual influences, such as economic performance, state population size, and the evaluations and behavior of other elected officials. We find that the senators' own tactical behavior affects the approval ratings, but a stronger influence is the context in which the senators operate.
Remaking the House and Senate: Personal Power, Ideology, and the 1970s Reforms
Authors: SCHICKLER ERIC , MCGHEE ERIC , SIDES JOHN
Published: March 2010

Although much has been written on the critical congressional reforms of the 1970s, few studies have analyzed support for reform systematically. In this article, we draw upon previously untapped sources of information that make an individual‐level, quantitative analysis possible. We analyze 20 indicators that measure support for a wide variety of reforms in both chambers. Our results reveal a remarkably consistent pattern: in virtually every case, junior members and liberals were more pro‐reform than were senior members and conservatives. Also, Republicans were often more likely than Democrats to back reform. Our findings challenge the view that the reform movement was essentially a Democratic party phenomenon; liberals and junior members in both parties—not just Democrats—supported reform.
The Keys to Legislative Success in the U.S. House of Representatives
Authors: ANDERSON WILLIAM D. , BOX‐STEFFENSMEIER JANET M. , SINCLAIR‐CHAPMAN VALERIA
Published: March 2010

Our research addresses how individual member behavior and institutional variables affect legislative success in the U.S. House of Representatives. Using new measures of activity from the 103d Congress (1993–94), a count dependent variable, and negative binomial regression, our analysis assesses member effectiveness. We find that a member's activity level encourages legislative success, but gains are limited when members speak or sponsor too frequently. Our results provide a clearer picture of the role of legislative context and the relevance of institutions in determining a member's legislative successes and failures.
What Happens When House Members “Run with Congress”? The Electoral Consequences of Institutional Loyalty
Authors: LIPINSKI DANIEL , BIANCO WILLIAM T. , WORK RYAN
Published: March 2010

This article characterizes the electoral consequences of messages of institutional loyalty and disloyalty sent by incumbent House members to their constituents. We show that, for the contemporary House, there is variation in these messages—not all incumbents in the contemporary House “run for Congress by running against Congress.” Moreover, we show that these messages can, under the right conditions, have significant electoral consequences, even after controlling for party affiliation and district political factors. In addition to demonstrating the electoral relevance of legislators' presentations, our results show an incumbent‐level link between constituents' trust in government and their voting behavior—a link created by interaction between constituents' perceptions, legislators' party affiliations, and the messages that legislators send to their constituents.
The Impact of Bicameralism on Legislative Production
Authors: ROGERS JAMES R.
Published: March 2010

It is generally accepted by scholars, as well as by cameral partisans, that adding a second chamber to an otherwise unicameral legislative process will decrease the volume of laws that a legislature enacts. This study challenges the conventional wisdom. First, I offer a simple theoretical argument that shows that when second chambers can originate as well as reject legislation, bicameralism will have an indeterminate impact on legislative production. Second, I provide historical data gathered from the four U.S. states that have experienced cameral transitions. Although very rudimentary, the historical evidence, when coupled with the theoretical argument, raises serious doubt regarding the traditional claim that bicameralism reduces the production of legislation.
Government Redistribution in the Shadow of Legislative Elections: A Study of the Illinois Member Initiative Grants Program
Authors: HERRON MICHAEL C. , THEODOS BRETT A.
Published: March 2010

We study an Illinois state government program called “member initiative spending” and examine the extent to which three competing theories can explain the program's allocations among Illinois's 118 House districts. We show that member initiative monies distributed before the 2000 general election were disproportionately allocated to districts that were politically competitive, represented by legislative leaders, or represented by moderate legislators. Our analysis supports theories that claim budgetary decisions made by elected officials are tactical, and it shows that the Illinois decision makers who allocated member initiative funds sought to distribute them in a way that would be most beneficial in the sense of vote buying.
Agency Design as an Ongoing Tool of Bureaucratic Influence
Authors: REENOCK CHRISTOPHER , POGGIONE SARAH
Published: March 2010

Theoretical work assumes that legislators use ex ante design to gain bureaucratic influence, not only at an agency's appointment stage but also as an ongoing tactic. Yet no empirical work has investigated whether or not legislators prefer to use design to exert influence after an agency's appointment stage. Using a mail survey of more than 2,500 legislators, we model legislators' preferences for ex ante design as a function of both institutional factors and individual legislators' characteristics. Our results suggest that the feasibility of agency design as an ongoing tactic of bureaucratic influence is more limited than theoretical work indicates and that both institutional‐ and individual‐level factors explain legislators' preferences.